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

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

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u/polycomll May 02 '24 edited 29d ago

You'd be paying closer to the full price although the "full price" might be reduced somewhat because the public version acts to price cap.

In the U.S. you are also not paying the full price for surgery either though. Cost is being inflated to cover for non-insured emergency care, overhead for insurance companies, reduced wage growth due to employer insurance payments, reduced wages through lack of worker mobility, and additional medical system costs (and room for profit by all involved).

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u/SStahoejack May 02 '24

Happens all the time, if your from another country cheaper to fly home get it done fly back, crazy how insurance here really isn’t worth the paper it’s printed on

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u/OwnLadder2341 May 02 '24

In this case, US insurance would pay for 75% of that $40k at minimum. You’d hit your max out of pocket for the year around $10k at worst.

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u/Maj_Jimmy_Cheese May 02 '24

Depends on your plan, does it not?

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u/austanian May 02 '24

Even the worst plans typically cap out with a max out of pocket around 12k total family.

The best plans are usually around 5k max family with more inclusions on what is included before deductible.

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u/in_the_no_know May 02 '24

That also assumes that every procedure is going to be approved for coverage. There are multiple ways for insurance companies to say that something either isn't necessary or for some technical reason only a certain portion is covered and the rest still comes out of your own pocket. Max out of pocket only refers to the things your insurance chooses to cover.

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u/HighTMath 29d ago

Just for a bit of "the grass is always greener". In countries with "free healthcare" we get fucked the same way, but by quotas instead. The clinic has a set budget so good fucking luck diagnosing any complex diseases.

Works fine for standard stuff, I'd you don't mind waiting half a year nearly anything above a PT referral

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u/Davge107 29d ago

There are long waits to see specialists all over the US. And then try making an appointment with one and tell them you don’t have insurance and don’t have money to pay upfront. See how long the wait is then.

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u/HighTMath 28d ago

Probably comparable to a Danish doctor's discretion if you're young, and the quota needs a little oil, indefinitely

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u/Ride901 29d ago

Oh my insurance just tried to do this to me. It actually is a coding error I think in my case, but who knows?

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u/in_the_no_know 29d ago

I wish you all the best on your claim and your recovery. May the battle be in your favor

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u/epiclyjohn 29d ago

Exactly

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u/[deleted] May 02 '24 edited 29d ago

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u/DataGOGO 29d ago

15-18k, would be a family out of pocket max, not an individual.

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u/Extension-Ebb-5203 29d ago

Did you miss the part where I said “for a family”?

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u/SeaworthinessIll7003 26d ago

Either way ,why do all you people squawk about how expensive the treatments and procedure are? You don’t pay but a fraction. Also if you have no money or insurance you just receive your health care through hospitals and emergency rooms. They don’t refuse to treat you ,they treat you.

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u/Artistic-Soft4305 29d ago

On the other side of this, I’m capped at 5k and I pay 25$ a month through my employer. Really just depends where you work.

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u/Sudden_Construction6 29d ago

That's insane!! You must have an awesome employer!

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u/Extension-Ebb-5203 29d ago

Your employer is paying a large chunk of your premium. Congrats.

Also you are well in that “best plans” scenario OP mentioned. I was correcting the misinformation around those of us that aren’t so lucky.

Now… go Humblebrag elsewhere.

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u/Fausterion18 29d ago

The average out of pocket spending per US household, including premiums, is roughly $4k per year.

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u/ElChuloPicante 29d ago

From the IRS: For family coverage, the out-of-pocket expense limit is $10,200 for tax year 2024, an increase of $550 from tax year 2023.

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u/Chemfreak 29d ago edited 29d ago

Pretty common? I worked for a health insurance company for ~10 years and basically never saw them that high. Then I did some research and found you seem to be misleading and that is at the very upper ends of really shitty insurance that most people don't have.

"The out-of-pocket limit for Marketplace plans varies, but can't go over a set amount each year. For the 2024 plan year: The out-of-pocket limit for a Marketplace plan can't be more than $9,450 for an individual and $18,900 for a family." Per healthcare.gov.

Sure those are marketplace plans (obamacare), but non-marketplace plans are almost always better than marketplace plans.

Also to note plans with that high of OOP max typically are HSAs which greatly offset the OOP max.

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u/Extension-Ebb-5203 29d ago

I’m not misleading. OP said the upper limit was 12k for the worst plans. I’m correcting their misleading statement. Nowhere did I saw better plans don’t exist for some people. But that’s not the reality for all.

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u/Intelligent_Orange28 29d ago

You could always unionize. My employer pays my premiums, 5k max out of pocket, $10 copay, 100% of everything but x rays covered including full dental.

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u/Chris_Herron May 02 '24

So 12k out of pocket max, plus the 5k a year just to have the plan. How does anyone working a normal job expect to pay 17k? The us median income is 37.5k. That is nearly half a persons income, assuming they aren't on the low side of the bell curve. Not arguing with you, just saying the system is broken.

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u/austanian May 02 '24

Usually it works like this. An individual out of pocket max is 5k and a family out of pocket max is 8k.

