It might say that your hospital stay is covered on paper ... but then at the hospital the robot (or another doctor) might not be billed through the hospital and some outside group that is suddenly out of network.... there's no way to know.
The worst-case max out of pocket for any insurance plan in 2020 is:
$8,150 for self-only coverage
$16,300 for family coverage
In America, it is important to have liquid savings to handle life events like losing a job or a serious health issue. We get taxed less, have fewer safety nets, so we need to build our own safety net. You can argue that one way is better than another way as a big picture, but many people misconstrue the individualist vs. collectivist societies as a serious moral issue instead of a choice. Some of the details of each can be serious moral issues, but the big picture is simply a difference in priorities.
Bottom line: If you can come up with $16k/year to cover medical expenses for a serious issue, you won't go bankrupt.
The US median income is $63k... $16k would be 25% of that.
The difference is for people with no or low incomes as the tax is used to pay for these. Social security.
Lack of food (9 days), and lack of potable water (72 hours). Since we seem to be leaning towards the opinion that the gov't needs to provide everything for us and we should have minimal/no responsiblity for our own sustenance, repair, or longevity, where's the Free Sh*t Army slogans for no-cost food and water?
Interestingly enough, most economic studies of social security show that putting the same money into a low-risk index fund would've netted more gains, plus that money would've been available to the person with far fewer 'strings attached' (vis a vis able to be withdrawn earlier if desired, descendants/spouses able to withdraw in case of untimely demise, etc). Coerced gov't meddling, again, has proven to be the more-painful economic road to go down, as opposed to letting individuals choose what to do with what they've earned.
>folks on social security
I notice that you call some people "folks" while others are simply "receipients". Do you think poor people are human?
For example, the French tax bracket for income between $28k and $81k* is 30%
In the US the rate in that bracket is 12% up to $39k and 20% after. If I did my math right that averages to 18%.
That isn't high income earners saving on taxes, that's a 40% lower marginal income tax rate for the middle class in the US vs. France. There are also many other sources of tax outside income which are different and higher in countries with social medicine.
* converted from EUR to USD
(taxation is complicated and making apples-to-apples comparisons is hard. it is easy to argue about fiddly details and hard to avoid a long list of caveats)
The poor and lower middle class aren't in any better position to save tens of thousands of dollars for medical emergencies, despite the lower taxes. Lower rates don't help, when your income is low.
And in California, that difference is a lot less than 12%.
How / when you might hit it is an unknown from plan to plan for the reasons I noted.
If you hit the max it is irrelevant, I am talking about hitting the max and going bankrupt.
The costs of a given hospital visit is still an unknown leading up to the max... and how quickly you hit it is an unknown... and thus actually finding "descent insurance" is not easy.
As far as I can tell you seem to just be hooked on this concept that after you hit the max you're not paying and that somehow means something. Perhaps you feel that hitting the max is a trivial thing?
https://time.com/5555988/medical-bills-out-of-network/
This lady had insurance, and yet was stuck with a $227,000 'balance bill'.
I'm no mathematician, but $227,000 seems to be a bit higher than the 8.5k max that this thread keeps citing.
This kind of issue should be taken into account when choosing an insurance plan. If you choose one which has a restricted network, you have to be more diligent about where you get your care in emergencies.
Medical billing is nonsense though. Just because someone sends you a bill does not mean you owe it or will ever have to pay it. This is one of those details and rare occurrences which get way out into the weeds and doesn't really support the argument of which type of health care your country should provide. There are similar edge cases in social medicine where some situation or another is appalling. Extreme cases need to be handled, but unless they are common, they shouldn't drive the debate.
2. Did you notice the anecdote in another part of this thread where an approved, in-network procedure at an in-network hospital had an out-of-network anesthesiologist, because every single practicing anesthesiologist in the region is out-of-network?
3. As a buyer of health insurance, how can I even know, ahead of time, that there's a problem, like what was listed in #2?
4. As a non-buyer of health insurance (Because my employer chose which one to buy), even if I knew about #2, I don't even have any choice in the matter!
It's ludicrous to expect people to do all the research they need to do, to avoid getting bitten, in an industry that is as hostile to transparency as the medical billing industry. Where do you even start? [1]
> Medical billing is nonsense though. Just because someone sends you a bill does not mean you owe it or will ever have to pay it.
Is this legal advice? Because as I understand it, there are plenty of places which will happily garnish your wages over medical debt, and there are plenty of hospitals who won't write off outrageous balance bills if they discover that you actually have savings in the bank. (Oh, and the ones that will forgive it... Are robbing the public, because they get to claim that write-off on their taxes. As a taxpayer, that's my favorite part of 'charitable debt forgiveness'.)
[1] And even if you could do that research, the problem of balance billing comes from your insurer, and the hospital not agreeing on which services should have been paid for, and sticking you with the problem. You cannot predict that, at all, because it is always an after-the-fact case-by-case scenario.
My friends from other countries say, not really when you add everything. Then add the US's system of 'private taxes' which drive up the cost of things like health insurance, schools, etc.
When I had severe hypokalemia and was effectively paralyzed several years ago [1] (sorta comical read) they never once asked me about my dietary intake, instead they assumed I had some rare genetic disorder (in the ER the doctor literally told me "we're googling your symptoms") and once I was admitted they paraded 3 doctors through my room and billed me for 5 or 6 'consults'.
While I considered my insurance to be 'good' getting dinged for each of those 'consults', 2 times each, despite only ever having seen 4 doctors total (one an ER doc that was probably a year or two into his medical career) face to face once each I ended up paying 10-12 different 'consul' fees, then a portion of the ambulance, then a portion of the room, the two different physical therapists they sent by after declaring me a 'fall risk' since I came in functionally paralyzed, then a portion of all the tests. From the time I set foot in the ER until I left I was there about 37 hours.
All they had to do was give me some oral and IV potassium and I was fine. I actually diagnosed it myself, with no medical training whatsoever, in the ER unable to move 45 minutes before they did. My mother was there and after I'd somewhat calmed myself (I could not move, I could barely move my fingers) I told her it was probably a sodium potassium imbalance and I could probably still make it to work for overtime that morning. I ended up paying a little bit under 7k$, 1/4 of my gross income at the time, with my 'good insurance'. Took me 4~ years to pay it all off.
[1] https://www.ryanmercer.com/ryansthoughts/2013/2/19/flashback...
Another major annoyance -- if you have surgery, the hospital usually gets their money from you right away. However, you're going to spend the next 18 months receiving random bills from various different firms representing nurses, doctors, lab technicians, etc. related to your procedure, many of which come down to "stuff we decided to do while you were unconscious."
My cost was 10 times his. His whole family for less than half the cost of just myself. My initial suspicion was he got generic and I didn't. Nope, same box. He's said before he has 'good insurance' but it's almost always just talk. Guess it wasn't in this case.