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Part one is: many Americans who oppose universal healthcare… have the luxury of being so-opposed, because they've had terrific insurance coverage their entire lives, they've managed to dodge any really expensive illnesses, or both; and so they have no actual idea how much medical care can cost. As a point of reference, I'm actually a really big fan of single-payer coverage—but I had no clue how much cancer treatment could run. Like, if you'd asked me, I would probably say “expensive,” but I’d have been thinking in the low tens of thousands, perhaps up to 100,000 or so, in a really awful, protracted course of care. I couldn't quote you a figure. Then my sister-in-law had cancer.Two years of treatments, which my brother added up the cash-pay cost of, just to see? Would have run half a million dollars, just for chemotherapy. That didn't include either of her surgeries; didn't include long-term pain management or ongoing medical care; didn't include hospice care. My bet is that after all of that, we’d be talking closer to $1,000,000. And that's two years—there are people who require much longer-term care, for comparably expensive conditions.Part two is: many Americans have been very effectively lied-to about why their own insurance coverage is so inadequate or expensive. I've met Americans who are angry about the ACA because they didn't qualify for cost-effective coverage—which is an issue with conservative obstructionism, insistence on laws that limit the scope of the ACA, and the absolute certainty that no law guaranteeing adequate, reasonably-priced coverage for everyone would pass a conservative-controlled Congress. You'd be amazed at the number of people who, asked about single-payer or universal health coverage, can work themselves into a fit of rage over how TERRIBLE such a thing would be. But ask them whether they and their families deserve reasonably priced coverage, which will actually pay for needed care? Well, obviously they should get it. And the government should do something about seeing that they do.I don't know how to explain that last one, aside from willful ignorance, astonishing levels of selfishness, or both.And, really, the same applies to the lies people are told about insurance companies. Like, as a healthcare provider, I can tell you with some certainty: insurance companies are greedy; they don't care at all about patient well-being; they cling to their money in the near-term at the expense of significant, long-term gains. Laypeople often don't realize that, because they're thinking about insurance companies as if they're humans, with concerns about long-term profits and sustainability. Corporations are not humans, though—and they're very seldom run by humans, at least in the way many people think of it. Corporations are bought and sold, a little bit at a time, by people who intend to turn a relatively short-term profit—-measured in years, perhaps, but not in a lifetime or generation. Not anymore. You don't make profits on that timeline by focusing on growth, sustainability, or long-term strategies—or meeting the needs of the people who need your company’s services. You do it by cutting costs right now, and that is what insurance companies do.They resist providing care, refuse to pay healthcare providers even for covered services, force us to spend hours on the phone that we could spend with patients/clients. They underpay and undertrain their people, such that it can take 30 hours on the phone (I counted) to get a straight answer about unpaid bills over the course of, oh, 11 months (really), even when it's a very simple error that is documentably their own (and which someone eventually apologizes, but certainly doesn't, say, pay interest on sums owed, for). They underpay healthcare providers, and do so on a basis that has no clear grounding in any rational evaluation. For the same service, provided in the same way, an insurance company can pay me anywhere between $45 and $135, and that's entirely legal. If I want to accept a given form of insurance, I have to sign a contract agreeing to “accept assignment,” which means that no matter what a fair wage is, I’ll take what the company sends me. What isn't legal is for me to opt out of requiring a copayment from a client I know can't afford it—or charge a lower fee to a client whose coverage is percentage-based—or allow a client not to pay my full fee while they meet their deductible. And the idea of our accepting or not accepting insurance, by the way? That's only half the story. Insurance companies can, and routinely do, simply—choose not to work with any more providers in a given field of practice. Not because we aren't adequately qualified, or there are problems with our treatment approach, just because they have “too many” providers in their network. Ask yourself: from the perspective of patient care, how many providers is too many? Then ask yourself: if patients give up on seeking care, or pay out-of-pocket, because all the doctors in-network are too busy to see them—who profits? 