Comment by runako
4 hours ago
Quick summary: the US does not have anything approaching a modern healthcare system. (And likely will not for quite some time due to a set of structural factors.)
Obamacare (the Affordable Care Act or ACA) was an attempt to expand coverage and slow the rate of increase of costs. It did the former but less well with the latter.
One other thing the ACA did is stop the scourge of scam insurers. This is a thing where people would pay for "insurance" and then find out later that their "insurance" did not actually afford them any meaningful coverage. The ACA tried to close a set of loopholes and overall regulate the insurance market more closely.
Anybody reading this from outside the US probably lives in a place where low-cost healthcare is more accessible than it is in the US.
Quick note that for people aged 65 and over the US does have a healthcare system somewhat like other developed nations.
Given that older people tend to be some of the main cost drivers in healthcare, it's sort of silly that we cover them and then refuse to allow younger (cheaper) people to opt in to the same system & perhaps defray costs that way.
You're missing a key piece. Medicare only sort of works because the larger healthcare system has a hidden cross subsidy where commercial health plans reimburse providers at much higher rates. In some cases providers are actually losing money caring for Medicare beneficiaries. We already have a problem with doctors refusing to accept new Medicare patients, and if we moved more patients from commercial insurance to Medicare then that provider shortage would only get worse.
Health care is fine here if you have a decent job. Health care is not that great in public systems and you still pay for it with higher taxes
And naturally you make this absolute claim because you've undoubtably lived in more countries than just the United States, right?
As point of reference, I lived in Taiwan for years - they have a national health insurance system, and taxes are comparable if not lower in some situations to the United States.
I have lived in 3 countries with socialized health care system and the public systems were just average to poor, and costing me a lot.
In Germany if you’re mid to high earner, a private insurance can cost you less than half than the public healthcare system and you get much better service. Starting with appointments with specialists, who always give preference to privately insured people.
In this day and age public healthcare system are not efficient and bill the wrong people.
They are mostly payed by young population, between 18 and 65 years old. Specially the highest earners.
However most of the usage comes from 65+ citizens, which are starting to become majority. And also tend to be the ones concentrating the wealth of the country.
These public systems work great when most of the population is young and is paying into the system. But modern western societies are not like that anymore. Wealth is not owned mostly by older people while they barely pay into the system.
Private systems work better because each citizen pays into his old age health coverage during his young years.
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