No matter what society you live, the advice is the same: try not to get sick.
Health Care in the U.S. isn't just bad, its outright fucking brutal. An elderly friend of mine recently fell and went to an urgent care where they couldn't get him into the x-ray machine. They told him to go to an emergency room where he waited for _13_ fucking hours with a broken pelvis. I'm basically 100% sure that such emergency room bullshit literally kills people from stress or exposing them to other sick people. You can't even wait in your damn car and just have them text you - they just force you to sit in this horrible room with a ton of sick people for hours on end.
The U.S. Health Care system absolutely fucking blows.
If I was in a public system, I’d fear I’d be fighting for attention alongside the general public, so I’m not convinced it would be better.
This ~92% insured in 2020 includes:
- People subscribed to unusable ACA and private plans (eg: $9100 deductibles)
- People considered eligible for Medicaid by CMCS, including those who are denied coverage by state administration agencies
- Millions of people who were directly granted temporary Covid Medicaid coverage by CMCS (bypassing state agencies) - which expires in days
[1] FCC broadband maps consider an entire census tract served, as long as an ISP alleges just one house there can be served.
Are you not a part of the "general public"? If it is true that there is a class of people who don't have your advantages and therefore have worse medical care, is that a situation that you see as acceptable?
It always seems strange to me when people argue this about this issue from a hypothetical perspective, when we have a wealth of actual data that we can use to compare health outcomes. We can just look at the results and see what works better!
https://www.pgpf.org/blog/2022/07/how-does-the-us-healthcare...
(TLDR: the US spends much more per capita on healthcare, especially in administrative costs, and has worse health outcomes than most wealthy countries).
The answer is obviously yes, given that they don't want the "general public" to have the same level of access and make them potentially have to endure any longer waits. Their convenience is more important than the health of others.
I've waited less than an hour in New Jersey and Connecticut.
When I still lived in NYC, I resolved that if I needed a hospital but I wasn't in extremely bad shape, I would drive an hour into an adjacent state's ER rather than wait in NYC.
Coming in via an ambulance doesn't trigger some sort of re-prioritzation, if you're not suffering from something that is immediately life threatening.
In most NYC hospitals, you will end up in a secondary waiting area that lies just beyond the regular ER doors.
Good luck if it's a Saturday night.
https://projects.propublica.org/emergency/
Where I live, all in driving distance have an average wait time more than 2.5 hours.
"Wait" can be defined very differently. Wait time to get triaged by a nurse? An ECG for chest pains? Initial physician assessment? Entry-to-exit? Lab results? Time to X-Ray if needed?
Lots of directives may be in place too. In an efficient system, the nurse is empowered to "order" many procedures that screen out serious things that require immediate physician intervention. Or just to save time like ordering an X-Ray first instead of waiting to see a doctor to order it and then waiting again for it to come back to review.
Sincerely, if anyone can explain to me - how can we as a species both have figured out game theory, AND consider this as a position that is in any way acceptable?
The current situation is that the parent poster has preferential healthcare access, and other people that they do not care about do not. The alternative is equal treatment which might mean the same access, or worse access as they are forced to "fight for attention alongside the general public" as they so blithely put it.
Given the option between the status quo, or a change which can only ever be the same or worse for you personally (regardless of the broader impact), of course someone self-centered would choose the former.
It's people in the middle who are getting squeezed by HDHPs, mostly not the poor, who have access to Medicaid (exact qualifications vary by state) or Medicare (everyone 65+).
Contrast this with Europe, where I could get a doctor to make a house call at 3am for a reasonable fee.
Ah yes, how dare the plebs interfere with the path of the chosen ones.
This anecdotal evidence is garbage.
Are you basing this fear on any sort of facts or are you just afraid out of ignorance?
I live in Massachusetts. I would take a public system over what we have now, no questions asked.
It's a well-known trope (probably proven, but I don't know the studies) that insurance companies routinely delay healthcare to AIDS and other patients with terminal diseases, in the direct hope that the patient dies.
With AIDS patients, there's a big moral component to the diagnoses, and companies can "get away with it," because there's such stigma to the disease, but I have also heard of the same thing happening to cancer patients. In fact, it can sometimes be a matter of life and death. If a treatment is delayed enough, it can change the outcome.
I have been told (but don't know it for a fact) that this is actually the point of the delays, and that the delays are triggered by the diagnosis.
In many cases, delaying payment, also delays treatment. Most patients don't have an extra 500K, floating around, that they can pay the hospital for a procedure, in the hope they get reimbursed. No promise of payment, no treatment.
So that means that refusal to pay is the same as withholding treatment, and these companies know it.
I think that AI is likely to make this worse, as they will probably give these decisions to an AI, thus removing any hope that there may be a caring human in the process that could possibly feel shame.
So I guess it depends on where (city/state) you live and also what type of insurance you have.
Where I live I have access to a SOTA network of hospitals with great technology and some practices amount the best in the world (people come here from other states and even countries for treatment) and I use their own insurance, so it's been great so far, never dealt with any issues having medical care rejected.
