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No One Goes There Anymore

noonegoesthereanymore.blogspot.com

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Re: No One Goes There Anymore

#291
post #50

A little investigation led me to https://doreenmichele.blogspot.com/p/me.html The disease appears to be ACF - Atypical Cystic Fibrosis

Now I'm more confused. Why do people "react weirdly" or "strongly" or think she's "some kind of drama queen" when she gives that name? I'm pretty sure my reaction would be to think "I have no idea what that is" and just move on.

[deleted]

Re: No One Goes There Anymore

#292

Earlier quoted context omitted.

To add my own anecdote about US healthcare, I needed a hernia repair surgery in my early 20’s. My dr referred me to a specialist, I asked if he was in network for my insurance and everything seemed good. But in what I have since come to realize is a quintessential US healthcare experience, it turns out the facility that this independent surgeon used and the anesthesiologist were not in network. Nobody bothered to tel…

My dad’s been a chronic diabetic for 25 years, and we’ve never had a large surprise medical bill. Even among people who file for bankruptcy, most have little medical debt: https://www.forbes.com/sites/aparnamathur/2018/04/09/exposin... > Department of Justice did a similar survey of bankruptcy filers between 2000 and 2002, which included a much larger sample of 5,203 filers, and found that 90 percent of filers had me…

Would statistics on medical debt be skewed by a society that has potentially grown accustomed to turning away medical aid for fear of the financial fallout?

Re: No One Goes There Anymore

#293

Earlier quoted context omitted.

A high-tech worker living in SF is actually not “one of the best case scenarios.” As your calculations show, the insane cost of living blows out the somewhat higher income. In terms of actual prosperity, run the numbers for places like Iowa. Salaries are 1/2 as much in Des Moines than San Francisco, but a house costs about 1/8th as much. And 95% of people have health insurance. There is a reason people are actually f…

And someone not living in Berlin can live significantly cheaper too - do you want to pick a city similar to Des Moines in Germany? EDIT: I took your number of 1/2 as truth, went through the numbers, and... our worker in Des Moines makes about 5k a year more than the one in Berlin. It'd still take 12 years to pay off the person above's unexpected medical expenses. Then, after running the numbers for a high-tech worker…

> I took your number of 1/2 as truth, went through the numbers, and... our worker in Des Moines makes about 5k a year more than the one in Berlin. It'd still take 12 years to pay off the person above's unexpected medical expenses.

That's probably quite accurate. But most people don't have a $60,000 unexpected health expenditure before they're eligible for Medicare at 65. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5865642/

> We calculated this estimate as follows: the graph shows that, on average, a hospitalization increases the annual probability of going bankrupt in the following 4 years by 0.004. Multiplying this figure by the annual hospitalization rate of 7.8% for our population (which we calculated using the 1999–2010 Medical Expenditure Panel Survey) reveals that 0.031% (0.004 × 7.8%) of the population goes bankrupt each year as the result of a hospitalization.

If you extrapolate this out over the 40-year period covered in the study (it covers people ages 25-65) there is just a 1.2% chance that you'll go bankrupt as a result of medical debt in your working lifetime. In a country of 205 million working-age adults, that amounts to 2-3 million people. That's why you see so many news stories about it. But the odds of it actually happening to you are fairly low. Meanwhile, the higher taxes from universal healthcare are something that affect 100% of people.

If you ask people "would you rather make $5,000 more per year, or have a 1.2% chance that sometime in your working life, you'll have to declare bankruptcy due to exorbitant medical bills?" You can't say it's an irrational choice if people choose to have more money in their pocket now.

> The definition of "health insurance" in the US is weird - it doesn't actually seem to mean you're going to be able to be able to access either expected or unexpected healthcare needs at a price you can afford.

And what are you basing this on? I've got a wife and two kids. We've need to rely on our health insurance for everything from a car accident that almost resulted in a pre-term birth, to child births. The system is chaotic and confusing, but as long as you're on top of the paperwork the coverage is usually very good. According to Gallup polling, people have negative views of the healthcare system as a whole, but most rate their own coverage as good or excellent (69%) and their own healthcare service quality as good or excellent (80%): https://news.gallup.com/poll/245195/americans-rate-healthcar....

Re: No One Goes There Anymore

#294

Earlier quoted context omitted.

My dad’s been a chronic diabetic for 25 years, and we’ve never had a large surprise medical bill. Even among people who file for bankruptcy, most have little medical debt: https://www.forbes.com/sites/aparnamathur/2018/04/09/exposin... > Department of Justice did a similar survey of bankruptcy filers between 2000 and 2002, which included a much larger sample of 5,203 filers, and found that 90 percent of filers had me…

Would statistics on medical debt be skewed by a society that has potentially grown accustomed to turning away medical aid for fear of the financial fallout?

Maybe, but are there statistics to support that? People point to things like the U.S. lagging on indicators like maternal and infant mortality, and life expectancy. But if you dig into the data, non-white Hispanics (which have a 20% uninsured rate) have similar maternal and infant mortality to whites (which have only a 5% uninsured rate). And hispanics have significantly longer life expectancy. American hispanics, despite widespread lack of insurance, live as long as people in Denmark or Sweden, who have comprehensive universal health care. Moreover, Asian Americans, which have a slightly higher uninsured rate than whites, live the longest of any people anywhere in the world. They live 2-3 years longer than people in Hong Kong or Japan. (And trust me, there is no secret health system for us Asians. We have the same shitty UHC or Cigna insurance everyone else does.)

