Check out this chart conveniently supplied by the government. Pay particular attention to the last row which tell you the income level below which you are screwed if your state does not take Medicaid.
You can stamp foot and keep repeating this until you are blue in the face, but it still doesn’t make it any less false. Did you bother to read the cite?
Please inform yourself.
Pride? Good heavens no. When seeing what goes on in the USA, it makes me feel very fortunate that I live in a country with universal health care, and I look forward to the day that all Americans can access truly affordable health care.
Prior to participating on the SDMB I never paid much attention to health care, for courtesy of universal health care I have had excellent health care and have not had to worry about the cost (and yes, when compared to the USA we live longer, live healthier, spend less per capita out of the government purse, and spend less personally out of our own wallets – WHO). Through the Boards, I learned that one of the ways that the USA is very different from my Canada in that the USA does not have universal health care. Time after time there have been threads in which Americans complain of not being able to afford health insurance, of job mobility restrictions due to health insurance issues, of having to fight insurers, of being restricted as to where they can seek medical help, of being saddled with debt, and most importantly, of not being able to afford medical treatment.
It’s been disheartening to watch people fight so hard to prevent universal health care in the USA. How do you feel when you are unable to help someone who is harming herself? Disheartened, frustrated, saddened. That’s how I feel watching Americans harming themselves. Pride simply isn’t part of it.
The claim is that for people who make less than ~133% FPL that live in one the 23 states that refused the Medicaid expansion, ~4 million people, as cited DO NOT HAVE ACCESS TO HEALTH INSURANCE SUBSIDIES on the exchange, as the PPACA was designed for these people to obtain coverage through the Medicaid expansion.
However, due to SCOTUS’ June 2012 ruling, the Medicaid expansion became optional and 23 states refused the expansion, ERGO creating a well cited gap of people too poor for subsidies (not earning 133% FPL) and don’t qualify for Medicaid.
Here’s another cite (requires PDF) about Medicaid eligibility requirements. Please note the far right column ‘Medicaid Expansion’ and states listed with ‘N’. Then please look to the column to the right ‘Other Adults’ and states listed with ‘0%.’ This is the ‘coverage gap’ being referenced.
Uh, I think you’ve been whooshed.
VunderBob’s point of view is a big reason why U.S. lacks public health care. Citizens of other countries think of their fellow citizens as part of an extended family. For many Americans it’s an Us-versus-Them morality play; they’re happy to have a system that spends $1000 in book-keeping to deny someone $900 worth of health care! I’ve no idea whether VunderBob blamed the victim for being in a coma or was just too stupid to realize the comatose make poor decisiuons(!), but his “Too bad so sad” is a perfect illustration of American right-wing “thought.” The rest of the world is lucky not to have such sick “morality.”
Nitpick. When I paid $40 for a U.S. doctor to confirm I had strep, it took him only a few seconds and required no culture:
“Say ahhh! … Red as a beet; I can save you the cost of the test; you have strep.”
(In fact I already knew I had strep! It has a pain sensation, at least for me, distinct from that of other sore throats.)
I can only think that the people who fight against it are generally healthy and don’t understand the costs of medications and treatments to those without coverage.
Even with coverage, I spend about $300 a month on meds and appointments. If I didn’t have a good job, I’d be up a creek. Well, I’d be less up a creek than when I lived in Florida, but it would be damned tough.
It’s crazy that the US is the only “western” country where we willingly spend hugely inflated prices on medical care and prescriptions, and give tax breaks to those charging us those inflated prices.
(BTW, I think the post you responded to was sarcasm. 
)
Okay, it’s not just me. Here’s what the Mayo Clinic says about diagnosing strep throat. Emphasis added.
MLS (11/13): “Whether declaring bankruptcy is or isn’t a good idea, it is generally possible to arrange a payment plan with a health care provider. It may be $100 a month for the next 50 years, but they can’t say she isn’t paying.”
A weird but persistent myth is the notion that a debtor is free to unilaterally impose a contract provision on a creditor and decide when/how much they will be paid. A creditor can indeed “say she isn’t paying” if she decides she will and does not pay up within net 30 days. Obviously, you’re right that we can’t know whether she qualifies for bankruptcy protection, but I suspect given the circumstances (including news coverage), she can expect some relief.
The “pride” comment is interesting, albeit from a different angle.
I don’t think people in the UK generally thought about the healthcare system in those terms until … the 2012 Opening Ceremony. That was a bit of a jolt.
For those of us on messageboards where US healthcare was discussed - and the NHS often condemed by right-wingers - it provided an interesting contrast.: reading some of the views of US politicians, you could be forgiven for thinking the NHS was something imposed on the people against their will …
They can and will say that if the payments fall below their minimum.
