> Americans' satisfaction with the way the healthcare system works for them varies by the type of insurance they have. Satisfaction is highest among those with veterans or military health insurance…

Sounds about right to me. The VA health care system has problems [1] but on the whole doesn't seem worse than the rest of the US healthcare system, maybe better.

Anecdote: when my dad retired, my parents lost their insurance through his work, and my mom wasn't eligible for Medicare yet. They looked around at individual insurance options, which were horrible. My mom ended up using her VA benefits and was very glad to have them. The VA has treated my parents quite well, although the VA doesn't seem used to having a lot of female patients my mom's age.

[1] https://www.pbs.org/newshour/nation/veterans-affairs-backlog...

I can't imagine living in a country where you loose health care when loosing a job or going into retirement.

I have to admit reading posts like yours makes me realize how lucky I feel with the German system.

And yes. I am well aware of the monthly costs that brings in terms of around 14% of my salary for health insurance. And of the limitations.

But to me this still sounds better than the risk of loosing everything due to an accident.

I am glad your parents found a way with your mom's benefits.

In general when someone retires they're old enough to be eligible for Medicare (government-sponsored health care). My dad was. But my mom was just enough younger that she wasn't eligible for Medicare when he retired. There were (and still are) all kinds of weird gaps like this.

I lived through that, uninsured, for five years or so as a business owner - to “rich” to get subsidies, too poor to afford 20k+ per year for nothing except a theoretical out-of-pocket max (I say theoretical because there are many exceptions, loopholes, and the annual reset). Being hammered by the IRS for this was.. just.. swell.

So for me Obamacare sucked because it made the cost of individual market plans completely unaffordable and then taxed me for not being able to afford it. As a business owner responsible for employing others, it seemed especially ridiculous because here was a strong disincentive for me to continue on, which would mean a negative ripple effect beyond just me, i.e. layoffs, if I shuttered the operation.

Once the individual mandate went away, and some new options for employer cost sharing like QSEHRA/ICHRA came about, it has gotten a bit more manageable, but most small business owners I know still struggle with healthcare. Cost sharing programs like CHM are about the only workable alternative but they don’t offer the kind of bankruptcy protection a solid insurance premium would cover, and they are religious by nature. Alternatively, DNR and a term life insurance policy.

Best option is to be married, have spouse work for the man to get into corporate group plan for family, while you grow your business enough to sustain an insurance scheme.

But it sucks out there on the individual market - the raw actuarial numbers to insure you are bad - and subsidies disappear quickly with any amount of AGI. Since the vast majority of Americans are on employer-paid healthcare plans, this is a view into it that most don’t see. The cynical side of me (as a small business owner) says this is by design to keep you working for corporate America - consolidation of labor, consolidation of the profits. For me, Obamacare further entrenched this aspect of the system, which has become more terrible, not less.

This has not been true for 2021 and is not true for 2022.

Your payments for health insurance are limited by a cap that is hard to explain, but basically, you should not be paying more than 8.5% of your AGI for the 2nd most expensive silver plan in your state.

I (self-employed) have an AGI in the mid-100k range, and these subsidies more or less reduced my wife and my insurance payments by half.

This system still sucks - we are paying private corporations, via government subsidy, for their overpriced goods and services. But from a numerical perspective, it's much closer to being inline with most of the rest of the industrialized world: 8-14% of income for health insurance that covers most stuff.

And in all likelihood, Congress will not renew it at the end of this year.

I am currently paying $800/mo for a "silver" plan in a state that did not accept the extended Medicare. No, I don't get subsidies. I believe my deducible is roughly $2000, although I don't know because all of my costs have been covered, including the trip to the emergency room after I wacked myself in the eye. (The out-of-pocket limit for 2022 is $8700 for an individual. (https://www.healthcare.gov/glossary/out-of-pocket-maximum-li...))

Before the ACA, individual market plans were cheaper (although for the first couple of years they were comparable), but did not cover asthma (as a "pre-existing condition). Hello, $750 daily inhalers.

Just out of curiosity I calculated roughly the cost in Germany. If you were self employed and made 5.000 € a month your health insurance would be somewhat around 900 € per month. Partly tax deductible if I am not mistaken.

So quite a bit of money. But probably manageable for many/most people.

I am lucky. As I only do freelance work on the side I am insured via what I pay from my main income. So no additional costs for me as long as I don't make more on the side than in my main job.

I wanted Medicare for everyone (still do), but politics...and lies about "government death panels"...

RAND found that the VA typically also provides higher quality care.

