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It's crazy how we call health insurance, insurance. All it does is slightly discount the bill. It doesn't insure anything.
But it does. If you get cancer, they pay everything after you hit your max out of pocket. So instead of paying $1M or whatever, you pay something like $15k.
Insurance is there to protect you from black swan-type financial ruin, it isn't intended to reduce costs for routine care.
The real problem is that costs vary depending on how you pay. The Rx should always cost $X and theb insurance shouldn't care or know which Rx you pick, they should just pay $Y. The problem imo isn't insurance, but the completely opaque medical pricing system we have.
If pricing is consistent, it's a lot easier to design assistance programs for those who need it.
Meanwhile former soviet republics: "Insurance for not going over 15k$? It's not bill insurance. You get healthcare, state gets paying."
But that's not insurance, that's universal healthcare, which is a completely separate thing.
Here it's called(translated) Mandatory Medical Insurance.
They can call it whatever they like. Government programs rarely reflect their actual structure.
That said, I don't know much about European healthcare systems, so maybe it is a form of insurance, idk.
Government programs rarely reflect their actual structure.
I know how it works in Russia. For citizens no matter how much you pay you get free healthcare. But, depending on region, it ranges from just therapist, ambulance and few hospitals few hours away somewhere in the middle of Siberia to polyclinic full of specialists and a lot of specialized hospitals in one city in Moscow.
But if you need "Emergency, including emergency specialized, medical care" because of "sickness, accident, trauma, poisining and other cases requireing emergency treatment", "Such medical treatment is provided by state and municipal healthcare organizations and is free of charge". Even if you are tourist.
So there is universal part(emergency healthcare) and "insurance" part(peventative healthcare, non-emergency like optometry). "Insurance" is called mandatory because it is basically 5% tax.
Also, it seems in USSA even citizens pay crazy sums for ambulance. While here it is theoretically possible to get fine for falsly calling ambulance, you have to do phonepranking to actually be fined.
I think it's very similar in rest of ex-sisters.
Yeah, the ambulance thing is super dumb. I wish we had universal emergency healthcare, it would at least remove that point of stress. You really shouldn't have to pay if paramedics decide you need to go to the hospital.
But I'm not really sold on the rest. The main issue I have is that what insurance you can get is determined by your employer, and if you don't like it, you lose whatever they would've contributed. If people could pick their own insurance, people would probably be happier, and things like a public option become more useful as a check against private insurance.
I'm not convinced universal healthcare is really going to be cheaper or better for most people though, especially in our already messed up healthcare system. We do need to simplify insurance, because care providers are spending more and more dealing with insurance, which increases costs for everyone without providing value. I'm convinced the ACA (Obamacare) made things worse in that respect, so it simultaneously went too far and not far enough.
But whatever, it could be worse. We pay something like 5%/year for medical care (1.5% for Medicare for the elderly, 3% through my employer plan, and a little extra for incidentals; we're pretty healthy).
The main issue I have is that what insurance you can get is determined by your employer, and if you don't like it, you lose whatever they would've contributed.
This is why UHC or at least UHC-like(citizens-only, separate tax) system is better. Here and in previous message when I write UHC, I refer to what any person can get regardless of citizenship. If you count what citizens can get, then MHI would be UHC by that definition.
and things like a public option become more useful as a check against private insurance.
As marshrutkas show, without public option private buisness is race to the bottom in terms of quality. While in cities that run their own public transport it is not as bad. It is interesting, how public perception was changing. In late 90-ies early 00-s people were saying "my city is better because it has marshrutkas", "marshrutkas are faster and more comfortable than old PT buses", while now "I don't want AC-less coffin" and "bring back municipal buses". Because PT always comes, no matter snow, rain or thunder, while commercial microbuses mostly work only in peak hours.
I'm not convinced universal healthcare is really going to be cheaper or better for most people though, especially in our already messed up healthcare system. We do need to simplify insurance, because care providers are spending more and more dealing with insurance, which increases costs for everyone without providing value.
