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Ask HN: Is USA that bad when it comes to health insurance, etc?

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Re: Ask HN: Is USA that bad when it comes to health insurance, etc?

#21

Post by beagle3 »

College degree is probably not too bad if you settle for local community college -- about $5,000/year or so. Private universities and colleges can easily get to $30,000/year.

As for healthcare, it IS that bad. Most working people have reasonable coverage (some of then even at reasonable price, as a percentage of income). However, it ties the worker to the employer. If you get fired, you lose your health insurance. If you quit, to move to another job, you lose your health insurance and have to get a new one (and at least until the recent healthcare laws, they didn't have to accept you -- sucks if something happens during your first job, because it's a "pre-existing condition" for the new one).

The end result is that employees are often held captive by their job because of the (essentially unrelated) health benefits. A friend of mine married 6 months earlier than planned to get coverage because she lost her own job.

Job mobility is much harmed.

There's COBRA -- an insurer must let you keep paying for one more year. However, the employer subsidy is gone, so people who pay $200/month all of a sudden find themselves having to pay $1200/month after quitting their job (or being fired).

Re: Ask HN: Is USA that bad when it comes to health insurance, etc?

#22

Post by Lewisham »

startupcomment wrote: post #19
Lewisham wrote: post #12

Even after all other factors that are mentioned already, the one significant difference I feel (having come to the US from the UK) is one of constant fear. Can I afford to go to the doctor with my co-pay? If something bad happens to me, will my insurance company look after me, or do whatever they can to ensure they don't pay out? If I get a terminal disease, will the co-pay for the medication I need to live as long a…

Many private health insurance policies feature annual out-of-pocket maximums (for deductibles, co-payments, etc.) so that you do not have a potential limitless liability for out-of-pocket cost-sharing during a given plan year - unless, of course, you happen to hit a lifetime limit on benefit coverage under the policy (another common feature - one that I believe the health insurance reform will phase out). Under the t…

This is another part of it: It's very difficult to compare health care in the same way you can compare, say, auto insurance. I've got a policy from my university, but it's still a significant document of legalese that doesn't easily explain what I am and am not entitled to.

It would have been nice if the health care reform created some sort of common labeling for policies that allows you to quickly scan your coverage. Or even some online "what if" simulator, where you can ask questions about what the policy will and will not cover (startup idea here?)

Re: Ask HN: Is USA that bad when it comes to health insurance, etc?

#23

Post by startupcomment »

Note to fellow HN readers in the U.S.: Please ensure that you have at least some basic health insurance even if you are self-employed or unemployed or you do not have access to health insurance through your employer. You should be able to find a relatively cheap policy if you are single and elect a high deductible. While the likelihood of a major medical illness is relatively low for healthy, young individuals, you never know when medical catastrophe can strike. I know couple of young individuals who were tragically diagnosed with cancer and did not have health insurance. You do not want to find yourself in such a position. Thank goodness Congress enacted health reform earlier this year. While the bill is not perfect, I personally am pleased that it includes a health insurance mandate.

Re: Ask HN: Is USA that bad when it comes to health insurance, etc?

#25

Post by akl »

aquila wrote: post #18
aquila wrote: post #16

Recomendation: Come check out Vienna Austria first. I am a "U.S. Citizen", "born in the USA", whose parents were also "born in the USA". I moved my family to Vienna, Austria 8 years ago. I have for 4 years, owned and operated my own business, a GmbH here. Vienna. The #1 city in the world 2 years in a row. http://www.mercer.com/qualityoflivingpr#City_Ranking_Tables First U.S. City, HONOLULU is at #31 with San Francisc…

I fully expect the Republicans to come into the majority in the November elections, and for McCain and Mitch McConnell to keep their shrill promise to gut the Obama healthcare law of its protections. And oh yes, I am a conservative republican.

I find your comment confusing. Do you believe they should be trying to gut the Obama healthcare laws?

Re: Ask HN: Is USA that bad when it comes to health insurance, etc?

#26

Post by all »

anamax wrote: post #15
all wrote: post #11

I used to be self-employed in the US and left in part because of the expense of health insurance. At the time, I had a family of three. When you declare yourself self-employed in the US, you are immediately projected into the highest tax bracket of (if memory serves correctly) 37.5%. Decent health insurance for three cost worked out to be around 40% of that at the time. So, to be self-employed with healthcare cost me…

> As for poverty in the US, 1 in 8 are in poverty if you use the CIA-polished statistics. I say CIA-polished because the CIA also says the US spends 12.5% of its GDP on healthcare. According to the OECD, it is more like 15.3%. By comparison, France (top healthcare in the world according to the WHO) spends around 9.5% or so. Note that US GDP is also significantly higher. Also, healthcare costs are affected by things t…

>Note that US GDP is also significantly higher.

Maybe I am missing something, but this should mean that the US can afford to do more. No?

>No, military spending doesn't account for the difference.

I didn't say anything about military spending. Where is that coming from?

Re: Ask HN: Is USA that bad when it comes to health insurance, etc?

#28

Post by xlorm »

stonemetal wrote: post #3

Health insurance costs me a little over 200 a month(pre income tax) to cover my family(full health, vision and dental). The homeless people thing is much harder to quantify. What do you mean by homeless people everywhere? I was 30 before I ever ran across anyone actually sleeping on the street. There are however homeless shelters were anyone can walk in off the street for a place to stay temporarily.

Where were you living before you were 30?

Re: Ask HN: Is USA that bad when it comes to health insurance, etc?

#29

Post by anamax »

all wrote: post #26
anamax wrote: post #15

Earlier quoted context omitted.

> As for poverty in the US, 1 in 8 are in poverty if you use the CIA-polished statistics. I say CIA-polished because the CIA also says the US spends 12.5% of its GDP on healthcare. According to the OECD, it is more like 15.3%. By comparison, France (top healthcare in the world according to the WHO) spends around 9.5% or so. Note that US GDP is also significantly higher. Also, healthcare costs are affected by things t…

>Note that US GDP is also significantly higher. Maybe I am missing something, but this should mean that the US can afford to do more. No? >No, military spending doesn't account for the difference. I didn't say anything about military spending. Where is that coming from?

> Maybe I am missing something, but this should mean that the US can afford to do more. No?

It implies that spending a larger fraction of GDP on healthcare can be acceptable, but you suggested that spending a larger fraction of gdp on healthcare was a bad thing.

So, what do you have in mind by "do more"? (Of course, being able to afford to do more and actually doing more are very different.)

> >No, military spending doesn't account for the difference.

> I didn't say anything about military spending. Where is that coming from?

"military spending" is the typical reply when someone points out that the US govt spends as much per person as "high tax, high service" countries yet doesn't provide the same level of services.

Spending money may be necessary, but it isn't sufficient.

Re: Ask HN: Is USA that bad when it comes to health insurance, etc?

#30

Post by rikthevik »

I've heard too many horror stories (and from people with supposedly good insurance) to consider moving from Canada to the States. Illness in the family is hard enough without a serious likelihood of bankruptcy. The Canadian system certainly has issues, but for the most part I think it works okay.

Can any other Canadians comment on their experiences? Are there any who would prefer American-style healthcare?

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