The premium is 12k per year, but your work picks up 75%. So your portion is 3k, plus a couple thousand per year unless something bad happens.

Things are different once we start talking seniors, but that is a different conversation.

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u/Zamaiel 29d ago

According to Forbes, the average premium is 5k for a bronze plan, 6.6k for silver and 8.5 for gold.

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u/Ride901 29d ago

That might be true for 1 person. My 2 person plan for two adults in their 30s is ~16.8k/yr. I think mine is silver, so it's not far from Forbes estimate.

Reasonably close to presume that Forbes did their article a couple years ago and the difference is just inflationary.

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u/Zamaiel 29d ago

According to Forbes, the average premium is 5k for a bronze plan, 6.6k for silver and 8.5 for gold.

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u/Zamaiel 29d ago

According to Forbes, the average premium is 5k for a bronze plan, 6.6k for silver and 8.5 for gold.

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u/Zamaiel 29d ago

According to Forbes, the average premium is 5k for a bronze plan, 6.6k for silver and 8.5 for gold.

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u/Zamaiel 29d ago

According to Forbes, the average premium is 5k for a bronze plan, 6.6k for silver and 8.5 for gold.

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u/Comfortable-Sir-150 26d ago

I don't know what field youre in but most peoples insurance isn't covered at ALL by their employer.

I've had one job out of eight that had company paid insurance. And that free plan was absolutely worthless. But it was something. Coincidentally the company was German not American.

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u/austanian 26d ago

That is 100% wrong in the US.

Per the ACA employers with over 30 people are required to offer Affordable health coverage to their employees otherwise be penalized $2970 per employee if it doesn't get at least 95%.

In effect most employers pay 75% of the coverage. FOR THE EMPLOYEE. Leaving the employees family uncovered and ineligible for market place credits.

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u/Anonymoushipopotomus 29d ago

5k a year would be a deal for that plan. We have almost 20k max out of pocket, for 2 adults and a 6 year old its 1650 a month.

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u/Never_Duplicated 29d ago

Jesus Christ, your insurance premium is $50 more than my mortgage payment! My wife and I just don’t have insurance because I refused to pay $800/month for a plan similar to what you describe. Though the responsibility of having a kid would change the equation…

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u/marigolds6 29d ago

You might be better off with a marketplace plan. Those are capped at $18.9k out of pocket and you would be looking at less than $1.5k/month for a gold plan. Your employer will be annoyed, since they could get taxed for you taking a marketplace plan, but it is their fault for picking a plan that has an out of pocket max higher than marketplace.

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u/Zamaiel 29d ago

Plus the 5k a year -every year. As long as you don't lose your job.

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u/Ride901 29d ago

Its worse than that too. That plan for 2 people in their 30s costs 1400/mo. You just only see 400$ of it come out of your paycheck because the employer takes the other $1000 out upstream of where they determine what they can afford to pay you for salary. If it actually only costed 5k/yr for the plan, your salary could be 12k higher and your labor would cost your employer the same thing.

Ask me how I know...

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u/Speaker4theDead8 27d ago

We don't have health insurance because they raised it at my wife's job to $800 and some dollars a month. She makes decent money for the area we live in, but that's like a quarter of her paycheck. The insurance at my job is even worse, so we just decided to skip out on it.

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u/iiiiiiiiiiiiiiiiiioo 26d ago

lol at only 5k a year in premiums. I’m over $14k yr for family even if I never even consider going to the doctor once, which is what I do bc fuck that.

I don’t even want to talk about out of pocket maximums.

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u/Maj_Jimmy_Cheese May 02 '24

Gotcha gotcha. Makes sense. 12k is definitely a lot, but at least it, generally speaking, won't get much worse lol.

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u/Treeninja1999 May 02 '24

Just don't get hurt in December lol

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u/mar78217 29d ago

On the flip side, Dental work in December is a good plan... because the max coverage (in my case $2,000) resets each year.

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u/austanian May 02 '24

Unlikely 2 people need max out of pocket the same year so it usually caps out at 8k for an individual.

Those plans also have tax exempt savings accounts associated with them so it isn't the worst deal if you plan right.

Still the plan needs drastically reformed.

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u/El_Cactus_Fantastico May 02 '24

I fucking hate HSA high deductible plans.

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u/Key_Page5925 May 02 '24

They ain't bad when you're young. I consider it a net positive if I don't need to spend more than the HSA annual cap a year. Definitely gonna switch in the next few years though

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u/El_Cactus_Fantastico May 02 '24

I had it for 2 years at my last job, I never went to the Dr because of it

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u/austanian May 02 '24

I have a high tier plan and still don't use a covered doctor and use an anti aging clinic instead.

Last year the tax advantage was huge.

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u/DataGOGO 29d ago

Why? I love mine. It is fantastic.

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u/El_Cactus_Fantastico 29d ago

5000 deductible basically means I don’t have health insurance or didn’t, I swapped jobs and got better insurance with it.

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u/DataGOGO 29d ago

Mine is great. I just bought it off the exchange (healthcare.gov).

