Americans Are Going Bankrupt from Getting Sick • Hacker News Board

Re: Americans Are Going Bankrupt from Getting Sick

#101

Post by bb88 » Sat, Mar 16, 2019, 9:40 PM UTC

lordnacho wrote: post #56

I remember when I heard about my uncle passing away in America. He had the symptoms this lady had. For some reason he didn't go to the doctor, and it really puzzled me. At the time I'd put it down to inherited stubbornness, because my dad had had the same thing happen as well and would only go to the hospital because I forced him to. Now I'm wondering whether my uncle was simply scared of the bill. I found out he'd t…

> Is it common for blue collar workers to be without health insurance in the US?

Yes. More so now than in the 1980's say. Collective bargaining doesn't really work when a company can just move a factory to Mexico.

There's cobra which covers the health insurance gap up to 18 months, but you have to pay the company's rate, not the discounted rate. The downside of it is that it can be rather expensive, and so unemployed people will often forego it.

Re: Americans Are Going Bankrupt from Getting Sick

#102

Post by archagon » Sat, Mar 16, 2019, 9:43 PM UTC

badpun wrote: post #57

tapland wrote: post #5

Don't fall for the 'yes, but countries that have cheap healthcare pay for it with taxes'. The US pays more than most from taxes[0]. In Sweden we pay less per capita than americans do (from taxes) and my total _maximum_ healthcare costs for _all_ treatments, medications, surgury etc, that in the US would be paid by your employer or yourself are: $125/year max for all visits and procedures [1] + $250/year max for all p…

If you make American-level software engineer salary in Sweden, your EFFECTIVE (not marginal, effective) tax rate is a freaking 55% - at least that’s the number given to me by a recruiter whi tried to bring me there. Also, you pay 25% VAT. I’m sorry, but that’s a bit outrageous.

I would gladly give up 70% of my salary to live in a comfortable and equitable society.

Re: Americans Are Going Bankrupt from Getting Sick

#103

Post by User23 » Sat, Mar 16, 2019, 9:44 PM UTC

Retra wrote: post #93

User23 wrote: post #54

Earlier quoted context omitted.

I support a variant of single payer healthcare too: you pay for your own healthcare out of pocket. All this requires is that wages be high enough and health care costs be controlled. If this sounds impossible, you should consider that it was how our system worked in the USA in living memory.

You then deny that health insurance is a reasonable way to plan for illness?

As currently implemented? Absolutely, it observably isn't. Why do we need middlemen preying on fear, confusion, and preventing any reasonable price discovery from occurring while driving an absolutely absurd inflation rate[1]. Please note those are monthly, not annual numbers, and some months alone hit 5%! Keeping costs down and wages up has plenty of other positive effects too.

[1] https://ycharts.com/indicators/us_health_care_inflation_rate

Re: Americans Are Going Bankrupt from Getting Sick

#104

Post by badpun » Sat, Mar 16, 2019, 9:48 PM UTC

archagon wrote: post #102

badpun wrote: post #57

Earlier quoted context omitted.

If you make American-level software engineer salary in Sweden, your EFFECTIVE (not marginal, effective) tax rate is a freaking 55% - at least that’s the number given to me by a recruiter whi tried to bring me there. Also, you pay 25% VAT. I’m sorry, but that’s a bit outrageous.

I would gladly give up 70% of my salary to live in a comfortable and equitable society.

As far equitable goes, Swedish elites are probably as dodgy as any other country's. For example, the IKEA is famously set up as a maze of international companies and non-profits (IIRC) to pay minimal taxes. Also, Nordea (largest bank by far in the Scandinavian region) was recently involved in money laundering and organized crime.

As for comfortable, stress free living, here's a fun fact about Sweden - the average length of a mortgage is over 100 years.

Re: Americans Are Going Bankrupt from Getting Sick

#105

Post by lumberingjack » Sat, Mar 16, 2019, 9:52 PM UTC

rayiner wrote: post #71

I think we should have universal healthcare, but I don’t know how I feel about the “medical bankruptcy” angle. It strikes a chord with the middle/upper middle class readers of the Atlantic because those people fear losing their financial status. But to me, protecting the financial status of middle class people seems like a particularly poor justification for universal health care. Why should the government use tax do…

Doctors charge way too much for their services. When's the last time you saw a doctor who was justifiably worried about money? They're all driving around in very nice vehicles, several houses, the best golf clubs you can buy,three months vacation to places most people only dream of. It's the same age old story your loved ones dying and all they care about is getting your last bit of gold for the treatment.

Re: Americans Are Going Bankrupt from Getting Sick

#106

Post by s_y_n_t_a_x » Sat, Mar 16, 2019, 9:54 PM UTC

cimmanom wrote: post #98

s_y_n_t_a_x wrote: post #77

Earlier quoted context omitted.

Most Americans have good healthcare through their employer. The premiums are reasonable, and the quality is great. Only if you're self employed or part time do you pay out of pocket, something you need to factor in when you make life decisions.

I think maybe you mean to qualify that as “most American software engineers?” Or maybe even “most Americans in white collar jobs”, although that’s not a universal, and the premiums and quality of care in many of those plans is absolute crap. Heck, even as a software engineer, my medical insurance is mediocre and a high-deductible plan costs more in premiums ON TOP OF what my employer pays than I’d spend out of pocket…

In 2017, 91.2% of people have coverage, 67.2% through their employer. 71% of Americans answered they are satisfied with their employer-provided coverage.