You already described one reason why UHC will be cheaper.
I'm convinced the ACA (Obamacare) made things worse in that respect, so it simultaneously went too far and not far enough.
I'm not an expert in american healthcare system, but as I understand that there is problem of private gatekeepers. Yeah, I can imagine things going worse.
We pay something like 5%/year for medical care (1.5% for Medicare for the elderly, 3% through my employer plan, and a little extra for incidentals; we're pretty healthy).
Per year? Does rate go up every year? Here it's basically just tax: if you don't work - you don't pay, but receive healthcare regardless of having any income just because you are
such great humancitizen.without public option private buisness is race to the bottom in terms of quality
Agreed. I've seen examples of that with charter schools (privately run, but funded with tax dollars). With a good mix of charter and public schools, charter schools tend to do a bit better and specialize, but if public schools go away, charter schools become crappy.
I'm a huge fan of public mass transit as a backbone and private transit to fill in the gaps.
So the idea has merit, I just don't know how that mix should work for medicine where competition can be less realistic. Perhaps it should be like transit, public services for emergencies, and private services for scheduled services. Idk, I'm not a policy expert, but there needs to be a middleground between queues for care and massive medical bills for small procedures.
does it go up every year?
The 1.5% tax stays constant and subsidizes retirees' public insurance (and very poor people, or those with specific conditions).
The rest is just what I approximate based on my income and my employer's selected plan. The plan is kinda crappy (1 free checkup and covered preventative care; deductible for everything else with ~$15k max paid by the individual in a given year). I'm pretty healthy, so I get an extra discount, but the amount is fixed and uncorrelated with income. So for someone making much less, it'll be a higher percentage of income.
Most years we spend near-$0 out of pocket (except maybe $20-30 for medicine), but we've spent ~$10k per kid when they were born. I didn't factor that in, I just counted the premiums, which are about 3% of each paycheck.
Sorry for late response.
charter schools become crappy.
Worse than public ones were.
I'm a huge fan of public mass transit as a backbone and private transit to fill in the gaps.
I think small personal transport((e)scooters) better fills in gaps. Big personal transport is overkill in city with proper PT. Private transport, I think, is only needed in rare cases, like you need to transport something big. For example moving server across entire city.
So the idea has merit, I just don't know how that mix should work for medicine where competition can be less realistic.
I know that in MHI system polyclinics get funding based on amount of people that registered there. And that people can register in any polyclinic they like, but generally they do in closest to their home.
But with healthcare I think there is no need for competition inside one country. Rather need for competence of doctors. And decent wages. And not have president stealing healthcare money to build palaces for himself.
Perhaps it should be like transit, public services for emergencies, and private services for scheduled services.
I think it's very bad idea, because this heavily disincentivises preventative healthcare. Sickness better to prevent than to cure.
Idk, I'm not a policy expert, but there needs to be a middleground between queues for care and massive medical bills for small procedures.
- We are talking about something for masses.
- Talking about masses and limited resource implies theory of mass service, or how it more commonly called in English - queue theory.
- If you want to not have queues for emergency care, hospitals can just reserve power(machines, operators, etc) for hospitals. If you need more, you(abstract you) either reserve more or build more.
The 1.5% tax stays constant and subsidizes retirees' public insurance (and very poor people, or those with specific conditions).
For 1.5% of tax USA has too little of healthcare. Even for its own citizens.
The rest is just what I approximate based on my income and my employer's selected plan. The plan is kinda crappy (1 free checkup and covered preventative care; deductible for everything else with ~$15k max paid by the individual in a given year). I'm pretty healthy, so I get an extra discount, but the amount is fixed and uncorrelated with income. So for someone making much less, it'll be a higher percentage of income.
This is main problem of private healthcare. No job = no healthcare. Well, one of main. Other is conflict of interests.
but we've spent ~$10k per kid when they were born.
I'm sad again. It's terrible. I hope your country will improve. Such things should not happen.