The fact that 27 million people (1) live in the US without health insurance alone is a big enough reason to know that that US system is not working. People should not die or go bankrupt due to not having insurance.
The current system might work for the rich and privileged but that is not good enough.
1. https://www.census.gov/library/publications/2019/demo/p60-26...
They aren't; they are expressly included in GPs coverage statistics.
That's 91-92% coverage of a country of 330 million.
91% of Americans have medical insurance, whether through their employers, or government programs like Medicare/Medicaid. That's compared to 95-97% in other developed countries because there are always some people who fall through cracks, like (say) a Canadian who doesn't get a new provincial health care card after moving, or a German who neglects to buy into a new sickness fund after changing careers. The only such systems with actual 100% (or as close to it as possible) coverage is something like the UK NHS, which does not have a requirement to show a membership card (because, well, there isn't one) to receive treatment.
PS - Obamacare did not greatly expand coverage. 85% of Americans had medical insurance pre-Obamacare.
There are things I'd certainly improve about the US system—decoupling primary healthcare coverage from employment, for one—but the way people online ~~lie~~ exaggerate it's not surprising that so many non-Americans believe that every American is one hangnail away from bankruptcy.
>People should not die or go bankrupt due to not having insurance.
Only 4% of US bankruptcies are because of medical bills (https://www.washingtonpost.com/blogs/post-partisan/wp/2018/0...). A tipoff that [insert large percentage here] of bankruptcies aren't actually because of medical costs is that only 6% of bankruptcies by those without health insurance are because of that cause. The biggest cause of bankruptcies is lack of income, which health insurance doesn't affect.
Listening to NPR and their ilk would lead you to believe anyone else is some ignorant simpleton (the word 'deplorable' comes to mind)
Fact Check:
Only 55.4% of all Americans and 58% of Americans under the age of 65 had employer-based health insurance in 2019.
https://www.census.gov/content/dam/Census/library/publicatio...
https://www.cbo.gov/system/files/2019-05/55085-HealthCoverag...
> I've tried to say these sorts of views on reddit, but just get called a troll or a liar.
I think it would help if you didn't start by saying that 80 percent of people have employer coverage, decent or otherwise. Because it's both false and easy to check.
I didn't mean it statistically, just that most americans are insured, either by purchasing privately or by their employer. It's an internet comment not a journal article.
Saying things you don't mean might be why people on reddit accused you of being a troll or a liar. I don't have proof, but it seems like a good place to start.
> It's an internet comment not a journal article.
"It's the internet so I can say whatever I want regardless of facts" is not a mindset conducive to meaningful conversation. I'm guessing again that it might be why the people on reddit dismissed you.
You might not think that this is important, but, speaking to your complaint that outlets "give this impression that dissent arrises only from ignorance, and I must be some evil, Mr Burns-esque robber baron", it seems pertinent that the available interpretations for people encountering what you said are that either you didn't know that the real number was far lower than what you said or you knew and were intentionally misrepresenting things.
Do you still have coverage if you get laid off? For how long? For kids too? That’s what freaks me out about the US system, is that it’s tied to employment to a high degree. This pandemic must have led to tons of people being laid off. Many of them got laid off and then they (or a family member) got Covid. How long after being laid off are people normally covered? How long is coverage for family members on the employee’s insurance after they are laid off?
I wouldn’t say care is better under my single payer than it is for US white collar employees, but I assign a massive value to the fact that I don’t worry about insurance or money if I get sick, have a child, or have a chronically ill child.
Even if it's the right thing to do, a lot of people are going to be opposed to it if it hurts them (even marginally). I think NPR sort of overlooks this, and focuses too much on the poorest 10 or 20 percent.
Certainly we need to care about the poor, but the rest of the people matter too.
Yeah, no, that's not the same thing at all. As a Canadian I have health coverage I can, y'know, live with regardless of whether I'm employed or not. And buying coverage in the US (with a pre-existing condition) was absolutely not worth it (even considering the wage gap) when I entertained a few offers in the early oughts.
Staying here means I have substantially better freedom of movement and negotiating power. In the US the "freedom" to not have healthcare just seems to mean that everyone has the "freedom" to pay more - and often for less.
Are there other systems aside from Cobra that pick up where Cobra doesn’t? E.g for bankruptcy , companies smaller than 20 employees?
With the ACA, things are at least a little better than before: individual people can at least buy insurance, which wasn't the case before if you had a pre-existing condition and didn't live in a state with a subsidized program (like Oregon's OMIP).
A criticism I've heard of Canada's system is just that it's under-funded. They could raise their taxes a little and divert more money to health care, and it would improve some of these wait times. I don't know how true that is, though, and how much of a legitimate problem it is. Canada definitely pays far less per capita for health insurance than the U.S.
Seems 'unfair' to pay in for almost 30 years and have that count for nothing.
Also all those scans have been completely free.
http://waittimes.alberta.ca/WaitTimeTrends.jsp?rcatID=19&rha...
https://www.hqontario.ca/System-Performance/Wait-Times-for-D...
The complaints I frequently hear from Americans regarding 'socialized healthcare' never ring true based on my experience in countries like the UK or Australia.
If you have good insurance in the US, you'll get a same-day CT in a hospital setting to bring in some revenue where a quick xray would suffice.
