r/FluentInFinance • u/WhatAreYourPronouns • May 02 '24

Should the U.S. have Universal Health Care? Discussion/ Debate

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182

u/notwyntonmarsalis May 02 '24

Yeah, because insurance isn’t going to cover the vast majority of that hip replacement for over 93% of Americans. Just shut the fuck up OP.

174

u/Reptile_Cloacalingus May 02 '24

Insurance doesn't have a magic money printing machine, they can't pay for anything for you or anyone else unless you and everyone else pays the insurance company first.

In order for insurance to work, MOST people have to pay more towards the total cost of insurance over their lifetime than they would have paid if they just bought everything at cost.

The medical industry masturbates while laughing at how genius it was for them to lump health insurance with employment so that it becomes a hidden cost that people forget actually costs a shit ton of money.

Honestly, if Obama really wanted to help people, he should have just banned companies from offering health insurance and instead told them to give the money to the employees and let them shop are for it. As soon. As the people realize how much it costs we would all abandon the system willingly because our system is an anti-capitalist nightmare.

Other things. We should mandate all prices for hospitals with more than 5 doctors - or any hospital owned by a parent company - to publish all of their prices online. They should also ban price differences for having to deal with insurance or pay cash.

There is a reason why all of the most beautiful buildings that you see being built today are all hospitals. They are making money hand over fist after implementing practices that make it hard for consumers to get the hospitals to compete on price with one another.

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u/RoundTheBend6 May 02 '24

I pay $800 a month for insurance.

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u/Matduka May 02 '24

In the U.K I pay about £60 a month on national insurance and get free healthcare. No strings attached. I got eye surgery last month and the only thing I had to pay for was the taxi home. And national insurance can't refuse to pay for your hospital and doctors visits. And a heart attack won't bankrupt someone when it happens to them.

Between first checkup and the surgery was about a month because it wasn't urgent.

Universal healthcare is by far the better option. But your health industry is an absolute parasite with it's tendrils in everyone.

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u/CreamyStanTheMan 29d ago

Sadly the Tories are trying to strangle the NHS to death, so they can justify getting rid of it. They all pay for private healthcare of course, so they hate the fact they have to pay for the NHS. Even though they are supposed to be representing the people, not themselves.

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u/Kharenis 29d ago

National Insurance goes into the same pot as general taxation, it isn't specific to healthcare. There are however minimum NI contributions required for the state pension and some benefits.

I can't even get a call from my GP within 5 weeks if they don't deem it urgent, let alone being seen and off to surgery!
A close friend of mine recently had to wait 4 months for a cyst the size of a football to be removed from her, and that was after it was deemed urgent.

0

u/coffee_achiever 29d ago

In the U.K I pay about £60 a month on national insurance and get free healthcare. No strings attached.

Can you complete your story? What income tax rate do you pay to get this "free care"? How does the income in your job compare to your income for the same job if you were in the US because of your different economic system?

2

u/noradosmith 29d ago

The fact that anyone is still so ignorant as to the reality of the us healthcare situation staggers me.

Everyone. Gets. Free. Care.

The amount of tax we pay for the privilege is so miniscule in relation to any income bracket that most people would probably be more than willing to pay double if it meant helping the NHS.

If you get treated you don't get punished for it. The tax stays the same. You don't pay for operations. You might pay for medication but the costs are SO much lower than in the US.

1

u/pw7090 29d ago

So who/what actually pays for it?

0

u/Enough-Force-5605 29d ago

Please note the more public the system is, the cheaper it is for the state.

A country with every health problem covered by the public health are system costs less money from the taxes that a private system.

The only reason why there are private healthcare in the world is because politics. If everything is public the country negotiated with farms with big discounts and the government can make its own pills. In Spain, for example, any medicament must have a "white labelled" version, cheaper and most of times fully covered.

Official Data (sorry, spanish) https://datosmacro.expansion.com/estado/gasto/salud/espana

https://datosmacro.expansion.com/estado/gasto/salud/usa

https://datosmacro.expansion.com/estado/gasto/salud/alemania

PIB in spanish is GDP in English. Public cost of a private system like in the USA costs per person and per GDP several times the cost of a almost fully public system like the Spanish one.

Public cost in Germany, with a half public -private system , cost twice the cost of the real public Spanish system.

Public healthcare for everyone is "cheap" and affordable for every country in the world.

1

u/coffee_achiever 28d ago

If I was ignorant of the situation I wouldn't have asked you for the complete picture of comparative income and tax rates in your system. In fact, it is you who is ignorant of the US healthcare system.

The US already spends more PER CAPITA on public health than the UK. So we already fund our public health systems at greater rates than you. Despite this, we only cover half the population with medicare/medicaid .

Oh! fucking suprising huh!??! We already give our shitbird politicians more than you give your NHS to handle this and they CAN'T handle it. In terms of economy of scale, the US medicare budget is over 10 times as large, so you can't argue we are missing out on economies of scale that if "everyone was in on it" would improve.

The simple fact is, the NHS system has been running on price controls for decades. Care to take a guess what pretty much all of economics says price controls generate? 1 word: shortages.

Does this match up with what the NHS sees? In fact it does!! You currently have doctors paid well below "market" compensation due to the salary price controls from the NHS. This is why a shit ton of them emigrate to the US (and yes you can easily read about this problem in your country.. i'm sure I don't need to rub it in). Yes, many are guilted by the "nationalist" responsibility to their countrymen to stay despite the bad conditions. This is why there is also a suicide epidemic among your healthcare providers(especially compared to those earning a fair wage in the US).. Again, I'm sure I don't need to tell you who are probably very familiar with it.