This is entirely false. I served my commitment on active duty and then went to college using the Post-911 GI Bill. I got 9 semesters (4.5 yrs) paid for with housing allowance as well.

I dropped out of school before I joined the military, and had $10k in student loan debt with nothing to show for it. After serving, I graduated with a CS degree, and a job lined up as a software engineer. I am truly grateful the opportunities I was afforded through my service.

> The most important thing to realize about military service is that you sign away all your citizenship rights (free speech, etc.) when you sign up for the service.

False. I can say the same things as any citizen outside of my uniform. I am a US citizen with rights. I signed away no such rights.

> The other thing to realize is that, at least in the USA, they'll do everything they can to deny you medical benefits for injuries suffered in basic training, and this will persist after you get out

False. I have had access to every medical care I’ve needed, for free, for myself and family. This includes four major surgeries. I can go to an ER for free any time we have an issue. Zero stresses over medical expenses here.

> the 'educational assistance' is barely enough for a two-year vocational training program, certainly nowhere near enough for a full four-year college degree.

False. The military completely paid for my undergrad and masters at a high quality university (50k+/yr). Zero loans. They subsidized a second masters in software engineering. After all this I still have my full GI bill that I can use for myself or pass off to my kids for their undergrad.

> If you're a teenage with zero alternative options and are completely desperate for a way out of an urban slum nightmare or a poverty-stricken rural life, the military is there as an option.

Or if you wanted to serve with every opportunity in the world in front of you, the military is an option.

You're not allowed to say disparaging things about anyone in your command chain, which goes up to the president. There's also limits on your political speech, in relation to making political statements in favor of candidates.

The limits on your political speech aren't limited to service members, but also includes a pretty decent percentage of federal employees.

> False. The military completely paid for my undergrad and masters at a high quality university (50k+/yr). Zero loans. They subsidized a second masters in software engineering. After all this I still have my full GI bill that I can use for myself or pass off to my kids for their undergrad.

I'm glad that the GI bill worked well for you. It does for most people, but note that not everyone gets the GI bill benefits they are promised. I don't agree with the OP that it doesn't cover enough for a four-year college, especially if you're going to a state school.

> Or if you wanted to serve with every opportunity in the world in front of you, the military is an option.

I agree with you, in general, but it's important to note that the benefit one gets, vs the risks one takes are heavily correlated to ones status prior to entering. If you're poor, with poor education opportunities in your past, the likelihood of being enlisted, and being in a more dangerous service (and post) are substantially higher. If you're rich and had good educational opportunities, it's likely you'll be an officer, in a better service and post, with relatively low risk (and substantially higher pay).

You are right, there are more restrictions for me. I'll change my evaluation of "you sign away all your citizenship rights" to mostly false. The OP made a rather encompassing assertion. I still retain most of my rights as a US citizen.

For anyone reading this that is curious, we do agree to a new law code. It's the Uniform Code of Military Justice. One aspect is that it ensures service members are held accountable to laws in countries where there may be drastically different laws. It also includes provisions such as article 88 which states:

> Any commissioned officer who uses contemptuous words against the President, the Vice President, Congress, the Secretary of Defense, the Secretary of a military department, the Secretary of Homeland Security, or the Governor or legislature of any State, Commonwealth, or possession in which he is on duty or present shall be punished as a court-martial may direct.

And article 89 also limits speech more than an average citizen.

> not everyone gets the GI bill benefits they are promised

I'd be curious to hear the facts behind this assertion. The regulations are pretty clear on how to qualify. I've never seen someone qualified then denied.

https://www.history.com/news/gi-bill-black-wwii-veterans-ben...

https://chicago.suntimes.com/2021/11/5/22765623/veterans-aff...

The second article is specific to the reserves and guard. The main point I gather is that the process of evaluating time served is flawed and caused mistakes which made members a) lose their benefits even if they were currently using them and b) place the burden and costs on the service member to resolve. I'll restrict my statement to active duty only.

Your statement is not entirely true, it is not irrespective of convictions. A conscientious objector is defined as either:

A member who, by reason of conscientious objection, sincerely objects to participation in military service of any kind in war in any form.

or

A member who, by reason of conscientious objection, sincerely objects to participation as a combatant in war in any form, but whose convictions are such as to permit military service in a noncombatant status. Also referred to as noncombatant duties or noncombatant service.

Yes there is an application which can be denied. Here is a GAO report on the rates of that. In an all volunteer force the numbers requested are pretty small.

