Healthcare in US

[nodegree]

Democratic Party. Remember SALT exemption cap? Well they had two years of Senate, House and Presidency but failed to repeal it. The guy who passed it in 2018 campaigned against it in 2024 but the dem party had nothing to say or show.

The SALT exemption cap is not a universal issue since it affects only a handful of deep blue states, why would a mid-western democrat want to prioritize this over other things like child tax credit, infrastructure, healthcare etc?
Seniors are everywhere and they show up to vote in larger numbers than any other age group.

Right so? They don't mind losing an election or two (maybe more) as long as they can keep the gravy train running. Even better, all those operators can start new podcasts dissecting about what went wrong and come up with excellent euphemisms like "We were highly successful to a point."

Coming back to watering down Medicare - the tax increase and the premium increases will be done by Dems but GOP will take care of the rest (change in eligibility, increased wait times).

[SAPPORO]

Democratic Party. Remember SALT exemption cap? Well they had two years of Senate, House and Presidency but failed to repeal it. The guy who passed it in 2018 campaigned against it in 2024 but the dem party had nothing to say or show.

The SALT exemption cap is not a universal issue since it affects only a handful of deep blue states, why would a mid-western democrat want to prioritize this over other things like child tax credit, infrastructure, healthcare etc?
Seniors are everywhere and they show up to vote in larger numbers than any other age group.

Right so? They don't mind losing an election or two (maybe more) as long as they can keep the gravy train running. Even better, all those operators can start new podcasts dissecting about what went wrong and come up with excellent euphemisms like "We were highly successful to a point."

Coming back to watering down Medicare - the tax increase and the premium increases will be done by Dems but GOP will take care of the rest (change in eligibility, increased wait times).

Dems are supposed to be morally superior either by choice or they were forced to be so, as Trump himself admitted a few days ago.
“We had no riots. We had no anything. It was a beautiful thing to watch,” Trump said. “They just said, ‘We lost.’
All the good things that ever happened in this country like social security, Medicare, Medicaid, food stamps, Obamacare, Consumer protections, HUD, civil rights and so on have all come under Dem regimes. Heck we won't even be here but for the Immigration and Nationality act of 1965. We have to go back to 1865 (abolishing slavery) to find anything good the Republicans have done other than a few fiscally irresponsible tax cuts.

All of this is moot - No one would do anything to Medicare until 2032 or whenever they need to do something. Heck, they won't even pay to keep the lights on until the last minute.

[teera]

Thought I’d share my very recent experience with healthcare system in India following a medical emergency while in India.
For reference, I’m a US citizen and plan to spend more time in India going forward. My recent firsthand experience in Bengaluru has bolstered my thoughts of spending substantial time in India.
There are highly competent medical centers and doctors in India. Appointments with specialists can be had in days, if not hours. It was heartening to see that hospitals/doctors do see medical emergencies as a priority. No networking/bribing was needed.
Dollar goes a long way in getting high quality care. Physio therapists and certified support staff make house calls, and I found them very dependable. As mentioned elsewhere, samples for a lot of the tests are collected from home.
My case required super specialty and skilled surgeon. My doctor in Bengaluru arranged for an appointment with one in another city and the surgery was done in 2 days.
The point of posting my experience is not to market healthcare system in India. It is to state that India isn’t lagging in providing high quality healthcare services, at a fraction of the cost and time (compared to US). There is no point in comparing the 2 healthcare systems to prove that one is better than the other. The 2 systems are very different with their pros and cons. For established treatments and procedures, the system in India surely is a lot more affordable without compromising on quality, and the lead time in getting appropriate treatment is significantly less. My doctor friends in the US attest to the fact that I have likely saved a bunch in money and at least 4 months of lead time in getting the right treatment compared to the US.

[Returning_Indian]

I am not entirely sure if this universal healthcare system is good as it puts lot of pressure on govt budgets. Govt collects the funds but is not good maintaining those funds. Those funds get spent elsewhere and when the time comes to pay, they don't have the money and have to borrow it. On top govt collects payroll taxes based on the treatment costs of today while the recipient will use them 45yrs later. Growth rate of funds is fraction of inflation in healthcare and steep costs of new tech/drugs. To add it all, there are so many people on benefits, low earners etc and they get the same benefits as high tax paying. Socialism in capitalist society. Lot of this is alleviated by long lines which only leads to high rate of mortality. People do not get diagnosed on time because diagnostics are backed up. Surgeries are postponed as there is no availability and people have to live in pain. So the system where you contributed for 45yrs comes to no use to you at the time of your needs. And then there are issues with what is covered and gaps are for you to fend with your own paltry savings.