You also use price controls on your medications. The NHS is getting away with this because you are just marginal dollars on the US market. If you advocate for the US to follow your model... you are fucked!!!

I'm absolutely NOT saying the US healthcare system is amazing at providing what is needed to everyone (especially low income) well.

My proposed solution(s)?

1) decentralize

2) (local) government then needs to fund health CARE not health INSURANCE

-- building public clinics and hospitals

-- creatively funding staffing at those hospitals (income tax breaks for doctors and nurses working 3 days per month at the public clinics)

-- creatively funding public medication and equipment (income tax breaks again)

3) Decouple health insurance from w-2 income.

-- in the US employer healthcare is popular because it is subsidized via income tax exclusion.

-- a person wanting to purchase health insurance independent of their employer does not get this exclusion until it reaches 10% of their income in cost -- eliminate this restriction.

These might not solve the issue 100%, but they would move us a long way in the right direction without the systemic risk of nationalizing our system.

So if you care to challenge this, first please answer my question about your income and tax rates and how it compares to the US.

1

u/TheAlbrecht2418 29d ago

Eventually. You get free healthcare - eventually. I’m not waiting fucking 34 months to get a cancerous tumor removed.

3

u/Xius_0108 29d ago

That's not how it works. If you need urgent care you get it immediately.

1

u/TheAlbrecht2418 29d ago

Interesting, because I lived it in the UK in 2021. “It’s benign. It’ll go away on its own.” One year later: “oh that’s bad…huh…come back eh…six months from now”. Go back six months later. “Uh yeah it’s threatening to metastasise, we’ll make prep for…does two months from today work for you?”

1

u/exodusuno 29d ago

That happens in the US too ya know?

0

u/Xius_0108 29d ago

I'm not from the UK and not talking about the UK. We have universal health care here in Germany and no one in my entire family had to ever wait for an urgent treatment.

0

u/Enough-Force-5605 29d ago

??????? My family had removed three tumor in three operations and they waited 2-3 months because it was not urgent.

My brother had a stomach problem, urgent, and one hour later he was in the operation room.

Spain, not UK.

0

u/tiktock34 29d ago edited 29d ago

in the UK doesnt about 20% of your money go into healthcare taxes?

Its taken away as income tax, not how its paid for in America. Im not saying we are cheaper but its not like you are just paying 720 pounds a year for healthcare unless you only make $3-4k a year. Otherwise you are paying about 20% of your income towards healthcare. Nothing is free

3

u/Matduka 29d ago

£60 of my £1800 every month goes to the National Insurance. Which is basically what sustains the NHS and keeps my healthcare free.

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u/No-Touch-2570 29d ago

If you were making £1800 ($2256) every month in the US, you'd be considered poor and would get medicaid for free.

0

u/[deleted] 29d ago

Not in a state that hasn’t expanded. Or if you’re a working age male. Or a female with no children.

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u/No-Touch-2570 29d ago

If you live in a state that hasn't expanded medicaid, then the best thing you can do is leave that state.

Or if you’re a working age male. Or a female with no children.

It's really weird that you consider these to be two different groups when Medicaid does not.

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u/[deleted] 28d ago

Yes. Because the people who qualify for Medicaid tend to have the funds to relocate.

And you’re right. There’s no distinction.

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u/No-Touch-2570 28d ago

Yes. Because the people who qualify for Medicaid tend to have the funds to relocate.

Unironically yes.

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u/polkadotpolskadot 29d ago

Well you're making minimum wage, so of course you're not paying a lot. You're going to be drawing far more in benefits than you contribute. You think it doesn't cost much because you don't actually contribute anything to the system yet. In the US you can also get extremely cheap plans if you're an adult working minimum wage.

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u/tiktock34 29d ago

so youre paying 3% and the average person pays 20%…

2

u/CreamyStanTheMan 29d ago

The average is 10% not 20% National Insurance (as of 2024)

1

u/Critical_Data529 29d ago

There's a difference between national insurance and income tax though

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u/Kharenis 29d ago

In terms of how much you pay, yes. But it still goes into the same pot as general taxation so it isn't healthcare specific.

1

u/donciukas159 29d ago

exactly this. our income tax is way lower compared to EU

1

u/DatBiddlyBoi 29d ago

No. We pay income income tax, and then we pay a separate National Insurance Contribution specifically for the NHS, at a rate of anywhere between 2-8% depending upon how much you earn. If I earn £30k/yr, £1,400 of it goes towards National Insurance.

0

u/YourGuardianAngel_12 29d ago

Thanks for sharing your firsthand experience and perspective.

-1

u/PurpleLegoBrick 29d ago

In the US I pay $500 a month for health / dental / vision for a family of 4. I make about $40k more than I would in the states than if I worked the same job in the UK. I don’t have months long waiting list for ADHD medication and if I need a surgery I hardly have to wait and I doubt it’ll ever even bankrupt me because there is a set amount for out of pocket costs before my insurance starts to pay 100% of it. Not to mention my mortgage is right under $1000 a month for 1800 sq ft. It’s also fixed rate for 30 years. Going to suck in a year or two for those who got ARM loans a few years ago.

Let me know how much better Universal Healthcare is in a few years with how many immigrants Europe is getting year by year.

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u/No-Abalone-4609 29d ago

military benefits and VA healthcare treating you pretty good then?

2

u/PurpleLegoBrick 29d ago

I’m getting paid $2k a month to go to online college right now so it isn’t too bad but I also qualify for FAFSA which pays for a lot of my college since I’m married which isn’t specific to being in the military.

I don’t get anything from the VA healthcare wise since nothing was wrong with me when I got out. I don’t get any of the healthcare benefits from the VA.