30 hours is an entire extra client. Want to guess where we get to make up that money, if we want to stay in business? Hint: it's not your health insurance company.Health insurance companies, left unchecked, allow untrained non-professionals to make your healthcare decisions for you. They choose, without expert informants, what they do and don't feel like covering. They throw people off of their insurance plans, when they get too expensive to keep covering, regardless of the reality that those people are the reason they exist.And for those, and many other reasons, health insurance just doesn't need to be a for-profit industry. The reason so many insurance companies have been backing out of insurance exchanges isn't that they're unsustainable. It's that they're unsustainable at their current, artificially and grossly bloated profit margins. Because how they kept those margins so high, previously, was by refusing to actually provide the service they were hired for.The point of insurance companies isn't to regulate healthcare; it isn't to tell doctors how to diagnose or treat; it isn't to try and manage the costs of particular procedures, without actually knowing anything about what they are, or how much they cost. The point of insurance companies is to collect a little money from a lot of people, then push it around wherever it's needed, so that no one drowns under the cost of two years of chemotherapy—or dies in agony because they can't pull $1,000,000 out of the clear blue sky. I'm not sure why people think that being tortured to death is a reasonable consequence for “not being responsible enough” to buy private health coverage that they couldn't afford in the first place, and wouldn't have covered them, anyway.Now, on to the last major factor in this debacle: cost of insurance. Lots and lots and lots of Americans are convinced that the reason insurance costs so much is that the ACA forced insurance companies to cover sick people, and so if the ACA would just stop that, their insurance would get cheaper. That's both measurably untrue (compare overall insurance cost increases before and after the ACA), and not actually important, if true. How do people think it's helpful to have cheap insurance, if there insurance will just kick them out, when they get sick? Well, their insurance shouldn't do that, the government should make sure of it. But the government demanding that insurance companies cover other sick people, now… that's just totally unreasonable.…and lots of folks in the US have somehow equated the ACA, which is very clearly a short-term, bandaid solution, originally created by political conservatives, with universal/single-payer health coverage. Never mind that the latter would solve many of the ACA’s problems and limitations. Never mind that political conservatives created or exacerbated many of said problems, themselves. Never mind that the theoretical horrors of state-run health insurance are radically out-stripped by the actual horrors of private-pay coverage that outrage these same people, in the first place. The ACA is bad; the ACA was pushed by a Democrat; therefore, the ACA is the same thing as single-payer coverage, and that would be even worse.So—some people really are just that selfish and apathetic as to the well-being of others. Some people are entirely well-meaning as to their own and others’ well-being, but don't have a deep understanding of how the current system works, and so can't quite see into the changes that could improve it. Lots of people treat politics as a kind of high-stakes reality TV show or football game, and fail to make the connection between policies and outcomes, because if their side won, regardless of what their side is pushing, that's good; and if the other side won, even if their win is actually tremendously helpful to the voters in question, that's bad. And there are some folks whose opinions I really can't account for, at all. They just… refuse to engage with actual data, at any point where said data might interfere with their existing worldview.

This depends on which country you’re in. Generally many countries will have some kind of system where people can get life-saving treatments regardless of their financial status, but the specifics vary. Here’s how it works in Norway.Everyone who is a resident of Norway (regardless of things like citizenship, employment-status and age) automatically becomes a member of our Social Security[*] program; this includes healthcare, both life-saving and routine one, and as such being “uninsured” is not something that is ordinarily possible for a person who live in Norway permanently.Tourists and other visitors from are however not members of our Social Security program, and these therefore need to carry travel-insurance or health-insurance from their home-country that covers medical treatment abroad.Should neither of these apply — i.e. you’re NOT a member of our Social Security program, and you do NOT have travel-insurance or some other form of insurance that covers the treatment; you still have the right to necessary treatment.The hospital will treat you in any case; and won’t be the ones to pick up the bill for uninsured patients; that’s done by the government. Letting the individual doctor or the individual hospital pay for it seems unfair to me, because it’ll mean a extra burden on doctors who happen to practice in locations with many tourists, better to divide this burden fairly across all of society.There is no condition where life-saving surgery will be denied because of your financial status. But if you lack insurance-coverage, you will (after the fact) be asked to pay yourself for that fraction of the cost that you are able to pay.[*] As an aside, the thing you become a member of when you live in Norway is called “folketrygden” which literally translates to “Peoples safety (or security)”, which describes it’s purpose well. It’s our overall single-payer system for securing people against many of the costly problems that can fall on a person in a lifetime, not solely healthcare. It includes unemployment-insurance, retirement-insurance, disability-insurance and several more things and makes up the biggest and most central part of our social safety net. The membership-criteria are simple; and there’s only 2 of them:You need to be in Norway legally.It must be a “permanent” stay, i.e. not just a shorter stay in Norway such as a vacation.

