Healthcare Systems

[fiksal]

As I learned many Americans don't think the government should provide for its citizens. It shouldn't take care of elderly or disabled, shouldn't use taxes for education, or healthcare. Anyone who doesn't have money to afford the previous is weak and undeserving.

That's just hyperbole. Sure, a segment of the population carry that "sentiment", but even among them it's not to that extreme. I have lived here for almost 20 years and I have never seen ONE person speak out against providing for the elderly. The arguments are usually centered around things like universal income, minimum wage ...etc... but when it get political it usually turn into an emotive argument like "shouldn't take of the elderly!!", I'm sorry but that's just a dishonest presentation, like how abortion argument usually get turned in "Satan is killing the babies!"

For sure those kind of views vary, but they are related.
- why should I pay for your healthcare?
- well why should I pay for your bridge?
- or your social security, or disability, or border, or military, or veterans.

For me personally, it's not that I'm against universal healthcare, it's more I don't think that's the problem. Finding someone to pay for healthcare doesn't answer the question why the **** healthcare in the US is so expensive in the first place. Guess what, most countries in Asia (including the more developed nations) do not have universal healthcare, and that's not an issue. We pay out of pocket every time we visit doctor or take our prescription, the difference is it doesn't cost us an arm and a leg to do so.

Why? It's because we have this kind of health insurance companies, that make up prices with the doctors and then spread the cost to "customers".

Another thing is I don't understand why health insurance work the way it is in America. Like we have insurance over there too, but health insurance is more an emergency thing, like when you go to ER or have an operation. But you don't pull out your insurance for every damn thing! Like why don't it work like car insurance. Everyone have car insurance right, but do you use your insurance when you do oil change or having flat tired? House insurance don't get used on replacing your window or having someone snake your sewer line either.

In Canada it's even the other way around.

Government will cover your hospitals, your ER, and pretty much everything else.

You can choose to have private insurance if you want to go to private clinics. But that's not a required, it's up to you - you can instead put the money into health savings, instead of paying for insurance.
(A little unclear on how dentists work without private insurance coverage).

And yes, as you mentioned, the health care cost in Canada is significantly lower as well. In fact, I've plugged some numbers awhile back with a buddy of mine; taking cost of Blue Cross in US, + how much they cover and how much you use them, somehow it is barely even with what's taken out of taxes in Canada + private insurance + what you pay above that. Which is hilarious because the Blue Cross plan definitely doesnt cover 100% of ERs and hospitals. Nor it guarantees any wait times, which are - from my view - are identical between the two countries.

Go back to the subject of cost, there are a lot of "excuse" for why it's so expensive. And you can tell that's an excuse. Remember the usual "reason" was oh a lot of people don't have insurance so hospital have to incure cost 'cause people can't pay. It'll go down if more people have insurance. We're in like what ... year 10 of Obama care, with a lot more people with coverage now and guess what, healthcare is still as expensive as it was before Obamacare! I got into an accident little over a year ago, and an evening in ER where I receive almost no treatment still came with a 10k+ bill, and that was a City hospital, not even a private one. **** that.

No finding someone else to pay for it (i.e government) doesn't solve any damn thing, and when it comes to government money it's just your money anyway. The greed and corruption on all level of the healthcare system is the problem, not the insurance coverage.

That's exactly the point, government money is still your money. In well oiled government, that money is put where you see the priorities should be.

Btw, the ER visit in Canada is $0. (Though I dont recall how much ambulance do you have to copay)

[PaperDog]

So the patient dies... but at least he/she will die with the satisfaction of knowing they woulda, coulda shoulda had that free liver. Meanwhile your failing system plows on... and the masses are still drinking the koolaid, being forced to pay into a system, from which its benefits are left to the off chance that a free liver is available. I wonder, do you subscribe to the notion which says that if I am younger than you and there is only one liver available, I get it and you don't...(even though you have paid into the system) ?

I continue to be baffled by this line of argument. The US uses a very similar prioritisation metric for liver transplants (MELD) to the UK because neither country has enough transplant livers to satisfy demand, and as I showed earlier, the average waiting time for a liver transplant in the UK is significantly shorter than in the US! Furthermore, no I don't believe that rich people should get transplant livers and not poor people.