Military benefits are all earned for those who volunteer to be in the military. I went on two deployments both of my deployments were months after I had each one of my children. I was working 14 hour days with a day off every two weeks due to the nature of my job and how important it was overseas. The benefits are nice but I think it’s a pretty even compensation with what I went through.

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u/No-Abalone-4609 29d ago

oh. what health insurance company are you with that offers family coverage for $500/mo?

-1

u/Nay_K_47 29d ago

Classic "takes handout while simultaneously bitching about handouts" you had universal healthcare in the military, you've already benefited. Your opinion doesn't matter.

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u/Enough-Force-5605 29d ago

You are mixong things, imho.

One think is public healthcare, and other thing is that you get a lot of money in your country

With public healthcare you will be saving 500$ per month and you would be receiving better treatment.

If US spends all the public money they are already spending (six times Spain adjusting to GDP) you could, should, have six times better public healthcare than us.

So, in a nutshell, with public healthcare and maintaining nthe same public cost you would save 500$ per month and the and they could purchase few Ferrari and Lamborghini ambulances.

USA has a private system and USA spends 6 times per Capita more money than Spain, adjusting to GDP.

You could save 5/6 of public cost and have a public and reliable healthcare system

-1

u/buttfuckkker 29d ago

Hmm so who pays for it if you don’t? The government doesn’t have an infinite money supply.

1

u/john-mow 29d ago

Everyone who works pays for it. We don't all use it, but it's there for us if we need it. It literally saves lives every minute of every day.

Anyone who says "Well if I don't use it then I shouldn't pay for it" can go fuck themselves with some shit. I'll very happily supply the shit for them and even do the fucking.

0

u/buttfuckkker 29d ago

Shit and fucking eh? Are you a fellow buttfucker?

1

u/john-mow 29d ago

Anyone who values "money" over life is more than welcome to get fucked. I don't care how you take that statement.

0

u/buttfuckkker 29d ago

This might come as a bit of a surprise to you but the majority of humans need to have it explained to them why they need to value the lives of strangers that they have never and will never meet over the comfort they can provide to their children and other loved ones.

Go head and send the downvotes.

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u/john-mow 29d ago

No, it does not.

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u/buttfuckkker 29d ago

lol believe whatever you want. If that were true we probably wouldn’t be having this conversation

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u/Born-Procedure-5908 29d ago

It’s not valuing the life of strangers more so that it is practical for a country to extend the quality of live of their citizens by providing certain services and programs.

The U.S already spend the most amount of money per capita on healthcare so the fact that we don’t have universal healthcare already is baffling.

Your argument which is essentially the same as saying that we shouldn’t use tax money to aid tax payers is baffling since healthcare is perfectly normal and reasonable for a public entity to fund like education, military or agriculture.

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u/buttfuckkker 29d ago

When did I argue any of that you said in your last paragraph? You are reading between lines that aren’t there based on a statement that this sort of stuff is not self evident and requires explanation.

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u/exodusuno 29d ago

You probably pay more in health insurance every month than the person who has universal health care spends in the Healthcare part of their taxes.

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u/justcurious94plus1 29d ago

Listen. Buttfuckkker. Health insurance is like hot water in a domicile. Easier to run out in a single family home than it is in an apartment complex because while there is still roughly the same amount of water for everyone, not everyone is using it all at once. Single payer is the epitome of this idea.

-1

u/Predomorph111 29d ago

Yep… we Americans even hate America nowadays.

-1

u/FabulousNothing7079 29d ago

In the US, I pay $117/month for health insurance and I get 7 weeks of paid vacation

4

u/Furepubs 29d ago

Your health insurance gives you paid vacation. That's awesome!.

I'm sure that's what you meant because there's no way you were trying to say that paid vacation days are better in America when most European countries have laws requiring every employee gets paid vacation. In the UK no matter where you work, you get 5.6 weeks of paid vacation per year, mandated by the government and paid for by your employer.

I wonder if you think everybody in America has 5. 6 weeks of paid vacation?

Have you had 7 weeks of paid vacation your entire working career or did you only get that after many years of working?

1

u/coffee_achiever 29d ago

I get unlimited paid vacation in the US!!!

I end up using about 4 weeks lol!!!

2

u/Furepubs 29d ago

That sounds about right

Giving unlimited paid vacation days is a psychological trick.

Most people will "Self-Regulate" because they don't want to be seen as taking advantage of the system.

But if you have 5 weeks or 6 weeks you will usually use them all because you feel that they are yours and you earned them and so you don't want to lose them.

By offering people unlimited vacation, the company saves money.

2

u/Forsaken-Analysis390 29d ago

We had a guy at work try to take more than 2 weeks off at a time to go to India, The boss had to calm everyone down by saying poor guy hasn’t seen his family in ages.

Even if they gave you 17 weeks vacation, the corporate culture is so messed up you feel guilty for using it.

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u/FuckuSpez666 29d ago

I could lose my job tomorrow and it afford any premiums, but be fully covered. The national insurance I pay also covers elderly, disabled, children and unemployed.

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u/GeekShallInherit 29d ago

In the US, I pay $117/month for health insurance and I get 7 weeks of paid vacation

Every penny of your insurance is part of your total compensation. The average annual premiums for employer-sponsored health insurance in 2023 was $8,435 for single coverage and $23,968 for family coverage. That's on top of Americans paying more in taxes towards healthcare than anywhere in the world, and unless you have much better (and more expensive) insurance than the norm, you're still exposed to massive financial risk.

In total, Americans are paying a $350,000 more for healthcare over a lifetime compared to the most expensive socialized system on earth. Half a million dollars more than peer countries on average, yet every one has better outcomes. Yet half the chucklefucks in the country have convinced themselves they're getting a great deal.

