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Comment by acaloiar | Hacker News Reader

The uninsured. The underinsured. People on the "wrong" insurance plan. People without the budget slack for $100s or $1000s per month for the medication they need. Poor people who don't bother going to the doctor to get needed prescriptions because they can't afford the initial visit. Rich people whose doctors fail to mention the drug that costs $250k because no past patients cleared for it could afford it. People going to the doctor who gets financial kickbacks from the inferior drug's drugmaker. People prescribed drugs that kill them.

If your question was actually serious, this is a non-exhaustive list.

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When the GP said "basic medicines", they probably meant all the generic stuff that can be had without insurance for a few dollars; all the stuff that is on the WHO list of essential medicines[0], that is.

I'd venture that drugs that cost hundreds of dollars or more per month in the US are all cutting-edge stuff. I mean, sure, you have stories of people getting charged $10 for a pill of acetaminophen at a hospital, but that's a separate matter unrelated to the fact that you can get a bottle of 500 pills for single-digit dollars at your local Walmart.

> The uninsured. The underinsured. People on the "wrong" insurance plan.

Plenty to criticize about the US healthcare system, but let's remember that countries with nationalized medical care also suffer from their own ills, mainly in the form of long wait times. Ultimately, no place has enough doctors per capita that every sick person can be treated promptly and cheaply; so care must be gated one way or another. In America, you pay with money; in most other countries, you pay with time.

[0]: https://iris.who.int/bitstream/handle/10665/371090/WHO-MHP-H...

The WHO list of essential medicines is not just over-the-counter drugs. It includes things like the chemotherapy drug cisplatin. I happened to need that for testicular cancer ~10 years ago, and the treatment cost was $50k (as "payed" by insurance). That overall seems pretty reasonable to me for the treatment I received, but definitely not something I'd expect the median American to be able to pay out of pocket.

The median American would not have to pay out of pocket, as nearly every American has health insurance (since the ACA, it is actually illegal not to have insurance).

I think it's accurate to say that the median American is insured, with only 8% of the population uninsured [1]. Although, to put that percentage in perspective, that's 26 million people and likely thousands in excess mortality relative to the insured poplulation.

I believe you're referring to the ACA's "individual mandate", which imposed a federal tax penalty for being uninsured. I won't argue whether that makes it illegal or not, but I can say that the individual madate was eliminated by the Tax Cuts and Jobs Act in 2019 [1]. There's no longer a federal tax penality for being uninsured.

[1] https://www.census.gov/library/visualizations/interactive/pe...

[2] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5944881/

This is purely anecdotal, but of that 8% (26 million), I would posit that most of those people are uninsured by choice. e.g., probably mostly young, maybe part-time workers without chronic illnesses.

I find it amusing that people are basically advocating for the government to become every citizen's Medical Daddy (the GP of this comment) backed by the threat of state violence in a thread that is ostensibly about freedom from the security state.

My question is serious. The US Government spends $2 trillion per year for health care for the poor and the elderly, and also spends a significant amount for for tax credits for health insurance for those that are neither poor or elderly. Furthermore, hospitals always treat regardless of the ability to pay.

How many more $ trillions and how many fascist medical bureaucracies would achieve your ends comrade?

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