Anecdotally, I'm satisfied with my coverage.

https://www.ahip.org/majority-of-americans-satisfied-with-th...

https://www.census.gov/library/publications/2018/demo/p60-26...

Re: Americans Are Going Bankrupt from Getting Sick

#107

Post by bb88 » Sat, Mar 16, 2019, 10:04 PM UTC

morningmoon wrote: post #76

- 65% of Americans don't save, despite most having the ability to do so. 1 in 3 have less than $5,000 saved for retirement! It's a massive cultural problem. [1] - Most Americans live unhealthy lifestyles that contribute to $1.5 trillion in estimated healthcare costs from preventable disease. 1 in 3 Americans have pre-diabetes and 2 in 3 Americans are overweight. 1 in 3 Americans are obese. Again, a cultural problem.…

Your post [1] discusses that half of those questioned can't afford to save money. It's not a cultural problem as much as it is an economic problem.

The adjusted median income really hasn't grown in the last couple of decades. And only recently got back to the rate in the 1990's. [3]

[3]: https://fred.stlouisfed.org/series/MEHOINUSA672N

Re: Americans Are Going Bankrupt from Getting Sick

#108

Post by bb88 » Sat, Mar 16, 2019, 10:41 PM UTC

lisper wrote: post #86

yongjik wrote: post #72

Earlier quoted context omitted.

While that's true, that's also true for all other countries where hospitals don't bill you $2,600 for glue and five minutes. So now the question merely shifts to why America needs that much money for stocking supplies and keeping doctors sitting at hospital.

Good point. There are three additional items that U.S. hospitals have to pay for that non-US hospitals don't (or that they have to pay a lot more for): 1. Malpractice insurance 2. The overhead incurred by insurance companies and 3. The cost of serving uninsured patients who can't pay out of pocket. The third one is huge. US emergency rooms by law must treat serious conditions -- but only serious conditions -- whether…

So currently if you get sick, you "win" the sick lottery and get to pay for other people's illness as a result.

What's a fair rate for a cut that just needs skin glue and some antibiotics? $500? or is it more like $2600? Because it sounds like he's paying somewhere around a 5x multiplier just because 1) he got a cut and 2) he can pay it.

At some point that won't be sustainable, and emergency rooms will shut down from the cost. People will just stop going to emergency rooms if it means getting a bill for 5x for what it should cost.

Re: Americans Are Going Bankrupt from Getting Sick

#109

Post by cam_l » Sat, Mar 16, 2019, 11:00 PM UTC

nosianu wrote: post #91

morningmoon wrote: post #76

- 65% of Americans don't save, despite most having the ability to do so. 1 in 3 have less than $5,000 saved for retirement! It's a massive cultural problem. [1] - Most Americans live unhealthy lifestyles that contribute to $1.5 trillion in estimated healthcare costs from preventable disease. 1 in 3 Americans have pre-diabetes and 2 in 3 Americans are overweight. 1 in 3 Americans are obese. Again, a cultural problem.…

2nd reply, for some reason HN refuses to accept my edit of the 1st one where I appended this, although it still lets me open the "Edit" option even when I reload. As for your second point, I have a similar argument to make as in my first reply about your fist point about "saving". Unless you think that suddenly, within the last fifty years somehow humans especially in the US were born radically different than any hum…

You have touched on what i think is the critical underlying difference between Left and Right thinking.

Systemic responsibility vs personal responsibility.

The thing is, they are not mutually exclusive. They are more like two sides of the same coin. And while those two sides may not be exactly equal, most arguments between the sides seem to centre on the disjunct between these two ways of thinking.

If you can acknowledge, but frame the very real issue of personal responsibility within the context of a system, we may find it easier to bridge this divide.

For example, judge the responsibility of three hypothetical people with a sweet tooth.

1. Tries to eat healthy, but goes out to buy a cake every day.

2. Tries to eat healthy, but friend brings around cake every day to tempt.

3. Tries to eat healthy, but friend brings around cake everyday, and empties pantry of all other healthy food.

Most people will waver on 2. or 3. But depending on where you live, 3. may well be the closest to reality.

Re: Americans Are Going Bankrupt from Getting Sick

#110

Post by dabbledash » Sat, Mar 16, 2019, 11:19 PM UTC

s_y_n_t_a_x wrote: post #106

cimmanom wrote: post #98

Earlier quoted context omitted.

I think maybe you mean to qualify that as “most American software engineers?” Or maybe even “most Americans in white collar jobs”, although that’s not a universal, and the premiums and quality of care in many of those plans is absolute crap. Heck, even as a software engineer, my medical insurance is mediocre and a high-deductible plan costs more in premiums ON TOP OF what my employer pays than I’d spend out of pocket…

In 2017, 91.2% of people have coverage, 67.2% through their employer. 71% of Americans answered they are satisfied with their employer-provided coverage. Anecdotally, I'm satisfied with my coverage. https://www.ahip.org/majority-of-americans-satisfied-with-th... https://www.census.gov/library/publications/2018/demo/p60-26...

I have “excellent” coverage in the US and am now pregnant with my second baby. My first pregnancy and birth ended up costing thousands of dollars. During pregnancy, I received an endless stream of unpredictable lab test bills (why does this test cost $13 and this one costs $273?). After the birth itself, every provider who saw me in the hospital sent me a separate bill, on top of which I was billed for the room itself and for the individual drugs.

Almost any other system would be better than this. If it were out of pocket there would at least be downward pressure on prices and clearer pricing in the first place. Or we could provide it as a public service like every other developed country.