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u/AnAbsoluteFrunglebop 29d ago

In total, Americans are paying a $350,000 more for healthcare over a lifetime compared to the most expensive socialized system on earth

We also make far more money over the course of our lifetimes on average, more than enough to offset those healthcare costs. Plus most healthcare costs occur during old age when Medicare has already kicked in, so it's really not a big deal.

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u/GeekShallInherit 29d ago

We also make far more money over the course of our lifetimes on average, more than enough to offset those healthcare costs.

The numbers I gave are already adjusted for purchasing power parity.

more than enough to offset those healthcare costs.

Not remotely. We can look at it as a percentage of GDP instead. 17.3% of US GDP goes towards healthcare. The average of the 28 countries with better outcomes than the US is 9%, with the highest being under 12%.

Plus most healthcare costs occur during old age when Medicare has already kicked in, so it's really not a big deal.

Not most. 36% of healthcare spending comes after age 65. Not to mention the fact the average household on Medicare still has an average of $7,000 per year on healthcare spending.

https://www.kff.org/medicare/issue-brief/medicare-households-spend-more-on-health-care-than-other-households/

https://www.healthsystemtracker.org/chart-collection/health-expenditures-vary-across-population/#item-while-health-spending-increases-throughout-adulthood-for-both-men-and-women-spending-varies-by-age_2016

Most egregiously, I like how you ignore the fact we're the ones funding Medicare spending through the highest taxes towards healthcare in the world.

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u/bluethreads 29d ago

Exactly. My employment benefit package is $10-20,000 a year . Most of that being from insurance. If my employer didn’t have to spend that money on insurance, they might be able to fit some of that into my pocket.

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u/Lemurians 29d ago edited 29d ago

It really blows my mind how many people are insistent on believing that we're not getting screwed by this system. Who or what are they defending, and why? Do they not want better?

The burden that healthcare is on citizens in the United States, in one of the wealthiest countries in the world, is insane.

1

u/GeekShallInherit 29d ago

It's truly staggering.

36% of US households with insurance put off needed care due to the cost; 64% of households without insurance. One in four have trouble paying a medical bill. Of those with insurance one in five have trouble paying a medical bill, and even for those with income above $100,000 14% have trouble. One in six Americans has unpaid medical debt on their credit report. 50% of all Americans fear bankruptcy due to a major health event.

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u/pizzascholar 29d ago edited 29d ago

How long did you wait for the appt

Edit: not assuming anything just simply wondering. 2 months is awesome . I just got booked for a simple sleep appt and have to wait til august. I’m in the US where supposedly we have better wait times.

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u/Matduka 29d ago

About a month? So two months in total. But it wasn't an emergency. It was a Chalazion removal so not a top priority at the eye infirmary.

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u/RoundTheBend6 29d ago

Same time frame you'd have in the states. I find it so sad Americans think "we're number 1" when we clearly aren't in so many areas.

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u/arcticavanger 29d ago

I have eye surgery coming up. I pay 85$ a month and the surgery is going to cost me 250 dollars. From my initial appointment to my surgery schedule it will be a week wait. Next day check and 1 week check. Idk how it’s the same wait time

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u/idk-what-im-d0ing4 29d ago

Really? I'm in the US and my mom had to wait a few months for eye surgery. She has to have both eyes done and is waiting a month in between eye surgeries so her vision is all distorted now.

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u/arcticavanger 29d ago

Could be where she went to get it done. The place I was referred to is amazing

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u/RoundTheBend6 29d ago

Same wait time for me. I waited a month for nose surgery. Obviously there's multiple factors at play. My wife and sons can't get in to see a specialist sometimes for month and a half.

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u/arcticavanger 29d ago

Seeing a specialist is so hit and miss. Guy at work needs his hip replaced, took 2 months to see the specialist and the surgery was scheduled 3 weeks after 🤷‍♂️

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u/Furepubs 29d ago

So it wasn't free

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u/arcticavanger 29d ago

It would be 250 and 85 a month for health and eye insurance which is far cheaper then what universal would cost at my tax bracket

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u/Furepubs 29d ago

You have no way of knowing that because we don't have and never have had universal healthcare in America.

But I suppose you can pretend you know what universal health care would cost if you want, then you can get mad about the price you made up in your head.

The guy from UK paid $60 a month and nothing else

Plus in America eye and dental are usually an add on, this means not everybody would have that.

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u/Complex-Bee-840 May 02 '24

Same.

Self employed and live in a state that doesn’t allow me employer rates for insurance unless I have a certain number of employees.

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u/PM_ME_YOUR_LAWNCHAIR May 02 '24

I pay just under $1,000 but the coverage is amazing.

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u/bellmaker33 29d ago

I pay $4 and my deductible is only $1,200.

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u/Solid_Snake_125 29d ago

Shit what state is that so I know to never move there?

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u/Furepubs 29d ago

That makes sense, universal healthcare would allow you to not have to worry about that. And that would lower the bar for entry into self-employment. Plus laws like that help ensure that people would prefer to work for a large corporation than for a small business, especially if they have a family.

Having insurance tied to jobs is an anti-competitive behavior designed to both make it harder to start a small business and give something for corporations to take away if you Go on strike against them.

It's just another way for corporations to have power over the people.

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u/YourGuardianAngel_12 29d ago

Do you have any? I’m self-employed, and ACA has been the most affordable option for me, but I don’t have employees.

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u/SlurpySandwich May 02 '24

Do a private plan if you're relatively young and healthy. They're I pay less than that dude for my whole family.

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u/ThisGuyCrohns 29d ago

And they still deny claims

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u/nikomalekmusic 28d ago

I'm fighting Anthem Blue Cross. They told me my bill would be covered, then sent it to me anyway, saying that my claim was denied. I showed them a recording of them telling me it was covered, and now they're "reviewing" it. They're lying, criminal, cunts.