And some hospitals will additionally tack money on as a fee. A local to me hospital in Ohio would tack on 18% if the bill were not paid “on time” including if you negotiated for a payment plan.
I can understand that hospitals and doctors need to be paid, and that some people need an incentive to not be deadbeats. But adding an 18% interest payment? That’s ridiculous.
What I meant was that it is often possible to consult with someone in the hospital to figure out how much the patient can manage to pay per month. Hospitals I’ve been in and that family members have been in have signage advising people who to contact if they have difficulty with costs. I didn’t mean that the debtor could simply decide the amount themselves.
You received a bill, or you received an Explanation of Benefits? Did the provider ask for your HSA card before the procedure? Did they charge you the contracted rate prior to the procedure?
Martin Hyde, I was curious to know whether you agree that you were wrong earlier when you said “If you have income under 400% of the poverty level you’re eligible for tax credit subsidies”? It was pointed out in two subsequent posts that below 138%, you do not qualify for these subsidies. If your state didn’t take the medicare extension, then you don’t get help on those premiums at all.
Correct? Does this change your view at all?
It’s also worth noting, by the way, that there’s some glitch in the code as written that makes things such that since I am eligible for insurance through my workplace, even though spousal coverage under that option is wildly unaffordable, nevertheless my wife is unable to get any subsidies. Our income is such that if I were making the same income but not eligible for insurance through work, we’d be paying very little per month for health insurance through the ACA. (I think it was below $100/mo IIRC!)
How *you *doin
I wonder if/when our system will ever change. My dad once drove himself to the hospital while having a heart attack to avoid thousands of dollars in ambulance fees and expenses. He made 6 figures and had good insurance at the time, and he still had to do that. I was watching a movie set in the UK yesterday and was shocked at how they just called an ambulance when people got sick or injured. No insurance, no ‘will I lose my house and retirement account if I get care’ conversations, none of that. All the attention was devoted to getting the sick person better, not money and red tape. This country is a disgraceful mess on health care. And its going to get worse, one of the ways insurance costs are getting cut is by having narrow networks with fewer in network providers.
But what can we do? Voting won’t change it.
We’re talking about national health care though, not State health care. If someone had a genuine need for healthcare and fell in this very rare category of people who: had income below 100% of FPL, but also did not have a job that provided health insurance, and did not have a spouse whose job provided health insurance they could simply move to another State. There is nothing preventing them from getting access to subsidies.
They had my insurance on file which may have covered any typical immediate fees, but not the entirety of the bill. I received an actual bill in the mail, I paid it by actually writing in the card number of my HSA card and its expiration date and mailing it back.
Yes, I was wrong on that, I genuinely didn’t know subsidies have a floor. But the floor is actually 100% (I’ve checked this), if your State declines to expand Medicaid you’re eligible for subsidies at 100% of FPL and above versus the 133/138% cutoff for other States. [133% is the actual statutory number, but the law requires a change to the calculation of income and poverty level, so 138% represents the percentage under the “old” calculation and thus why it is still cited, but Medicaid expansion States are listed as kicking in at 133% of the new FPL calculation and below.]
It does change my view in that we don’t quite have universal health care, yet, but I also see that those who now truly do not have access is less than 2% (4m) of the population (as per the Kaiser Family Foundation); however we have to assume some portion of that two million may have access to insurance through: spouse, parents or their workplace. Probably not a majority, since families below 100% of FPL often do not work for companies that give health insurance and if you’re over 26 you can’t get it from your parents (and just because you can get on your parent’s health insurance doesn’t mean your parents have it or opt to put you on it.)
Where it doesn’t change my view is that the complaint about universal healthcare was misplaced. Universal healthcare means universal healthcare access, generally defined as “I can get medical services due to being a resident of this country, regardless of my ability to pay.” I argue we are quite close to that right now, and further the woman in the article was not bitten by not having access to medical services. She was bitten by a problem with the way the coverage system works and the way hospital chargemasters work. Those are a result of the uncontrolled billing practices of medical service providers and have nothing to do with universal healthcare.
If someone had said we needed single-payer to avoid this, I wouldn’t have argued, single-payer systems usually empower government to tightly control ludicrous overbilling by requiring providers to bill at a standardized rate. [You can control costs without single-payer, though, some countries have holistic insurance schemes with multiple insurers but strict government controls on prices.]
I suggest that definition be changed to add, “… without being bankrupted, or facing foreclosure or wage garnishments, or otherwise burdened for life with bills I cannot possibly pay.”