Why the Hell do we in the USA connect our jobs to our healthcare?

I feel free to agree with you once in a while. Deal with it.

Yes I do.

and no, I don't think I should be worried, because that will not help anything.

I will land a good job with good benefits. It may take a while, but that's what is going to happen.

The Tories are trying to muck about with our NHS. Cameron really thinks he can get away with it, he hasn't got a clue. The NHS is the closest thing to a national religion in the UK.

It's probably because our government dropped the bag on this one; most developed countries have universal health care. It's how "they" provide "security" to their citizens rather than going to war across the world to prove you are the high and mighty superpower military to spend zillions of dollars on war machines. Costa Rica has no military, but has universal health care; smart people.

If a family member gets sick in Costa Rica, they don't go bankrupt; that's what you call the best security.

You'll get no answers from me. I've never understood it in the least.

Hingehead wrote:


Yeah - I feel a little confused and out of touch with things as they are now in the US as I haven't lived there for seven out of the past eight years. But this has been a hot topic at work as apparently there was an episode of Panorama on this very subject aired sometime recently. I don't watch tv, so I missed it, but I was regaled on all sides from the other staff to the prisoners who watched it about how the US is little better than a third world country in the way that they treat their sick, and they were telling me for instance that this guy who had gangrene in his leg was turned away from the hospital because he didn't have $20,000 upfront to pay the bill BEFORE they amputated.
Is this true now?

All I know is that when my husband and sister who both work(ed) in inner-city ER's - him in Philadelphia and my sister in Atlantic City- they HAD to treat whoever walked through the door, insurance or no insurance- money upfront or no money upfront.
Yeah - people were then billed for that treatment - but if they only had $5 a month to spare toward paying it off that's what was accepted.
Has that changed? Are they turning accident victims and gunshot wounds and stabbings away from the ER's now - BEFORE they treat them and bill them?
I don't know - I'm asking.

The whole situation is indefensible. I agree with Rockhead that health care should be as free and available as education. I said that yesterday and a traveller student of mine - who is 40 and currently learning his alphabet and how to sound out words, having never been made to go to school in his youth, then turned it into a debate about why us gorgio's (non-travellers) feel we have the right to inflict education on children. He said, 'I never went to school and it didn't hurt me,' - I was too kind to remind him to look at where he was sitting and with whom at the age of 40. I just said, 'Yeah - all cultures are different, aren't they?'

But I can't defend this healthcare fiasco going on in the US.

And Chai - I've always had jobs with insurance through my jobs too- but I doubt they paid 75 or 80% of the cost because I remember paying over $400 a month (as a public school teacher) for insurance for my two children. It was free for me and their father got it through the hospital he worked at - but even a hospital wouldn't insure the family of an employee at a reasonable rate. We got it for the kids at my job because it would have been even more at his job - he got it at his job for himself for free.
So if $400 a month is 25% of the total bill for insurance for a family of 4 - we're talking over $1500 a month for health insurance - that's like another mortgage payment.
It's just not feasible for most people.
We should all be ashamed of ourselves. What happened to that whole health care reform thing? Is it the majority of the American people who are so selfish and greedy and only care about themselves?
I'd hate to believe that - but I will tell you - that's what it looks like to the rest of the world.

I can't speak to emergency care, as I've not attempted to be treated there.

at the clinic I go to, however, I must pay the cashier before I am taken to an examining room. and I must go again to pay for any lab work before it is done.

bigger cities do tend to have better care in place for the poor...

Wow! Yeah, that is really different than how I remember it being. It sounds like it's gotten worse instead of better. When I was in graduate school and too old to be on my dad's insurance anymore but without a job that offered me any and no money to buy it, they used to have these clinics that you could go to and get treated on a sliding scale- and again, you got treated and then worried about paying whatever small amount it was (depending on your income - mine was very low at the time so it was never a huge amount) later.