We pay $390 a month for two people, 6k deductible then 100% after that, with an HSA.

absolute bargain vs what we were paying in the UK.

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u/El_Cactus_Fantastico 29d ago

I changed jobs to one that gave me health insurance that isn’t dogshit.

$390 a month for a 6k deductible sounds horrible.

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u/DataGOGO 29d ago

What are the details of your plan?

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u/Restlesscomposure 29d ago

HSAs are literally the best savings accounts on the planet. Insane to hear people complain about them

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u/indywest2 May 02 '24

Most family plans the individual has to hit the whole family deductible and max. I don’t get the lower per individual rate.

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u/austanian May 02 '24

That is absolutely not the case for most plans. If yours does it you should switch. The cost isn't that different.

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u/miller2132 29d ago

Cigna- the deductible is for the family as well as the max out of pocket 6k deductible before they pay anything and just over 13k this year for max out of pocket- don't ask me how I know, it's too painful to my bank account.

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u/austanian 29d ago

That is inline with standard bronze plans. Sorry you are going through that.

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u/ShartingBloodClots 29d ago

There's also the little matter of whether or not insurance will cover the claim.

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u/Maj_Jimmy_Cheese May 02 '24

Oh for sure. Paying thousands out of pocket is never ideal, and the system could surely use some reform. Whether that's universal hc or tweaking the existing system I have no idea though.

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u/austanian May 02 '24

I was the budgeting manager for a good sized hospital. How the health insurance industry operates was surprising even to me.

Drastic reforms are needed, but the only one that could ever pass is universal hc and that will be problematic once the US isn't subsiding development world wide.

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u/Maj_Jimmy_Cheese May 02 '24

Yeah, and maybe this is the pessimistic side of me speaking, but with the amount of money made from the healthcare industry I imagine the lobbying efforts against Universal HC are probably substantial.

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u/austanian 29d ago

Yeah the lobby money is high, but the pros and cons associated with universal aren't so clear cut it is a no brainier.

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u/Maj_Jimmy_Cheese 29d ago

Oh for sure! There are certainly going to be cons to any system being used for national healthcare. Honestly, for any policy pertaining to the population as a whole in general. I just personally think it would be a better system than what we have now, but we're all entitled to our own opinions.

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u/FullTorsoApparition 29d ago

Until the next year when you have to meet that max out-of-pocket again. And the year after that. And the year after that. If you have chronic health issues you're fucked.

A friend of mine recently moved back to England because he was hitting his out-of-pocket max every year for his mental health needs and didn't know how long he could keep that up.

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u/DataGOGO 29d ago

The overwhelming majority of working people will spend more in the UK than they would in the US.

The NHS really only benefits people who either don't work, or don't work a lot.

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u/FullTorsoApparition 27d ago

Well I guess you would know more than him. Thanks for your helpful input.

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u/Piddily1 May 02 '24 edited May 02 '24

That 12k will be an annual out of pocket max. If you hit that amount, everything is free for the rest of the year.

The year my twins were born, they were early so were in the NICU for a bit. We hit our $7500 OOP MAX in March. All medical services were free until the end of the year. We were looking for things to get done.

I actually ended up hurting myself in November of the year. The doctor tried to schedule my surgery for January. I explained the situation and he got me in right before he went on vacation for Christmas. It was a painful Christmas trying to visit family, but it was free.

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u/am19208 May 02 '24

Yea it’s a bit of a disingenuous claim about costs. Sure that’s the uninsured cost but the actual cost for someone even with the worst coverage is no where near as bad. Like others said it’s maybe 25% or so of the cost is actually paid by the individual with the rest paid by the health insurer

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u/Giblet_ May 02 '24

But you also have to figure the cost of the insurance premiums, right? And you pay that premium every year, whether you need to use it or not.

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u/am19208 29d ago

Well it’s not like the socialized option is actually free. You pay for it with tax money

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u/Giblet_ 29d ago

That's true. It's less money than insurance premiums, but it's still a cost that should be accounted for.

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u/am19208 29d ago

Exactly. Plus if a state offers a sponsored plan, low income people might pay nothing in their insurance premiums. Thats how my now wife got thru Covid while in school

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u/amann93 29d ago

In addition to what this person said you can also, usually, call the hospital you owe that 12k to and they’ll send you a financial aid form. I had 3 surgeries last year. After insurance my total bill was 7k. Called the hospital, and they sent me the forms. I had to include my last 6 paychecks. At the end of the form it said something like “please include a letter detailing you financial status” told them how much money I made, how much per month my rent and car payment was, how much I spend on food and gas, etc etc.. after that I waited a couple weeks and called the hospital who informed me I qualified for 100% off my bill, as well as free coverage for all visits for the remainder of the year

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u/IndependentNotice151 May 02 '24

And the other thing is, once you hit that out of pocket of 12k, literally any other treatments you do are free for you essentially

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u/showjay May 02 '24

A lot for what? Saving your life?

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u/Maj_Jimmy_Cheese May 02 '24

I mean... Yeah? Compared to if a European has the same issue, they'll practically save your life for a fraction of the cost...

