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Is the U.S. health care system broken?

Yes. And immoral.True story. A friend of mine in another state developed cataracts in her early 50’s. She was working at a job with no insurance (before the ACA). She had to drive for this job. She could no longer drive, nor could she afford the $10,000 for cataract surgery. She lost her job. She couldn’t get unemployment as she couldn’t see properly to do work, much less not have the transportation to get to a job. She didn’t qualify for disability income because cataracts are treatable. She declared bankruptcy. In 2014, she had no income so she couldn’t qualify for a subsidy on the exchange. Her state-a red state-didn’t take the medicaid expansion. By the time the applications wound their way through the bureaucracy (years) she was destitute. Eventually her application for free charity surgery was approved and she could see again. She didn’t have the income to fix her car. Or her home. She eventually got disability for other issues, but by this time, and with no relatives to help her, she lost some of her SNAP benefits and can’t afford to fix her home. She goes hungry for a good part of the month. All because an easily treatable condition was not covered due to our lack of universal healthcare. (don’t get me started on SNAP or the lack of other social safety nets).An acquaintance had a bad run of severe medical issues. Deductibles, co-pays, and co-insurance completely wiped her out financially. She lost her job and is still attempting to find another. No savings due to above. I’m not sure if she has declared bankruptcy, but I wouldn’t be surprised.A young adult forced to be on medicaid for a disability is on her fourth therapist (mental health) in a year because most mental health providers don’t accept it, and she is at a clinic with a huge turnover.I have a chronic pain condition. I can get limited prescriptions for narcotics if necessary, (I do not take them) but what helps me more than anything is what insurance does not cover. Water exercise. And medical marijuana. I’m 60, my husband is 64. He’s semi-retired so we no longer have employer health insurance (that didn’t cover the above either)…He’ll go on medicare in Sept. (not perfect and with costs) I’m terrified of losing our insurance through the medicaid expansion in our state, as I’m on a very, very, expensive medication for a severe eye condition that popped up suddenly last year. FYI: apparently, if you have either medicaid or medicare, you can’t use the pharmaceutical company discounts. When my husband gets social security, I will lose medicaid due to income requirements and I will be pushed on to the exchange, where they can charge up to 3x the amount depending on your age. I doubt we will get a subsidy. And then we will have the deductibles, etc. Meanwhile, the constant stress of knowing that the ACA and coverage for pre-existing conditions could be struck down is not fun.

Which foreign country’s type of Universal Healthcare System could the U.S. adopt to improve Obamacare?

The Netherlands would be a good place to start. Health insurance in the Netherlands is mandatory. Healthcare is covered by two statutory forms of insurance:Zorgverzekeringswet (Zvw), often called ‘basic insurance’, covers common medical care.Wet Langdurige Zorg (WLZ) covers long-term nursing and care. (Formerly known as Algemene Wet Bijzondere Ziektekosten (AWBZ)).While Dutch residents are automatically insured by the government for WLZ, everyone has to take out their own basic healthcare insurance (basisverzekering), except those under 18 who are automatically covered under their parents' premium. If you don’t take out insurance, you risk a fine. Insurers have to offer a universal package for everyone over the age of 18 years, regardless of age or state of health – it’s illegal to refuse an application or impose special conditions. In contrast to many other European systems, the Dutch government is responsible for the accessibility and quality of the healthcare system in the Netherlands, but not in charge of its management.Healthcare in the Netherlands is financed by a dual system that came into effect in January 2006. Long-term treatments, especially those that involve semi-permanent hospitalization, and also disability costs such as wheelchairs, are covered by a state-controlled mandatory insurance. This is laid down in the Wet Langdurige Zorg ("General Law on Longterm Healthcare") which first came into effect in 1968 under the name of Algemene Wet Bijzondere Ziektekosten (AWBZ). In 2009 this insurance covered 27% of all health care expenses.[12]For all regular (short-term) medical treatment, there is a system of obligatory health insurance, with private health insurance companies. These insurance companies are obliged to provide a package with a defined set of insured treatments.[13]This insurance covers 41% of all health care expenses.[14] Other sources of health care payment are taxes (14%), out of pocket payments (9%), additional optional health insurance packages (4%) and a range of other sources (4%).[14]Affordability is guaranteed through a system of income-related allowances and individual and employer-paid income-related premiums.A key feature of the Dutch system is that premiums may not be related to health status or age. Risk variances between private health insurance companies due to the different risks presented by individual policy holders are compensated through risk equalization and a common risk pool. Funding for all short-term health care is 50% from employers, 45% from the insured person and 5% by the government. Children under 18 are covered for free. Those on low incomes receive compensation to help them pay their insurance. Premiums paid by the insured are about 100 € per month (about US$127 in Aug. 2010 and in 2012 €150 or US$196,) with variation of about 5% between the various competing insurers, and deductible a year €220 US$288.From 1941 to 2006, there were separate public and private systems of short-term health insurance. The public insurance system was implemented by non-profit health funds, and financed by premiums taken directly out of the wages (together with income taxes). Everyone earning less than a certain threshold qualified for the public insurance system. However, anyone with income over that threshold was obliged to have private insurance instead.In 2015 the Netherlands maintained its number one position at the top of the annual Euro health consumer index, which compares healthcare systems in Europe, scoring 916 of a maximum 1,000 points. The Netherlands has been in the top three countries in every report they have published since 2005. On 48 indicators such as patient rights and information, accessibility, prevention and outcomes, the Netherlands secured its top position among 37 European countries for the fifth year in a row.[6]The Netherlands was also ranked first in a study comparing the health care systems of the United States, Australia, Canada, Germany and New Zealand

Why are some Americans so opposed to universal healthcare?

I’m an American. I want universal healthcare. I don’t trust my government to do it.The basis for my mistrust is the Social Security Disability system. I have two reasons to distrust it.First, this system is fiscally broken and our politicians lack the political will to fix it. We have a drop-dead date on the calendar when the system won’t have enough money left to pay claims. This alarm has been going off for a decade and they still haven’t fixed it.Second, I know two people who have applied for Social Security Disability benefits, and both have been denied. In my informed opinion both needed and deserved the benefits. The hard numbers are that Social Security disability system accepts 36% of claims on first review, accepts 14% of the claims that are reconsidered, accepts 62% of the claims that are further reviewed by an administrative law judge, accepts 13% of the claims that go to an appeals council, and then accepts 40% of the cases that go to federal court. You can be paid back-benefits if your social security disability claim is denied and then approved.There is no equivalent for back-benefits if you are denied medical care and die.Any sane system would backpropagate the knowledge from these after-denial approvals into the initial application review, but my government is too incompetent or inflexible to do this.I wanted the affordable care act to take the 3% Medicare tax, make it 10%, and give us an NHS-style system of universal healthcare. I would have been happy with a system where anyone, regardless of age, medical conditions, or employment could have bought health insurance with no health or age questions for under 5% of the annual median income.Instead, I got a tax on people least able to pay it, a “marketplace” that wasn’t an improvement over what we already had, and ten-thousand more pages of regulations for my Doctor to deal with.If my government can’t figure out how to pay disability claims to someone who had an aneurysm and can’t put three intelligible words together then why should I trust them to pay for their medical care?

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