Healthcare providers are not allowed to charge publicly-insured patients for covered services. Insurance companies are not allowed to insure for covered services. So for covered services (e.g. lab tests and doctor visits) the only available options is public. For non-covered services (e.g. ambulance, dental, prescription drugs, etc.) you pay out of pocket or use private insurance.
Many healthcare providers themselves are private. For example, doctors are independent contractors, not government employees, and their offices are private businesses. But they get paid for services by the government (why we call if a single-payer system rather than a public system).
B. It is not a loophole. The federal government fines provinces who don't rein in private billing. British Columbia loses millions of dollars in Canada Health Transfer every year because of lax enforcement though. BC lost $15.9 million in 2018 and was on track to lose $32 million in 2019, but they started enforcing the law better.
https://lop.parl.ca/sites/PublicWebsite/default/en_CA/Resear...?
https://www.cbc.ca/news/canada/british-columbia/extra-billin...
If you are lucky enough to have an employer that loves you so much that he/she is willing to pay ever increasing cost for your medical care, good for you. But I can tell you that you are in a tiny, tiny minority. As things currently, stand medical care costs are scary high and they are getting higher every year at a very scary rate. And most employers are looking at ways they can limit their health care costs, most of the solutions resulting in limiting benefits for employees.
Even if you have good insurance, wait times can be bad. For a point of reference, someone close to me had a potentially fatal condition and wasn't able to get a specialist appointment for 4 months. That sort of thing isn't uncommon.
I guess my gf will have to attempt suicide to get help then... maybe if she succeed, she won't be a burden on the system !
Market rate in Mexico is undoubtedly lower than in the U.S., though. Speaking of Mexico, they seem to have a pretty solid public healthcare program. Maybe expectations are lower, maybe people are sufficiently contented by access to relatively unregulated pharmaceuticals and medical practices regardless of poorer outcomes, or maybe griping doesn't make it across the language barrier to American news, but it definitely seems like there's less anxiety about healthcare in Mexico.
As mentioned, dental coverage in the US is typically decoupled from medical coverage. (This is the same in Canada.) Your neighbors go to Mexico purely because most things, not just dental work, is cheaper there, as opposed to said dental work not being available immediately. Very different from why Canadians typically travel to the US for medical care, which is either a) to avoid long lines (and legislative prohibition of private clinics to pay more for quicker access), or b) expertise that isn't available in Canada.
Various Canadian politicians agree including Prime Minister Jean Chretien, who secretly traveled to the Mayo Clinic twice in 1999 (https://web.archive.org/web/20100204202553/http://www.montre...) during "ski trips" (https://web.archive.org/web/20160624132234/http://www.ezrale...).
Have you ever thought about what would happen if you want to take 12 months off work so you can spend time with your kids, learn a language or just some personal time?
Have you looked into how quickly your insurance would drop you if you developed a serious illness, or suffered a major auto-crash with extremely expensive and life-altering medical conditions?
Tying ones health to their employment is barbaric, and as someone that has never suffered such a fate, I consider it the next step up from slavery.
i.e.
Slaves - work or you don't eat/live.
US heath insurance - work or you get bankruptingly-expensive healthcare.
(Rest of the developed world) - work or not, healthcare is for everyone.
I'm not really trying to argue one view or the other. I'm just saying that it isn't as clear cut as this NPR piece makes it out to be.
Just in this thread people are downvoting anyone praising the US system and talking about the shortcomings of the Canadian one. I've had a Canadian doctor tell me first hand that the US healthcare system is far superior provided you have insurance.
Speaking personally, I had surgery for a long-standing condition, which the surgery failed to correct. Under a different system, my issue might not have become chronic, I might have been able to make a better decision regarding the surgeon and surgery (e.g., getting a second opinion, follow-up imaging, etc.), and I would not have missed a follow-up appointment after losing my insurance. Because I'm an American, living under this system, the circumstances of my treatment and subsequent outcomes were drastically shifted towards unsatisfactory.
The US is at or very near the worst among OECD countries in: life expectancy at birth, healthy life expectancy, rate of obesity, disability-adjusted life years, doctors per 1000 people, deaths from treatable conditions, rate of mental health disorders, rate of drug abuse, rate of prescription drug use.
It would seem health insurance companies charge a lot of money for not such great healthcare.
Good healthcare is available to some in America, but not all healthcare in America is good.
> Its the insurance system that is broken.
Financing is the root cause of some of the other problems, but there are absolutely problems with care quality, too, even if resolving financing issues would lead to those going away.
I am absolutely happier having american healthcare than canadian. Admittedly, that's because I am of the 80 percent of people who get decent health coverage via my employer. A significant minority of Canadians agree with me, so it's not like this is some radical position.
There is a famous story in canada where you could get CT scans for your pet the same day, but non-urgent scans for humans had like an 8 month waiting list.
My great grandfather had to wait 6 months for cataract replacement. He considered going to North Dakota to have it done, as it was preventing him from working. So now canada has inadvertently fallen to the same trap as everywhere else: if you're wealthy enough you can just go to the us for care. Everyone else has to wait.
I've tried to say these sorts of views on reddit, but just get called a troll or a liar. I'm not trying to argue that public healthcare isnt better in some ways, or even that americans shouldn't consider it. It's just that these sorts of outlets tend to have a rosey view and give this impression that dissent arrises only from ignorance, and I must be some evil, Mr Burns-esque robber baron.