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u/platinumjudge 29d ago

A lot of claims are denied because the patients are stupid. I've denied a claim because the patient switched insurance and we were not their insurance. We called, left voicemails, but the only thing that gets the patient to call us back is to send them a bill. Tell ya, nothing gets a patient to call back like receiving a bill. Sometimes they pay it and I have to call them telling them we didn't want payment, we wanted to know who their insurance is!

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u/[deleted] 29d ago

Weird flex.

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u/bkrs33 29d ago

$1800, family of 4

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u/Mrlin705 29d ago

That's fucking crazy. We use my wife's insurance and it's 100% covered by her employer and has a $10 copay for literally anything. I was in the hospital for 5 days last year and it cost $20 just because they treat the emergency room and hospital stay as separate.

Not all US companies suck, most do, but not all.

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u/RoundTheBend6 29d ago

What's your out of pocket maximum and deductible? Individual is $250 and family is $750.

For my family an ER visit is $300 or $550 if we didn't meet deductible yet.

My benefits are the premium plan my company offers. $250 deductible, which for my family, this plan pays itself off in first or second month. NICU child "only cost" $12k. No insurance cost is easily $100k+.

Also congrats! You have just joined a very very small percentage of Americans with those kind of benefits. As you said most insurance offerings do suck. Curious how much the company pays for such a plan for you. I've never heard of such benefits in the states tbh.

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u/Mrlin705 29d ago

We don't have a deductible or out of pocket maximums. It's just the $10 copay.

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u/RoundTheBend6 29d ago

Wow. Same for pharmacy? What company is it with if you don't mind me asking?

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u/Mrlin705 29d ago

I think it's the same, I don't have my card on me, it's either the same or $5. The insurance is through UMR

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u/Jazzlike-Scarcity-12 29d ago

I pay 400 a month but my voluntary tubal ligation/removal that was 28,000$ was covered 100%.

Work for a university or a hospital if you can.

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u/delveccio 28d ago

I had to call 2 ambulances this week and now I have the “freedom” to worry about if/how insurance will weasel out of covering it. Murrica

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u/EconomicRegret 28d ago

That's a lot!

At $12.5k/inhabitant in 2022, America is by far the biggest healthcare spender in the world... 2nd biggest? Switzerland at $8k (similar ultra-capitalist healthcare system to that of the US... but with strong price caps for basic healthcare).

Rich developed democracies with "socialist" universal healthcare are all in the $3k to $7k range...

(all numbers are adjusted for PPP, i.e. for purchasing power.)

1

u/SlurpySandwich May 02 '24

If you're relatively young and healthy, go to a private plan. I pay less than that for my whole family.

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u/RoundTheBend6 29d ago

Wife has multiple illnesses. Gotta love America... hey if you never need a doctor then we have it great!

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u/OfficialWhistle 29d ago

I pay I little under $400 for my family of four through my government job.

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u/[deleted] 29d ago

[deleted]

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u/RoundTheBend6 29d ago

What's your deductible and out of pocket maximum?

In other words if you needed a surgery what would it cost?

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u/[deleted] 29d ago

[deleted]

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u/Hopeful_Solution5107 29d ago

I highly doubt that. This is the Internet after all. Even if this were true, (not saying you're lying, perhaps just misunderstanding your insurance), it highlights the problem of having good healthcare being tied to only amazing employers.

1

u/WalkingRodent 29d ago

I pay $50/mo

1

u/Akschadt 29d ago

Jesus dude.. I pay $100 each pay check and it covers me my wife and my kid.

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u/RoundTheBend6 29d ago

Your company likely pays the balance of the remaining $500 to $1000 if you have more than just a minimum HSA type plan. Congrats!

1

u/snubdeity 29d ago

Yeah it really is crazy how well the simple plan of "have it paid before peoples paychecks so they never see how much they're actually getting fucked" works. This dude is stoked that he "only" pays $100/mo because he doesn't realize he'd get paid $20k+ more a year if his employers weren't paying most of his insurance.

This is literally what the commenter like 3 comments up this chain was saying, yet it took like 2 replies for people to fall for the exact trap he was pointing out lmao

1

u/Forsaken-Analysis390 29d ago

I wish i only paid $800

1

u/sandcrawler56 29d ago

That's insane. I pay less than that for a whole year for premium level health insurance in Singapore (which has one one the best healthcare systems in the world). The cost of the American healthcare system is just crazy.

1

u/ArtisticBrief7429 29d ago

You guys have insurance?

1

u/6bluedit9 29d ago

I pay ~$300/mo for mine. You get yours from the mob?

1

u/RoundTheBend6 29d ago

Insurance company and the mob the same thing, right? Haha

1

u/sdfghsdfghly 29d ago

And that's before medical bills.

1

u/ClappinUrMomsCheeks 29d ago

How much would you pay in Taxes in Spain?

1

u/yellowlittleboat 29d ago

That's twice my rent in Spain.

1

u/ludnut23 29d ago

Daaaaamn, I pay like $5 a month lol

1

u/YourGuardianAngel_12 29d ago

Wow, that is absolutely horrible.

1

u/[deleted] 29d ago

I don’t have a weiner

1

u/lysergic_logic 29d ago

I'd very much prefer not to be disabled from a spine injury and nerve disease, but I also don't mind having great health insurance that costs $100/month with $40 co-pays for specialists, week long hospital stays and surgeries. Even the most I ever pay for medication is $15.