No need to be baffled...Its called seeing another point of view. A key difference in my argument. is that in the US system, we don't make promises to people about their healthcare prospects... And Because we don't socialize the entire healthcare option , we have no need to 'pitch' lofty fantasies. BTW we do socialize some of it. We have federal Medicare and State Medicaid. The program benefits begin and end with the elderly and the disabled. The rest of us ..weel we have to get off our asses and work / contribute enough to afford the insurance. We don't 'leave ours behind' ...despite your implication. But you can be assured, we don't cut slackers any breaks either. That aside; The price of medicine is ridiculously high and excessive, and Big-Pharma, Hospital Admin , are a bane on the free market . I cant speak for the UK. But in America, we once honored the notion of fair play. The game has since changed and the three aforementioned are the culprits (File under the category: Greed) .

[Vertigo 7]

No need to be baffled...Its called seeing another point of view. A key difference in my argument. is that in the US system, we don't make promises to people about their healthcare prospects... And Because we don't socialize the entire healthcare option , we have no need to 'pitch' lofty fantasies. BTW we do socialize some of it. We have federal Medicare and State Medicaid. The program benefits begin and end with the elderly and the disabled. The rest of us ..weel we have to get off our asses and work / contribute enough to afford the insurance. We don't 'leave ours behind' ...despite your implication. But you can be assured, we don't cut slackers any breaks either. That aside; The price of medicine is ridiculously high and excessive, and Big-Pharma, Hospital Admin , are a bane on the free market . I cant speak for the UK. But in America, we once honored the notion of fair play. The game has since changed and the three aforementioned are the culprits (File under the category: Greed) .

You're right, we don't leave ours behind. 'Murica!

I can agree with some of your sentiments, but not everyone who can't afford proper healthcare and such are in their position by choice or even by their own doing. Yes, there's going to be some who continue to have their hand out and chose not to do anything on their own. But that's a very small percentage compared to the rest that have no alternatives or those that are providing for themselves. If your life were suddenly upended, wouldn't you also want some help? Wouldn't you also like to know that if you got injured or sick that you could be cared for? But what if instead of getting help, you were just told to do it yourself, get a job, or some other insult to your situation. Bet you wouldn't like that very much.

[RegisterMe]

I'm not a doctor, but I count many doctors amongst my friends. They tell me stories of relief, joy, and success against the odds. They also tell me stories of heartbreak, loss (and anger at unnecessary loss and ****).

Not once have I heard of, or experienced, a promise about healthcare beyond "we'll do the best we can". No doctor says "sir, your liver cancer is no problem, we'll get you a new one". Instead the message is "sir, your prospects are terminal, unless we can get you a new liver, we'll do the best we can".

And trust me, as somebody who drinks waaaaaaaay too much, this subject is of interest to me.

The most invasive procedure I've had on the NHS is my ears being syringed. I'm delighted that the money the NHS has "saved" through my good fortune can benefit those less fortunate than me. Equally I have no problems with the fact that the taxes I've paid have provided the state with far more than I have ever taken out of it.

When and if the time comes that I need a replacement liver, and the NHS replies "sorry sir, you have a life long record of alcohol abuse, and there's a young mum that needs the one we have available more than you", well, that's how the cards fall.

[RegisterMe]

Infant mortality rates

Maternal mortality rates

Guess what happens if you factor by the colour of a person's skin?

EDIT: The urls didn't come out cleanly so I tidied them up to make sense.

[RegisterMe]

The most invasive procedure I've had on the NHS is my ears being syringed.

Though I should add that, at 49, I'm likely to get a free finger up my arse before I get a COVID jab in my arm. The latter still being free of course.

[BrasatoAlBarolo]

About private clinics: in Italy, even a lot of treatments in private clinics is paid by public healthcare system...

[fiksal]

About private clinics: in Italy, even a lot of treatments in private clinics is paid by public healthcare system...

Do you have private health insurance?

[Mightysword]

For sure those kind of views vary, but they are related.

Lumping what people actual talk about and what people do not talk about is exactly what I meant by dishonest presentation. I'm not calling you dishonest specifically, but this way over used in politic.

Why? It's because we have this kind of health insurance companies, that make up prices with the doctors and then spread the cost to "customers".

The reason is way more entrenched than that. Hospitals, or even care facilities like nursing home are designed to be constantly in red or as close to it as possible. Let's say there is a consortium called Vector (just random name), here is how it goes:

- They want to build a new Vector Hospital.
- An entity called Vector Real Estate will provide land at a premium price.
- Once the hospital is up and running, most of its service will be contracted out to Vector medical providers.

