Health care is not tied to employment in Canada, for one.
You can get health insurance without having a job. It's expensive, but it's not like it's cheap through employers. Just cheaper.
Health care - at least, treatment for life-threatening emergencies - is a right protected by the Emergency Medical Treatment and Active Labor Act in the US.
It turns out a few turn-your-head-and-coughs in your 30s is a way better deal than waiting for it to become a trip to the ER in your 50s.
The US has the highest cancer survival rate in the world, which would not be possible if poorer populations were not having their cancers proactively treated.
On the other hand, it's basically dismissive of a very real problem here. I read a lot about homelessness. I've seen far too many people indicate they are homeless in part because they have cancer and it's ruining them financially.
America is hardly some utopia where we take wonderful care of all our people, regardless of ability to pay.
This way, you die with treatment and our system does not seem cruel. Even advanced, expensive chemotherapy is paid for, sometimes exceeding hundreds of thousands of dollars.
The Affordable Care Act provides subsidies for health insurance based on income, not assets. If you're diagnosed with cancer and lose your job (because chemo is tough), and have assets, pay the Cobra until next sign up period. Sell all assets and invest to make about $20-$30k a year. Your premiums will be low and you'll have access to quality care. Move near large academic institutions because they do medicaid / bad insurance care. This way you minimally touch assets.
Rich people hate the Affordable Care Act because they don't get subsidies on premiums, which are about $3500 / month for a family now, and they have to pay 4.8% Medicare tax on all income over $250k . So, in essence, someone that makes $1m a year pays $78k/year in health care costs.
Lastly, I take care of a Pizza Hut delivery person who gets his insurance through the Affordable Care Act and only pays $40 / month for it, because of the subsidies.
Just for clarity's sake:
Medicare is a health insurance program for all citizens of U.S. whereas Medicaid is health coverage for low income group and people with disabilities.
Medicare is federal-supported program and Medicaid is a joint program by the state and the federal government. As such the eligibility and coverage for Medicaid vary from state to state.
https://www.differencebetween.com/difference-between-medicar...
The US isn’t bad in that respect, but according to Wikipedia, this statement isn’t even true for the subset of countries on their list: https://en.m.wikipedia.org/wiki/List_of_countries_by_quality...
It is attributable almost entirely to more aggressive (and expensive) diagnostics combined with many new cancer therapies being available in the US years before they trickle down to the rest of the world.
No it doesn't.
But even if it was true (and it isn't) you should also specify which type of cancer.
No country gets every type of cancer better than any other.
For example if we consider stomach cancer, South Korea is on top with 57.90% survival rate, USA is 30 points lower at 29.10%
> which would not be possible if poorer populations were not having their cancers proactively treated
It wouldn't also be possible if rich people couldn't get the same treatments other countries have developed by traveling abroad or having them for cheap in Mexico, Bolivia, Venezuela.
But to put it in another way: take breast cancer, where USA leads the charts with 88.87% survival rate.
According to the sources "About 1 in 8 U.S. women (about 12%) will develop invasive breast cancer over the course of her lifetime."
In Italy, where I come from, we measure breast cancer as patients over 100,000 women, not in %.
"Breast cancer is the leading tumor among women in Italy ... The incidence per age group was estimated to exceed 100 new cases every 100,000 women ≥ 40 years of age"
100 over 100,000 is one in a thousands or 0,1%, which is 120 times better than U.S. 12%.
It means that every 120 women that develop breast cancer in USA there is only one Italian woman in the same condition.
That's what really an universal health care system make possible: to not develop the diseases.
Cancer incidence rates are primarily the product of genetics and environment, which is why it varies across countries. It has little to do with access to healthcare. Stanford hospital has given state-of-the-art treatment for both liver and stomach cancer for free to poor members of my family.
I'm sorry, but that's not how it works.
For example only 1 in 4 breast cancers are attributed globally to risk factors (i.e genetics or environment)? [1]
Since you're bringing it up, I know a things or two about cancer, my father worked in health care, in pulmonary oncology, my mother worked in health care too, in infective diseases, most of my family is tied to Italian public health care, my aunts and uncles worked for it, our family best friends worked there, one of their children and one of my best friends is now a geneticist and is researching rare disease (some types of cancers among the others).
If it was simply about environment and genetics, looking at the numbers, one would assume that in Africa or India they have a very resilient genetic pool and the best environment in the World and in USA they've got some serious problem [2] [3].
Of course that's not the entire story, in those places people don't develop cancer because they die for many other (curable) diseases before cancer gets them.
