EDIT: I have a family like most people.
EDIT2: I'm thinking about how insurance isn't as expensive as giving up more than that in salary, but maybe I need the security of steady work on the resume, sick leave and a job to lean on if things get tough.
Nothing crystalizes support for medicare-for-all faster than ten seconds looking at the public health insurance marketplace.
If someone's work is truly all-remote I'd seriously recommend looking into residency visas to places with functioning governments and healthcare. I'm currently working remotely at a US client from several locations in the Pacific.
I just had a complete auditory workup to diagnose some recent hearing changes that included consultation with a US-educated doctor, and some medication, and the total cost without any sort of insurance was ~250 USD. My monthly insurance premium at home is 400 USD and likely wouldn't even have covered half of that, because fuck you, that's why.
I spent several months working from the Canary Islands and other than my difficulties in mastering the local Spanish it was great.
> Nothing crystalizes support for medicare-for-all faster...
It's pretty messed up that the lack of universal healthcare throws a huge wrench in the thing that generates the future of society, at least among financially self-aware young people.
It used to be even worse just a few years ago. Before the ACA insurance companies often considered pregnancy a pre-existing condition:
https://www.webmd.com/health-insurance/aca-pregnancy-faq#:~:....
Don't get me wrong, healthcare is the most corrupt industry in the United States (by lobbying dollars). But I give some blame to my peers for not even attempting to understand how insurance works.
I understand what they're saying but no one plans to get sick (pregnancies aside). Cheaper plans within the same insurance group is probably ok. Which hospital you can go to can be the difference between life and death, especially these days: https://www.nytimes.com/2020/07/01/nyregion/Coronavirus-hosp...
Read the link provided that explains the terms and proves that low cost plans are the best for chronic conditions.
Kind of figured there was a catch though, maybe not!
At that point, different metals might hit the out of pocket max sooner, but I just went for the one with the least total of premiums and out of pocket max, which was also the one with the least total of premiums, so I save money if I don't use it or if we hit the cap.
But why is healthcare bought individually more expensive than healthcare an employer buys for all their employees?
One is real and one is hidden.
The hidden price difference is that most employees think they pay $200 per month in health insurance, but actually their employer is paying $600 and chips in $400 so the employee only pays $200. And of course, $200 taken out of a paycheck before you receive it doesn't feel as bad as a monthly $200 charge to your credit card.
The other reason is adverse selection: When an entire employee base gets health insurance together, the people needing expensive care and the people not needing any care all average out together.
But in the individual market, less healthy people are insured but more sick people are. Healthy people forgo health insurance, so the average cost per person rises.
Often/usually, the people needing very expensive care aren't employed in the first place, as they're often not able to work, or at least not able to work in a company with employer-provided health insurance in the first place.
Quick story. Once upon a time I was in a Contract-to-hire position where the contract house (CH) was paying my salary/etc until I was on-boarded.
However, this was a small shop, they had 3 people running the business and less than 2 dozen contractors under them at a time.
Between the Owner's Knee surgery, and some health issues I had had years prior, the CH's premiums were going to jump by 200$ (both on their end and the employee's). Thankfully they were able to find another insurance provider, but it was a pretty clear cut example of how sick people in the pool can sway costs by a large amount.
That's part of why a lot of US companies now will give you discounts for various wellness tasks. My BIL's company offered an insurance credit just for taking a smoking cessation course (not even STOPPING.)
Insurance is expensive because medical care is expensive. Medical care is expensive because of a litany of policy failures.
The second part of the story is that the US is richer than Europe. I moved to the US from Western Europe. Before I moved here I didn't expect how much more everything is more expensive here, but at the same time salaries are also higher. The US's GDP per capita is $62k, Germany's is $47k. But that doesn't tell full story. In the US there is a big difference between low paying and high paying jobs, rural and urban areas.
The recent collapse of movie theatres clearly illustrates that there is no reason they could be getting away with making $10 margins on popcorn, of all things, other than customers were being charged exactly as much as they would tolerate without telling the proprietors where to stick it.