Most contracts will be negotiated to make the hospital incur maximum loss, so it can keeps up the pretend the hospital is underfunded and can be lobbied for higher charge and more tax money injection. In short, they are designed to be blackhole to "drain" money.

So you may say freemarket, there should be other providers who charge more reasonable price to compete for the contract? Perish the thought, the law markers (read government) have already ensured there are enough regulation to make it cost prohibit for anyone want to play outside of the rules. So unless you're a billionaire running at a loss out of the charity of your heart, it's not sustainable to run a low cost medical service.

That's exactly the point, government money is still your money. In well oiled government, that money is put where you see the priorities should be.

No, that's not the point at all. On a macro level, it makes no different whether I am the one paying that 10k bill, or my company paying that 10k bill, or the government paying that 10k, that's NOT the problem. The problem is 10k is an absurd amount for the service rendered. Over the years, the industry and the politician on the pay roll had crafted a very beautiful argument to manipulate the general public into thinking this is a "who pay what" argument. Because it's easier to divide (look at all the name calling, labelling, virtue signaling often associate with this issue), and as we argue among ourselves who should pay our bills like sheeps, the people behind the consortium just sitting there sipping tea, because they will collect that 10k. As long as people are distracted enough to not question why the hell it costs 10k, you think they care if that 10k came out of your saving or your tax coffer?

To illustrate the point further: it's completely misguided to think the US as a whole do not take care of its own people or leave people out to dry. We do provide coverage to our vulnerable, you want the number for it:

Federal medicare: 800billion a year.
State medicaid: 630billion a year.

So together that's like 1.4trillion a year? That BARELY covered only the most vulnerable population of the countries, so do you want to be up for calculating the cost to provide courage for every Americans? Btw, the defense budget for the entire US military cost freaking less than that. So until you address the real issue, nothing gonna change. The industry and lobbyists will give you BS reasons for why it is high, and most of the politician will just go a long with it, like I said the 10 years of Obamacare should show that the cost of healthcare in the US isn't high because the operating margin, but because it's designed to stay high. But hey, they can continue like that because so far they have been very success in manipulating most people into thinking "I don't care how much it is along as someone (else) is paying for me"

[Vertigo 7]

Them's some fancy numbers but they're meaningless without context. You have to be 65 and older AND have paid into medicare for 10 years to be eligible. Medicade eligibility varies wildly per state with red states, generally, being the most restrictive. And hey, veterans can go to VA hospitals. But despite all them fancy numbers and wishful thinking, it still doesn't stop people dying by the truckloads due to lack of proper health care. Roughly 26,000 US citizens die each year because they couldn't get proper health care, more than double the murder rate.

I'm not arguing the system isn't corrupt. But to sit there and pretend we're taking care of our people is farcical, at best.

[PaperDog]

Infant mortality rates

Maternal mortality rates

Guess what happens if you factor by the colour of a person's skin?

EDIT: The urls didn't come out cleanly so I tidied them up to make sense.

I dunno, what Happens? If we follow the W.H.O. recommendation to assume that' all signs of life' constitute a birth, then I would say the mortality rate is much higher for children, who were aborted. Taking that further, We should then ask : what the skin color for those, most associated with the highest rate of abortions... Taking that further, we should then ask: out of the most associated; how many of those women were 'uneducated'? Following this, we could then ask: out of the most uneducated woman, what was the most common skin color, in relation to their highest mortality rates .
So, if we can determine, which skin color has the most uneducated women, and then just go ahead and educate them... then we could reduce the mortality rates of those children. In fact, we could apply education t to ALL skin colors and substantially reduce ALL mortality rates.
Whew! I need a beer now...

[BrasatoAlBarolo]

About private clinics: in Italy, even a lot of treatments in private clinics is paid by public healthcare system...

Do you have private health insurance?

Nope.
Most of private clinics have some sort of "agreement" with the public healthcare system. This way, if you have to operate the thyroid or the meniscus or something like that, even if you go to a private clinic, your cost is covered by the public.

[BrasatoAlBarolo]

Infant mortality rates

Maternal mortality rates

Guess what happens if you factor by the colour of a person's skin?

EDIT: The urls didn't come out cleanly so I tidied them up to make sense.

