~£250/per person/per month. Which is $330. Or $350 adjusted for inflation since 2017.
That covers everything: emergency room, ambulances, giving birth, cancer treatment. Everything: no copays (except very small ones (<£10) for prescription medicines). And it covers the entire population.
* Except dentistry. For some reason that is separate.
[0]: https://www.ons.gov.uk/peoplepopulationandcommunity/healthan....
That's why Medicare/Medicaid is cheaper per person even though they serve the poor and elderly.
It might seem expensive and wasteful, but it might be better than the status quo.
A few years later, there was a budget crisis and the government cut the pension to a fraction of what was agreed on. But the ex-samurai were too demobilized to overthrow it by then.
We could also drag the obstructionist leeches into the capital and roast them like Jim gaffigan just roasted Karen.
When someone's abusing an entire country you don't pay them to stop, you throw them in jail. People are dying are dying by the truckload and we care about
If you work for a large company it’s pretty much the same thing. Your employer brings a risk pool and then a private insurance company like Cigna quotes for how much it takes to “fill” it while taking their vig.
I would expect the same under M4A: 5 really big insurance companies would continue to cost-plus bill the Feds, and then maybe there would still be a few re-insurance companies to cover stuff M4A doesn’t cover.
In going through her things after she died, I found letters to her bosses about how well she'd treated the plumbers, electricians, etc. I know she would take work home and do it off the clock.
What was really unfortunate, for me, is believing that her job shouldn't exist. To me it's crazy the expenses we have a universal healthcare system.
Of course, that also applies to avoiding taxes, etc. There was an attorney interviewed on a recent podcast about tariffs - he specialized in finding things like shipping bikes from China without tires and the tires from Vietnam would be much less in tariffs than just shipping from China.
Do you have numbers to back this up? I'm not saying you're wrong, but my mom worked for a GP for ~20 years (recently retired) and listening to her talk about it this was not true for her employer at all. She said that in many cases the private insurer paid less, and on top of that required more back and forth to get claims addressed.
I'm not trying to be an ass, just trying to point out that many, many sources all say the same thing.
what do all these people do in the UK, Scandinavia and other countries with single-payer health care?
Eventually, they would join other parts of the economy in the US, but in the short term, the unemployment rate would spike and the economy in general would suffer.
[1] https://www.cepr.net/documents/publications/small-business-2... [2] https://www.nationmaster.com/country-info/stats/Education/Se...
And if an administration managed to get this through in the beginning of their first term, they'd never get re-elected, and most of the Congresspeople who supported it would be out as well. The next group voted in would dismantle it and put things back the way they were.
Any plan to dismantle the US private insurance industry will need to ensure a very soft, cushy landing for the people employed in that industry, or it'll never work.
The US healthcare system is a Rube Goldberg machine.
+£2,033 paid per month
-£ 149 national insurance (healthcare, welfare, etc.)
-£ 198 income tax
=£1,686 take home pay (=$2,224)
+$4,148 paid per month
-$ 317 social security
-$ 357 federal tax
=$3,474 take home pay
$1250 per month should go a fair way to covering health insurance premium, deductible, co-pays & drugs (these are all £0 in scotland)
The real difference, of course, is that taxes will ensure you're covered even if you're low income.
[1]: https://www.marketwatch.com/story/1-in-5-americans-get-hit-w...
For example, Canadians going to https://surgerycenterok.com/
Here is another fact. The above has had transparency in prices since it was founded in 1990
Guess what also has not changed: the price that they charge for every single procedure since they were founded. In fact they technically charge less now because some procedures include additional services that were originally not part of the package.
So why is it that 1 clinic does not need to change pricing in 30 years, while everything else is increasing at 5-10% per year?
Hint: you dont have to throw away the baby with the bathwater. Its possible to have a system that is not going to bankrupt you and also at the same time not make you wait for 3 years for something you need today
Talking to low income folks, it's not the same as in other countries. They still have financial stress because of medical concerns.
Medicaid experience differs greatly depending on the state you're in. And how it compares with people who have the means to buy insurance also varies quite a bit.
There’s certainly variation in who can qualify, per State; some States are more generous than others. It’s debatable whether it makes sense to even consider the US as a whole, since it’s really a heterogenous collection of 50 self-governing sub-cultures. The Canadian healthcare system for eg is also provincial, with the Federal government providing minority financial support. It’s actually more Province-driven than Medicaid is State-driven, today.
Consumer goods made abroad are incredibly cheap in the US in comparison to the UK, but as a Brit living in the US I definitely relate to this observation I recently saw go by:
> As a friend of mine from abroad who lives here put you “you don’t really get that there’s a really high standard of living and nothing works“
Still lower, we're a poorer country, but it is quite a difference.
Also consider that everything isn't covered when your employer pays for your health insurance. Americans still have a lot of out-of-pocket costs.
And remember that there are a lot of people who are unemployed or underemployed, or work under arrangements that don't provide them health insurance at all. They also probably make a bit less than the median salary. So sure, maybe 50+% of the US could afford their own health insurance, but is it ok there's some percentage, regardless of how small, that can't afford it and has to do without? I say no.
I have a doctor I see every 4 months. I mentioned to her that I thought my copay probably was about what she was actually making off my visit and she said, 'if that'.
She also said insurance companies are now doing things like not approving full scripts for insulin. And demanding that she prove a 50 year Type I diabetes patient still needs insulin.
It's just about the lowest per capita health expenditure in the developed world.
[1] https://knoema.com/atlas/Singapore/Health-expenditure-per-ca...
An annual primary care visit, cancer screening, vaccinations, and so on. So for example if you have medical need for a colonoscopy, it will be covered before the deductible has been met.
Would the reason be that British teeth are maintained like American waistlines?
