Truck drivers and substitute schoolteachers too (I was a sub teacher at one point and the closest place to go to get fingerprinted was a truck driving school.)
This is why insurance plans have out of pocket maximums. To prevent this exact issue.
We can say whether those maximums are still too high (some really are), but the mechanism is there.
The real issue is that most people don't have a rainy day fund to deal with such emergencies. And that they are too expensive anyway.
There are 2 concepts you should always keep in mind.
1. Always avoid the hospital unless you are literally dying. Surgery centers are owned by doctors who will negotiate a fixed fee, because there's someone to negotiate with (unlike Hospitals which run on the CYA principle). Also, most doctors can do procedures in office, if they have the right one.
2. Medical debt will never lead to collections. Hospitals may sue you, depending on the state, but that carriers reputational risk. A good PR push and a decent lawyer to threaten discovery will be enough to fend off even the most aggressive hospitals - this allow you to setle at a very reasonable price vs what insurance would normally pay.
That analysis is flawed because it misses the systemic nature of the risk. The Out-of-Pocket Max is an annual liability, not a one-time fix. A single serious illness, like cancer, spans multiple plan years. A $9,200 OOPM hitting three years in a row, on top of $15k-$18k in annual premiums, is the bankruptcy. This also assumes 100% in-network care, which is a fantasy in a real emergency when you don't get to pick the ambulance or the anesthesiologist. This isn't a "rainy day fund" problem. This is a system that requires a $50k-$100k emergency fund just to handle a single medical event, all while assuming you're still healthy enough to keep the job that provides the plan.
"Always avoid the hospital" isn't a choice either. You don't "negotiate" with a surgery center for a heart attack, a stroke, or a major car accident, which are some of the common events that cause this. And the claim that "medical debt will never lead to collections" is factually incorrect.
It is the number one cause of collections in the United States. The idea that every citizen can just "hire a decent lawyer" or "run a good PR push" to settle debt isn't a functional or scalable mechanism, nor is it reality.
> Hospitals may sue you, depending on the state, but that carriers reputational risk
I'm sorry but if I need a hospital, my first thought isnt, "well how is their reputation".
I don't understand why people defend the insurance system in the US when you're already paying taxes. If it's not the responsibility of the government who you pay to take care of their people in an emergency then what are taxes for. It's like people just accept it because that's how it's always been.
Insurance is what i have when i drive my car , or get water damage insurance for my house.
The monster we have today is not insurance. Instead, it is the frankenstein born out of the womb of bureaucrats and politicians influenced by money. Decades of tinkering politicians without a clue, messing around with the relationship between the doctor and patient, responding to voting patterns of the electorate, led us to today.
Unless you blow it up, (and it will blow up, just like it happened in sweden) there's no solution, except paying more for ferrari all-you-can eat.
>>> No, I get the point because I've spoken to several specialists on the matter. The budget cuts Milei performed were far higher than what even the most conservative IMF program proposed.
You clearly don't. There was 2100% annual hyperinflation on the day Milei assumed. "Specialists" said that cutting inflation to monthly single digits couldn't be done, period.
Milei did it in less than 6 months.
The current predicament is a political one, not an economic one.
He allowed Argentinians to finally experience the freedom of a floating exchange rate. Under normal circumstances, if the Argentinians decided they had enough of the peso and wanted to forcefully commit to the USD, they could do so at whatever rate was offered.
The political problem is that now there's an election this weekend, and he now has to explain why Argentinians (and investors) don't want pesos if the FX goes too high. He should not have put the govt in the position to defend a peso... that Argentinians themselves do not want.
After the election, there will be nothing to speculate against, the currency will find whatever equlibrium was needed, and the "specialists" will go back to their corner, where they hide for being wrong.
>>>The grant committees didn't earn the money, but as practicing scientists of some renown they have earned the right to weigh in on how public dollars should be spent.
No. They have not. They haven't earned anything. If they did, they would have had a connection to a company and thru their technical expertise, chosen exactly what to develop next, with their own (or investor's) dollars at stake.
You can't claim the best at a subject and purport to demonstrate it by writing a book. Say, risk management. Real risk managers open hedge funds. Academics write about other's hedge funds.
One has battle scars. The other is soft. Soft people don't get to make decisions on how to allocate anything. No cowards for leaders, since time immemorial.
> chosen exactly what to develop next, with their own (or investor's) dollars at stake.
We are talking about fundamental research here. Most investors are not interested in funding fundamental science, evidenced by the fact they have all the power to currently fund such work, but they choose not to.
> You can't claim the best at a subject and purport to demonstrate it by writing a book
They don't, they do it by doing science and building a reputation in their field for doing good work. People who work at the NSF and NIH are vouched for by others in their field.
> Real risk managers open hedge funds. Academics write about other's hedge funds.
The interests of private equity and hedge fund managers are well represented. They have plenty of say on public policy and how resources are allocated. It's good to give other people with different perspectives a say as well. Again, the total amount of money allocated for public research is very tiny compared to the rest of the federal budget, private research dollars, total hedge fund wealth, etc.
This kind of marginal risk thinking has never made sense to me because of the declining marginal value of money.
If you have $0 you can't accept any risk and can't make any decisions correctly. But if you have like $4 million you also have no reason to make any decisions correctly because risk no longer matters to you. So it relies on them having expensive tastes such that they can't just retire?
It has to do with the lindy effect. If you have $X, statistically you will quit trying to accumulate money when you have $2X. Hence you are safe to entrust some reasonable fraction of $X in without fear of you running away with it. Someone with substantially less than $X will see that as the most money they will ever see in their lifetime and immediately being trying to cash out.
because government regulators are backstopping the loan that young adult took for that sauna.
There's no free lunch. Its not a free market when a 17yr old with zero job experience can enter loan agreements of 100k per year.
And you know that's true because in any other scenario, the same 17yr old will get laughed out of any loan office. I'm not even sure a 17yr old would get a 400k bank loan if the kid showing up at the bank as the patent holder of Wegovy, for example.
That ans I'm not sure the free market could not provide private independent luxury sports amenities just next to universities if it was a real need. I'm pretty sure the free market sports places would fail fast however.