I dunno, what Happens? If we follow the W.H.O. recommendation to assume that' all signs of life' constitute a birth, then I would say the mortality rate is much higher for children, who were aborted. Taking that further, We should then ask : what the skin color for those, most associated with the highest rate of abortions... Taking that further, we should then ask: out of the most associated; how many of those women were 'uneducated'? Following this, we could then ask: out of the most uneducated woman, what was the most common skin color, in relation to their highest mortality rates .
So, if we can determine, which skin color has the most uneducated women, and then just go ahead and educate them... then we could reduce the mortality rates of those children. In fact, we could apply education t to ALL skin colors and substantially reduce ALL mortality rates.
Whew! I need a beer now...

It's not about their skin colour, it's about their wealth. When you make education and healthcare paid services (and, in the case of the US, very expensive), you're doing something very wrong for society, period.

[Chips]

So the patient dies... but at least he/she will die with the satisfaction of knowing they woulda, coulda shoulda had that free liver. Meanwhile your failing system plows on... and the masses are still drinking the koolaid, being forced to pay into a system, from which its benefits are left to the off chance that a free liver is available. I wonder, do you subscribe to the notion which says that if I am younger than you and there is only one liver available, I get it and you don't...(even though you have paid into the system) ?

I continue to be baffled by this line of argument. The US uses a very similar prioritisation metric for liver transplants (MELD) to the UK because neither country has enough transplant livers to satisfy demand, and as I showed earlier, the average waiting time for a liver transplant in the UK is significantly shorter than in the US! Furthermore, no I don't believe that rich people should get transplant livers and not poor people.

No need to be baffled...Its called seeing another point of view. A key difference in my argument. is that in the US system, we don't make promises to people about their healthcare prospects...

You conflate the idea of presenting ill informed opinion (demonstrably based off false assumptions/statements) as "another point of view". Your first posts in the entire split thread are demonstrably false - simply by examining actual published data/statistics over waiting times. Baffling how you hold that opinion, but its your prerogative to do so. But don't for one second claim you've an "argument" you're presenting.

However, from the start nothing written gives any indication you've done any due diligence with regards to forming an informed opinion based off simple research and reading regarding the NHS/UK Healthcare. You appear to misunderstand the NHS and repeatedly put forward statements that are just inane. For example, the "Free" healthcare (as people call it) is DEFINED as free at the point of issue/use. That's the actual definition which people abbreviate to "free".
Trying to jump on the "it's not actually free is it..." as you misunderstood what the term "free" is in the context of the NHS - well, as said, the point you make is inane. We all know it's paid for via taxes. But it *IS* free at the point of use. You aren't correcting or enlightening anyone here, just highlighting a misunderstanding on your part.

I've not commented so far simply because - what's the point. Anyone who's "debating" a system they clearly know nothing about isn't really trying to hold a discussion of merit are they - the determination exhibited to "prove"(?) we're ignorantly suffering from our system is baffling as well. Note I make zero reference to the US Healthcare system.

I'm very happy we have our healthcare system as it is; yes, it could improve, it has issues, but it's fair. If you don't think it's fair, then "oh well" (not remotely interested).
I'm also glad I don't present myself as someone who determines the value of human life like a commodity - "What's their value to us though?" (us being society). Treat them all.

[PaperDog]

I continue to be baffled by this line of argument. The US uses a very similar prioritisation metric for liver transplants (MELD) to the UK because neither country has enough transplant livers to satisfy demand, and as I showed earlier, the average waiting time for a liver transplant in the UK is significantly shorter than in the US! Furthermore, no I don't believe that rich people should get transplant livers and not poor people.

No need to be baffled...Its called seeing another point of view. A key difference in my argument. is that in the US system, we don't make promises to people about their healthcare prospects...

You conflate the idea of presenting ill informed opinion (demonstrably based off false assumptions/statements) as "another point of view". Your first posts in the entire split thread are demonstrably false - simply by examining actual published data/statistics over waiting times. Baffling how you hold that opinion, but its your prerogative to do so. But don't for one second claim you've an "argument" you're presenting.

However, from the start nothing written gives any indication you've done any due diligence with regards to forming an informed opinion based off simple research and reading regarding the NHS/UK Healthcare. You appear to misunderstand the NHS and repeatedly put forward statements that are just inane. For example, the "Free" healthcare (as people call it) is DEFINED as free at the point of issue/use. That's the actual definition which people abbreviate to "free".
Trying to jump on the "it's not actually free is it..." as you misunderstood what the term "free" is in the context of the NHS - well, as said, the point you make is inane. We all know it's paid for via taxes. But it *IS* free at the point of use. You aren't correcting or enlightening anyone here, just highlighting a misunderstanding on your part.