Now if the Medicare eligibility is increased to 70yrs then it may still be ok for some as some maybe fit/healthy but vast majority will suffer. Benefit curtailment is not good as this is not something anyone is planning on their retirement. They are told it's all free after 65. And suddenly it's not but it's too late now and now they have to greet at Walmart to cover the rest, reverse mortgage their house and be home less if they live far too long. US govt borrowing is becoming a problem. This debt was very lucrative until now but with shifting economy heavyweight, its becoming less appealing for the foreign lenders. A time may come where debt may not be the solution anymore. Increased payroll is an option but that only provides 34% of funds currently and projected to go down to 25%. Plus we don't know how AI will impact the job market and how many jobs would be lost/outsourced. So this leaves payroll anyways a unreliable avenue.

Overall, situation is bleak for people wanting this coverage in another 15-20yrs and want to rely on it for another 25yrs. It's better they find refuge elsewhere and keep the setup ready. India offers a good option but real estate in metro is expensive and may put a big dent if people want to maintain two residencies. Buy an apartment close to a major hospital.

[nodegree]

The SALT exemption cap is not a universal issue since it affects only a handful of deep blue states, why would a mid-western democrat want to prioritize this over other things like child tax credit, infrastructure, healthcare etc?
Seniors are everywhere and they show up to vote in larger numbers than any other age group.

Right so? They don't mind losing an election or two (maybe more) as long as they can keep the gravy train running. Even better, all those operators can start new podcasts dissecting about what went wrong and come up with excellent euphemisms like "We were highly successful to a point."

Coming back to watering down Medicare - the tax increase and the premium increases will be done by Dems but GOP will take care of the rest (change in eligibility, increased wait times).

Dems are supposed to be morally superior either by choice or they were forced to be so, as Trump himself admitted a few days ago.
“We had no riots. We had no anything. It was a beautiful thing to watch,” Trump said. “They just said, ‘We lost.’
All the good things that ever happened in this country like social security, Medicare, Medicaid, food stamps, Obamacare, Consumer protections, HUD, civil rights and so on have all come under Dem regimes. Heck we won't even be here but for the Immigration and Nationality act of 1965. We have to go back to 1865 (abolishing slavery) to find anything good the Republicans have done other than a few fiscally irresponsible tax cuts.

All of this is moot - No one would do anything to Medicare until 2032 or whenever they need to do something. Heck, they won't even pay to keep the lights on until the last minute.

Not to derail the thread's main topic.. lot of these accomplishments by Dem administrations were before 1980s. Since Clinton, the party became Pepsi to GOP's coke. Obama ran on a single payer system but instead delivered Obamacare which was pioneered by Romney in Michigan. Obamacare was effectively a giant BJ to insurance companies with a side benefit of covering preexisting conditions. Consumer protection agencies were gutted since the 90s and only found some footing in the first two years of Biden administration (again all set to be gutted by KH admin had she won).

[SAPPORO]

Dems are supposed to be morally superior either by choice or they were forced to be so, as Trump himself admitted a few days ago.
“We had no riots. We had no anything. It was a beautiful thing to watch,” Trump said. “They just said, ‘We lost.’
All the good things that ever happened in this country like social security, Medicare, Medicaid, food stamps, Obamacare, Consumer protections, HUD, civil rights and so on have all come under Dem regimes. Heck we won't even be here but for the Immigration and Nationality act of 1965. We have to go back to 1865 (abolishing slavery) to find anything good the Republicans have done other than a few fiscally irresponsible tax cuts.

All of this is moot - No one would do anything to Medicare until 2032 or whenever they need to do something. Heck, they won't even pay to keep the lights on until the last minute.

Not to derail the thread's main topic.. lot of these accomplishments by Dem administrations were before 1980s. Since Clinton, the party became Pepsi to GOP's coke. Obama ran on a single payer system but instead delivered Obamacare which was pioneered by Romney in Michigan. Obamacare was effectively a giant BJ to insurance companies with a side benefit of covering preexisting conditions. Consumer protection agencies were gutted since the 90s and only found some footing in the first two years of Biden administration (again all set to be gutted by KH admin had she won).

This is the reason why Dems would be/have been underdogs in all elections- factionalism whereas Republicans are very much united even in electing an unhinged felon. The same factionalism gutted the single payer option, and it was good in a way since with that included the entire ACA would have been abolished by GOP in one of the umpteen times they tried.

For the record, Clinton created FMLA (Family Medical Leave), Direct student loans, Child tax credit, CHIP (Children's Health Insurance Program), Lifetime Learning Credit that are all part of American life till today and a few like Assault weapons ban, believe-it-not budget surplus, extending Medicare solvency etc.., that have been squandered away by later administrations. Nothing more to add since it does not make sense anymore.

