> There is public health care in US. Medicare for old people, Medicaid for poor people, and anyone without insurance can go to the ER. It may not be great, but it does exist.

There is some public healthcare but no universal healthcare.

ER is not healthcare. You do not get treatment for chronic diseases, cancer etc. ER only treats you for the life or health threatening consequences of not getting treatment.

For cancer, yes. For chronic diseases that can treated with a pill like heart disease and diabetes, they will prescribe the pills. People should use the word universal if that is what they mean.

Most people outside US when they say public healthcare they mean what's known in US as universal one.

This seems like a pedantic point. The US AFAIK is the only healthcare system that is as dysfunctional as it is in the first world.

While traveling outside the US, I have found many people think Americans are cold and heartless and just let people die. It is an understandable conclusion the way people talk about the US system in the media and internet, but it also isn't true. The US has dysfunctional, public healthcare but it isn't so dysfunctional that you just die if you fall or get an ear infection without insurance. So saying the US has "no public health care" is not only incorrect but it is also overly dramatic.

But you are fucked with a huge bill that would cripple your life in a way that you might as well be dead.

And folks do skip going to the doctor, ration their medicines, and other such things.

Folks suffer until things are an emergency as well and hospitals won't always help if you, say, need surgery for cancer that isn't presently killing you and isn't an emergency.

Yes, it is dysfunctional. No one is arguing otherwise.

The government reimburses hospitals for ER visits if the patient can't pay.

Hospital will gladly send you to collections and fuck your credit, though.

Citation? Genuinely curious.

The source is my wife who is a clinical pharmacist at a large hospital which has a sizable uninsured patient population. Here is the first result on Google which does talk a little about federal funding for "uncompensated care" [1] starting near the halfway point.

My wife's hospital was hit hard by ACA because it reduced federal funding for uncompensated care. The idea was that the funding could be cut because more people overall would be insured. Unfortunately enough of their patients still are without insurance that the funding shortage led to two rounds of layoffs. They seem to have adjusted to the new financial reality now and are hiring again. But the first couple years after ACA passed were tough.

I guess it would be more accurate to say that the federal government funds uninsured ER visits, but the funding falls short of what is necessary especially after ACA.

1. https://www.usatoday.com/story/news/politics/2017/07/03/who-...

But there are people who choose to die rather than risk bankrupting their family with uncontrollable medical costs.

So there's plenty of drama. Medical bankruptcy in particular is something that I don't think occurs anywhere else.

> So there's plenty of drama. Medical bankruptcy in particular is something that I don't think occurs anywhere else.

I doubt the veracity of this oft-repeated meme, but I'll let Snopes provide the detailed analysis: https://www.snopes.com/fact-check/643000-bankruptcies-in-the...

I would appreciate similarly-detailed evidence to the contrary.

The summary of that Snopes article is that while medical bankruptcy in the US is indeed far more common than anywhere else, it's not entirely unheard of outside the US. Not all medical expenses are always covered, and disability can always lead to financial difficulties anywhere. Though medical bankruptcy is still significantly less common; in the US it's the leading cause of personal bankruptcies, in other countries it's a lesser cause.

This paper from the American Journal of Public Health says ~530k/year.

http://sci-hub.tw/https://doi.org/10.2105/AJPH.2018.304901

What's more, Medicaid costs about as much per American citizen as the NHS costs per British citizen. The only difference is that NHS also covers all those British citizens, whereas Medicare only covers a small group.

So Americans are already paying for socialised health care, they're just not receiving it.