It's a pretty terrible market out there if you don't have an employer subsidizing it and using their size for negotiation leverage.
No, we can't. If we could, we would. Things are like this because we want them to be like this: it's reflected in how we vote. We've had candidates pushing for "Medicare for all", universal healthcare, etc., and who gets elected? The candidates promising to go the other direction. Clearly, American society and its voters do not want this.
Just because Universal Healthcare didn't catch on the first time doesn't mean it's dead forever.
It'll happen eventually. Maybe in 4 years, maybe in 40.
The poor person obviously cannot afford that bill so the provider eats it and the result is increasing costs for everyone else. So unless the solution is just to let the poor and their children die, providing everyone with access to health care would probably be a net benefit. Not to mention universal health care would provide for incredible bargaining power meaning drugs such as insulin would not cost an individual hundreds of dollars a month.
Everyone with new health insurance is not going to go all at once, I doubt there will be any significant increase in wait time to see a doctor. Finally, people are not units of exchange, they are people and poor or rich they deserve at least a shot at a decent life for them and their family and universal health care goes a long way towards providing that.
This is exactly what Americans like briandear want, and the political tug-of-war between people like him and people like you is much of why the US healthcare system is the mess that it is.
I'd say briandear proved my earlier point completely: Americans do not want anything like universal healthcare, and no, we really can't do better (by your definition of "better"). Too many Americans are like briandear for that to happen.
No, it just means that people who are rich can afford healthcare and those who aren’t can’t.
> It’s logical, but politically tough because those that generate little value outnumber those that produce high value — and those low value people vote.
Should they not?
In the minds of many Americans, yes. We even have many mega-churches here whose doctrine states that rich people are rich because God loves them more. This is why American Evangelical Christians overwhelmingly support Trump.
> an electrical engineer is more useful than an unemployed cashier.
And then we jumped into the Randian deep end. Peace, I'm out.
Maybe some poor don’t get the best care quickly
an electrical engineer is more useful than an unemployed cashier
low value people
It’s logical
I live in Canada as an immigrant, love it here, would never move, and USA health/insurance system frankly baffles me, even having lived there for a year previously. Don't even remotely understand why people put up with sheer complexity and opaqueness.
But I appreciate people like the GP [briandear] that eloquently and clearly help me understand alternative perspectives different to my own. I think it's a very valid, very core discussion of values and goals: is it equal care for all, or do we prioritize it? And I agree with GP [briandear] that shying away from this core discussion muddles the issue. Sometimes it feels like USA builds ever more complex systems to mask the goals and direction of its health care system, rather than a simple system that would fess up and do whatever it's meant to do efficiently :-/
All of that aside, it's impossible to know how much you're actually going to visit the doctor aside from chronic ailments.
don't know how it is in the US, so this may look uninformed, but are you getting extra $$$ added to your salary, equivalent to what the employer was paying for the insurance?
Typically people opt out of company insurance because of one of the following reasons: It's cheaper for them to find services through the marketplace (extremely uncommon, but possible), They have superior insurance through a spouse or family member, they feel that the insurance they're provided with isn't sufficient and they would prefer to purchase better insurance themselves.
Edit: My wife though pays more for her company insurance as they would need to insure me as well.
Personal commentary:
As someone from New Zealand, who moved to Canada, I still don't understand why people would want the responsibility of their employer and themselves to choose what health coverage they want in life, especially when employment tenure can be upended so easily.
Yes I know, USA has funky research and new drugs and whatever, but as a whole, it doesn't seem like a particularly efficient system. So if it's not efficient, what's its objective? For me it sounds like prioritising medical providers to extract the maximum amount of revenue from captive customers, in a scheme where all the prices are similar so it's not a monopoly, but none of them are cheap, so it's nearly like a cartel.
Citations: (1) https://en.wikipedia.org/wiki/List_of_countries_by_total_hea...
(2) https://en.wikipedia.org/wiki/List_of_countries_by_life_expe...
Health insurance is one of the strangest insurances - a single month costs more than a year or often at least 6 months of car insurance.
Honestly I wish someone would just be a whistleblower and reveal the profits and operating costs (claims) of an "expensive year" at a health insurance company. The government would likely have a price collusion case.
Now we’re paying from our paychecks, then paying again at the doctor, then getting billed, then waiting for the EOB from insurance, then taking hours a month to manually match up the EOBs with the bills to verify who to pay and how much. And then, MAYBE by the end of the year you reach your deductible and insurance starts actually paying.
They call this a benefit??
No they don't, they still have to follow relevant laws.
You have a point about universal healthcare, there's a few other things that could help in this situation though. In the EU I believe this would fall foul of anti discrimination laws (this affects only part time workers, part time works are more likely to be women). There are also protections against an employer unilaterally lowering peoples compensation.
These employees are now put into the ACA exchanges. They can shop for insurance there, and their premiums are capped at a certain percentage of their income. The feds cover the difference. Now these employees don't have to rely on their employer for health insurance.
This was the dream of the ACA. Employers would get out of the insurance game and send their employees into the exchanges. It didn't work it out that way in reality, but this is what that looks like.
Private companies also use accounting and sometimes do not look out for their employees.
This isn't to nitpick, I just think there are other parts of the problem, not just shareholder value.
Although, yes, there might be additional pressure from shareholders when a company's finances are public, I don't see how it could be the root of the problem when the same thing happens in private businesses.
Why are wages in Europe lower than the US, even after adjusted for health insurance expenses? Americans have far more disposable cash than Europe even when health insurance is considered. Why is that?
If those resources are not money, then the employee is really out of luck as they likely will not be able to afford whatever those alternatives are. In addition, there is no way you can take a bunch of people that work 20 hours per week and let them work 30, no need for that many scheduled hours, just fancy corporate communications.
Amazon has the right to do whatever they want to increase Shareholder value; however, shareholder value is the root of the modern trend of devaluing people and treating them as line items in an expense report. Many of these people likely have this job primarily for the health insurance it provides.
I think it is time for the US to switch to a universal healthcare system. Removing the responsibility of corporations to manage health care would free up a large amount of resources they could invest in expansions, wage increases (likely c-suite bonuses). In addition it would allow individuals, especially working parents to more freely make employment decisions and find careers that are both financially but also emotionally rewarding. I think it would have a major impact on the working structure of this country. Not to mention it would allow people to actually go to the doctor when they need to.