This is largely explained by economic differences in the US. The poor have awful tooth health; the wealthy have very good tooth health. In the UK, the poor and wealthy are closer to the median.
https://www.cnn.com/2015/12/17/health/british-american-bad-t...
So I guess that the US is fatter, but the UK is still one of the fattest countries in the world. The BBC claims the UK is getting fatter faster than the US too.
https://www.bbc.com/news/uk-41953530
http://www.oecd.org/unitedkingdom/Health-at-a-Glance-2017-Ke...
Teeth are probably a myth. People see Americans on TV, of course they do extreme things to make them blindingly white.
Health insurance in the US is an untenable situation and I really just hope it explodes sooner rather than later.
The biggest issue, in my opinion, is how much of the cost is shielded by employer contributions that no one ever thinks about.
This makes it too easy for people with good employer-sponsored health insurance to scoff at and dismiss all the people who aren't in that situation.
When your employer is shouldering $20k in health insurance premiums without really telling you, it's easy to feel like the costs aren't a problem.
Yes and this makes it really suck if you happen to be a sole proprietor or self employed.
It's over $500 a month here to get insurance for a single adult for the absolute most basic insurance possible with the worst possible service you can expect.
I don't understand how society puts up with this. It's not that just the service is horrible and massively over priced but it's a torturous experience just to interact with anything related to medical insurance. Like having to wait 30 minutes on hold or spending weeks trying to resolve things, or spending a month trying to find a doctor who even takes your insurance, etc..
Suddenly instead of getting the best treatment plan for your issue, it becomes a game of trying to extort you for doing the minimum amount of work while making sure you pay as much as possible out of pocket while already paying for insurance.
And then on top of that, it's like btw, $500 / month please or you run the risk of being bankrupt if you step foot inside of a hospital for anything that's non-trivial.
When the cost of healthcare is visible, maybe then the majority who have employer provided insurance would then fight with the minority of us who use the marketplace, and shoulder the entire burden of the price.
Its horrible. I had one billing department lady in the US literally tell me when I complained about the exorbitant cost of a simple ER visit (in the thousands), "Well, how much is your life worth?" After the steam stopped coming out of my ears, I was able to come back with: if that's your position, then why stop at 5k? Why not charge 50k? Or 500k? Why not take everything I have or will ever have? She didn't respond, and just looked at me thoughtfully, as if I'd just given her a really good idea.
In Spain private healthcare is somewhat affordable, even full coverage plans, because everyone can walk away any moment.
AFAIK the situation is very similar in many other countries.
edit: I was incorrect, this is 80% of people get healthcare from their employer OR the government. Only 20% of people are responsible for paying for their healthcare separate from their employer (if they have one)
[1]: https://www.peoplespolicyproject.org/2018/07/30/mercatus-stu...
Relatedly, I like to joke that you can get a huge discount on delivering a pregnancy if you make sure you're on a European vacation when the baby comes due.
They'll come to you and super-apologetically explain that, well, you're not a citizen or permanent resident, so you haven't paid into the system and have to pay the full price of the medical services, which is sadly ... something like 500 USD. And then you laugh at how that's less than you'd pay with insurance in the US.
But if you have a partner, kids, and are a bit older then suddenly it can be quite expensive.
Health insurance is just a tax, with the premiums going towards paying for healthcare for the sick and elderly (in the US, people 55+).
ACA specifically capped health insurance premiums for the elderly as a multiple of a 21 year old’s premiums.
Otherwise health insurance premiums for 20 year olds would be $30 a month and $3000 a month for 60 year olds.
You cannot really judge a win w/o seeing what is/isnt covered, co-pays, deductibles, co-insurance, networks, and a variety of other factors.
Healthy people go in for annual visits and think "wow, this is great" not knowing what exception scenarios are like. Then people vote for politicians who uphold the status quo thinking everything is fine.
Keeps most things as-is, keeps people fighting over who gets to proxy-kill sick people and what the best way to screw each other for perceived personal gain is.
Edit: here on HN there was a comment from someone along the lines of "from the outside looking in, the USA looks like people fighting over who gets to punch babies and you're not allowed to not want to be on either side because that's taking a side as well".
That leaves care that doesn't get covered by insurance of course, but people aren't on the hook for 20% of the bill that insurance covers.
I think you're still on the hook for the full coinsurance amount if you're at a hospital and a doctor from out of your network happens to step in the room without telling you they're out of network.
Totally fair to always discuss the huge caveat of out of network providers getting involved without any opportunity to refuse their care alongside the out of pocket maximums for in-network services.
A few times a year I spend an hour on the phone arguing about coverage or an incorrect billing code.
This is all for peace of mind that if I get hit by a car or fall off my roof that I won't instantly be ruined by debt.
In the event of one of those accidents I fully expect to have to fight the company I pay over $10k a year to actually provide that "I'm broke but at least I'm not bankrupt" coverage.
Oh also, we need a separate plan to insure our teeth for some reason and most plans only cover $1500 a year. I needed to get my wisdom teeth out and ended up splitting it over two years so I didn't have to pay the full uninsured price.
Our "liberal" presidential candidate is painted as "radical" by the current president, and said "radical liberal" has said on multiple occasions that "people love their insurance"
I've considered trying to move to another country simply because of healthcare. I am immediately skeptical of anyone who thinks this is a reasonable system.
That doesn’t mean it wouldn’t be better than what we have now, but it’s disingenuous when people imply that all it takes is to change the “payer” and we’d magically fall in line with costs seen in Europe. The real issue is many-fold and in order to truly bring costs down its going to take a lot of sacrifices from the provider side as well. Most doctors, nurses, and others in the health care industry in Europe (and other places with single-payer systems) do not earn nearly as much as their counterparts in the U.S.
[0] https://www.commonwealthfund.org/publications/issue-briefs/2...