If you think the US health insurance law is a good idea, go look up the costs !! http://www.valuepenguin.com/ppaca/exchanges/pa
For some one my age, total out of pocket yearly expenses for each plan level are :
Bronze - $10,000 +
Silver - $7,500
Gold - $4,500
Platinum - $3,000

There are no government subsidies for this - these are the "other costs" ( deductible, coinsurance, copay, e.t.c. ) not related to the plan premiums .

*[1] "Deductibles" are what the person is responsible for paying before insurance kicks in.

*[2] "Out Of Pocket Maximum" is the most an insurance company can charge some one AFTER the deductible is payed.

I dont understand the obsession in US about this. Surely it is preferable to have an insurance and get healthcare if you catch some sickness; and not die from it or pay a multiple of that amount in a day and get into debt.

Even if you never get sick atm, everyone gets older and with some bad luck you could still get into a staircase-accident, be hit by a tree or many other things.

The law is targeted at the lower income demographic, and in the US 40.28% of American workers make less than $20,000 a year ( 2012 ).

Lets assume you get your health insurance for free due to being in the 40% demographic, and it's a mid range plan.

You fall down the steps breaking a leg and a rib ( $14,000 average cost in the US ).

When you arrive at the hospital you are asked to pay $4,500 before they treat you ( under new law, hospitals can turn away "non life threatening emergencies" if they can not pay ) - that's 22% of your yearly gross income.

Once you get home, you get a bill from the hospital for another $3,000 ( 15% of your gross income ) that the insurance company did not pay, along with a statement that they will file a lawsuit against you if you do not pay ( this was also introduced under the new law ).

The average cost of living in the US is not cheap - most folks struggle to get by right now paycheck to paycheck, with no savings. Whats the point of health insurance, if you can not USE it ?

The impression I've got from snippets of world news is that the republicans fought tooth and nail to block these reforms at all, so the eventual compromise in the end is basically "business as usual".

There needs to be an industry-wide dissolving and rebuild from scratch to fix it, not these little compromises. I've had colleagues go to the US for business and require doctors/hospitals while there, and ignoring insurance, they were charged 10x more than what you'd pay at a private clinic here, and 100x more than what you'd pay at a public clinic... Something is obviously wrong with the system in the US.

I'm just sad too though, because the current government here wants to sell off any and every public service that remotely competes with the free market. Hospitals, schools, the postal service, telecommunications backbones, the unemployment office (welfare benefits), etc, are all planned to be handed over to corporations, like in the US, so the price gouging can begin here too...

Yeah, my basic impression is that while insurance isn't super cheap, it's still way less expensive than if you didn't have any if something happens ($100k+ isn't too uncommon). Plus, by getting people on insurance with preventative programs you reduce cost by catching issues early, get people to doctors before they cave in and go to an ER (super expensive), and reduce cost in the whole system because hospitals will be able to get money from insurance carriers where before they were often stuck with IOU's for an indeterminate amount of time.

Likewise I just fail to understand the US system. Affordable (or even free) health care is something that the rest of the developed world has had for a long time, it works, it's been proven to work. There's just something badly screwed-up in the thinking there.

For those of you in the EU and Australia, how does national healthcare affect your national debt? Granted this may not matter to you, but in the US, it's a source of major concern.

Shippou: You're mistaken about the out-of-pocket maximum and also about required treatment at the emergency room. And about deductibles.

Out of pocket maximum is the maximum amount that you personally can pay out of pocket in a given calendar year and is set by your contract. In nearly all policies (though not necessarily all) the deductible counts towards the OOP max, as do copays and coinsurance rates. It's one of the few insurance features that has a name which realistically indicates what it is.

Deductibles are the amount that an insurance subscriber pays until something changes in the benefit payment scheme (so, an insurance plan might have a coinsurance rate for the subscriber that is 50-50 until the deductible is hit, after which it changes to 80-20 until the OOP max is paid). Additionally, deductibles are not quite blanket values; there are a lot of policies that offer things like free preventive care visits whether or not the deductible has been met in a year, for example. Also, having a policy with an insurance company gives you access to their negotiated rate with a health care facility, again regardless of deductible (so it reduces your bill before any charges are billed to you).

Nothing about EMTALA has changed with regards to treatment at emergency rooms. It would be unverifiable in any case (the ED triage staff can't possibly contact your insurance company to see if some clause in your policy has been satisfied while you bleed out in the lobby). The ED cannot turn you away under any circumstances, though they can determine that you're "stable" enough to leave without a lot of fuss.

Finally, nothing in the information you posted is any different than the health insurance system in the US a year ago, five years ago, whatever. Insurance policies have had copays, coinsurance rates, and out of pocket maximums for a long, long time. And the gradient between plan medal-levels isn't new either. A bronze plan will have a lower premium, but higher risk exposure for the subscriber, compared with a silver, gold, or platinum plan. That's always been the health insurance tradeoff-- cheaper monthly rates to be a subscriber and higher risk, or higher cost per month and lower risk. The numbers you listed reflect possible expenditures. If you don't use any medical services in a year, you pay nothing beyond your premiums.

For those of you in the EU and Australia, how does national healthcare affect your national debt? Granted this may not matter to you, but in the US, it's a source of major concern.

The NZ government spends approximately 20% of the budget on health, and our national debt is ~33% of GDP.

The US spends 5% of it's budget on health and it's national debt is >100% of GDP.