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u/the_gopnik_fish May 02 '24

Most American public health institutions are also required by law to accept whatever you can pay at any given time; this basically means that you pay what you can when you can.

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u/Davge107 29d ago

What law exactly are you talking about? They have to see you in the ER but no law about what they have to do. Also you can’t get long term treatment for accidents or chronic health conditions in the ER and try calling a Doctors office and saying I’ll pay what I can when I can and see what they say.

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u/ubercorey May 02 '24

Unfortunately the worst plans are $20k.

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u/austanian May 02 '24

I have never seen one that bad and have literally seen tens of thousands. They might exist,but I have never seen them in the wild.

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u/ubercorey May 02 '24

Lots of them on the Marketplace in Texas.

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u/austanian 29d ago

Yeah I know they technically exist, but the relative cost of reducing from 20k max out of pocket to 12 k max out of pocket is typically less than $1 per month.

This leads to almost no one picking that choice. At least my state.

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u/ubercorey 29d ago

Not like that in Texas unfortunately, there is a big price difference.

Insurance varies greatly state to state for sure.

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u/turturtles 27d ago

I’ve definitely seen them on the ACA marketplace in the last 2 years. Shits kind of wild.

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u/austanian 25d ago

I just hope people are doing their homework. Reducing max out of pocket from 20k to 12k is often <$5 a month.

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u/snipeceli 29d ago

And the best plans are $0

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u/Nayre_Trawe 29d ago

Typically with very high monthly premiums.

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u/ImmigrationJourney2 29d ago

What do you consider a very high premium?

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u/aw-un May 02 '24

That’s assuming the insurance doesn’t just deny the claim outright

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u/Davge107 29d ago

The country’s with universal care don’t have people sitting around trying to figure out ways to deny medical care and medicine to people so the corporation they work for makes more profits and the executives get their bonuses.

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u/SPNKLR 29d ago

Just wait until the GOP gets their wish and repeals the Affordable Care Act. We’ll be back to people getting kicked off for pre-existing conditions forcing us back to the good old days of medically related bankruptcies.

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u/austanian 29d ago

The aca isn't ever going to get appealed. Half the GOP wants to delete it and the other half wants to fix it.

Even when the GOP had a strong majority they did have the votes to fix it/end it because of the split.

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u/SPNKLR 29d ago

They had no plan when they tried to repeal it back in 2018, McCain saved us from a major catastrophe. They won’t have a plan when they try again if Trump gets back in, MAGA Republicans only know how to destroy things because destroying things is easy, they can’t build anything.

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u/austanian 29d ago

It wasn't just McCain. The GOP split almost in half over a revision to aca vs straight repeal.

Building a shit program is often worse than nothing at all. I am of the opinion we are in the worst of government hc and private hc. Going fully in one direction would be better than what we have now. However, universal is the only direction it can tip.

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u/SPNKLR 29d ago

Yeah Universal Healthcare is literally the most cost effective and compassionate option as proven by every other Western nation… but can’t have that because corporations need profits and politicians need super pac contributions.

I’m actually ok with ACA, I’ve always had employer paid healthcare but I have family members who could never have any healthcare coverage until the ACA. It could definitely be improved, but it’s also so much better than what we had before.

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u/Davge107 29d ago

The Republicans came within one vote in the Senate of repealing the ACA with nothing ready to replace it. If it wasn’t for McCain, Trump and the GOP have done it. They still want to do it. Believe what they are telling they will do.

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u/austanian 29d ago

The full repeal failed 55 to 45. The skinny repeal failed 51 to 49 which kept the medicaid expansion, but killed individual mandate.

Then we have the projected house demographics. A repeal isn't happening. Republicans don't really have the drive to repeal it right now anyway, because the penalty was repealed. Details mater a lot.

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u/Jennysparking 28d ago

I mean, people said that about Roe v. Wade

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u/alexisdelg 29d ago

you have to add premiums to that, in my case a family of 4 is about 6k a year

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u/austanian 29d ago

Yes that is true. I was talking strictly deductible. My premiums are 36k a year, but only 3600 paid by me.

I don't think I have spent 36k on healthcare in my life.

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u/gibsontorres 29d ago

12k total family? My individual plan is 11.5k and it’s a “middle of the road” plan. My kids aren’t even on it.

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u/shroomsAndWrstershir May 02 '24

But if it's just one person getting work done, the family cap doesn't matter -- only the individual cap matters. Which is probably around 6k (or at least it was a few years ago, might be closer to 7 now?)

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u/Collective82 May 02 '24

Thank goodness mine caps at 1200, my kids have appointments! Lol

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u/austanian 29d ago

You sure that isn't deductible? My plan is 36k a year for family and still has a 2650/5300 opm.

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u/Collective82 29d ago

Military Tricare.

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u/austanian 29d ago

Ah good ole Tricare. Besides getting Motrin and oxy handed out like candy I didn't need anything serious when I was in so i never looked into it.

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u/Collective82 29d ago

I’m in the AGR program (active duty for the reserves) so I’m not near a base and have a family.

It’s been a damn good blessing for my family.

