Some IT companies (especially startups, but it varies) do it with stocks or stock options as well, tying them to your employment.
Anyway, no civilized country should require you to be employed to be entitled to health care. Not making health care available to everyone, regardless of wealth or employment status, is classist eugenics.
tell me that these laws don't apply to you and that you've not had to struggle with them to get health insurance without telling me that these laws don't apply to you and that you've not had to struggle with them to get health insurance
Through the exchange, without a struggle, I received insurance comparable to what I had before, no questions asked about my existing health condition, with a subsidy to help pay. The best I could have hoped for previously would have been up to six months only of COBRA coverage, at 102% of my employer's cost, no subsidy. And if I chose to go without any coverage at all for a few months, in the past I would have had to divulge any pre-existing "conditions" as part of the application process.
It's tough to be an expert, to be well informed on how US medical care gets paid for. I'm no expert, but I know a little more than nothing:
So, for "bankrupted", yes, sort of ....
But the US has Hill-Burton hospitals, likely named after two guys in Congress who got the bill passed. With the Hill-Burton act, if are starting a hospital, then can get funding via the act. BUT: Have to accept all patients independent of ability to pay. Soooo, a large fraction of city hospitals are Hill-Burton. Then there are the medical school teaching-research hospitals -- again commonly or always, patients are accepted independent of ability to pay.
If someone really is broke, then they can qualify for Medicaid -- "never receive a bill for medical care."
For people old enough to be retired, there is Medicare. Part A covers a major fraction of hospital charges and is free. Part B covers physician charges, and is not free, maybe a few $hundred a month. There is another part for drugs.
For poor people, there is the HRSA (Federal Health Resources Services Administration) or some such -- clinics with sliding scale charges based on ability of patients to pay.
It goes on this way. It's a patchwork system. Not all the important details are really clear. E.g., there is a lot of over billing, that is, charging too much, and in this case the insurance company has a talk with the physician/hospital and negotiates lower charges. For drugs, the prices can vary enormously based on whatever.
There has been at least one effort to get the medical providers to publish a price list, i.e., to clear up the lack of cost information.
I don't know all the details, but my understanding is that it is very rare for medical care charges actually to bankrupt someone.
E.g., one approach is for a patient who owes big bucks to pay, say, $10 a month for 6 years -- then by laws of debts, the rest owed is forgiven, that is, not owed.
One way and another, in summary, from 50,000 feet up, generally, the US tries really hard not to have all of medical care run by the Federal government, or any level of government. E.g., there could be a system single payer where the there is only one entity that pays for anything about medical care; of course, that entity likely is run by the Federal government and gets a lot of tax money. Single payer has been proposed 220,872,879 times and rejected by that many times.
Some of the scare is that single payer would result in some or all of (a) taxes way too high, (b) too much just wasteful, silly, and unneeded medical care, (c) low quality of care and, thus, too many people hurt or dead, (d) too little capacity where too many patients die from waiting too long for care, etc. I don't know what if anything is right/wrong with (a) -- (d), but these are concerns commonly voiced.
Maybe the US could borrow from, at least learn from, Switzerland, England, ....
But actually bankrupt from just losing a job? I suspect that is actually not very common.
Oh, by the way, if fired, then commonly get to continue medical insurance coverage for some length of time.
This site gives several survey findings related to medical bankruptcy. The data is complex and conflicting at times (like you would expect given something as complex as 300+ million people’s healthcare) but the number that the stats seem to fluctuate around is 1 million people. 1 million people declare bankruptcy a year due to medical-related costs. That’s 0.333% per year.
So there are a lot of people (1 million if you believe the data in that link) per year being affected by this.
Half of all GoFundMe's are now medical-expense related.
These are absolutely indefensible statistics about our current system. Literally, anything else (already in use in other countries) would be better.
tell me then, why do a bunch of my US friends not have health insurance? even the ones who left their jobs during the pandemic?
to be frank, it sounds like your income is too high for you to actually know what happens when dealing with this 'patchwork' (as you call it) shitshow system in real life, to try to get the care you need to survive.
> Some of the scare is that single payer would result in some or all of (a) taxes way too high, (b) too much just wasteful, silly, and unneeded medical care, (c) low quality of care and, thus, too many people hurt or dead, (d) too little capacity where too many patients die from waiting too long for care, etc. I don't know what if anything is right/wrong with (a) -- (d), but these are concerns commonly voiced.
why state all these downsides and try to play this sort of 'neutral' card by saying "I don't know what if anything is right/wrong"? all of these so called reasons (or fears/scares) are just completely irrelevant when we can see that all other global north nations have single payer systems.
let me repeat that: the US is the only country that doesn't provide universal healthcare to the working class.
can you help me understand why you posted this comment? to me it just looks like a laundry list of the many failed strategies used by the US govt and huge pharmaceutical corporations that have helped them scam the working class out of trillions of dollars in the form of medical debt and pharmaceutical drugs, etc.. i could probably find all this on some wikipedia page about the history of the US medical care system.
On your post
https://news.ycombinator.com/item?id=29474353
> tell me then, why do a bunch of my US friends not have health insurance? even the ones who left their jobs during the pandemic?
I don't know anything about the circumstances of your friends.
> to be frank, it sounds like your income is too high for you to actually know what happens when dealing with this 'patchwork' (as you call it) shitshow system in real life, to try to get the care you need to survive.
