I'm not convinced on this point. Over 90% of Americans have health insurance[1]. Sure, insurance might not cover every dime of every bill, but I can't imagine falling ill is an instant and universal cause for financial ruin like people claim.
Disclaimer: I've been lucky enough to not have to use my health insurance for anything serious. But I have had to use other kinds of insurance (car, home) and by and large it's been fine. We hear horror stories a lot because they're sensational and they sell well, but people continue to buy insurance because it actually does provide value.
[1]https://www.census.gov/library/publications/2019/demo/p60-26...
Insurance isn't equal to insurance. The car insurances in the US are the most comfortable in the world. Something happens, you're covered, the insurance pays. Not so in other parts of the world. You drive out of the parking lot scratch another car? It's considered normal in the US. Not so in Germany. You scratch someones car by accident? Anything is possible now.
Why compare apples and bananas? I had a surgery in Taiwan and worked in Healthcare in a couple of countries. I also had health insurance when I was working in the US and got hit by a car while on a bike.
And while the insurance and the other drivers car insurance paid for most, man you sure have to be careful that someone can tell the emergency not to take you to the wrong hospital.
Let's stop pretending there isn't something seriously wrong with the US healthcare system. If all stars align everything is fine, but just an MRI can take anything from 1000 to 2000 or more dollars depending on whether you have insurance or not. You don't have to pay the 2000 dollars if you know better, but it's basically like a bazaar where you have to bargain if your insurance hasn't done so already.
Germany was at that point in the 1920s(or sometime around that) actually. I'm not a fan of Germanies healthcare system, especially since it's such a huge chunk of an already low income, but all the issues you describe about other countries are mostly non issues in Germany.
https://www.amjmed.com/article/S0002-9343(18)30509-6/fulltex...
Studies looking at out of pocket costs for insured people show much lower figures: https://healtheconomicsreview.biomedcentral.com/articles/10....
> The financial burden of cancer varies with the types and coverage of health insurance. An analysis of the 2010–2014 MarketScan data showed that an average patient with employer-provided plan had incurred about $7000–$11,000 OOP expenses over 4 years following diagnosis for a series of care that worths $100,000–$280,000.
Another report: https://www.forbes.com/sites/arleneweintraub/2017/08/10/even...
> More than one-third of cancer patients who carry insurance spend more out-of-pocket for their treatments than they anticipated having to pay. Among those who report being blindsided by the costs of their therapies, the median monthly out-of-pocket expenditure is $703.
Among the one third of people who report being surprised by out of pocket costs, the median payment is $703 per month, or about $8,500 annually. That’s a lot, and it can be surprising. But The median individual income for someone 45-55 is $80,000. That’s about 11% of income, or smaller than the difference in the tax wedge between the US and Sweden.
And to put that in context: out of the minority of people who get cancer, and the 1/3 of those people who report being surprised by out of pocket costs, the amount of out of pocket costs is about the same as what everyone with the median prime age US income would pay in extra taxes in Sweden every year even when healthy.
This is where my question stems from I suppose. How well insured is the average American? How often do people get stuck at out-of-network care and how much does that cost?
The study you linked is very interesting. My main takeaway is that the average loss after 2 years is 92k, which is significant.
It doesn't seem like they control for employment status? Cancer and cancer treatment can often mean people are unable to work. So, medical bills or not, I could see keeping up with your mortgage and expenses getting near that figure.
I am a much bigger believer in "the market" than most people. But the problem with the medical industry is that many / most things happen under serious time pressure.
The seriousness and imediatness of medical procedures means that competition and choice often do not get to play a role in your decision making. For many people in many circumstances, the MRI machine nearest them has a complete monopoly.
How do we bring the miraculous efficiency of the market to an industry where people often cannot make consenting and informed decisions? Its a very hard problem to solve.
There is also full car insurance in Germany: https://www.howtogermany.com/pages/vehicle-insurance.html
When I see the costs of an operation in America, they just do unnecessary operations, because they can earn extra money. When your argument is "most people won't go broke", that is a really fucked up statement.