So what makes survival rates so high in the US?
Well, this Forbes article [4] explains it quite well: overtreating.
But at what price? (not talking about raw monetary value here)
Cancer insurgence is tightly related to aging [5], I've brought up the example of Italy because it's the second oldest population in the World on average after Japan.
And we know that the best cure for cancer is (still) avoiding it.
We have a system here that tries to prevent cancer: women are called in for regular check ups for a number of diseases (including breast cancer), men are checked regularly for prostatic cancer when they are 40 or older and its for free.
Companies, by law, have to send their employees to regular check ups every five years.
I have high blood pressure, I have to attend mandatory check ups every year, because I am more at risk than the others.
It's all paid by the Company.
Would you prefer to develop breast cancer and have a 90% chance of survival or not develop it at all?
Breast cancer is by far the most common type of cancer for women [6] and it has high levels of survival rates in all the western World [7].
What's particularly controversial about the way US counts average survival rates is that they also count breast cancer in situ, which is not a try cancer, but it's used to inflate breast cancer statistics [8]
One statistics is particularly interesting, despite the fact that since the 90s sales of cigarettes per adult per day dropped dramatically and are among the lowest in the west [9] the share of cancer deaths attributed to tobacco is still pretty (alarmingly) high [10].
What's really important in cancer prevention and cure is that globally the chances of going back to an average life expectancy is rising, not only the survival rate after 5 years. In Italy 25% of cancer patients can expect to go back to a normal life, I haven't found the numbers relative to USA.
[1] https://ourworldindata.org/grapher/share-of-cancer-deaths-at...
[2] https://ourworldindata.org/grapher/share-of-population-with-...
[3] https://ourworldindata.org/grapher/cancer-death-rates?tab=ma...
[4] https://www.forbes.com/sites/quora/2017/06/13/why-the-us-has...
[5] https://ourworldindata.org/grapher/share-of-population-with-...
[6] https://ourworldindata.org/grapher/share-of-population-with-...
[7] https://ourworldindata.org/grapher/five-year-survival-rates-...
[8] https://en.wikipedia.org/wiki/List_of_cancer_mortality_rates...
[9] https://ourworldindata.org/grapher/sales-of-cigarettes-per-a...
[10] https://ourworldindata.org/grapher/share-of-cancer-deaths-at...
You edited your post to add a line about emergency healthcare being a legal obligation of hospitals - we both know that emergency healthcare (i.e. "I am literally dying right this second") is not the total of necessary healthcare for many people. I invite you to try surviving very long as a diabetic when the only treatment option is to go to A&E when you are literally dying.
[1] https://www.medicaid.gov/medicaid/program-information/medica...
I'm not offering an opinion here. I just think the distinction between health care and insurance is important.
The original post I was responding to implies to some that you need a job to receive treatment. It also conversely implies that having a job means you can get treatment. I've actually talked to people outside the US who think that because of how our discussions are often worded.
> You edited your post to add a line about emergency healthcare being a legal obligation of hospitals
I'm sorry. I often think of things to add to my post right after submitting. I was editing it before I saw your response.
> we both know that emergency healthcare (i.e. "I am literally dying right this second") is not the total of necessary healthcare for many people.
I agree, which is why I specified that the right only extends to life-threatening emergencies.
If you believe that, you've bilged a test of basic humanity. If you don't, perhaps re-think what drives your well-actuallies in the future?
[0] - https://www.cbsnews.com/news/elderly-couple-found-dead-in-ap...
Stop projecting opinions that are not mine onto my post. I believe the health care and insurance industries in the US is broken and does not adequately serve a huge portion of citizens with low incomes. I have never suggested the current system is okay.
If your opinion is reliant on misinformation, you should reevaluate it. Otherwise, you should not be concerned with someone like me "splitting hairs".
My intention is not to say "you're just broke, you're not dead". Quite the opposite. My intention is to say that health care access is not limited by whether you have a job - it's whether you have money. Plenty of people have money but no job and even more have jobs but no money.
That's hilarious.
I mean, you are correct that employers bundle employees together. But without massive government intervention during and after WWII, the industry would have been wildly different, and the way the trend began was highly historically contingent:
https://en.wikipedia.org/wiki/Stabilization_Act_of_1942
Econ 101 is insufficient for understanding the world.
It is very useful to look at other countries - we have lots of natural experiments in health care markets. If bundling were determinative of market structure, you'd see the same pattern elsewhere.