Having experienced emergency care in both Denmark and the U.S., this is also the main reason I won't relocate to the U.S. until this is sorted out. I had what was thought to be a broken ankle in Denmark thanks to icy conditions and I was so well looked after, and charged nothing, I was awe inspired and wish there had been some way to pay it back. I sliced a finger in the U.S. and was made to feel like a statistic, with a $1000 bill. Thanks to inexpensive travel insurance that cost me just $100, but how I am supposed to feel when my travel insurance is less than quarter of the price that actual insurance would be if I lived there?
(Edit from reading other comments: probably not charged in Denmark because of European health reciprocity, but they never verified this at the hospital).
It's not fair, and not right, but it is a fact that for the most part, most of us here don't have to worry about that.
If you're a software engineer or systems administrator or similar type of professional earning a fair living it's not at all uncommon to have completely free health insurance for yourself, and affordable options to cover your family. I haven't worked for a place with an individual premium in 5 years.
Again, not saying the system isn't broken, but rather that there's a reason all Americans aren't vocally supporting the ACA and the president: this is mostly a lower-middle-class-and-below problem
It's a huge problem if you want to start a company. It's an even bigger problem if you want to hang up a sign and do business as a freelancer.
I agree with your point: the reason the country isn't completely behind health care reform is that they get it from their employer and don't understand how it works. Of course, they're also getting screwed financially in the process.
As others have said, it's a problem for anyone who wants to do work outside of the "middle class employment cocoon".
I'm self employed, and even if I go back to working for a larger company, I would prefer to continue to keep my private insurance. I have private homeowner's insurance. I have private car insurance. I have private life insurance. Why oh why do we demand/insist that employers provide health care, to the detriment of market forces favoring individual purchasing?
Conservatives in this country should be in an uproar that the 'free market' isn't allowed to run its course because of the combined interference of big business, big labor and big govt over the past several decades, but they're not.
> Conservatives in this country should be in an uproar that the 'free market' isn't allowed to run its course
Because unlike cars and homes you only have one life. If you let a profit seeking entity control and dictate what happens to your health, you might not have a chance to go back fix the problem by choosing a better one. You could be dead.
There was just recently a story on Reddit about someone who's relative a was killed by a driver and his dead relative' insurance company effectively provided council for the defendant. That's the kind of stuff you'd be dealing with. You health insurance company would be interested in killing you promptly as soon as you develop a chronic or expensive condition. And they'd all want to do it. All 1 of them after they merge into a giant conglomerate (since you know can't be messing with the free market and stuff, there will be nobody protecting against monopolies).
I agree, and I feel it used to work even better in that respect, when educated Americans typically had lifetime employment. I would guess that's one reason the debate is growing louder lately. The West basically solved the healthcare problem via collective coverage, but in different ways: the European countries did it nationwide, but the US did it with employer group plans. That was almost equivalent, for people with good jobs, as long as people stayed in jobs for life: having the IBM group plan was about as good as having state health coverage, as long as the IBM job was more or less for life.
It's more broken if you're middle-class-or-below (as you mention) or an entrepreneur who isn't either early-20s-and-healthy or raking in huge piles of cash. The part that seems most out of keeping with the American ethos is how anti-entrepreneur it is: you get good collectivized coverage if you work for IBM or Microsoft or Google (because it's socialized across their employee base), but if you start your own company or are trying to buy insurance for a 10-person company's employees, well then you're screwed.
Interesting. I mostly know people trying to buy individual health insurance, whose difficulty really varies, depending on age and health history. Is even a 10-person company big enough that buying it isn't a problem, if you're willing to pay the "10-person company" premium? In particular, do they inquire into the distribution of health among those 10 people? I would've guessed that if 1 of your 10 employees happened to have some disqualifying condition you'd be SOL.
Not entirely a theoretical question, b/c one of my friends has a congenital heart defect, and is himself not 100% sure how his condition would impact a small company. They aren't allowed to inquire into such things when hiring, but could it possibly tank their group health-insurance plan, if 1 of [small-N] members had a major preexisting condition?
You can get group coverage (by which I mean, "insurance plans in which individual members of the team will not need to fill out applications") for teams smaller than 10 people, but probably not much smaller.
In the US, group health coverage is distinguished in part by not "qualifying" patients, so that latter example doesn't really come up. There are horror stories about companies being forced out of their insurance plans by prohibitive cost spikes after major medical events, but I don't have any of them ready to deploy on this thread.
I disagree. It's really common for small software companies not to provide insurance, and of course anyone who wants to strike out on their own, either selling software or contracting, has to deal with the question. I would wager that the average programmer is more exposed to the problem of health insurance than the average.
Exactly what part of an emergency room visit is going to change in 2014, when PPACA is fully implemented? Please be as specific as you can, while limiting the detail you provide to the "amount of time taken to see someone at an emergency room" example you've used in this comment.
I expect the continued growth of socialized medicine to continue the trend of less and less competence among medical professionals, and less and less medical professionals period (particularly doctors--which seem to be in acute shortage already). So, nothing will change overnight, but this certainly isn't going to allow things to get _better_, which would eventually happen in a more free-market medical system.
Americans are exceptionally good at everything the free market touches (consider the tech world). Medicine could, and should, be a lot like going to the vet. Extreme competence, speed, and low price. The difference? There honestly isn't that much of a difference, except veterinary practice is pretty much a free market.
By the way, I've personally been forced to undergo unreasonably waits at the ER (I was kicked out of the building by a security guard because I wouldn't take a seat or stand - I couldn't physically do either, and I went and laid down in a parking lot outside). I've also seen a loved one hurt--potentially very severely over what could have been the case, but who knows--by not getting competent attention during a stroke. And there is at least one other bad story I won't get into here.
By the way, I do think my stories are representative of a larger trend. The above-mentioned incidents occured in different hospitals mixed between the east and west coast. That still isn't enough to prove anything. But I'm hearing complaints from a lot of people. Also, if you talk to someone applying to med school, you'll see that the number of doctors is being artificially restricted.
The public discussion about healthcare is missing a huge component, which is: why is our healthcare so completely shoddy and incompetent today? What can we do to change that? And, why aren't there enough doctors? I'm talking totally independent of the _cost_, which admittedly is also a problem.
"Medicine could, and should, be a lot like going to the vet."
Yeah, and patients whose cures are more expensive than they can afford should be put down painlessly, eh?
There are some aspects of health care where free market mechanisms can improve efficiency, but efficiency is not by itself the ultimate goal a health care system should have.
How much does it cost to treat a dog for the most serious medical problems, like cancer? I bet it's trivial compared to the cost of a human. I bet it's so little, that we could actually think about treating everyone for everything, if we could get human treatment to that level of efficiency.
Seriously, it's the most humane way to go.
In the meantime, I'll be thinking about going to India if I or loved ones need serious medical care.
It seems that most people get confused between ER & "trauma" service. If it was a "real emergency" (chest pain/stroke etc) the patient would go straight to the trauma service. Not so critical emergencies are treated in the ER, and that can involve 3-4 hour wait.
Quite a few hospitals with ERs also have a 'urgent care' or 'express care' clinic attached which are quite effective as they can a lot of things a ER can do, and expedite transfer to the ER if can't be treated there.
(Edit from reading other comments: probably not charged in Denmark because of European health reciprocity, but they never verified this at the hospital).