1. Bad plans have really, really high deductibles and high OOP max. If you're looking at 9K OOP max then you can absolutely be financially ruined. I mean, for many people that's more than their car.
2. Out of network charges and ridiculous billing. You can get denied, you can be given the run-around, and you WILL pay more than whatever your OOP max is. Your hospital visit will result in you getting bills 3 months later. Things will conveniently slip through the cracks.
3. Not everything is covered, for example, long-term care. If you're old and sick and need to be in a nursing home, you're 100% fucked. You need medicaid for that. Not medicare, that doesn't cover it, you need medicaid. So you need to basically forfeit all your money you've ever made. Or, pay 10k a month, which is functionally equivalent for almost everyone.
I get $9K can be a hit, but is the expectation that tens of thousands or hundreds of thousands of dollars in medical care is just free?
Let's say that $9K OOP max is for a significant health event - like a badly broken leg. In the NHS, approx 4.5% of the person's income is directed to the NHS via taxes, and at an average income of 37,430 that's a yearly 1,684 going to medical expenses, or an equivalent $2,426 PPP. Are you having a health crisis every 4 years where the NHS system would be more manageable financially?
That's all even before you get into the write-offs, reductions, and relative unenforceability of US medical debt, especially for lower-income people. If you're in a place where you can't pay $9K, you're also medical "debt-resistant", really.
As for LTC, there is LTC insurance and Medicaid as a last resort. Ignoring the idea of a Medicaid trust, doesn't it seem fair that you would spend down your estate in exchange for this very expensive care you're receiving? I can only imagine the reaction from the left if a multi-millionaire's kids got to inherit the estate while the taxpayer picks up the tab for his care. In some other countries, euthanasia is increasingly being positioned as an alternative to long-term care because of the challenges with bed-availability, which seems equally unpalatable to the public.
> I get $9K can be a hit, but is the expectation that tens of thousands or hundreds of thousands of dollars in medical care is just free?
Largely, yes, it is free in most of the developed world. Or close to.
> Are you having a health crisis every 4 years where the NHS system would be more manageable financially?
Yes, the average US citizen pays about 12K dollars a year for healthcare. That's twelve. That's including health care costs, insurance, and taxes - because yes, we also burn tax dollars on healthcare.
That's the average. Are you noticing something? How is it so much more expensive?
It's because US healthcare is also socialized, just like the NHS, but it's done shitty. It's done in thousands of tiny little fiefdoms which produces one of the most inefficient medical systems imaginable.
And, what I think you and other's really need to understand, is that the US does not have good healthcare. We have consistently worse healthcare outcomes than other developed countries.
Not only are we paying sometimes an order of magnitude more per person, we don't get anything for that. It's not like we have high-quality healthcare.
> In some other countries, euthanasia is increasingly being positioned as an alternative to long-term care because of the challenges with bed-availability, which seems equally unpalatable to the public.
Yeah, we also do this in the US. Again, not only is our care very expensive, it's also very bad.
It's definitely not free. Someone is paying for it: the government, the taxpayer, etc. On a person by person basis, you can call it free because that individual doesn't pay, but that's just because they're making their neighbors pay for them.
I accept the US does pay more, but the original question I had was confined to how individuals are finding themselves in 5 to 6 figures of medical debt, given a 9K OOP maximum. The apparent answer is some combination of they weren't paying for insurance (even the comparatively tiny post-subsidy ACA plan amounts) and a broader "insurance billing is tough and messy".
As for health outcomes, the part you're leaving unsaid is just how much money in American healthcare is going to treat and manage costly chronic conditions. As just one example, the "obesity rate in the U.S. is 42%, which is a whopping 134% higher than the average of the other five nations (Spain, Italy, Iceland, Japan, Switzerland)", and the CDC estimates "obesity alone costs the US healthcare system a colossal $147 billion annually" [1].
Do you think centralizing our healthcare into a single payer or government run model would address the fact that so many Americans are so unhealthy as to consistently need thousands of dollars of care a year? Is the Canadian, UK, or US VA healthcare systems a "model system" in your opinion?
> s the Canadian, UK, or US VA healthcare systems a "model system" in your opinion?
No, because every system has problems. But they are better.
Single-payer systems are more efficient by definition. When you don't have thousands of insurers and the logistical overhead of that, you save money.
Also, yes America is unhealthy... but not that unhealthy in the scheme of western countries. Obesity is very slightly lower in the UK, for instance. And we have less tobacco use than the UK.
1. Bad plans have really, really high deductibles and high OOP max. If you're looking at 9K OOP max then you can absolutely be financially ruined. I mean, for many people that's more than their car.
2. Out of network charges and ridiculous billing. You can get denied, you can be given the run-around, and you WILL pay more than whatever your OOP max is. Your hospital visit will result in you getting bills 3 months later. Things will conveniently slip through the cracks.
3. Not everything is covered, for example, long-term care. If you're old and sick and need to be in a nursing home, you're 100% fucked. You need medicaid for that. Not medicare, that doesn't cover it, you need medicaid. So you need to basically forfeit all your money you've ever made. Or, pay 10k a month, which is functionally equivalent for almost everyone.