There is a lot of rhetoric in this area, but few firm conclusions to be drawn.

Re: No One Goes There Anymore

#295

Earlier quoted context omitted.

"They aren't assuming anything. They know that healthcare in the US is hit-or-miss, that it is normally for people to move between having and not having healthcare throughout a lifetime." That's a general complaint that has nothing to do with insurance being a cost you pay out of your take-home salary in the US. Your anecdote seemed to be predicated on an accounting difference between the US and Canada, that the Chin…

I never said my friend had a job. Part of the problem, in the US, is the link between employment and insurance. My friend earned reasonable money as a moderately-sucessful artist but did not have an employer. In the US that would mean paying out of pocket. In canada he didn't have to pay a dime.

Well, if I was the Chinese government, it sure wouldn't make sense to me to let him adopt in either country regardless.

Re: No One Goes There Anymore

#296

Earlier quoted context omitted.

Nation-sized leverage. The same reason why equivalent pharmaceuticals are cheaper elsewhere in the world.

Nation-sized leverage? Piffle. Pass a law that Big Pharma can't price higher in the US than the lowest price negotiated elsewhere. Boom, problem solved.

That's the problem... The political conditions that preclude passage of such a law.

Re: No One Goes There Anymore

#297
post #284
post #184

Earlier quoted context omitted.

I don't buy it, due to first-hand & second-hand experiences of friends and relatives I have in the US. Let me give you one example: my friend(and at the time business partner)'s wife got cancer in the US. It was fairly "mundane"/common cancer that got treated and everything was alright at the end. He was working as a software developer (normal employee, not self-employed - our venture was a side project) with the afo…

I thought everything is covered after you got your total out of pocket expense (~$6k IIRC) in the traditional PPO healthcare plan? How did your friend get hit with $65k?? Out of network doctors/hospital?

I have no idea, I didn't dig in as it seemed a touchy subject. But I have heard similar anecdotes from other Americans.

Re: No One Goes There Anymore

#298
post #287
post #230

Earlier quoted context omitted.

Not sure what you put in to get that number (keep in mind that $100k is roughly €92k) but there are many possible variables that can change your tax rate. In my personal case it is significantly lower than the number I posted above. I used mostly default values in the first online calculators I found for both California & Germany in the example in my original post.

Just from personal experience: 42% is pretty much on the dot. It might be that with 92k you're still taxed in a lower class (or maybe you're married and thus getting a discount).

Yes, I chose the wrong tax class by mistake.

My personal tax rate is even lower than that as we have 2 kids & my wife and I file together (both self employed so we add up our incomes and file with all tax bracket at double the threshold). I think we ended up paying just over 15% off the top of my head but don't quote me on that (I earn less than €92k but still enough to have a very comfortable life).

I knew you pay more as a single/childless person but I didn't realize just how much more - which makes it all the more surprising that Germans have such a low rate of both marriage and reproduction.

Re: No One Goes There Anymore

#299

Earlier quoted context omitted.

And someone not living in Berlin can live significantly cheaper too - do you want to pick a city similar to Des Moines in Germany? EDIT: I took your number of 1/2 as truth, went through the numbers, and... our worker in Des Moines makes about 5k a year more than the one in Berlin. It'd still take 12 years to pay off the person above's unexpected medical expenses. Then, after running the numbers for a high-tech worker…

> I took your number of 1/2 as truth, went through the numbers, and... our worker in Des Moines makes about 5k a year more than the one in Berlin. It'd still take 12 years to pay off the person above's unexpected medical expenses. That's probably quite accurate. But most people don't have a $60,000 unexpected health expenditure before they're eligible for Medicare at 65. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5…

I'm sure that as you say it works out for most people on a purely rational game-theory economic sense but I would definitely chose 100% coverage over an extra $5k/year.

The whole system (not just health care) seems so stressful and antagonistic in the US.

If I had an extra $5k/year I'd probably just spend it on meaningless consumption like a bigger TV or a better car, where as not having to give a second thought about costs for medical care or higher education for my kids gives me so much more peace of mind.

Also keep in mind that not everybody has their proverbial shit together. You have to be resilient and make a lot of right life choices or you can fall into a pretty deep hole. The "paternalistic" approach of welfare states like in central & northern Europe means that as long as you basically "follow the rules" (like not breaking the law & having/keeping just about any job/career, even working-class ones) you're going to have a decent life, at least materially.

Re: No One Goes There Anymore

#300
post #184

Earlier quoted context omitted.

I worked at an international company where we frequently had employees from other countries visit the US for a while. Some even chose to relocate to the US. These were almost all technical people, raised on the Internet, social media, and discussions in comment sections. It was fascinating to see how bad they expected America to be according to Internet comments and news articles. Many of them were shocked to realize…

I don't buy it, due to first-hand & second-hand experiences of friends and relatives I have in the US. Let me give you one example: my friend(and at the time business partner)'s wife got cancer in the US. It was fairly "mundane"/common cancer that got treated and everything was alright at the end. He was working as a software developer (normal employee, not self-employed - our venture was a side project) with the afo…

I don't buy your story either. Extraordinary claims require extraordinary proof.
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