Between my employer and myself, we pay $1806 a month for my family of 3. My employer has 3000 employees, so it isn't a weird situation with poor purchasing power.
Insurance is expensive.
And it's wrong to call this insurance. It's not insurance, it's a health care payment plan.
Before ACA I was paying 1/3 the price, and had 1/4 the deductible. These higher rates are basically a tax to subsidize others, which is fine in principle, I just don't like the idea that this is going largely to a massive for-profit private bureaucracy. My problem with ACA is the private insurance industry is shit, and ACA made the expansion of shit mandatory. It should have been single payer, destroy the perversion that is the private insurance industry who have lobbied for all the anti-competitive behaviors they engage in to ensure near monopoly status in the vast majority of counties in the country. But the political capital just wasn't there to see how treacherous the insurance industry has been.
I don't see how the next round of politicians actually fix this though. Preexisting conditions are made feasible by mandates, mandates are made feasible with subsidies, subsidies are made feasible by some people paying more under mandate. So you can't take away any single one of those without the whole system unraveling entirely. Even the insurance companies have said this. They just don't want to say it loud enough that the blowhard in chief gives them a tweetirade.
The US is the only modern country without cost controls. Providers set prices and insurance companies do little other than pass those costs onto consumers.
When will we get cost controls? Likely never. It's very anti-capitalism to restrain free trade. (Yes, there's some sarcasm there. This issue pisses me off.)
Until we treat healthcare like we treat our regional monopolies (electricity, education, etc.) the the government won't be able to set prices lower.
This is what we need in the US. I should not pay a different price if I have insurance or pay cash. People that pay cash are routinely charged far more than people with insurance.
Secondly, hospitals charge people with insurance more. Typically if a patient is uninsured and paying cash, the hospital will work out ways to charge them less, because they are personally liable for way more than what insured are. Hospitals still want to get paid, and charging a patient into bankruptcy is not a way to achieve that.
Haha fat chance. But there is the subsidy.
One of the reasons that the ACA is broken from a financial point of view is that the Democrats didn't want to simply raise general taxes and redistribute to fund the program. Instead they played all sorts of games with the 'individual mandate' to try to force participation without 'raising taxes'. But this is just a way for healthy individuals to avoid participating in the insurance pool -- which is a great way to destroy the actuarial basis of insurance.
It is entirely possible to be for nationalized health care and still think the ACA is structurally unsound and needs to be replaced.
That colonoscopy was $6000, btw. This, for preventative care that could save hundreds of thousands of dollars from colon cancer (and quite possibly my life) down the road. In a well designed system, price controls would put preventative care like colonoscopies below actual cost (and make the money up elsewhere), to save money at the macro level.
On the assumption you're making ... $100K a year, this is 20% of your income.
Hard to imagine how it could be done less efficiently. Of course, the issue is then going to be "Say we reduce costs to even 5% of income", "think of the physicians/hospitals/etc"...
In the USA, income tax is a marginal rate, while Social Security and Medicare taxes are fixed rate (and therefore regressive).
"Medicare gives Australian residents access to health care. It is partly funded by taxpayers who pay a Medicare levy of 2% of their taxable income.
Your Medicare levy is reduced if your taxable income is below a certain threshold. In some cases you may not have to pay the levy at all.
If you don’t have private hospital health insurance, you may have to pay the Medicare levy surcharge (MLS) in addition to the Medicare levy. This depends on your income for MLS purposes."
If anything happened you'd be in the emergency room and would either pay outrageous amounts magnitudes more than $460/mo, or declare bankruptcy making your hospital debt a burden for everyone else.
Of course, choosing to accept work for 80% under market rate in a place where the high market rate for labor drives high cost of living is going to have short-term negative economic consequences.
If you're self employed and make over $50,000 a year no matter where in California you live, you'll have to pay full retail premium prices without any discount. My company as a whole makes over 50k a year, but less than 100k a year (still getting off the ground). Thus a monthly premium of $460 a month for a standard decent PPO plan puts a large burden on me. Additionally, if I don't get health coverage I'll have to pay a heavy tax penalty at the end of the year. Essentially as a bootstrapped small business owner, health insurance is a large burden of cost and I was forgotten in the Affordable Care Act. Instead my cost to purchase a plan skyrocketed as I subsidy other people's care. That is not fair, everybody is not paying their fair share. Middle class self employed are the one's who got hurt the most.
Finally go compare CoveredCA.com and then go use https://www.blueshieldca.com. CoveredCA literally is one of the worst designed and functioning apps I've ever seen. It constantly errors and doesn't keep state that I am logged in. The UI/UX is terrible. I'm guessing CoveredCA was outsourced to a non-technically competent contractor overseas. Compare that to BlueOfCalifornia which is a great site, beautifully designed, and functions as it should. This is why government can't have nice things.
[1] - https://news.ycombinator.com/item?id=13353755