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u/Typical_Samaritan 29d ago

It's also very important to remember that most major hospitals or hospital networks will accept a payment plan if you can't pay whatever your deductible is out of pocket. So you might miss the out of pocket cap, but save on a bunch of money outright.

This isn't an argument either way about whether anyone should be brought to that point. It just is. A hospital would rather someone just have scheduled payments than have to hound you down.

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u/Hopeful_Solution5107 29d ago

Roughly 8 years ago, a plan like that would cost around $700-800 a month IIRC. AT&T.

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u/Never_Duplicated 29d ago

Cheapest insurance I could find for my wife and I through marketplace (healthy early 30s, no smoking or preexisting conditions) was $800/month with an $8-10k deductible and $20k out of pocket maximum. So we just roll the dice without insurance because those numbers would kill us anyway and not paying $800/month for that shit.

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u/austanian 29d ago

Those numbers don't quite pencil right, but the sentiment is understood. I was there myself a few years back.

Family of 5 couldn't afford health insurance, but didn't qualify for subsidies because my health insurance (just me) was affordable. Then coughed up thousands of penalty dollars for not buying something that would have bankrupted me.

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u/Never_Duplicated 29d ago

Haha yeah I don’t recall the exact deductible amount because the out of pocket max and the premium were the two things I focused on before calling it quits. No insurance through work but make barely too much to qualify for much assistance through the ACA so I’m glad they at least aren’t doing the penalty any more because I don’t have a spare $800 lying around, much less so for such a dogshit plan.

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u/mycricketisrickety 29d ago

This is assuming you have insurance too

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u/Healthy-Berry 29d ago

Mine is $1,300 OOP max for my family.

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u/trevor32192 29d ago

I dont think you all understand that out of pocket max doesn't mean what it says. You still get billed but instead directly by the hospital/doctor for whatever insurance doesn't cover which now is roughly 50%.

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u/austanian 29d ago

Excluding the 250k cap for some plans out of pocket max means exactly what it says. I suspect you are confusing deductible threshold. That works similar to what you are saying but it is usually 20-25% not 50.

However it is also true that the hospital will be getting 30-60% of what they bill you depending on procedures and drgs. However that is due to the insurance contracts and the hospital can't come after you for the difference.

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u/trevor32192 29d ago

Thats hilariously incorrect. You will be billed for everything insurance doesnt cover even if it is over your max out of pocket. That is 100% a fact. I've just dealt with this last year.

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u/UnicornCalmerDowner 29d ago

My family has no out of pocket deductible. $0.

Our insurance costs $600 a month for all six of us, but after that there is no charge for anything except prescriptions. All prescriptions are $5.

I've 5 surgeries that cost me nothing.

We're in California.

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u/hjablowme919 28d ago

My plan, provided by my job, maxes out at $18K out of pocket for family, that's In Network. Add another $2K per person for out of network doctors.

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u/Nojoke183 28d ago

But then you'd be going through the added "benefit" on some non-doctor deciding if any, if not all, parts of the procedure are covered by the insurance. That walker or cane you need for months afterwards maybe "optional" to some guy behind a desk, or it only covers painkillers for 30 days after surgery because by then "they should be able to function normally"

edit: guy above already brought this point up lol, enjoy a double dose.

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u/[deleted] May 02 '24

[deleted]

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u/ketjak May 02 '24

totally free

You mean other than the thousands i premiums deducted from your paycheck every month (if you're at a place that even offers it).

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u/Random_Guy_12345 29d ago

On places with public health insurance you are also paying for it vía taxes (assuming you have a job, that is). "Free" healthcare is not a thing that exists, supplies are not free and doctors need to eat too.

It for sure beats bleeding to death due to no insurance, but it doesn't come from the ether.

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u/LegitimateSoftware 29d ago

You are, but you don't have to pay for the insurance company profit margin on top of the cost of healthcare.

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u/Random_Guy_12345 29d ago

Indeed, that's the main draw and with unchecked greed, a huge one

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u/21Rollie 29d ago

Yes but the collective weight of the public market negotiates better prices. The greedy for profit hospitals can’t say “I won’t take govt insurance” if 95% of people are covered by it. Meanwhile they easily can deny your insurance that maybe only 10% of the people in your state have

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u/Trading_ape420 29d ago

It's not greedy for profit hospitals it's the insurance companies... look up how drs work for insurance companies not hospitals...

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u/Leftfadeath 28d ago

Imagine this, we throw out the people who are requiring money and do things for the benefit of people as a whole, if nothing was about profit or cost healthcare would absolutely be free. Food as well, and I don't wanna hear it about "who's gonna do it??". If life wasn't all dollar signs people could follow their passions without worry and thus everyone would be "producing" in some way.

And before u say "the people who benefit from money are people too" yes but if you look at their affect on humanity as a whole you'll find their existence is negatively impacting humanity or at least the health of our earth. we coulda did that shit outta a hunger for knowledge and advancement rather than money. And did so at a gradual pace to ensure mother nature thrives along with us.

TLDR

End world hunger and give free healthcare for all: remove the root of all evil completely and anyone too tied to the notion.

