Maps like this give a sobering view of the Healthcare debate.
Insurance for a family is now > $20K a year. Look at how many counties this would be half or more of the median pay. The whole situation seems like a melt-down ready to happen.
Insurance for a family is now > $20K a year. Look at how many counties this would be half or more of the median pay. The whole situation seems like a melt-down ready to happen.
I live in France, which is known for its good health coverage. However, I know a few people who worked both in France and in the US, and they made more there in terms of purchasing power, even after paying all the insurance required to get at least the same level of protection we get "for free" in France.
I suppose that the situation can be different depending on your occupation. But what I am saying is that it is just a different system. Healthcare is expensive by nature: highly trained personnel, state of the art research, unforgiving safety requirements, etc... and has to be paid for in some way, be it by taxes or by private insurance companies.
Healthcare is expensive. The US government started providing healthcare to old people, rather than letting them die on the street outside the hospital.
But rather than the government paying the full cost of this program (ala food subsidies), the government dictated that providers give them special lower prices. The hospitals want to make up for that money some how, and so attempt to pass on extra costs to others. The next target (private health "insurance") doesn't want to subsidize that cost either, so they negotiate lower rates. The hospitals are still optimistic that they can still fool someone, and so attempt to take it out of helpless patients.
The entire system is essentially musical chairs. This is why after you receive medical services, the hospital will send you a fraudulent bill with a fictitious inflated price list rather than waiting for your "insurance" to cover their part first - they're hoping to luck into a sucker who will mindlessly pay the sticker price rather than the back room reduced rates.
I can foresee a trend of people setting up trust funds for themselves, to reduce the chance of losing their assets to the healthcare reverse lottery. That's really the point we're at - the last attempt at healthcare reform was basically jiujitsued by the health "insurance" industry into making patronizing their cartel mandatory!
A no brainer step to reforming the health care market is to force all providers to publish a price schedule, uniform across any payer. We wouldn't accept grocery stores forgoing price tags and instead trying to gouge each person for as much as they can, and any free market rhetoric needs to incorporate that fact.
(Note this is orthogonal to what level of care should be guaranteed by the government)
When you tally up both government and personal expenditure the US is far more expensive for no valid reason.
Even government spending alone the US system is a bizarre outlier against OECD countries who all have universal healthcare as a core part of their system. When you include personal spending it's plain and clear that vested interests have corrupted your healthcare system.
https://data.worldbank.org/indicator/SH.XPD.CHEX.GD.ZS?year_...
https://www.healthsystemtracker.org/chart-collection/health-...
"While the U.S. has similar public spending, its private sector spending is triple that of comparable countries".
Healthcare in the US is corporate welfare for insurance companies.
Another example: someone who has trouble concentrating at work in the US might spend (out of pocket, or through insurance) $1000 a year on an Adderall prescription Where in Germany it’s quite unusual to get an adult ADHD diagnosis, and even harder to get medication. People are more likely to just live with their genetics on this issue, or make non-medical accommodations, and their problems holding down a job or a relationship never become a medical cost on any spreadsheet. Again, I’m not saying one is better than the other, but culturally speaking, a larger number of personal problems faced by Americans are medicalized than in other countries.
This also really shows how #medicareforall wouldn’t automatically solve every problem.
Different in the same way that Windows 3.1 is "just a different system" than MacOS X 10.14. The U.S. pays 2-3 times as much, and does not provide healthcare to vast numbers of people. Many who do receive health care go bankrupt paying for it; many who think they have insurance find that they are denied it by insurance companies.
For a family of 4, if you make under $98K per year, you're eligible for a subsidy so that you will not pay more than 9.5% of your income in premiums.
That can still be a large burden, but it's a far cry from half or more.
EDIT: I re-read your comment, and yes, in the context of the healthcare debate, where the subsidies could potentially go away, this is quite concerning.
https://www.fool.com/retirement/2017/05/01/this-is-the-no-1-...
How will it melt down, won't they just become infirm or die?
Potentially causing the next recession.
Or, we modify the system, the whole health insurance industry and hospital industry causes a recession.
The people who can't afford insurance aren't the people that have substantial generational wealth to lose, generally.
