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Comment by JohnVideogames | Hacker News Reader

This is mad (especially from a UK perspective!) and it doesn't cover the key point of insurance: you insure risks that you couldn't afford if they went wrong. I insure my house, my life and my car because it'd be financial ruin for me and my partner if the worst case scenario happened to any of those. Sure, I could avoid going through insurance for small things and negotiate with 3rd parties to get bills down, but that wouldn't make a difference to a £500k house rebuilding cost, car crash settlement, or medical bill.

Similarly, if something went wrong then I couldn't go back and insure that risk afterwards! You can't insure unpredictable events as and when you need them, and there's no point in my organising insurance from the wreckage of my car, house or health.

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America would benefit tremendously from adopting any of the universal healthcare models successfully implemented by many other countries.

Our existing insurance model is basically a giant racketeering scam. The lack of access to affordable healthcare increases crime, stifles innovation, decreases longevity and quality of life, and has created a breeding ground for lot of the crazier shit we are seeing in America.

I think we see Medicare For All sometime in the next 10-15 years. The first major party nominee for President who embraces it is going to get elected.

> The first major party nominee for President who embraces it is going to get elected.

And Republicans will use every ability in their power to prevent it from happening, through the filibuster and Supreme Court most likely. Fighting that sort of socialism is their entire reason for existence. That and upper-income tax cuts obviously.

That "tax cuts for the rich" line buds me so much. Republicans do not simply cut taxes for the rich. I've looked at income tax tables going back to the mid 70's. It's clear that Republicans cut taxes for all, not just the rich. Regan , G.W. Bush, and Trump cut taxes for the poorest, Middle class and the wealthy. I don't know of any case in the past 50 years when Democrats have cut taxes for the poor, though Obama did continue the Bush tax cuts.

Now if that's a good policy to cut taxes and spend as much as they do (Trump especially), that is another question.

They do throw a couple bucks to the poor and middle class so they can say that, you've got me there, but you should be able to see in your explorations of the historical tax tables who is getting the biggest benefit.

This has been the dynamic long enough that I can remember an SNL skit from 20 years ago about how bad the Democrat's messaging was on the subject. Something like the Democratic leadership of the time cutting ads about how the rich could use their tax cut for a full-service holiday at a brothel, while all the middle class could get from their cut was a lousy handjob. Obviously it was amusing enough to stick with me.

Actually, the article mentions a person who got cancer and then got "insurance" afterwards. It's not really insurance due ACA rules, iirc.

That throwaway line is a bit suspicious to me. Maybe they were lucky enough to be diagnosed right around annual enrollment time; someone diagnosed in February might be in a lot of trouble.

There are a couple of things I think are important to point out that does make this not just mad but annoying too.

1. No hospital will leave you (because of decency and federal law) to die if you can't pay. This right here obliterates any justification for private health insurance unless said insurance is mandatory like it is in a country such as Switzerland. When someone like the OP inevitably gets injured and has a $370,000 bill or something they go bankrupt and then society has to pay for it. If OP and others were willing to let themselves and others die on the street outside of a hospital I would be at least a little more sympathetic toward their decision to have or not have health insurance.

2. Health insurance is basically a jobs program in the United States. Health insurers do not provide value or innovate. What they do is became defect state agencies with private profits attached, and then when they decide they aren't paying for something we still end up with the bill anyway (both personally and as a society). My main gripe here is that because of the way we've structured our society, we're basically bankrolling a private industry and protecting its profits for no added value. At least the defense industry actually builds things for us. We could eliminate these insurance companies, their profits, and those jobs, and overnight our healthcare costs would go down and everyone would be insured and the economy would be better off too.

> No hospital will leave you (because of decency and federal law) to die if you can't pay.

Yes, they will. The legal requirement (under EMTALA) is to provide emergency screening and care until stabilized. https://en.wikipedia.org/wiki/Death_of_Nataline_Sarkisyan

"UCLA declined two livers while waiting for insurance approval from Cigna. Sarkisyan's family was also informed that they could proceed with the transplant if they could make a down-payment of $75,000."

Stabilization and emergency care are exactly not leaving you to die.

They won't give you months worth of chemo, or a liver transplant. You will die without them, but the hospital has no legal obligation to prevent that in these cases. You can keep coming back to the ER, getting progressively sicker and sicker, and they'll give you fluids, pain meds, treat acute symptoms, and then refer you to an oncologist or surgeon, who won't treat you further without knowing it's gonna be paid for.

I've provided a very concrete example of how this plays out.

Yes but the concrete example of how this plays out doesn't contradict what I said. If you wanted to contradict what I said you would find an example where someone showed up to the ER and the hospital said sorry we're not treating you because you can't pay, and then they died outside of the hospital or in the waiting room. And even then you'd have to find a number of examples to establish a pattern.

Also once you reach the point that you are describing that is typically when state resources kick in. If you become sick enough (for example with cancer) you go on Medicaid and disability. I recently went through this exact process with my mom. It wasn't fun and boy do the spam and scam calls really add to the experience. Why we tolerate this crap in America is absolutely bewildering.

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