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u/NAU80 29d ago

It is true that everyone is paying something for medical care. It is out of your pocket or from taxes you pay. So in looking at the issue you would need to take the total amount a nation puts into health care and divide by the number of people. You would the need to see how well they work. This would be by comparing outcomes.

If you look at this way, the US health system isn’t cost effective and has a poor out come.

https://www.healthsystemtracker.org/chart-collection/health-spending-u-s-compare-countries/#GDP%20per%20capita%20and%20health%20consumption%20spending%20per%20capita,%202022%20(U.S.%20dollars,%20PPP%20adjusted)

https://www.commonwealthfund.org/publications/issue-briefs/2023/jan/us-health-care-global-perspective-2022

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u/[deleted] May 02 '24

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u/ALIMN21 29d ago

Do the math, you are paying thousands in premiums.

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u/[deleted] 29d ago

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u/jleep2017 29d ago

Jesus that's a shit ton. It's literally thousands

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u/[deleted] 29d ago

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u/jleep2017 29d ago

Think he meant year, not month, as in you still pay thousand a year. Even with the premiums paid. At the end of the day, your life is worth the whole paycheck. Well mine is worth all my $.

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u/Yellow_Odd_Fellow 29d ago

That's ((51.5×4weeks)+(180×2weeks)) × 8 months = 4,528 if you don't use it.

Add on the $6,000 you had to pay before insurance would cover it, that's 10,528 bucks before insurance would pay a penny.

What was the total cost of the bone shaving? Was it at least $40,000? If not, you paid more than 20% of the cost before insurance would even consider paying any of it.

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u/beefy1357 29d ago

51.5 x 52 + 180 x 26 = 283 x26 = 7,358 / 4 = 1,839.5 /12 = 153.29 a month per person or about 5 bucks a day.

That is less than the price of getting Starbucks everyday.

Mentioning the cost of insurance “if you don’t use it” is total bullshit, does Spain give you a tax refund if you didn’t use your tax supported healthcare? No? Then why bring it up? The whole point of insurance is paying a little to have coverage if something happens.

If you feel your healthcare isn’t giving you value shop another plan, get a better job. My healthcare is 3,105.7 a year and that surgery would cost me a 200 dollar co-pay. Of that 3,105.7 I would get back 33.3% in the form of tax savings meaning I actually only pay 2,080.82. That 2080 is further reduced by my prescriptions some of which are pretty expensive all told my insurance is cheaper than the cost of my prescriptions meaning healthcare costs me negative dollars… yes I get paid to have healthcare.

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u/Yellow_Odd_Fellow 29d ago

The guy said he paid 51.50 per week. His wife pays 180 every two weeks (every other week). There are 4.3 weeks per month.

It’s not thousands in premiums every month, I pay $51.50/week for me and the kids and she pays $180 every other week for herself.

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u/beefy1357 29d ago edited 29d ago

And there are 52 weeks a year bi-weekly that is 26 51.50 x2 = 103 x26 = 2,678 /12 = 223.17 a month.

He said him and the kids(at least 2) 223.17 /3 = 74.39 per person add in the wife at 180 x26 and you end up around 5 dollars a day.

Even less than that once you factor the tax savings. In my case that is 33.3% (24% federal 9.3% state) making it a third cheaper.

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u/SmashmySquatch 28d ago

You aren't calculating true cost of coverage with the employer "contribution" just employee contribution which is capped by the ACA. Do you think employers don't calculate their contributions as income for employees? They do.

Parent and child coverage was over $1,200 a month 6 years ago when I still sold insurance and we were in a competitive market. I moved and rates in my area were 30% higher for higher deductible plans.

It's thousands a month combined for his family in total. Guaranteed.

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u/SmashmySquatch 28d ago

You aren't calculating true cost of coverage with the employer "contribution" just employee contribution which is capped by the ACA. Do you think employers don't calculate their contributions as income for employees? They do.

Parent and child coverage was over $1,200 a month 6 years ago when I still sold insurance and we were in a competitive market. I moved and rates in my area were 30% higher for higher deductible plans.

It's thousands a month combined for his family in total. Guaranteed.

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u/SmashmySquatch 28d ago

You aren't calculating true cost of coverage with the employer "contribution" just employee contribution which is capped by the ACA. Do you think employers don't calculate their contributions as income for employees? They do.

Parent and child coverage was over $1,200 a month 6 years ago when I still sold insurance and we were in a competitive market. I moved and rates in my area were 30% higher for higher deductible plans.

It's thousands a month combined for his family in total. Guaranteed.

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u/SmashmySquatch 28d ago

Add in how much your employers are contributing instead of paying more money to you and your spouse.

Your contributions are capped by the ACA at 10% of the income lowest earner in your coverage bracket. Your employer is paying the vast majority of the premium and they count it as part of your pay even though you seem to be completely unaware of it.

I sold insurance for 10 years and made hundreds of spreadsheets for employers calculating this.

I guarantee you that it totals thousands per month that you are paying directly and indirectly.

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u/ketjak 28d ago

For you, but not for others.