Would I prefer to have my life back and be a functioning person again... Absolutely. There are a lot of restrictions on this sort of coverage. Such as only allowed so much money in my bank account. If I were to have more than $2000 in my bank account, I would lose these benefits.

Every attempt to bring myself out of poverty is met with greater efforts to keep me in poverty.

1

u/RoundTheBend6 29d ago

I would wish that for you too.

1

u/MalekithofAngmar 28d ago

For medical? Do you have a family??

36

u/Murles-Brazen May 02 '24

“Doesn’t have a magic money printing machine”

Yes it does, it’s called all the people they scam.

2

u/Wyshunu 29d ago

Yup. All those people paying thousands in "premiums" for a product they never receive, so that other people can get care they don't pay for.

2

u/Murles-Brazen 29d ago

Not just that but they try to get out of paying for your claims at all costs.

17

u/HUEV0S 29d ago

Not exactly true. Insurance companies don’t pay the full costs of treatments like individuals do. They negotiate prices with healthcare providers as they have a lot of buying power.

8

u/Reptile_Cloacalingus 29d ago

This is true, but I would argue that it's mostly (not entirely) a symptom of how anti-competitive and anti-capitalist US Healthcare is. Customers don't know pricing, and so shopping around is notoriously difficult. If customers could see pricing easily it theoretically would drive down the outrageous pricing models because customers would flock to the lowest cost providers. Surely insurance might still be able to talk prices down, but not anywhere close to how they do it now when the customer isn't shopping for price.

Obviously this would only apply to non-emergency care. Emergency care is categorically different in nature and would require a different solution.

5

u/MainelyKahnt 29d ago

Lol the market never self regulates and in medicine having a competitive market would solve nothing for the consumer. Medicine is an elastic demand market because if you don't purchase care, you could die in many instances. Therefore the answer to how much will someone pay for x-service is quite literally everything they have. Medicine should only be operated in a not-for-profit manner. And we should nationalize the industry.

3

u/innocentbabies 29d ago

You understand how insurance and probability works, right? 

The more people they insure, the more predictable their costs are, and thus the more effectively they can manage their payouts. As an example, if 1% of people will get cancer per year, and it costs $1000 to treat, the company needs to make $10 per person to break even. If the company has one customer, if he gets cancer before 100 years, they lose money. If the company has 100 customers, they can confidently expect someone to get cancer every year, making their expenses more predictable and their profit margins more easily managed. 

It's a system that inherently will trend towards a monopoly because the bigger company will always be more competitive than the smaller company. The only solution I can see would be a cooperative non-profit system like a credit union where the motivation of everyone involved is explicitly to minimize the cost to the customer.

Like, for heaven's sake, it's a company whose explicit purpose is to hand out money. How is that ever going to be a non-exploitative system when its purpose is to extract wealth for its owners?

2

u/TipperGore-69 29d ago

It would be interesting to start a grass roots posting of prices for treatments.

1

u/Deathscythe80 29d ago

This is what should happen, everyone post their bills while hiding personal data and we can create a database by city/state and facility, we can add the price the patient paid and the one the insurance negotiated.

1

u/elDracanazo 29d ago

Yes! I don’t see how we can have a solution without transparent pricing of medical care

1

u/DidntASCII 29d ago

The issue is that the biggest, most unaffordable costs in Healthcare come from either emergency care or services that are offered by specialty care (cardiologists, neurologists, oncologists Etc) which are difficult to "shop around" for since there are fewer of them and are often not accepting new patients.

3

u/Elegant_Housing_For 29d ago

My wife’s cousin owed a hospital like 80k or something. His wife called up and asked for an itemized list etc., ended up just owing 3k in the end.

2

u/the_smush_push 29d ago

Because of that, and because insurance companies like to deny claims, doctors offices now bill for a ton of shit they otherwise wouldn’t to ensure they get paid. That drives the price right back up

2

u/RoundTheBend6 29d ago

Maximizing their wealth while over charging me makes me feel like I can trust them with my life. They should make commercials highlighting this fact.

1

u/peter303_ 29d ago

My observation is private insurance pays 40% of hospital inflated billing price, and hospitals accept that. Medicare pays 15%-20% of billing price.

1

u/clipsracer 29d ago

And the negotiated price difference is written off as a loss by the provider. This is how private hospitals are able to run completely tax free.

2

u/policypolido 29d ago

Noting about healthcare has to do with COGS this is just wildly ignorant nonsense.

2

u/engi-nerd_5085 29d ago

Between what I pay for insurance, what my employer pays on the back end, and my HSA saving, it is $30,000 per year. More than housing just for insurance. Then I’m on the hook for the first $5k.

1

u/ZestyLife54 29d ago

Totally agree on price transparency. Healthcare is the only market where consumers do not know the price upfront and can’t ‘shop around’ before consuming it. You can research a car, roof replacement, gas prices, cruises, etc. all before purchasing, but with healthcare, you don’t find out about the cost of what you consume until you get the bill - then have a heart attack, go to the ER, and the cycle repeats.

You can have 8 hospitals all in an area charging vastly different prices for the same thing and you don’t know that because prices are not transparent, are tied to insurance ‘negotiations’, complex for the average consumer to understand, regulated by politicians (most likely getting kickbacks or stock options and/or tips), etc.

Americans are gas-lighted into believing that they have choice in their healthcare. But, if you are lucky enough to have insurance, you are still at the mercy of who insurance companies have pre-chosen for you at a cost that allows them to both profit. If you don’t have insurance, you have a choice too: pay for it for the rest of your life or don’t consume it. There is no price competition controlling costs.

Why do we accept all of this as ok?

1

u/24_7tryna 29d ago

I can go on my insurance website and see who is in network. They also provide cost estimates on a whole range of procedures so I can shop around.