I've not commented so far simply because - what's the point. Anyone who's "debating" a system they clearly know nothing about isn't really trying to hold a discussion of merit are they - the determination exhibited to "prove"(?) we're ignorantly suffering from our system is baffling as well. Note I make zero reference to the US Healthcare system.

I'm very happy we have our healthcare system as it is; yes, it could improve, it has issues, but it's fair. If you don't think it's fair, then "oh well" (not remotely interested).
I'm also glad I don't present myself as someone who determines the value of human life like a commodity - "What's their value to us though?" (us being society). Treat them all.

Unlike you...(an armchair quarterback , subject to the Dunning-Kruger effect ) I have first-hand experience in how our healthcare systems work. (If you read the whole thread you would have caught that) I have witnessed directly, the issue of our fraud, waste and abuse in our system. I have even worked side-by side with CMS regional directors (The top guns responsible for mitigating the CMS system flaws, nationally) . You, on the other hand, obviously have no experience, or any idea of what you are talking about. (This was evidenced by your self indulgent and rather pointless explanation on the word "free"....) Hint: Just cause the internet said it was good system, doesn't mean its a good system..
I cant speak to the NHS program, but I do know for a fact that its not Free...Its paid for off the backs of your working class, and its siphoned off in 'Cadillac' plans by your elites. SO, by all means, continue to defend your old folks Jello factory. Someday, for any number of health reasons, you will be forced sit in some convalescence home, drooling in front of the BBC, while you ask yourself how it is that you never got that free wheel chair they promised. But hey , I hear that Cherry -Lime jello is da bomb!

[Vertigo 7]

Hint: Just cause the internet said it was good system, doesn't mean its a good system..

You haven't done anything but show the current US approach to healthcare is a joke, which everyone here has said as much. Since you're the expert here with gobs of first hand experience, exactly what do you think we should be doing?

[pjknibbs]

Its paid for off the backs of your working class, and its siphoned off in 'Cadillac' plans by your elites.

You know, the mere fact you think that "elites" use the NHS shows just how little about this subject you actually know. We still have private healthcare available in this country, and most of those with the money to pay will be using it, not waiting their turn on the NHS. As for old folks drooling wondering where their wheelchair is, the fact is, we have a chance to get old and drool without going bankrupt due to healthcare costs along the way. My 84-year-old mother, who's had occasion to use the NHS's services for broken fingers and wrist, a heart attack and a broken hip over the past 20 years, is undoubtedly very happy that she didn't have to sell her house or any other treasured possessions to pay for all that.

[Aken_Bosch]

About private clinics: in Italy, even a lot of treatments in private clinics is paid by public healthcare system...

Do you have private health insurance?

Nope.
Most of private clinics have some sort of "agreement" with the public healthcare system. This way, if you have to operate the thyroid or the meniscus or something like that, even if you go to a private clinic, your cost is covered by the public.

Just to add a bit of clarification to what Brasato wrote, we indeed have private health insurances in Italy, it's just that they are more of a personal choice and/or a convenience, rather than something mandatory to avoid risking life for a simple appendicitis. Several job contracts include private insurance plans covering a series of health occurrences, from simple routine exams to complex procedures, it's up to to the insured to take advantage of them or not, depending on circumstances.
Just to give a personal example: about a year ago I had to make a series of exams for screening. For blood/urine I opted to do them via the public health service, since there are virtually no waiting times, the fixed cost (the "ticket") is lower than private and I could still get a refund via my private job insurance, only having to pay a tiny deductible on it (10-20%, can't remember at the moment).
I also had to do an ecography, but under public service the queue for those are generally quite long, on the order of several months, so for that one I went to one of the private clinics Barolo mentioned, where I could have it done in a matter of days by paying a fixed deductible (higher than public, but still a fraction of the exam cost) with my insurance covering the rest. That clinic (as most of others) offers its service as both private and public healthcare via the aforementioned agreements; while they get a direct source of income from the services offered privately, they can still benefit from having sort of a fixed quota of income from taxes (it's more complex than this, but you get the idea) for the services offered as national healthcare. In some way, it's win-win for them, win-win for the patients.