[SAPPORO]

I am not entirely sure if this universal healthcare system is good as it puts lot of pressure on govt budgets. Govt collects the funds but is not good maintaining those funds. Those funds get spent elsewhere and when the time comes to pay, they don't have the money and have to borrow it. On top govt collects payroll taxes based on the treatment costs of today while the recipient will use them 45yrs later. Growth rate of funds is fraction of inflation in healthcare and steep costs of new tech/drugs. To add it all, there are so many people on benefits, low earners etc and they get the same benefits as high tax paying. Socialism in capitalist society. Lot of this is alleviated by long lines which only leads to high rate of mortality. People do not get diagnosed on time because diagnostics are backed up. Surgeries are postponed as there is no availability and people have to live in pain. So the system where you contributed for 45yrs comes to no use to you at the time of your needs. And then there are issues with what is covered and gaps are for you to fend with your own paltry savings.

Now if the Medicare eligibility is increased to 70yrs then it may still be ok for some as some maybe fit/healthy but vast majority will suffer. Benefit curtailment is not good as this is not something anyone is planning on their retirement. They are told it's all free after 65. And suddenly it's not but it's too late now and now they have to greet at Walmart to cover the rest, reverse mortgage their house and be home less if they live far too long. US govt borrowing is becoming a problem. This debt was very lucrative until now but with shifting economy heavyweight, its becoming less appealing for the foreign lenders. A time may come where debt may not be the solution anymore. Increased payroll is an option but that only provides 34% of funds currently and projected to go down to 25%. Plus we don't know how AI will impact the job market and how many jobs would be lost/outsourced. So this leaves payroll anyways a unreliable avenue.

Overall, situation is bleak for people wanting this coverage in another 15-20yrs and want to relay on it for another 25yrs. It's better they find refuge elsewhere and keep the setup ready. India offers a good option but real estate in metro is expensive and may put a big dent if people want to maintain two residencies. Buy an apartment close to a major hospital.

Wal-Mart greeter is quite a cliche - there are 67 million Medicare beneficiaries currently!
All valid points but nothing immigration and medical innovation probably aided by AI can't fix! Wonder how many Indians would apply and pray to be picked up in the lottery, if the H1C visa limit is increased from 500 to 50,000 for nurses/ doctors. For some reason the system has become EB3-GC for nurses rather than temporary visas.
When that happens, Malayalam would replace Telugu as the fastest growing language in the US It would be a big loss for the middle east which some would perceive as an added benefit.

[r2somewhere]

I am not entirely sure if this universal healthcare system is good as it puts lot of pressure on govt budgets.

Your opinion doesnot matter. Here are the facts:

US spends 2x per person on healthcare than Canada. Source: https://medical.rossu.edu/about/blog/us ... n%20Canada.

Canadian life expectancy is 4 years more than the US.

[r2somewhere]

[

Not to derail the thread's main topic.. lot of these accomplishments by Dem administrations were before 1980s.

Because Rs became better at blocking and moving the overton window to the right.

[old-spice2]

Thought I’d share my very recent experience with healthcare system in India following a medical emergency while in India.
For reference, I’m a US citizen and plan to spend more time in India going forward. My recent firsthand experience in Bengaluru has bolstered my thoughts of spending substantial time in India.
There are highly competent medical centers and doctors in India. Appointments with specialists can be had in days, if not hours. It was heartening to see that hospitals/doctors do see medical emergencies as a priority. No networking/bribing was needed.
Dollar goes a long way in getting high quality care. Physio therapists and certified support staff make house calls, and I found them very dependable. As mentioned elsewhere, samples for a lot of the tests are collected from home.
My case required super specialty and skilled surgeon. My doctor in Bengaluru arranged for an appointment with one in another city and the surgery was done in 2 days.
The point of posting my experience is not to market healthcare system in India. It is to state that India isn’t lagging in providing high quality healthcare services, at a fraction of the cost and time (compared to US). There is no point in comparing the 2 healthcare systems to prove that one is better than the other. The 2 systems are very different with their pros and cons. For established treatments and procedures, the system in India surely is a lot more affordable without compromising on quality, and the lead time in getting appropriate treatment is significantly less. My doctor friends in the US attest to the fact that I have likely saved a bunch in money and at least 4 months of lead time in getting the right treatment compared to the US.

You echo my thoughts. At this time India offers the best in medical treatment compared to US, EU or other western countries. In socialist countries like UK/Germany, the waiting time for non-life threatening problems like hip/knee replacement is 6m - 1 year. In Germany where I have family, first hand experience is you will be put in a que for non-emergency procedures. Remember for some issues you need surgery within few days, otherwise one will be forced to live with a painful knee or backside for months. India is better than other nations for $ rich NRIs (note I am not talking about locals or poor in India).

I have got excellent care in ER (for non life threatening) in BLR for cost that may be slightly above copay I have to shell out in US. I use ER in India if I don't have patience to wait in OPD. In our family, we have used medical tourism to get few surgery done there when insurance company in US refused to cover it calling it as "elective". But the doctors recommended those procedures. The decision to undergo surgery or not should be decided by doctor and patient. In America it is decided by insurance companies. That is dangerous and sometime leads to more complications.