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Comment by beagle3 | Hacker News Reader

> contrary to what Europeans perceive, the healthcare system works very well for the upper middle class)

... until you get a really expensive chronic disease. And then it fails miserably.

I know upper middle class parents whose kids got a disease which need ~$5000/month meds for a few years (and nontrivial infusion center costs on top).

It worked ok for some, many had been informed that the insurance company decided not to pay - requiring lawsuits (some settled, some ongoing).

No European, Canadian or Israeli parent that I know of kid with the same disease ever had to fight or pay out of pocket - it was all covered by the single payer with no hassles.

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Not defending the US healthcare system, but I’ve never heard of an insurance plan without an out of pocket maximum. For example, my plan has a 2k maximum for individuals and 4K for married couples. Combined with a health savings account (allowed to be funded pre-tax from both the employer and employee), I’ve generally put $1-2k a year in that during my 20s when I rarely needed medical expenses. I still haven’t had a year where I’ve spent more than I’ve saved to the point I could cover multiple years of out of pocket maximums just from that account.

And since it’s a “savings account” I can invest the tax-free savings into the stock market with index funds. I’ve actually had a decent amount of growth in that account just from stock market gains.

2k max out of pocket expense to me sounds absolutely ludicrous.

In Germany you can have private health insurance (if you make more then 63k a year you can opt-out of public health insurance) and there the out of pocket is usually around €350. In the Netherlands the out of pocket is also something like €300, which most already consider too high.

The option to get it to zero is of course possible but usually doesn't offset the savings.

However the notion of having to need savings to be sick is... to me extremely foreign and strange.

Just out of curiosity. What would happen if, for any reason, you lose the capacity to work for a couple of years? Let's say that you have a bad accident that affects your hands, or you get a depression.

Are you asking me or ABeeSea?

I agree that American healthcare needs reform (and I want single prayer in particular), but I’ve never heard of an insurance company refusing to cover a necessary drug, at least not any health insurance plan that an upper middle class family might have.

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