That said, if you happen to have a stroke, an accident, the need for an emergency transplant, whatever, you'll get treated, no matter what, no questions asked. The nominal "ticket" fee (amount may vary from a few euros to a few dozens) will only be payed for standard exams or routine, non emergency procedures. If you are unemployed or poor below a certain threshold you are exempted, if you are disabled or suffer from some serious or chronical diseases (like cancer, some autoimmune diseases and such) you are exempted, and so on. My mother underwent surgery for breast cancer and had to pay nothing for it, takes a long series of drugs for that and related pathologies for which she pays almost nothing, and is now living on permanent home oxygen therapy for which she is still paying nothing. Several years ago, my father-in-law underwent months of experimental chemoterapy to treat severe leukemia, having to pay none for a dozen of chemo shots that were worth 900 € a pop. If people like him and my mother are still around and we are not living under a bridge yet, it's only because we have the luck of living in a place with socialized healtcare, as most of the places around the world actually are in one way or another.

To comment on who thinks that these kind of systems are wrong, a waste of resources, or whatever other inane rambling, it's really not worth any additional minute of my time, so I'll just leave it at that.

[PaperDog]

Its paid for off the backs of your working class, and its siphoned off in 'Cadillac' plans by your elites.

You know, the mere fact you think that "elites" use the NHS shows just how little about this subject you actually know. We still have private healthcare available in this country, and most of those with the money to pay will be using it, not waiting their turn on the NHS. As for old folks drooling wondering where their wheelchair is, the fact is, we have a chance to get old and drool without going bankrupt due to healthcare costs along the way. My 84-year-old mother, who's had occasion to use the NHS's services for broken fingers and wrist, a heart attack and a broken hip over the past 20 years, is undoubtedly very happy that she didn't have to sell her house or any other treasured possessions to pay for all that.

Two words for you : "Sadly naive".

I never said the elites 'used' the system...I said they siphon off of it. Do I really need to spell this out? Your govt is in the "insurance " business...(because insurance is exceedingly lucrative for your elites) and I bet you can't name one member in your parliament, who is certifiably 'poor'. Our govt saw how rich yours was getting, and now they want to do the same thing...force socialized medicine down 'everybody's' throats. It 'appears like a good thing until you realize the real cost. Your Margaret Thatcher even said once; "Socialism works great until you run out of other peoples money" . Ok I'm done with this chat... We can just agree to disagree.

[Mightysword]

That said, if you happen to have a stroke, an accident, the need for an emergency transplant, whatever, you'll get treated, no matter what, no questions asked. The nominal "ticket" fee (amount may vary from a few euros to a few dozens) will only be payed for standard exams or routine, non emergency procedures. If you are unemployed or poor below a certain threshold you are exempted, if you are disabled or suffer from some serious or chronical diseases (like cancer, some autoimmune diseases and such) you are exempted, and so on. My mother underwent surgery for breast cancer and had to pay nothing for it, takes a long series of drugs for that and related pathologies for which she pays almost nothing, and is now living on permanent home oxygen therapy for which she is still paying nothing. Several years ago, my father-in-law underwent months of experimental chemoterapy to treat severe leukemia, having to pay none for a dozen of chemo shots that were worth 900 € a pop. If people like him and my mother are still around and we are not living under a bridge yet, it's only because we have the luck of living in a place with socialized healtcare, as most of the places around the world actually are in one way or another.

It's not really different in the US.

- It's not the getting treatment part that is the worst problem. Hospital in the US are under the law required to treat anyone in an emergency. Even if you're an illegal immigrant without a single penny or paper on you, they will treat and save your life. It's the cost that come after it is the problem, without insurance or government coverage, it can bankrupt or put a collateral on everything you own.
- If you are old enough to receive medicare, than your medical care is free irregardless of what you get: cancer, stroke you name it, you get it for free. Only one catch: you have to be either citizen or legal immigrant. Like I said illegal immigrant get that too, but afterward they're likely deported.
- I personal know a deathbeat of a man. In the last 20 years he had turned most of his paycheck into alchohold. A few years ago things finally caught up to him, got a stroke due to drug overdoze and had one foot in deathdoor. The hospital treated him for 3 months and save his life. Now with half of his body paralyze, he's living in a care house with all expense covered by the government. He is a legal immigrant.
- In most states if you're poor enough, you'll get medicare which is something like medicaid-light.

But if you doesn't fall into the old, the poor, or the disable category, then it sucks if you don't meet one of the two following:
- You works on a job that provide insurance coverage.
- You have enough income to get your own.

Otherwise, you gonna have to pray you don't get sick. You can be someone who's living relatively comfortable and are only 1 hospital trip away from bankruptcy or having your house up as a collateral. Self-employed, partimers, gig-workers are the one most at risk for this.