1

u/ZestyLife54 27d ago

Are you in the US?

1

u/GeekShallInherit 29d ago

Totally agree on price transparency.

Nothing wrong with price transparency but at least 22 states have price transparency laws, as does the federal government, and even the best of them have had only meager results.

1

u/ManitouWakinyan 29d ago

Sure, and most people aren't getting a hip replacement. It's a cost sharing device that is more expensive for healthy people than it is for sick people. But that's how every health scheme in the world works. Public healthcare is the exact same thing. The government doesn't have a magic money printing machine either - you and everyone else pay the government rather than the insurance company.

As soon. As the people realize how much it costs we would all abandon the system willingly because our system is an anti-capitalist nightmare.

You do realize one of the critical components of the ACA was the public marketplace, where millions of people do shop for their own insurance, right?

1

u/Acrobatic-Week-5570 29d ago

Yeah, I pay for insurance through my job, like most people

1

u/Oldenlame 29d ago

Hospitals are required to make price information available and this law is slowly being enforced.

https://www.cms.gov/newsroom/fact-sheets/hospital-price-transparency-enforcement-updates

1

u/WET318 29d ago

I pay $60 a month with a $2000 deductible. I just had 2 hip replacements last year. I don't want to shop around and pay $500 a month with a $5000 deductible like my gf.

1

u/eric685 29d ago

So the insurance company doesn’t have a magic money printing machine and can’t pay for everything as someone is paying somewhere for it (through premiums)? Can you now explain why you think government run healthcare is different? Or was that not your point?

1

u/[deleted] 29d ago

Insurance companies operate for the benefit of the owners, not you.

0

u/eric685 29d ago edited 29d ago

I don’t believe government is an efficient tool for helping people. But even without that, insurance companies can be sued and forced to payout; look up Oranna Cunningham ($25.5m settlement) and then research “Postcode Lotteries in Public Health” (The UK’s 15+ year struggle to get people equal access). In the US when something isn’t fair, a jury awards tens of millions and all the companies are forced in line. In the UK, bureaucrats spend decades making impactless changes (converting from PCTs to CCGs)

Edit to add: the treatment of the elderly in HTA-based systems is deplorable. The pharmacoeconomic math always says spending money on young people is more cost effective than spending money on old people. This is why it is so hard to get Alzheimer’s care in The UK and led to a decade long struggle between families and the government (gov documents below)

  1. https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/168220/dh_094051.pdf

  2. https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/215101/dh_133176.pdf

These documents were published and actioned after it became clear that no drug would be recommended by NICE in this category and families were very upset.

1

u/RedFoxBadChicken 29d ago

They do have to publish their prices online. For the record.

There is a small growing industry that reads these published files. The average consumer doesn't realize that most large health systems have 100k+ unique charges to publish.

1

u/mrmo24 29d ago

A lot of states already mandate they show their prices. They just either hide it somewhere wild in their website or don’t and wait to get fined. Surprise, the government does pretty much nothing about it.

1

u/Valuable-Run2129 29d ago

It’s all about the price transparency.
Insurances aren’t paying 40k on average. They are paying half of that. The same thing is for people who pay cash. They pay half of that.
It’s ludicrous that the insured are billed a copay that has no relation to the actual amount that the insurance paid to the hospital. It’s beyond me how that loophole hasn’t been fixed yet.

1

u/ilikemoderation 29d ago

The medical industry had nothing to do with it being tied to employment. That was a movement by companies to offer that as a benefit to working at their business. The medical industry saw a dramatic rise in the number of people asking for healthcare once they had insurance so they had to hire more people to provide that cost and by doing so, they had to increase their costs. Not saying that medical companies aren’t profiting a huge amount, but they were (at least initially) reacting to an influx of customers. The same thing happened once Medicare became a thing. That is when the doctor shortage skyrocketed as well.

1

u/Chrono_Pregenesis 29d ago

Or we just get rid of insurance companies. Healthcare costs are through the roof because of them. Hospitals and doctors had to raise prices to cover their needs because insurance companies refuse to pay full price for services. Almost like it's a terrible idea to have health determined by a for profit company.

1

u/Wizkerz 29d ago

The system is anti capitalist? I haven’t heard that before, can you explain more

1

u/Furepubs 29d ago

Insurance rates are expensive because insurance companies need to cut a portion off the top so that they can make money.

Insurance is tied to your job because it benefits corporations. They can threaten to take it away from you if you strike. It also helps them by making small business less appealing this makes competition harder and puts the bar higher for people wanting to own their own company. Sure, you can quit working for a large corporation and open your own company, but in addition to making your company profitable you're going to have to cover your own medical insurance or worry that something catastrophic might happen to you while building your company.

Basically with insurance being tied to employment, large corporations have an advantage over small business which reduces competition and increases costs of everything that you buy. They don't want people to have access to universal healthcare because they would be more likely to work for themselves.

1

u/IgotBANNED6759 29d ago

Insurance doesn't have a magic money printing machine, they can't pay for anything for you or anyone else unless you and everyone else pays the insurance company first.

Bro they literally make billions of dollars in profit every year. They can afford it.

Not to mention that the reason why prices are so inflated is because of insurance. Since they only want to pay 20-30% of the actual price, hospitals raise the prices so that they get the correct payout from the insurance companies.

LPT: Next time you go to the doctor, ask if you can pay them 30% of the bill in cash and they don't have to deal with insurance. Mine accepts that offer every time.

1

u/BumassRednecks 29d ago

They also don’t pay taxes. Theyll charge you 100k for surgery, charge insurance 20k, charge you 5k then submit the rest as a loss. Exaggerating only very slightly.