I thought, and this is what I was trying to explain to the people over here, that it was the insurance companies who fucked people over by classing their treatments as 'experimental' or finding other means to weasel out of paying for their treatment, after these same people had payed their premiums for years and years.
I didn't know that now you had to pay upfront for treatment or not get it. So what if someone has diabetes and runs out of insulin? Do they have to have the money upfront if they turn up at the clinic asking for a prescription or a blood test to ascertain how much they should be taking?
I just don't get how it has turned so much worse when we were all supposed to be working on making it better.

Hi Iz, I was only reading today in the GW about the Tory 'justification' for NHS reforms - I thought this piece showed what a crock it is

http://www.guardian.co.uk/uk/feedarticle/10090402

I am pretty sure that the answer is that employer based health plans are a legacy of unions, which are now pretty much irrelevant. Why America has not adapted to the current reality is a more complicated question, having to do with poor education and the lack of gumption.

Thanks for that mate, what is most significant is that neither the Tories nor the Liberals actually have a mandate for this. Their grass roots is very nervous, if the NHS goes tits up they'll get the blame. In fact the Tories slogan in the last election was all about protecting the NHS, not bringing in creeping privatisation.

Aidan you are the saint of discretion - interesting that you have siblings also in the 'caring' professions - nature or nurture?

It actually started as a cheap perk to attract good workers, especially after WWII. Health insurance was like offering people free coffee and donuts for breakfast back then. Even very small businesses could afford to offer it. It's true that once the price started going up Unions recognized it as an important benefit and grabbed on tight. The real problem came when insurance companies grew into big profitable monsters with powerful lobbyists in Washington. They didn't want their services to have to compete with government programs. Insurance companies are the reason we do not have a good national health safety net for all, and we probably never will.

I think everyone should have to pay the full cost of their insurance for a year, or two. We'd have a public option at the end of that for sure, particularly when many folks discover that the insurance industry won't cover them because of a pre-existing condition.

I agree JPB. Most Americans have no idea their insurance costs between $12,000-$16,000 because they don't see the whole bill. Plus, it has all types of restrictions built in. In France the average person pays $3,600 and never has to worry to about treatment if they need it.

That's not quite true: the average person in France has to get an extra (private) health insurance if she/he doesn't want to worry - the mandatory health insurance doesn't pay all and everything and only up to 70%.

For the mandatory insurance, they pay 12.8% of their salary plus 5,25% "contribution sociale généralisée".

Oh yeah. The best way to get rid of a bad law is for everyone to obey it.

It's about risk pooling. You can buy health insurance on the free market, the way you buy buy home insurance. But it's prohibitively expensive because of adverse selection (good risks drive out bad). And, unlike car insurance, it isn't mandatory. Consequently, the best way to get affordable healthcare is to join a broad risk pool where membership is unrelated to your individual risk. Large employers are the best candidate for that.

In systems with a mandate---like Obamacare---patients can buy insurance on the free-ish market. Better yet, in single-payer healthcare systems---like Canada's and France's---everyone is one big risk pool. Either way, your healthcare needn't hinge on your job.

Why is healthcare connected to our jobs in the USA?

At the risk of being obvious, it happens this way for the same reason nearly everything in the U.S. happens the way it does: Somebody figured out a way to make a lot of money setting it up this way. And pretty soon, everyone wanted a piece of the action. So laws and company policies were established, and....well, here we are.

Now, if someone could just figure out a way to make large amounts of money doing it a different way, I'm sure the insurance companies, corporations, etc. would consider changing the present system to enable themselves to get a piece of that action, too. Got any ideas?

Healthcare in Canada is also tied to our jobs, but not necessarily health insurance. In Alberta, we pay no healthcare premiums so it's not part of the equation. Extra insurance covers drugs, dentists, ambulances, private rooms, wheelchairs, glasses, physio, getting some forms filled out and so on. Without insurance, you are left to cover many things out of pocket. You can buy private insurance, and like employee plans depending on the premiums or plans, you can get almost full coverage - up to a certain dollar limit. The monthly fees are a fraction of those in the US.
Insurance companies up here always post a profit, seems to me a system like ours, while not perfect, would still make money in the States. Might not make 'em filthy sinking rich though...