Medicare ( that the current administration is trying to slash) is a partial fix for a very expensive and failed system.
The policy problem is that to adequately cover the lower-middle class you would need to substantially raise taxes on the upper-middle class, which pay anomalously low tax rates in the developed world. And the upper-middle class in the US quite enjoys their low tax rates. (While often focused on, the upper class often pays aggregate tax rates in places like California and New York that are more in line with Europe.)
All this fearmongering over such a rare occurrence is actively causing harm: https://www.washingtonpost.com/opinions/2019/10/11/lockdown-...
For literally nothing.
They are _avoidable_, that's why they are not overstated.
A school age child is nearly 200x more likely to die by suicide than from a school shooting. That's a tragedy. And that's _avoidable_. Which do you hear about more?
The attention and resources of society are limited. We would be better off allocating resources to bigger problems, but we don't. That's a tragedy.
The rest of the world doesn't have the school shooter problem.
It's fixable, and the fix is bleedingly obvious. There's no excuse.
Not that the US obsession with guns and lax gun control that enables school shootings is defensible.
Who knows who is right. But it’s ridiculously arrogant to say that the American position is not defensible. It was literally just a couple of generations ago when the US was air dropping rifles into France to support the Resistance. Even if we have now entered an age where ordinary people don’t need guns—that new age is younger than computers, supersonic flight, or television. Its far too soon to conclude that’s this is how the world will always be from here forward.
It's a crackpot idea to think that 'arming citizens' helps the whole. And the fact you think it's 'arrogant' to spell out a basic truth that the rest of the world understands is dumbfounding.
Crazy, I know.
> However, the magnitude of the bankruptcy effect is much smaller than previously thought: we estimate that hospitalizations cause only 4% of personal bankruptcies among nonelderly U.S. adults, which is an order of magnitude smaller than the previous estimates described above.
What I think would be helpful in the US is universal catastrophic insurance. Worst case scenario, you’re covered. If you want everyday health insurance, let people buy it or get covered if low income.
Many universal system use this type of coverage.
https://www.politifact.com/factchecks/2019/jan/31/jose-oliva...
https://www.commonwealthfund.org/press-release/2018/new-surv...
The median American household currently holds just $11,700 in savings. most people in usa would be ruined financially by a serious sickness where each day at the hospital alone could be up to $5000.
Those news stories about people being ruined, are in the news exactly BECAUSE they are unusual.
Do you go to a special doctors office for the top 5-10%? The one I go to is full of ordinary middle class people. 80% of Americans polled rate their healthcare as excellent or good: https://news.gallup.com/poll/245195/americans-rate-healthcar....
The American healthcare system isn’t hard to fix because it only works for 5-10% of people. It’s hard to fix because it works for 80% of people. Americans don’t irrationally cling to a system that’s bad for 90% of them. (Even among Democrats, a large fraction oppose getting rid of current health insurance: https://slate.com/business/2019/10/medicare-for-all-is-getti...)
Americans stick to the current system, because it works for most people. Most middle class people don’t go bankrupt when they get sick. And the middle class pays the lowest taxes in the developed world, because they don’t pay 20-30% payroll taxes like in European countries to support healthcare for the bottom quarter of earners. That’s the bargain people have voted for. That is obvious, because candidates who campaign for Swedish style healthcare don’t propose Swedish style taxes to go with it. Elizabeth Warren isn’t running on a top tax bracket that kicks in at $75,000 — she’s running on a wealth tax Sweden abandoned and corporate taxes higher than Sweden. Because Americans won’t vote for the bargain between healthcare coverage and middle class taxes that Swedes have adopted.
It’s not the system I’d prefer, I’d rather pay more taxes and make sure the bottom 25% have adequate healthcare. But the notion that everyone is actually irrational and the current system only benefits a small minority is self deception.