23 hours ago, dave2013 said:

How in the world did you manage to break your spine?  Was it an accidental fall?  Anyway, hope you get better soon.

I was perusing the other posts here and want to comment on the USA healthcare system, as I think there are some misconceptions. 

The insurance=based payment model that we use here, albeit dwindling due to more govt.-provided care(more on this later), is actually not a bad system.  Up until the 1970s, most people had what is called a catastrophic health insurance policy, where one pays for all healthcare out of pocket until it exceeds a large amount, say $10,000, whereupon the insurance kicks in and covers all further care.  Healthcare was generally affordable under this system.

What changed things is when Medicare and Medicaid came online.  These programs are essentially govt. single payer health insurance plans, one for folks 65 and older and the other for folks whose income is below 139% of the federal poverty level.  With Medicare, one pays a reasonable premium to cover the 20% that Medicare doesn't cover as well as doctor visits and medication.  My mother pays about $400/month for everything and she's pretty satisfied.  If you think about it, $400/month for healthcare is a good deal for someone nearly 80 years old.

Medicaid doesn't require any premiums or copays.  Those on Medicaid get 100% free healthcare, and right now there are about 71 million Americans in this program.  

About 20% of Americans get Medicare, about 23% get Medicaid and CHIP(Children's Health Insurance Program), about 6% get the Affordable Care Act coverage which is govt.-subsidized private health insurance, and about 2% are on Veterans Healthcare, so a little over half the U.S. population is on govt. provided or subsidized health insurance.  The rest of the country overwhelmingly get their health insurance through their employers who generally pay about 50-90% of the cost.

Now, healthcare in the USA is very expensive, averaging about 2-3 times what other developed nations pay for their healthcare, which is the main reason why health insurance in the USA is so expensive, and which explains why there are so many people on govt.-provided or subsidized health insurance plans.

One of the reason healthcare is so expensive here is that Medicare and Medcaid pay much less than what is actually charged by a provider.  My mother worked in medical billing and told me that often Medicaid only paid about 20-25% of the actual charge and the patient cannot be charged for the difference, so the provider simply has to take what they consider a loss. Medicare pays a bit more, but not a lot more, maybe 35-40% of the actual charge.  So, in reality, over half the country pays a lot less in healthcare costs than the other half.  So what do you think providers might do to "remedy" this loss of revenue?  Well, they might very well jack up prices for everyone else, which IMO is exactly what they've been doing for decades, hence our sky-high healthcare costs.

What we have is a very unfair 3-tier healthcare system: one tier for those on govt. health insurance, a tier for those on employer-sponsored private health insurance, and a tier for Federal, State, and local govt. employees - about 23 million people who have their private health insurance paid for by the taxpayers - and it's usually *very* good insurance with low deductibles.  There are also private pay folks who buy their own insurance or pay outright, as well as some uninsured folks, but this is a small percentage.

In conclusion, our system is not by any means perfect and has several flaws, but it isn't exactly awful.  My main beef is that it is an unfair system in that it is not equal for everyone, with some people paying nothing, some a little, and some a lot.  Healthcare should not be this way.  We should all pay a roughly equal percentage of our income for healthcare and only the very poor should pay nothing at all.  Then there are the health insurance company shenanigans with denials which should be illegal and the company executives should be prosecuted for fraud.  Lastly, there is the egregious price-gouging that Americans suffer for many pharmaceuticals, something which hopefully will be dealt with soon.

Other countries have single-payer systems or socialized medicine, which have their own advantages and disadvantages, but the fact remains that healthcare is not free.  Other countries' citizens pay for it with their high taxes, whereas those in the USA pay for it more directly through insurance premiums, copays, and deductibles.

Dave

 

Nice but should mention Supplemental insurance aka Medigap for Medicare?  Medigap has no copays and practically no limit or caps. One can also go to any approved licensed doctor you want, unlike Medicare Advantage and HMO's.

30 minutes ago, Matthew Kane said:

Currently we pay $5.94 a gallon for gas in New Zealand, you guys are currently paying about $3.15, but the differences are we are also paying our auto insurance personal injury coverage in our gas prices you guys are not, therefore in New Zealand we don't have to have auto insurance at all, that is optional. I choose to take out full comprehension coverage for my SUV and that works out to just under $500 a year for full coverage auto insurance. You guys pay close to $2400 a year for auto insurance which I find crazy, but when you work out your lower gas rates and higher insurance premiums that just ends up working out the same.

My truck gets 24 miles per gallon, so if I drove 100 miles/week that works out to about $600 more a year that I would pay for gas if we had the same govt. auto liability insurance, and that's only for liability.  I have full coverage on my truck and it costs me $900/year, and I only pay $3/gallon for gas.

Cost of living varies widely throughout the USA, and I've chosen to live in my home State where it is relatively low, plus no State income tax.  People who live in the Northeast or West coast have a much higher cost of living.

Dave

 

1 hour ago, dave2013 said:

Cost of living varies widely throughout the USA, and I've chosen to live in my home State where it is relatively low, plus no State income tax.  People who live in the Northeast or West coast have a much higher cost of living.

Yes I would be just as happy in Appalaichia as I am in New Zealand, I prefer smaller isolated and mountainous regions, TBH they are not too different:

Number 1 selling vehicle in Appalaichia and New Zealand??? Ford Pickup Trucks (both the same)

Where do people live??? Up the hollar or in the valleys, both the same as well people have amazing views in both places

Both have funny accents to outsiders but the accent is normal to the locals

Work Hard Play Harder, enjoy the environment around you

Most people have dogs

Most people grow their own food or raise small animals etc

Slightly different musical tastes but appreciation of music and culture is similar,

Kiwis Love Rugby Americans love Football but the concept is similar enough

This picture if I were to show it to people in New Zealand they would say it was New Zealand North Island,  but it is actually taken in West Virginia:

This one is taken in New Zealand:

It's all the same to me, just get out there and enjoy it 

Edited July 24, 2025Jul 24 by Matthew Kane

I've said it before, West Virginia is my favorite state for motorcycle rides.  I also had my scariest ride there.  My GPS system showed a short cut road over a mountain, which turned out to be an abandoned logging road.  At first it seemed like it was just a dirt road.  Then it got steeper and in really rough condition.  I was on an 800 lb Harley Heritage and couldn't turn it around without dumping the bike, probably with me under it.  At the top, it was washed out with only about a 2ft wide strip left.  I managed to ride down the other side and eventually got back to a paved road.  I still have nightmares about that ride and what if.  My body would probably still be there.

Moral of the Story, sometimes GPS systems lie!  I forgot to mention, it was 100f that day.  Not fun.

Edited July 24, 2025Jul 24 by tdflightsim

Drifting off topic, guys!  Any more and 🔒

45 minutes ago, charliearon said:

Drifting off topic, guys!  Any more and 🔒

Got it.  Sorry about that.