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Comment by marknutter | Hacker News Reader

You can do this today, though. Retire now and your income will drop to the level where you can qualify for the ACA.

I wouldn't exactly call the ACA reliable with the GOP in charge. Access also depends heavily on which state he is in.

Common misconception. Medicaid kicks in when you’re down on your luck but they’ll try and recover their costs by taking a lien against your house. It’s the ultimate cruelty.

Only if you are permanently institutionalized is that a concern.

A multi-hundred thousand dollar lien for someone who's already too low income to afford medical insurance? Where exactly do you think they'll get the money from?

The house equity? This is for people who are terminally ill; the costs are coming from the estate.

And if they recover? You know in every other country in the OECD if you get sick, you go to the hospital, then they cure you and you walk out. That’s it! No liens, no debt, no bankruptcy. If you give it a chance you might just like it and if not, you can always go back.

If the person returns home, they release the lien: http://www.nls.org/Disability/MedicaidMedicare/MedicaidLegal...

Do all other OECD countries cover nursing homes for free until death? That's the case when liens apply - not hospitalization.

https://www.aarp.org/health/medicare-insurance/info-1996/are...

I don't think it is entirely unreasonable that medicaid - a medical program for poor people - has the right to put a lien on someone's estate. Normally people on medicaid don't even have estates (or else they wouldn't meet the asset test), but for some reason we don't count house equity for the asset qualification criteria. Very unfair for renters - this at least somewhat equalizes things.

> Do all other OECD countries cover nursing homes for free until death? That's the case when liens apply - not hospitalization.

The NHS in the UK does, yeah [1]. In Ontario, end-of-life care is also provided and long-term care is provided for ~$1800CAD per month if you can afford it, and it may be free if not via a combination of CPP, social security and income-based subsidies. [2] In 2002, France introduced universal, income-adjusted, public long-term care coverage for adults 60 and older [3]. The Netherlands does too [4]. The rest of the OECD I'm not sure. Most developed systems do offer something.

The health system really is better pretty much everywhere else in the OECD. And remember! Every one of the systems I mentioned spends less per capita than the US. In some cases like Canada half.

> I don't think it is entirely unreasonable that medicaid - a medical program for poor people - has the right to put a lien on someone's estate. Normally people on medicaid don't even have estates (or else they wouldn't meet the asset test), but for some reason we don't count house equity for the asset qualification criteria. Very unfair for renters - this at least somewhat equalizes things.

While I don't believe in inter-generational wealth I'd argue this furthers the cycle of debt and poverty by taking an estate away from those who could most benefit - the poorest.

[1] https://www.nhs.uk/conditions/end-of-life-care/hospice-care/

[2] https://www.ontario.ca/page/get-help-paying-long-term-care

[3] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4462881/

[4] https://www.researchgate.net/publication/304653227_Long-Term...

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