There is typically some out of pocket component to prevent moral hazard. A good plan will still be covering something like 90% of your costs until you hit the max out of pocket, then it becomes 100%. It’s so you are at least a little conscientious in choosing doctors and pharmacies and such.
I'm sorry, but $7000/year is not about "preventing moral hazard". NHS charging a flat £9/per prescription is preventing moral hazard so you don't request medicine nilly willy. The out of pocket expenses that people quote in this thread are insane - having to suddenly pay few thousand dollars for treatment would cripple my finances, and I'm a software engineer.
You’re very unlikely to spend that much. If you have multiple serious medical emergencies in the span of one year, $7000 is nothing for having your life saved and getting treatment. Also, the cap is usually much lower than $7000. Also, remember, they’re still covering ~90% of every individual expense. By the time you’ve spent $7000, the insurance company has put down many times that.
Our medical providers are competing private businesses. There are really good doctors, really bad doctors, and everything in between. Everyone wants to go to the better doctor, but there’s just not enough of them. Price differentiation is important.
There are $0 deductible and $0 copay plans and $0 coinsurance plans. They are also exorbitantly expensive because of the absurd moral hazard they create.
It’s a strange mindset to think that something should just be free. We pay for our cars, our housing, our food. Medicine is not free to provide. The America system is broken in many ways, but not because people have to pay for medical care. The problem is that it’s too expensive because of artificial constraints on the supply of doctors and other medical resources.
>>It’s a strange mindset to think that something should just be free.
When it comes to healthcare? Yes, it should absolutely be free to the recepient.
I don't know why it's such a strange concept to you - afer all, Americans are also used to receiving certain services for free - you don't have to pay the police for coming to help you, or the fire brigade for that matter. To me it's the same thing - if your house on fire, the fire brigade will come and help, free of charge - that's what taxes are for. So if I'm ill, I will be given any and all help needed - also free of charge, after all, that's what taxes are for.
>>They are also exorbitantly expensive because of the absurd moral hazard they create.
Like, sometimes I think Americans live literally on a different planet. Do you think that in countries where healthcare is free to use people have medical procedures without any reason and simply because they don't have to pay for it?
In general, it's simple - if a country wants to have healthy, productive citizens, it should pay for their healthcare, I don't understand why it's such a divisive concept. The crown example of how crazy the US system is, is the fact that you have to pay to give birth. Like.....so US cares so little for its citizens that literally the very act of giving birth to new ones is not covered by the government? That's....beyond mind boggling.
You have to pay for food. That doesn’t mean that eating isn’t important or that a society wants people to go hungry. By your logic, the private market would just be the domain of luxuries and useless trinkets. The government here provides health insurance for the very poor and subsidizes private insurance for the somewhat poor.
Police and fire are public services because they would not work as market systems. Fires spread from house to house, for example, regardless of who pays or doesn’t, so private fire brigades would have to protect non-payers in order to also protect payers. That’s a classic market failure that can be solved by public services. (Potentially, that problem could have been solved by requiring fire coverage, but then there's the further problem of a row of houses, each with different fire services, some better than others, with the better ones still needing to protect the houses insured by the worse ones to protect their own customers. Not to mention that
a single house fire can lead to a whole city burning down. It's just not a service that the market can effectively provide in most places.)
And no, of course people don’t completely waste care in other systems either. That’s because it’s rationed by the government. Elective procedures have long wait lists, access to specialists is specially guarded, etc. Limited resources always have to be rationed by some mechanism.
Our system in the US is far from perfect: we let the doctor’s guild limit the supply of doctors, we are too uncomfortable with ending care for the very old and terminally ill, and the whole hospital and medical device industries could use an antitrust shakeup.
Yeah, no, hard disagree. Every citizen should have the right to free healthcare, and it should be provided for everyone, regardless of any other factors.
Roads require labour of others to build and maintain, yet every American would object if they suddenly had to pay to use them to get anywhere - how is that any different. You're just moving the line elsewhere, but the exact same principles exist in America too.
And in countries with public healthcare private hospitals exist too.
The existence of toll roads in a country where 99.9% of roads are free to use has no impact on your ability to get anywhere, just like the existence of private hospitals doesn't change the fact that every citizen can receive free care from public hospitals in countries with public healthcare.
I have another reply to you that engages with all of your points. Feel free to respond to that. As of now, you haven't given any principled reason for which services should be provided free by the government and which should not.
1. Free travel is a right. At it's most basic, walking requires nothing from anyone else.
2. Everyone benefits from the economy being able to function. Only one person benefits from a person receiving a free million dollar medical procedure.
2) everyone benefits from the economy having healthy citizens who aren't worried about medical bankruptcy. It's not true that only one person benefits from receiving a million dollar medical procedure . Also outside of US medical operations don't cost a million dollars.
>> At it's most basic, walking requires nothing from anyone else.
Also, to add to this point - no, walking anywhere requires permission from whoever owns the land you are walking upon. Americans also are incredibly restrictive here, despite being the land of freedom. In UK you have the right to roam[0], where you are allowed to walk through someone's private lands(as long as you don't damage anything). In the US try walking through someone's land - you will be shot in the worst case.
Canadian living in USA. My brain is regularly fried by healthcare here, it ends up being a simple high level equation.
My out of pocket max per year is around $6000 USD, and my salary is double what I was (under)paid in Toronto, and taxes are a bit lower here (CA).
So the take home pay is mid-5-figures more, and worst-case scenario healthcare is mid-4-figures, so it balances out very favourably for my situation (anyone in tech with a full-time job, basically).
(Of course, those who aren't well-paid in tech have a much worse situation and I can't imagine how difficult that must be.)