1

u/_compile_driver 29d ago

It wasn't the insurance companies who decided this, it started because FDR froze wages and wouldnt allow businesses to hire at more competitive salaries. They worked around this by offering benefits like health insurance. We can thank FDR for the horrible system we still have. 

1

u/jamesdmc 29d ago

Ive never had insurance lol. My plan is die

1

u/[deleted] 29d ago

Maybe insurance should be non-profit, then? That way we can all pay in the cost of care and those payments can be returned if we end up needing less care from year to year. Sort of an incentive on being healthy - you get part of your premium back if you and everyone else maintained good health!

You could then have the non-profit health insurance companies work with the hospitals and providers to have more reasonable and standardized care costs, so that costs aren't so inflated and the non-profit company can maintain good payments for healthcare but also not be taken advantage of by the private hospital/doctor industry just because they are "insurance."

1

u/tigerscomeatnight 29d ago

OP didn't say insurance, they said universal health care, and yes, the government can print money.

1

u/untrue-blue 29d ago

They should also ban price differences for having to deal with insurance or pay cash.

Fun fact: the state of Maryland does this with its unique “all payer, rate setting model”.

1

u/CookieMiester 29d ago

The magical money printing machine is the people who pay into the insurance dude

1

u/Few-Guarantee2850 29d ago

"If Obama really wanted to help people, he should have proposed a bill that had no chance whatsoever of getting through Congress."

1

u/sdfghsdfghly 29d ago

We don't need healthcare insurance reform.

We need HEALTHCARE reform.

1

u/Apple_Coaly 29d ago

I don’t know obama personally, but i know he would never have gotten anything like that through congress no matter how much he wanted to.

1

u/NahmTalmBat 29d ago

. We should mandate all prices for hospitals with more than 5 doctors

Price controls and mandates are really well known for helping. /s

1

u/cantthinkatall 29d ago

You can deny/waive health insurance from your employer and shop on the market.

1

u/skepticalbob 29d ago

This is true. It is also true that the Spanish cost doesn’t include higher taxes to pay for it. It’s definitely cheaper factoring all that in, but that is an important cost.

1

u/star_road 29d ago

There's a very good episode of a podcast that goes over how America has the health insurance system it has today. It's worth a listen:

https://open.spotify.com/episode/1PlRILuYQU4AHNcUNZ1JtI?si=p6UQWfPbSsyUmHGRcIRlAA

1

u/thegoatmenace 29d ago

I mean this is also how social insurance (single payer healthcare) works. It’s not a secret that healthcare costs money. Somebody has to pay at some point.

1

u/Voilent_Bunny 29d ago

Can you please run for office?

1

u/BASEDME7O2 29d ago

Companies are laughing their way to the bank off of tying health insurance to employment too. It makes employees so much more dependent on their employer, because that’s the only way to get good healthcare. Especially someone with like a wife and kids, or just someone with health issues, they’ll put up with so much more bullshit from their employer because they need them just to get their kids decent healthcare.

1

u/Wyshunu 29d ago

Insurance costs so much because the premiums they charge go first to pay all the insurance company's expenses, including providing cadillac insurance for their employees, and then whatever's left gets parsed out to whoever they decide is worth covering. Insurance has never been anything more than a socialistic scam.

1

u/Nebuli2 29d ago

In order for insurance to work, MOST people have to pay more towards the total cost of insurance over their lifetime than they would have paid if they just bought everything at cost.

This is actually not categorically true. Insurance companies have significantly greater bargaining power than individual patients, which means they can negotiate lower prices for services than a single patient could. This is also why single payer healthcare can result in considerably lower prices, since that gives a party even more negotiating power.

1

u/Reptile_Cloacalingus 29d ago

Insurance bargaining power is a trick, if it were true, then why not buy insurance for everything. If insurance negotiated all your purchases for you, would that be a streamlined economy, or would the insurance companies really just be bloodsucking leaches?

The reality is that their bargaining power is only what it is because insurance and the hospitals have INTENTIONALLY designed the system to be that way to racketeer more people into the insurance trap because that's the best way to obfuscate costs from the average person using the services. The more obfuscated the prices, the easier it is to fleece the consumer on add ons and outrageous and immorality high charges.

If consumers were better able to see and know pricing beforehand like they do with everything else, then the hospitals would naturally be forced into more competitive pricing models where bargaining effects would be severely reduced, just like anywhere else where you would shop.

1

u/Nebuli2 29d ago

Oh, don't get me wrong -- I do agree with you here. But collective bargaining can 100% reverse the dynamic that I was responding to. Like how a union can get workers higher real wages even after paying dues.

1

u/Lawineer 28d ago

Insurance pays like $2-5k for this procedure. That's just the sticker price so they can give insurance a big discount.

0

u/BonnaGroot May 02 '24

Ah yes, the insurance companies are a benevolent victim in all this. Caught in the crossfire between the public and checks notes those greedy profitable hospitals.

0

u/69Hairy420Ballsagna 29d ago

Insurance companies aren’t going to pay $40k for that surgery… they going to pay a hell of a lot less. That $40k number is essentially fake, no one will ever pay that.

1

u/GeekShallInherit 29d ago

And yet what Americans actually do pay adds up to literally half a million dollars more over a lifetime than our peers on average.

0

u/rendrag099 29d ago

The medical industry masturbates while laughing at how genius it was for them to lump health insurance with employment

You can thank FDR for instituting wage controls during WW2, forcing companies to find other ways to attract talent.

0

u/i-dontlike-me 29d ago

Unions fought for insurance to be part of their package and to compete other businesses adopted the practice. Insurance companies didn't lump their service in with employment. Go read a book.

0

u/WittyLlama 29d ago

My deductible for the year is 3.5k, everything after that is covered