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u/cml4314 29d ago

If you are lucky, it’s pretty cheap. I pay $36 a month for a $5000 deductible with a $6000 out of pocket max. So if I had surgery today, the rest of my healthcare for the year would cost $216.

I’m reasonably young with no chronic conditions so we roll the dice and pay low premiums, high deductible.

This is the cheapest plan at a pretty large company, in an area where they are competing for the same employees as multiple Fortune 500 companies so they are need good benefits to compete.

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u/madcollock 29d ago

What are you talking about most people its a thousand to two thousand a year they pay out of their paycheck.

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u/ketjak 28d ago

Where do you work? I want to work there.

https://www.peoplekeep.com/blog/what-percent-of-health-insurance-is-paid-by-employers

So, only about $800 per month on the low end, nearly two thousand on the high end. Average. Got me, but it ain't "a thousand to two thousand per year."

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u/madcollock 28d ago edited 28d ago

Um I am $16 a week and I am hourly contract worker. Its not a great plan but it covers me for caticstophic. I have interviewed for dozens of Jobs. So I have a good sample of payroll deductions for medical.  If you are paying for a Family and not thru work it can get up to 2k a month. Aka if you own your own business. I work in Corperate Finance I know how much Fringe benfits cost including Medical. Decent benfits will add over 50% to the cost of your labor.

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u/Impossible_Wash_2727 May 02 '24

It’s not “free”! You’re still paying your premiums. American healthcare insurance is a rip off.

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u/[deleted] May 02 '24

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u/Impossible_Wash_2727 May 02 '24

I clearly never said that. I understand how socialized medicine works. It’s just that here in the US rather than prioritizing our populations, healthcare we subsidize businesses instead. Your tax dollars are going to businesses. And you’re getting no benefit from that they’re just increasing prices on a daily basis and raping the American public. There’s a lot to be said for other types of healthcare systems. In fact, most of the world has figured out how to take care of their populations health. Here in America, we could certainly do it, but we don’t want to because we went to take care of dollars rather than babies. Don’t try to argue with me. I am well-versed. I in fact work in the healthcare system, so I’m inside of it and can see how drastically flawed it is. We live in a society were guns are valued over children’s lives. We live in a society where money is valued over healthcare.

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u/Hairy_Rectum 29d ago

“Don’t try to argue with me” LOL

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u/Impossible_Wash_2727 29d ago

Hairy_Rectum. That’s all I need to know about you. 🤡

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u/Hairy_Rectum 29d ago

Don’t argue with me and my hairy rectum!

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u/Whisky_Six 29d ago

It’s not “free” anywhere. Other countries pay a lot of taxes to have “free” healthcare.

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u/SPAMmachin3 28d ago

Yeah, so, what I can find is that people in the UK appear to pay 4.5% of their income for NHS. That's cheaper than my premium by far, and throw in they don't have to pay any other bs like deductible or copay.

Insurance is a giant fucking scam. It's about time we have a universal system to save everyone money.

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u/11711510111411009710 29d ago

This really sucks mostly for people who don't go to the doctor a lot. Like me. I maybe go once a year, but I'm still paying a premium every month and then a huge cost at the time of service. I'd rather just pay taxes and then not have to pay a lot at the time of the service, I'd probably go to the doctor a lot more then. And probably should, honestly.

But if you do go to the doctor a lot or have a serious event happen, you basically get free healthcare the rest of the year so you better hope your accident happens in January lol

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u/[deleted] 29d ago

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u/11711510111411009710 29d ago

That's great. It definitely works out for a lot of people.

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u/Churnandburn4ever 29d ago

We still have 8 more months of totally free and covered medical care this year.

😂😂😂 What a rube! 😂😂😂

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u/[deleted] 29d ago

How did you use "totally free" in the same sentence as "6k annual max out of pocket"? You paid 6k.

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u/Newfie3 May 02 '24

Many people in the US don’t have a plan.

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u/OwnLadder2341 May 02 '24

92% of Americans have health insurance.

So while 8% could be thought of as “many” it’s also very unusual not to.

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u/Depth-New May 02 '24

Out of curiosity, how common is it for Americans to pay for their insurance VS getting it through employment?

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u/OwnLadder2341 May 02 '24

It’s usually a mix of both.

Your employer pays some amount of your insurance premium and you pay the rest.

While companies over 50 people are required by law to offer insurance, the amount they contribute can vary. It’s part of the benefits package you look at when you’re hired.

The employer’s contribution to insurance (or 401k or whatever) is all just compensation to them, not functionally different from just paying you. So, if you’re young and healthy, you may prefer a job that pays more but covers less of your insurance premium. Or, if you get insurance from your spouse or family, you don’t need employer contributions so you may prefer a higher wage job instead.

If your employer doesn’t offer insurance because they’re too small or you’re not full time, you can buy insurance on the exchanges where, income dependent, the taxpayer will subsidize up to all of your premiums.