Without going into my "income", it turns out I know something about the US HRSA system: They run clinics that can do well providing primary care and then can refer patients to more advanced care when needed.
Charges vary but generally are low: At a clinic, the really poor pay nothing. If they have a little money, maybe the cost is $20 a visit. With a little more, the cost is $75 a visit.
> can you help me understand why you posted this comment?
I was responding to user
try_again
and their post at
https://news.ycombinator.com/item?id=29472346
with in part:
> If that's a correct guess, as a European the US work standards frighten me. Health insurance so tightly coupled to work that if you get into an accident shortly after being laid off and don't have (expensive) private insurance you could be bankrupted by it.
So, I wanted to add some information to the issue of "bankrupted by it".
For your
> why state all these downsides and try to play this sort of 'neutral' card by saying "I don't know what if anything is right/wrong"? all of these so called reasons (or fears/scares) are just completely irrelevant when we can see that all other global north nations have single payer systems.
The "fears/scares" I listed really are "commonly voiced". Soooo, take this list as the POLITICAL answer to why the US does not have single payer, etc., not the rational, economic, financial, moral, medical, etc. but just the POLITICAL answer for the post of user
beckman466
at
https://news.ycombinator.com/item?id=29474353
Or can't give a good, rational answer to
beckman466
using only what is rational, economic, financial, moral, medical, etc. and instead must at least include some of the politics. Here define politics as using false information, cherry picking evidence, quotes out of context, lies, manipulation to fool people!
The security benefits of being a company man are to be weighed by each individual against their own priorities. For some, doing whatever work a company needs how and when they need it in exchange for a secure paycheck or other benefits is the smart choice. For others, the lowered perceived security is worth being able to decide what to work on and how and when to work.
Generally speaking, if those security benefits that come with giving one entity a monopoly over your skills and productivity were as strong as they once were the gig economy wouldn't exist. The benefits IMO are overstated. In a world where these entities treat professionals as fungible, it only makes sense that the professionals treat those entities as fungible as well, and it is only fair, and freeing and empowering, if that sort of thing appeals to you.
Broadly - oh my goodness, this article is pure regulatory arbitrage amalgamated with some kind of hellscapish McKinsey/VC dross. Net - firms would like to reduce you to an expendable, unprotected line item without recourse to traditional employment law. There is nothing innovative or interesting here, a pure desire to extract maximum value from fellow humans without consideration or care for what we owe each other.
Enough of this shit, in particular the aggregation of labor for the purpose of building a surveillance sensor aperture for ads.
Yup, and now add on family or other responsibilities. It's also a way to keep hiring 22-year olds right out of school who won't stand up for themselves and don't have the experience to ask to be treated better. Likewise, a great way to keep anyone with a family out of the workforce/desperate.
> My company is very "woke," and I know a lot of people have problems with such things, but one very welcome outcome of this is that they really do put people first, and the bottom line second.
Be careful with this; it can go either way: Either they're great OR the wokeness is a great cover for complete exploitation. One good way to figure out is to ask how they address disability; it's the one identity that can impact somebody's ability to produce, and it will tell you if they see their workers as people or if they're more interested in diversity check-boxes for the sake of funding/PR.
Instead we have a situation where people basically cannot be trusted to save for times when they can't work and that compensation is held in trust by the company, which then enables the company to manipulate with it and hold it over people's heads. People feel stuck at their job for this compensation just like with healthcare, to reference a point you made elsewhere in the thread, why not decouple them both?
IMO if we are going to have these paid time off schemes, they should be negotiable (in the banking sense) by law so that people who want to receive the compensation as money rather than time off can do so. Some companies do this, others do not, but these are part of our compensation, we should still receive it if we don't use it, like we otherwise would if we were just working for money.
Decoupling healthcare is just the first step, decoupling everything except monetary compensation is ultimately what frees people to work on what they want to work on.
This also reeks of “unlimited PTO” which effectively results in individuals taking less vacation and other comparable benefits.
Can you let me know how someone should save for time off to recover from an unplanned pregnancy at the beginning of their career?
The majority of people do not make enough money to save for hard times.
People, no matter how poor they are, both need and deserve luxuries in their life, however small.
Pay people enough, and—surprise!—suddenly they can totally save for hard times.
And then people would be forced to pee into the bottles, poop into their work assigned bags, or wear diapers to continue working without breaks. What a horrible future it would be.
In addition, taking a few months and putting in almost no effort at work to focus on other parts of your life has a lot of value and that's really hard to pull off in the gig-type economy. The last few months, I've been giving very little at work due to some mental health issues (I've still done my job just fine, but the extra things I do to build my skills + benefit my company aren't getting done), which in the long term is going to do way more for my productivity and quality of life than chasing the next gig. This can also be true of health, or family (e.g. if a family member needs your help after surgery).
There are benefits and drawbacks to each work arrangement.
Take this with a grain of salt, though, as I don't work in tech, and the primary reason why is because I wasn't willing to forego all my other hobbies for it. Tech is for fun: The times I've to support myself with my tech skills I hated it.
A lot of the benefit of conventional employment in my experience is being more able to leave work at work. It's also, in some ways, more beneficial as you age and are more likely to accumulate additional non-work responsibilities. That said, this is only if you get DECENT traditional employment. I'd take gig work over what they do to retail and food-service workers ANY day of the week.