I pay $350/month (self employed) and I have a very reasonable deductible, $60 copay to see specialists and many preventive procedures such as cancer and heart disease screenings (which I use), blood work and some PT sessions completely free.
I even get discounts on fitness centers and health tracking apps which helps offset part of the premium.
My shoulder was actually spared from a very invasive surgery thanks to a doctor top of his field (he sees olympic teams) who was able to treat me with only PT.
I don't think I paid more than $1000 out of pocket for everything including several MRIs and multiple visits to his practice, plus several sessions of PT and medications.
It could have been free back in my country, I guess, but I could have also been screwed for life due to an unnecessary surgery.
> without autonomy
This is an incredibly poor way to act given that doctors usually have unlimited personal liability, even if they are employees
Not everyone came to this nation due to capitalism. My parents partially came here to be free to say whatever they wanted and not disappear, for instance.
It doesn’t mean healthcare is done right; just as using TP to wipe one’s ass is 100 years backward.
I sometimes wish they stayed back, because my own life and theirs would’ve probably been much better in the long run.
No, I won’t be forced. I’ll just get shouted down by anonymous accounts just like the cancel culture of the left.
You think complacency is patriotism. I actually would prefer to improve my country.
> So it’s not unsurprising that your attempts at forcing others to pay for your things is met with hostility when you and others that share your views don’t even want to face those policies themselves.
“My attempts”? Your response is indeed hostile, but you have it backwards.
My family and I have been directly paying for and subsidizing for your own care and other Federal entitlements for decades.
Your response is also irrational to the core. We collectively pay for law enforcement, the military, highways, etc.
Why is it suddenly taboo to consider whether we’d actually save money if we had a baseline?
Why is the worst of socialized medicine and the worst of market-based medicine an acceptable status quo?
Alternatively, I simply state that we both agree on law enforcement and military but not healthcare, so at a baseline you want to force others to pay for more things than I do.
I don't support the US healthcare system, but I won't support socialized healthcare because of that. The government can follow the rules it enforces onto private companies by operating its own healthcare service without forcing those that did not choose to use it to pay. Problem?
I specifically also mentioned highways. How does that fit into this narrative?
> Alternatively, I simply state that we both agree on law enforcement and military but not healthcare, so at a baseline you want to force others to pay for more things than I do.
I’m already paying for your care, so I’m paying for more than my fair share.
You have no idea how much I make, which your claim entirely depends on. You also don't seem to be reading very carefully, I'm stating what I believe should happen. I would like people to be forced to pay for less things. You would like people to be forced to pay for more things. Simple as that.
So you’d pay for law enforcement and a military, but without roads and highways they would be ineffective.
What is your proposal? Do police and soldiers have to pay money for its use?
> You have no idea how much I make, which your claim entirely depends on
And you have no idea whether I’m overpaying for healthcare to subsidize your care.
Those services you’re enjoying now and the professionals you’re relying on? Those are costs far beyond just the single treatment and whatever private insurance you’re paying for.
You made the claim, the burden of evidence is on you. All I said is that you wish people be forced to pay for things they don’t use and I do not, which you conveniently ignored after asking me to address every bit of your comment.
People like you always pull this “indirectly use” argument to justify making people pay for things they do not use. I don’t pay for the gym membership of the delivery guy, this is no different.
> The government already operates roads. Nothing would change.
Okay. So we established that you don’t mind if the government runs the roads as long as they pay for it (tolls, gas tax).
I’ll go out on a limb and say that until the Federal stepped in, our road system was haphazard and ineffective. Having standards and an interstate system was crucial, and only possible with government.
Now given that law enforcement and military can incur injuries, can we have an effective law enforcement without the medical support to get them back up when injured or sick?
Now for this portion: > So it’s not unsurprising that your attempts at forcing others to pay for your things is met with hostility when you and others that share your views don’t even want to face those policies themselves.
Why would you assume the worst ? This goes against Hacker News’ core principles.
> People like you always pull this “indirectly use” argument to justify making people pay for things they do not use. I don’t pay for the gym membership of the delivery guy, this is no different.
I help pay for all of infrastructure, the building safety codes that ensure the gym doesn’t collapse or electrocute me, that the machines aren’t death traps, etc.
It’s great that I don’t have to pay for a membership or other services if I don’t want it, but the foundation that makes these services even possible or reliable costs money.
Having these services on standby also costs money, even if you don’t use it. So yes, I’m already paying more than I’ve ever received in healthcare.
Back to healthcare. What I find frustrating is that your kneejerk reaction is neither unique nor uncommon, yet it never comes with a workable alternative and solution.
You realize we're discussing the US which has all this?
> beauracracy.
It's funny you mention this, because the US spends vastly more on bureaucracy in its health systems than other developed nations.
those are all there because the people that created the system did not think paying for it was good enough. it doesn't have to be that way. and even with wait times being long you still eventually get it. in the privatized system if you are poor and have bad health care you don't get it at all.