And I'm going to get very political for a moment here: There is a lot of enthusiasm on HN for "market forces", and a lot of hero worship of people who could build their wealth in part because things like a lack of decent healthcare make doing business in the US very cheap.

I wish Jonathan Dale nothing but the best. Supporting him because he needs it is great and compassionate, but supporting him because he's One Of Us, when HN is usually so happy to cheerlead for a system that caused this in the first place? It makes me cringe.

If you're the only X-believer in a community of Y-believers and you get cancer, well, it's not that the Y-believers want you to die, it's just that you're not part of their church and hence your fundraiser will get nowhere.

This is not a good system.

And it ignores that people do not have an equal start in life. You get born into a wealthy, well-connected environment, and, well, even if you do some coke and maybe kill some people with your car, your community is still going to stand by you.

It's generally not a question of having to actively alienate people. Not being in a wealthy/powerful community is enough. The Y-believers don't have to hate that lone X-believer to fail to fund his medical bills. They just have to think of the X-believer as somebody else's problem.

If you get born into the wrong environment, all you've got is "the people who think no one deserves to get left out in the cold" - and those people's resources are stretched way past the breaking point. How much do we pay nurses? Does charity provide for adequate medical care for poor inner-city black kids? No.

This libertarian stuff pretends to be progressive, but the actual outcome of the suggested policies is incredibly regressive. It's no coincidence that libertarianism is a politics espoused by the already-privileged.

In the end, I am very happy to choose human dignity being more important than property rights as the hill to die on.

Unfortunately, some people find that appealing. Time will tell which is the proper philosophy.

In our case, we are very lucky. Both my Aunt and stepmother have good drug plans that refund their expenses. However, their treatments still cost thousands of dollars out of pocket. They're relatively lucky - they're both seniors who were well prepared and highly insured. Even luckier, they don't have dependents.

I can imagine many, many circumstances under which someone with a family, even in our relatively good health care environment simply could not afford many of the drugs they need. For example, in many cases, complete drug coverage is a premium offering through private insurers. I'm not sure how many healthy people in their mid-30s would really consider premium health insurance a huge priority, especially if they have families. Rather, the tendency could be to assume that their good health will hold and they won't need insurance.

In response to your valid criticism, I do agree with most of what you say. But, I would also argue that cancer is an asshole and, if I were in a situation where saving my life could bankrupt my family, I'd sure pray that my community put helping me out above making a political statement about the quality of prescription drug coverage in Canada!!

I have friends and family in Europe and Canada. One relative in Canada was told that they would have to wait several months for an x-ray needed for diagnosis (and might die by that time), so came to the US for treatment instead. A relative in Europe was told that he was too old to qualify for treatment, so he came to the US for treatment instead.

From what I've been told, some treatment options that are expensive or not-fully covered in the US may not even be available at all in Europe or Canada.

So, while the US has much work to do, I think the more socialized systems of some other countries are not better in all respects.

I was raised with Medicare, but I see nothing but problems with how it is administered. And, I hope that your country doesn't follow our mistakes...

Why is it structured this way? Why don't they just directly bill the insurance without requiring large outlays upfront from the patient?

There is help for prescription costs - people can get deductions for long term meds.

Luckily, most people do not pay prescription cost. About 80% of people on a prescription have some exemption or other.

There are big problems with medication non-compliance, even for serious life-critical meds (cancer meds; HIV meds; transplant surgery meds) but it seems the cost (free or high cost) is not relevant - non-compliance is similar in the UK and in the US.

There are some problems with the English NHS, but "getting access to meds" is not one of them. Unless you count fantastically expensive new cancer meds that add maybe a week of poor quality life.

If you are lucky you have a good insurance plan and your employer provides disability insurance that covers your lost salary which recovering.

In no other developed country (or should I say in no developed country) do people die because they can not pay their medical bills.

The system has to change.

http://www.washingtonpost.com/wp-dyn/content/article/2007/02...

Something analogous to a Red Cross/Crescent which does not want to influence policy directly, only to help individuals.

This is why, for many people, it's a big deal to be an atheist: if the main community for you is the church, you're not just foregoing religious and moral support, but also the material kind.

It's certainly an understandable reaction to point out that the problem is bigger than one person on giveitforward.org, and that the US health insurance system with insurers being given cheap excuses like coverage ending with your employment contract (rendering your health coverage useless whenever you have a severe disease) or allowing insurers to retroactively (sometimes by 10 or 20 years) invoke a preexisting-condition clause means that many more people have to beg the last months of subsistence off of their friends, family, and community. Or just sit in a corner and die, if they're not well-connected socially.

If thousands of very public uninsured and preventable deaths have happened without a change this likely won't make the difference

Not that abstaining is reprehensible

But it sounds as though you think that not donating to this individual will have some indirect effect on improving things for other people in the future.

No, if you have the funds to both campaign for a systemic solution and help the individuals that are currently in trouble because of the systemic problem, then you are of course free to do so.

Suggesting that one is more important of our time, energy and money than the other is, however, a valid opinion [1].

[1]: It is valid if my assumptions about the insurance not covering Jonathan and other such cases were true; that may not be so.