Comment by Victerius | Hacker News Reader

Comment by Victerius | Hacker News Reader

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The comment thread that is soon to follow is predictable.

Someone will reply: Medical costs are responsible for X% of personal bankruptcies in America.

Someone will reply: Most Americans don't have to worry about medical bills because they have coverage through their employer.

Someone will concur: Yeah, I have fantastic benefits with my company.

Someone will provide a counter anecdote: I also have great benefits with my employer. But I still have to pay a $5000 deductible before coverage kicks in.

Someone will reply to the parent with: The US has the best health care in the world. Why do you think people fly from overseas to receive treatment in the US?

Then someone will reply: The US has the best health care ... if you can afford it. The last time I saw my doctor, he looked at me for five minutes and prescribed me a bottle of aspirin.

Someone will reply: You need a new doctor. I once had an experience like yours. I found a new doctor, who truly cares about my health and well being.

Someone else will reply to the comment two spots above:

> The US has the best health care ... if you can afford it.

"No, the US has the best health care in the world, including for middle class people and poor people. I once injured myself in [insert first world country] and their health care system was practically third world."

_______

Being a European, I'm fascinated by the crazy healthcare and I love reading these US healthcare topics. You really captured the gist of the conversation :)

Hey me too.

I know it's real people suffering and because of personal relationships with US citizens I feel for them.

Yet it's a fascinating lesson in how complex social problems can be acknowledged by pretty much everyone while at the same no-one is able to implement a workable solution.

PS: I'm glad there will always be someone who reminds me that here in central Europe I can not choose my doctor, have to wait months for an appointment and that we don't have health insurance here because it's covered by taxes. Since that's not how it works at all I always forget ;)

PPS: Obviously it's not all sunshine and roses here either and we have our fair share of problems but large unexpected bills for scheduled or emergency procedures just don't happen frequently enough to matter in the grand scheme of things.

Love these abstractions of HN flamewar threads, it reminds me how me little information gain there is over time. Here is one of my all-time favourites: https://news.ycombinator.com/item?id=23003595

That first comment nails it as well. Everyone wants to feel like they're contributing something novel or unique to a comment thread but....

That’s not limited to US healthcare threads, there’s plenty of similar topics (prison systems come to mind). I appreciate your response, I’d love to see a resolution to the groundhogday-esk parts of HN.

The socialising of healthcare and de-privatisation of prisons would probably resolve it ;).

Add that to the template!

I would love it if you could write a reply like this for all the major HN topics and create a bot that automatically pinned it to the top.

Dang, that’d be a heck of a feature.

It's been done:

http://n-gate.com/

Haha, I'm just linking this comment every time the issue comes up.

One of my app ideas was to make it so you can have that "graph" for every issue, and then instead of rehashing the same debate every time, you just tell people to find where their argument is in the graph, and they can link it or improve what's there.

This comment needs to be immortalized somehow

Poor people are eligible for Medicaid, which means they pay nothing.

It's the middle class that takes it in the neck.

As of ~5 years ago, you could be cripplingly poor and still not qualify for Medicaid. I've lived it.

Depends on the state.

Most states use 100% to 138% of the federal poverty level, which would cut off a single person from Medicaid if they make ~$12k to ~$16k a year.

I don't understand what your comment adds to the discussion... Are you saying it's OK for some states not to have healthcare for poor people? Or that poor people should move to better states (they can't because moving costs money; poor people aren't mobile)? I don't see how pointing out that some states are worse than others is useful.

It is very useful, factual information. One might not know that Medicaid is a program run by the individual states, or that it is possible to move to a state with better options - and many "poor people" can and do move long distance for various reasons. Also, it's important to understand that if you want to change things you should be directing your efforts toward your state government.

States that have accepted Medicaid expansion make you eligible if you make up to 138% of the poverty level.

Not all of them have, of course. Without going through every single state, Texas allows you to make up to $25,503 for a household of one and still be eligible for Medicaid.

Those who make more are eligible for free or subsidized Obamacare plans.

What do you mean by "cripplingly poor", and what state was this?

In Texas a household of one is ineligible for Medicaid at any income unless you're blind or otherwise disabled.

Depends on the state. States like Florida and Texas did not expand Medicaid, so if you make under the minimum for ACA subsidies, your choice is pay full price ACA or nothing.

For example, in Florida, to be eligible for Medicaid, you must be below the poverty line AND:

> You must also be one of the following: Pregnant, or Be responsible for a child 18 years of age or younger, or Blind, or Have a disability or a family member in your household with a disability, or Be 65 years of age or older.

There tens of millions of people who live in states that never expanded Medicaid under the ACA, so Medicaid is not available to them unless they're disabled.

Expanded Medicaid in states that accepted it cuts people off at 100% to 138% of the FPL, meaning if you make more than $12k to $16k a year, you're ineligible for Medicaid.

If you have more than $2k worth of assets, you must sell them before being eligible for Medicaid.

The asset test is gone in states that expanded Medicaid too.

Not poor people, indigent people. Like you need to sell your car to qualify for some doctor 50 miles away.

And if you live in certain states, they throw in all sorts of impossible restrictions and surprises. Sometimes they’ll suggest that you move.

It does vary by state. In this state, you're allowed to own a car or even a home and still qualify for Medicaid.

Many doctors refuse Medicaid patients.

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