Healthcare in the US
There’s a couple ways to anger me immediately: overpromising but underdelivering, whining about first-world problems, and talking about the US healthcare system.
For most of my life, I was blissfully ignorant about healthcare. My parents were gainfully employed, and I clung to their healthcare like a leech until I turned 26. Before I reached that prodigious milestone though, I took full advantage of my free healthcare. And since my dad was working in China at the time, his company offered a global healthcare plan. To this day, it still blows my mind how incredible that plan was. It was a dream — I had comprehensive healthcare while backpacking in South America!
The nightmare began when I got back to the US. I was turning 26 the next month, and I needed to figure out how to prevent my family from going bankrupt if something catastrophic happened to me and they tried to cover my healthcare costs (I later learned that “catastrophic” is an industry term — nice).
I turned to healthcare.gov — the official site of the Affordable Care Act passed by the Obama administration in 2010 — to look for a marketplace plan. Unfortunately, by that time, Obamacare had effectively been gutted by the Trump administration. Without the government’s support, there’s little incentive for healthcare providers to support sensible plans — I was scraping the bottom of the barrel. I need to pay a $10,000 deductible before any benefits kick in? And a premium of $500 a month to boot? Just hit me in the head with a baseball bat, because that’s the kind of catastrophic event that needs to happen for that plan to make sense!
Here’s where the government support comes in.. they cover an increasing percentage of your marketplace healthcare plan costs as your income gets lower. The income thresholds vary by state but generally follow the same distribution around the poverty line. Learn more here. My problem was that I wasn’t sure how long I’d be without income, and if you exceed the income thresholds, you pay the government back in your next tax return. I didn’t want to risk paying the government back later for a crappy plan now.
Instead, I ended up going with a recommendation from a family friend — a health share plan called Liberty HealthShare. It’s a faith-based co-op style system in which members share healthcare costs. They keep costs down by screening out individuals with pre-existing conditions or high-risk behaviors like smoking. I’m just glad they didn’t screen for my knowledge about the bible (i.e. non-existent).
Thankfully, no one ever hit me in the head with a baseball bat. I only filed one claim and then was fortunate enough to be employed later that year. Funny enough, I ended up setting up the healthcare plans at the company, but that’s a story for another time. Even now, my mom faces the same dilemma. She works part-time for a small business that can’t afford healthcare. And while she has a marketplace plan, she’s constantly struggling with the plan and worries about the income thresholds. This is not how healthcare should be.
My personal experience highlights two systemic issues with US healthcare system:
- You’re dependent on your employer.
- It’s controlled by private corporations.
These issues are at the root of problems with healthcare, but they’re also incredibly hard to tackle. Most politicians won’t touch healthcare with a ten foot pole, and even well-funded, well-intended efforts die in the face of overwhelming bureaucratic inertia. As long as people are tied at the ankle to their employers and private corporations are incentivized to do what they were created to do (i.e. make lots of money), we’ll never solve healthcare.