The biggest issue, for me, is in the U.S., if you're either born with a severe disability or become severely disabled due to accident or illness prior to the age of majority - and choose to work despite your disability - the system punishes you.Allow me to explain.I was born with Osteogenesis Imperfecta Type III/IV, a collagen disorder which makes my bones brittle and prone to fracture. I am also short-statured and use a manual wheelchair for mobility.Growing up, my parents told me I had to work as hard as I could for as long as I could, because there might come a time when my disability would make it impossible for me to work any longer, and I'd be in a better position to receive help if other people saw how hard I'd tried, despite my disability.So, after college I accepted a full-time position with a major commercial airline, which I held for 22 years.It was hard. While employed, I worked an average of nine months out of every 12 - fractures and surgeries kept me out of work about three months per year - long enough to use up my sick time but not long enough to collect long-term disability. Making nine months of salary stretch to cover a year's worth of bills was challenging, to say the least.When I was working, I had the same types of basic living expenses non-disabled people have. In addition, I also had very high premiums on my medical insurance (because of my disability, the "basic" plan offered by my employer didn't meet my needs, so I had to pay for extra coverage which cost several hundred dollars a month). In addition, there were co-pays and deductibles I had to meet.My insurance did not cover disability-related non-medical needs. When you have a disability, you can't just live anywhere, or drive just any car (or use a bicycle - an alternate form of transportation many able-bodied folks utilize to save money). Clothing has to be altered. As a matter of fact, my disability factors into just about every decision I make, and usually forces me to spend more for everyday things than a non-disabled person would.Because I was working, I didn't qualify for any help - financial or otherwise - from any programs serving people with disabilities. I either paid for what I needed myself, or did without.Then I was involved in a hit-and-run auto accident. My car was totaled, and I broke several bones. It took me over a year to recover from my injuries, and I was left with chronic pain. At the recommendation of my doctors, I left my position at the airline on long-term disability.At first, I thought I'd be okay. After all, I have a serious disability and while I didn't qualify for help while working, I couldn't work anymore - so certainly there would be help available to me now, right?Wrong.I learned I'd qualify for SSDI (60% of my former salary) and Medicare. That's it.I spent countless hours, days, weeks - calling every organization I could find only to be told that because my SSDI income exceeded Medicaid Income Guidelines I did not qualify for any assistance from any program serving people with disabilities, whether government or privately funded - because they all use Medicaid Income Guidelines to determine eligibility for their programs/services.I live in a home with no adaptations whatsoever, save a ramp up to my front door (which I had to pay for out-of-pocket at 1500.00) - because Medicare doesn't cover home adaptations (but Medicaid does).If I have a fracture and am unable to transfer in/out of bed, or on/off the toilet - too bad! Medicare doesn't pay for Home Health Aides (unless one also requires skilled nursing care) - but Medicaid does.I don't qualify for lower cost utilities, rent reductions, free prescriptions - all available to those who meet Medicaid Income Guidelines.So, since I left my job at the airline, I've been struggling to live on 40% less money (when it was a struggle to make ends meet even when I was working and getting 100%). Because I can't get the help and adaptive equipment/modifications I need, I am forced to take a lot of risks I shouldn't take just to get through an average day - which increases my chance of getting injured.Many countries with universal health care provide services to people with disabilities that aren't means-based, which allows those with disabilities to be productive and get the support they need.In the U.S., if one is disabled, you’re forced to choose between working and doing without necessary services, or declaring oneself unemployable to get the help you need.No one should have to make that choice, and it's because of this only 2.7% of those of us who are categorized as having a "severe work disability" ever work full-time.