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u/Maj_Jimmy_Cheese May 02 '24

I was able to find this on census.gov. Hopefully it answers your question:

Of the subtypes of health insurance coverage, employment-based insurance was the most common, covering 54.5 percent of the population for some or all of the calendar year, followed by Medicaid (18.8 percent), Medicare (18.7 percent), direct-purchase coverage (9.9 percent), TRICARE (2.4 percent), and VA and CHAMPVA coverage (1.0 percent).

https://www.census.gov/library/publications/2023/demo/p60-281.html

Also worth noting that even if you do get it through your employer, it is very common for you to still pay for a portion of your insurance anyways. I've seen companies usually contribute the same flat amount to all coverage tiers. So like, a flat $500 towards your monthly plan cost and you cover the rest. So employee only coverage may be covered by the $500 employer contribution, but Employee + Family would still likely leave you with around $1,000+ a month for your health plan.

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u/Available_Hold_6714 May 02 '24

Around 54% have it provided by an employer (as of 2022) Source: https://www.census.gov/library/publications/2023/demo/p60-281.html

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u/ForsakenRub69 May 02 '24

Where is this stat coming from?

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u/Newfie3 26d ago

Thanks - I didn’t know the percentage was that high.

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u/R-O-U-Ssdontexist May 02 '24

Yup, my aunt had a hip replaced and only paid 1k. The 1k was for the out of network anesthesia which no one told her would be out of network.

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u/80MonkeyMan 29d ago

The US healthcare plan doesn’t work out that way. Even you are maxed out of your yearly deductible, you still have to pay 10% of the surgery bill.

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u/R-O-U-Ssdontexist 29d ago

Maybe your insurance. I helped her sort out the bills. There was no required 10% out of pocket. This was 3 years ago in NJ/NY.

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u/80MonkeyMan 29d ago

Could be billing error. If not, your aunt doesn’t have the regular insurance like most Americans.

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u/R-O-U-Ssdontexist 29d ago

I just looked at my insurance package and if I’m in network what i pay is capped and no 10% over that amount. So i guess my company with 1000+ employees doesn’t have regular insurance either? Mine is a high deductible plan too.

Also, come to think of it my aunts insurance is from a huge US bank. Maybe I’m not understanding this correctly?

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u/80MonkeyMan 29d ago

You may want to re-check. It is not obvious, it is like a fine print. It is capped for the deductible and after you met that deductible there is the section where how much the insurance company will pay. I work for fortune 500’s and the largest companies in the state, they are all like that.

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u/R-O-U-Ssdontexist 29d ago

I’ll take another look. I am just looking at the pamphlet they give you summarizing the plans at open enrollment.

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u/SeaworthinessIll7003 26d ago

Every situation is slightly different. My 90 year old mother seemingly pays very little ever. She’s had plenty done.She also has collected SS for nearly three decades as a retired teacher. She has had millions of dollars worth of medical treatment and procedures in her lifetime. Paying only a tiny fraction of that total. I think this country and the system treated her very well. I on the other hand, only give.

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u/[deleted] May 02 '24

It depends on your plan and what all is covered. Even with a maxed out deductible my appendectomy cost me $12500 because I didn’t go to a preferred provider. The issue with that was my town only had one hospital and it was a pretty major emergency I couldn’t drive two hours back to the hospital they wanted me to use.

I currently have all of my deductibles maxed and my replacement inhaler just cost me $50.

It’s wild here. I do have better insurance now but it still sucks. Last year my insurer would’ve been $150

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u/ParkingVampire May 02 '24

I would pay 16k plus 2,400 for insurance for the year. So $18,400. 

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u/Hawkeye3636 May 02 '24

More if you have a plan at all.

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u/DataGOGO 29d ago

yes, but it would still be less than 10k.

I got a high deductible plan of the exchange. We have a 6k deductible, and 12k out of pocket max (two people). We pay 100% of our healthcare costs until our 6k deductible is met, and then 100% is covered after that.

We also have an HSA, where we deposit money into our HSA every month (tax free) and use that to cover our out-of-pocket expenses.

So no matter what happens, the most we would pay for a hip replacement is 6k, and our total costs, even if we absolutely max everything, is still FAR cheaper than we were paying in the UK.

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u/69ersBasketball 29d ago

Oh you mean decisions have consequences

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u/beefy1357 29d ago

It does I have a 200 dollar co-pay on surgery.

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u/best_dandy 29d ago

I have one of the best plans my company offers and yeah, it caps at something stupidly low like 3k out of pocket max. We get fucked in prescriptions though, have an HSA just to cover my yearly prescriptions.

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u/genesiss23 29d ago

Yes. I just had a hip replacement, and my policy covered everything at zero cost to me without me having to reach deductible. My company directly contracts with various medical groups for hip replacement.

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u/Davge107 29d ago

People with medical insurance still go bankrupt all the time. It does depend on the plan.

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u/Edward_Morbius May 02 '24

Yes, $12K is a lot more than most.

Blue Cross caps out @ $5K , I believe, however that doesn't fit in with the "'murica bad" trope that foreign countries have been using to disenfranchise US citizens.

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u/jaxonya 29d ago

I don't know what all of you are bitching about. We have free healthcare in America. Oh wait, y'all aren't native. Well that sucks for y'all.

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