I’m inclined to agree with you. Perhaps not the absolute cheapest but having some provider diversity makes the system more robust.
Lol. I literally and currently have a high deductible policy with a $50 co-pay for in network visits. You apparently have no clue. As I am retired I purchased my policy through the marketplace …which is where you select your ACA policy. Also, telling me the origin of certain types of policies, as if that is in any way relevant to this topic…is like telling me your sexual preferences….I just don’t care. Third, the ACA uses a sliding ADJUSTED gross income scale to determine sliding eligibility. Max benefits used to be awarded to people around $22k or less in income, single filer. You are ineligible after you reach 4x poverty level. Which is currently around $50k single/ $70k joint filing. The average starting salary in 2023 for college grads is around $35k. So if you think $35k a year is middle class (which is subjective) then maybe you would have a point…but like your entire incorrect diatribe…you don’t. The overwhelming percentage of middle class Americans are NOT on ACA coverage because they have employee benefits.
Single payor systems are fraught with fraud and waste. Further, our country is huge and our current system is not only very costly, but also have significant access issues, both income related and geographical related, which would likely get exacerbated by moving to a single payor system.
And what do the studies show for government provided health care for all, with secondary insurance available to those who want higher end coverage and will pay for it? In other words, you have government provided health care with government doctors, protected from lawsuits via sovereign immunity. You also have private doctors paid via personal funds or separate insurance. Private doctors will charge more and presumably provide better service, but will not be protected by sovereign immunity. The conversations to make health care more accessible without causing long term debt is productive. These are the topics we should be discussing .
The trend is actually away from employer coverage. It’s barely over 50%. How is that an “overwhelming majority”? It’s not long until it’s no longer even a majority receiving health coverage in that way. Arguably, employer coverage distorts the market since a lot of people have no idea what they truly pay for insurance, they only know the “employee contribution” and (wrongly) assume that’s the true cost of health insurance. The income maximum for ACA for a family of 4 is $111,000 (4x poverty level). That is definitely middle class in most areas. Does middle class “stop” at $110,000, surely not, but they have to phase it out somewhere. My understanding is there are tiers to the “subsidies” for the ACA plans. Kind of like tiers in the income tax system. A “working poor” barely getting above Medicaid level gets the maximum subsidy, the amount of subsidy goes down as you approach $110k of income (for family of 4), at which point it is purely free market pricing.
I believe the stat is 50% of Americans are insured by an employee run plan. I believe about 20% are insured through the marketplace. Then about 15% are on Medicare/Medicare.(not really insurance, but a hybrid at best). I haven’t looked at the numbers in a long time as they are no longer really relevant to finishing what my group is working on. Most middle class workers have employer provided health care and are thus ineligible for ACA. Often times these employee policies are crap, with huge out of pocket burdens. You basically parroted back my previous post, so not sure if you are just agreeing with me or didn’t read my post.
That is a simplification of a small part of the big picture. But good for you for thinking out of the box.
Perhaps your ACA plan has a copay and a high deductible but it isn’t literally a “high deductible health plan”, which allows you to to have an accompanying HSA. Yes I understand ACA subsidies are on a sliding scale and most policies are actually through their employer.
Yes they likely have higher fraud and waste, because their payment system is so much leaner. As to the other issues, we essentially have a single payor system for old people through Medicare. Like all plans it isn’t perfect but I have not heard of issues where old people can’t get health care due to unavailability of Medicare.
Really? Where do you live? I’m guessing not in central Colorado or the countless other locations that are more than 100 miles from any type of health care
What is a high-deductible health plan (HDHP)? | healthinsurance.org). They may have made a change recently as to prescriptions and copays.
It is a marvel to me that Brits still worship their NHS. It has gone from decidedly mediocre to epic failure, during ‘Covid’, and is still reeling, with prodigious waiting lists, even though the purpose of brutal lockdowns were to save ITSELF and not so much Brits who needed care. Why is ‘Our’ ‘World-Beating’ NHS Such a Basket Case? – The Daily Sceptic
No Brit or Canadian for that matter will ever experience this although thousands if not hundreds of thousands of Americans do every year. And the article focuses in a single healthcare provider in one state. ‘UVA Has Ruined Us’: Health System Sues Thousands Of Patients, Seizing Paychecks And Claiming Homes
If NHS is so bad, why are they healthier than we are. Answer, everyone goes to their family doctor on a regular basis - Euros live on average 3 years longer than we do. My son was born in 1989 at the Royal Liverpool Maternity Hospital - a premature baby who received excellent treatment from doctors/nurses whose only motivation was health care. My daughter was born in 1992 at Mercy General here in Sacramento, CA. My wife was probably given oxytocic to augment normal contraction because time is money. My daughter dropped off my insurance in 2018 and the next year was diagnosed with leukemia. She was treated at Stanford Medical and because she was a student with no income, MediCal paid the bill. If she was on my insurance, my bill would have been around $100,000. Health care for profit is evil and I wish we could discuss solution w/o folks screaming socalism.
The only reason the NHS didn’t kill more than the US is because the population of UK is only a fraction of the US.