It always amuses me when we hear "that's not who we are as a nation"

[PatrickforB]

38. I have a really good job and have worked there for over 30 years.

For this entire time, my employer has supplied health insurance coverage through a well-known HMO.

You can tell me how great that is all you want, but the reality is that my healthcare package, which this year alone has cost me personally just under $15,000, is the result of a policy that needs to be changed. And that's me. My employer has paid in over $12,000 for this HMO. So the total cost this year for me, my spouse and my employer has been ~$27,000.

As to it being rationed, consider this:
-Try having your spouse wake up every morning weeping with pain and have your HMO make you wait five months to even see a surgeon.

-Try knowing your spouse will need surgery and your out of pocket maximum copay per year is $4,000, and spend a couple of years saving up for that. On the day when she was having the surgery in question, her nurse said his mother in Canada had to (gasp) wait six months for the same surgery, and wasn't that just horrible, awful and terrible? I replied that since our copay for the surgery was $4 large, she'd had to wait over a year while I saved up the money to afford it without going into medical debt.

-My spouse needed hearing aids, and everything beyond $2,000 of the cost of those didn't count against the the $4,000 out of pocket max, so for a basic set I had to get a loan for $1,200.

-And my dental package has a yearly max of $1,500 worth of treatment. That's one crown and you're done. After paying out the $4,000 and taking out the additional loan for $1,200, on top of a couple other unplanned expenses, I lost a crown. Boom. More debt. I had to borrow another $650.

So Hortensis, this year I have spent just under $15,000 on healthcare. The surgeon we had to wait five months to see, by the way, really was a good actor. He pretended to care. He really did. But he won't do the surgery because this HMO is strictly evidence based and the tear in her rotator cuff didn't look bad enough in the MRI and X-ray to merit surgery.

But he did authorize an ultrasound guided cortisone shot, which we had to drive nearly 100 miles to get, and you'll be happy to know that my wife isn't crying as much lately because it took the edge off the pain.

So, let me correct you, please: In my experience, my healthcare is crummy and rationed, and I do have to pay financially crippling copays. In addition, I have, in fact, had to incur medical debt.

See, I'm talking about policy. Somehow we decided in this nation in spite of the fact politicians in both parties tried to get universal healthcare that is not tied to employment through at least 2/3 of the last century. Nixon tried, for gosh sake. But we don't have that. Why, Hortensis? Because of the doctrine of shareholder primacy. Profits. We have allowed the profit motive to be imposed on health care. These insurance companies that cover us necessarily hold profit above patient welfare because they have to if they are publicly traded. And even if they are nonprofit, they strive to retain maximum earnings, often denying care that is needed, and subjecting people to long wait times, or to unnecessary tests to keep from getting sued.

For everyone like me who says we ought to take the profit motive out of healthcare, including dental and vision, we have a group of well-paid lobbyists from health insurance companies and HMOs, who are afraid the government will negotiate down costs, even though numerous studies have shown that the prices of certain procedures vary wildly between hospitals, and there is also variance between what insurance A is charged as opposed to insurance B.

So please do not patronize me by telling me how great my healthcare is. I would cheerfully pay a whole bunch more in income tax and not have to worry about being wheeled through the accounting office to make sure I can 'handle' the copay (yes this has happened, but to be fair the guy wheeled a cart into the ER with a laptop and asked the question. Seriously).

In addition, Hortensis, right now, according to the US Census American Community Survey 1 Year Estimates, there are 29.6 million Americans who have no health care coverage, and of these, 16.8 million are employed.

Not too good by anyone's standards. Certainly not mine. Sure if you own stock in United Health UNH, you have seen your shares go from $136 in 2016 to $407 at the latest close. Great return on your investment, really spectacular. In the meantime, while shareholders are experiencing absolutely WONDERFUL profits, the patients are getting more and more and more of the cost of care passed on to them.

So, Hortensis, healthcare in America is NOT the best in the world, not everyone has access to it, it is rationed in terms of maximum out of pocket copays, and yearly caps on treatment in many cases. Too many have no healthcare coverage at all, and most of us count the pennies to make sure we can afford it if we need to actually use it. Our system is lousy, broken, and needs an overhaul. The problem, to my mind, is healthcare is a public good, and we have, through the greed of a few, imposed the profit motive on it, and that has proven a mistake. Not for investors but for patients.