1900s... so, the X-Ray machine had just been invented. Antibiotics, Radiation, Chemotherapy, laparoscopy, endoscopy, the mri, titanium, stainless steel. Medicine was in a relative infancy and outcomes were much, much worse.
It's not just their own problem. They won't simply die and get out of the way of the more fortunate.
To your point, the meltdown is more on the insurance side. The normal, every day providers will just charge patients directly.
The issue is the people who get "left behind"--ones who have large numbers of issues. All our insurance money right now goes to provide for them. If insurance collapses, what happens to them?
You must be joking. In the US, that $20k would barely cover a pregnancy. I’m about to blow $10k on a few dental bridges. It’s insanity.
1: https://www.ucsf.edu/news/2014/01/111071/how-much-does-it-co...
I've never heard of it being over $5000. I can imagine that an at-home birth in San Francisco might be that bad or worse, since the midwife needs to deal with the cost of living.
The problem here is "depending on which hospital they visited". There is no need to involve a hospital (full of exotic infections) for a normal bodily function. That is why your cost is so high.
It isn't even desirable that hospital births should be the norm. Besides the financial cost, directly to the consumer or spread out via higher taxes, there are reasons to prefer non-hospital births. Disease is one. Being able to calmly rest with the comforts of home is another.
I know, I know, other conditions apply. But even with young kids (and related pregnancies), my family has not consumed anywhere near what I've paid in premiums the last decade. I'd be shocked if we "got back" 10% of what I've paid in.
The real question is why is it so expensive?
When I was growing up in my town with about 1000 kids we had 1 kid who was diabetic, 1 attempted suicide, and 2 serious car accidents.
We had plenty of minor problems like broken bones but you didn’t need insurance to cover these.
So it was maybe 800-1000 working adults covering a handful of serious cases over a 14-16 year time period.
The model you describe, a town subsidizing a few, is why the optimal state of healthcare affairs is the whole of a nation (through taxes) providing healthcare to everyone. It maximizes your healthy pool to offset the costs of the sick.
Theres a completely different mindset in the first world compared to how people in the US behave - if there is anything unusual "its better safe than sorry" in any European country. You still go to the doctor even with a "routine" illness because there is often no expense to you to do so.
But that is the right behavior. You want that at the societal level. Because for every false alarm there is someone developing a crippling or lethal ailment that will dramatically reduce their productivity and cost you substantially more than 15 minutes of consultation and 30 pills would have had they seen a doctor right away.
The US is killing its own citizens to line the pockets of the money hungry just by having its healthcare system be insurance based at all, regardless of if people are insured or not.
[citation needed]
> Look at how many counties this would be half or more of the median pay.
Even if your $20K is a correct national average figure for family insurance costs, you can't do that and get meaningful results; insurance costs vary widely between states and localities (e.g., of ACA exchange plans, the statewide as average second lowest cost silver plan costs for states using the federal marketplace range from $459 in ND to $1,185 in WY—and the range of local rates, and/or including the states that don't use the federal exchanges, is even wider.) So you'd need to map local income against local costs to get anything meaningful.
http://www.ncsl.org/research/health/health-insurance-premium...
Your link shows $20k / Family too :-) Look at the chart with the caption "Recent from HHS/CMS"
(The costs are you quoting are the monthly costs for a single individual)
The costs do vary, but they do not drop off the way median income does in rural areas.
No, it shows < $20K, not > $20K as you claimed. But, the accuracy of the national average figure is mostly a side issue.
> The costs do vary, but they do not drop off the way median income does in rural areas.
The costs vary enough locally that you can't make anything like a reasonable point by comparing the national cost to local incomes (and, also, you need to consider the effect of subsidies, which are based on income in relation to FPL.) I suspect the reality, before subsidies, may be even worse than what your naive comparison would suggest, but I don't have a lot of confidence in that because I haven't seen, or had time to analyze, national locality data. The bits and pieces I've seen, though, seem to suggest that, while there isn't a simple relationship, local health insurance costs may overall be weakly inversely correlated with local income. But, then you still have to consider subsidy availability—and Medicaid eligibility—to get the real picture.