Text version: https://www.gao.gov/assets/a267698.html PDF version: https://www.gao.gov/assets/gao-07-1196.pdf

In the experience of the people I know, the VA goes out of their way to give benefits as needed. One case, in particular, they were granted 100% disability for life with a packet submission and one phone call.

https://www.va.gov/education/about-gi-bill-benefits/post-9-1...

https://www.va.gov/resources/how-we-determine-your-percentag...

You also get 100% of the benefit if you served for 36 months. That is a far cry from what you described.

Also, many universities (private and public out-of-state) have the Yellow Ribbon program that will cover gaps between what the government provides and the university's costs.

Finally, the Post 9/11 GI Bill also provides BAH based on your universities location which can be quite substantial.

I used the Post 9/11 GI Bill to get my degrees in CS and ECE. If I was single, the money from the program would have more than covered me.

Explain this please. Are you a veteran? I am and this doesn't correspond with my experience.

yeah... I was in DEP for Marines felt like an ahole when I didn't follow through/returned to school. I was desperate to escape my life situation but I had to wait a while before going to bootcamp. I made a dumb choice with what I was going to do, despite getting 90's in ASVAB. I was going to drive trucks. I felt bad for the people that wanted to get into the military but could not pass the ASVAB or they had a medical condition. My education was funded with student loans/aid but I was able to leave my home.

Edit: in retrospect if I didn't go into school (debt) I could have just lived off labor jobs... It was the piling up debt from school that was freaking me out because I was also failing out of it (low 2.0's GPA). Idk if I would have ended up in tech/make the 3-4x labor wage (medium-level dev).

That is a far cry from “sign[ing] away all your citizenship rights (free speech, etc.).”

I know of a guy who got run over by a speeding MP during Basic and had his leg broken in like 3 places. The guy who got run over got a medical discharge, and now gets a full pension and Tricare

Are there varying levels of educational assistance?

For the GI Bill, I put in $1200 ($100/month for the first year), and I while enrolled at an accredited university I was paid $400/month. I could use that however I wanted. Early 90's, that didn't come close to paying for much, but it was certainly something.

I was in the Marines, however. The Army, Navy and Air Force had matching funds and paid a lot more (like triple). This may have all changed or become consolidated.

I've also been through the VA for something and it's very much a government bureaucracy. If you have things documented it will run smoother, and it may run slow at times, but there is certainly no policy of denying everything.

The poster above just has an axe to grind and isn't concerned with reality.

I had the GI Bill. I submitted paper work each month that showed I was taking a certain number of credits towards my degree to the VA dept at the school. Money was deposited into my bank account a couple weeks later. I could use that money for anything I wanted. Sounds like this is what your friends had/have.

There are other programs such as paying off student loans when you join up, but I am not familiar with them.

"The GI Bill can pay up to the full resident tuition at any public school, if you are qualified to receive benefits at the 100% rate based on your active service shown above. If you are attending a private or foreign school, the VA will pay you an annual maximum of $26,042.81, that amount increases to $26,381.37 on Aug. 1, 2022."

Not forgetting horror stories about what they did to Vietnamese, Afghans or Iraqis...

Could you expand on this, please? My experience was different so I'm curious about what you actually know.

> completely desperate ... the military is there as an option

This does not happen by accident. It's practically indentured servitude with extra steps

Step 1: cut public schooling, food programs, job programs, affordable housing, public transportation, free healthcare

Step 2: fund the army to recruit a lot of people. Provide schooling, housing, food and healthcare to soldiers.

The US spends a lot on public education. A lot of it is inefficient due to highly politicized unions and top-level admins that pilfer the money out from benefitting ground level teachers and students.

https://www.manhattan-institute.org/issues-2020-us-public-sc...

> 1. Thanks to decades of increases, America spends more per student than any other major developed nation. U.S. per-pupil expenditures have nearly tripled over the past half-century, from $4,720 in 1966 to $13,847 in 2016 (2018 dollars). America spends more per pupil than any other major developed nation—10% more than the United Kingdom and 28% more than France; in the OECD, only Norway, Switzerland, and Luxembourg spend more.

  Per Pupil Nearly Highest in the World and in History

Similarly, we spend a lot on other social programs. But inefficiently.

This is due to both governmental inefficieny and rent seeking.

Plus, your reply is besides the point.

https://en.wikipedia.org/wiki/Gish_gallop

False

2. Even then, my point stands. US is #2 in post secondary education (#1 is the tiny state of Luxembourg). US spends more than twice the OECD average.

https://nces.ed.gov/programs/coe/indicator/cmd

(See Figure 2)

You are welcome!

These are easily verifiable numbers.

We spend a lot. A lot gets wasted due to rent seekers in the govt and unions.