No, not really. This is a narrow picture of reality. People are often willing to sabotage their own bodies and drive their bodies toward obesity, clogged arteries, and liver disease while not spending the money to go to a doctor for annual checkups or flu shots.
The dollar menu is cheaper & tastier option than buying a salad and people consistently choose the cheaper, tastier option
Prices quoted aren't actually prices. You have zero idea how much it's going to cost you until you get the bills, often split across dozens of providers, and what you see are the results of negotiations between providers and insurers.
However Obamacare changed the scene, I dont support it.
These plans are typically referred to as “junk insurance” but if you can’t afford or just don’t want a more comprehensive plan they’re better than nothing.
300 to 600k per year salaries are not natural, German Physicians don't make that much or go to school for as long yet have similar outcomes.
In the U.S. it's 8 years of school plus a 3- to 7-year residency program, versus 6.5 years of school plus a 5- to 6-year residency program in Germany.
This is just another example of the US being a place where the gap between the haves and have nots is extremely large.
b) Your cost isn't actually $100. Your cost at the point of service is $100 but you're paying more taxes which subsidize your healthcare (among other things).
edit: And before some snarky jerk tries to score some cheap virtue points by saying something to the tune of "well I am perfectly ok paying more taxes for healthcare". I was deliberately avoiding making a value judgement one way of the other and simply explaining why his bill at the point of service is lower.
I have lived and worked in many cities in the US as well as a couple of central European countries. Once you get into a high salary range the taxes aren't much different. The exception being if you have a bunch of kids then you will pay lower taxes in the US. However, you will also have increased costs including medical for the kids.
The United States propaganda is that we are capitalistic, when most of my money isn't controlled by me.
My health insurance is through my employer, a large publicly-traded company. My insurer is one of the large well known providers.
Our insurance is very mediocre. We pay the first $3,000 out of pocket and 20% of the cost beyond that, but that's only if a doctor is "in network" (which is sometimes hard to find). Out of network doctors have a separate deductible.
I also pay 1.45% of my paycheck to Medicare, and my employer pays another 1.45% on my behalf. Plus my wife and I pay an extra 0.9% of our paychecks for all combined wages above $250,000. But I won't be eligible for Medicare until I'm 65 years old.
[I am a US citizen and also have the ability to google this, but just wanted to ask another human being...]
Calculate how much taxes you'd pay in e.g. Germany or Belgium, and put half of that towards health expenditures. I think you'll still come out ahead by a large margin.
For a healthy, non-smoking 35-year-old you're looking around $80 a month.
For a healthy, non-smoking 70-year-old you're looking at 3 times that.
A family with a couple c. 40 and a couple of 10 year old kids is around $200-$300 a month (with no excess). With a $1300 excess that drops to $120 a month.
The USA spends 20% of GDP on healthcare. All other advanced economies spend about 10%.
https://www.ibtimes.com/how-us-subsidizes-cheap-drugs-europe...
Though there are lots of other ways to frame this of course since most of that is eaten up by US marketing expenses:
https://journals.plos.org/plosmedicine/article?id=10.1371/jo...
Essentially, no participant in the market has an interest in reducing costs.
It goes like:
Employee's quitting, termination or reduction in hours: 18 months
Employee's divorce: 36 months
It can be further extended based on other events like disability, partner's illness etc.
Taking time off was hard for me mentally with that high rate, knowing how much gross income I'd give up to take a week off for a trip.
That’s like double the IRS allowed maximum for pre-tax 401k deferral in a year, no? This is not my area of expertise so I could easily be unaware of something. Can you explain how you did this as I’m genuinely curious and want to do the same.
When I did it it worked out to paying $3k for an MS, but I bet you could look harder and get the degree and a discount over just buying a high quality plan.
-$4,800 in premiums -$11k maximum health costs
That 'maximum health costs' also doesn't really factor in the time having to deal with insurance companies chasing up decisions they make (or don't), and for money/income lost due to no work. Insurance for that - short term disability insurance - may add another $100/month on the the equation.
For whatever reason, American love to malign things as socialist, and confuse communist totalitarian with socialism.