For those of you who aren’t U.S. residents and have never had the pleasure of interacting with the U.S. health care system, let me offer you an example of what unfettered capitalism does to medicine. Below is a bill I received today for a 45-minute diagnostic exam. Fortunately, I have excellent health care insurance, but imagine if you’re a poor person. F*ck Trump and people like him.

Wtf 😨 How much is the insurance /month?

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I pay $832/year for my health insurance and my employer pays just under $7,000/year (I know what my employer pays because it’s reported to me when I file my taxes each year). I have a $1,400/year deductible. But my health insurance is better than 99% of all Americans. Most Americans pay much more.

For most employed people in the U.S., their deductibles are much higher than mine. Ten years ago when I spoke to my neighbor about his insurance (for him, his wife, and two kids), he stated his deductible was $12,000. I’m sure it is $20,000 by now. So, Americans pay thousands and thousands of dollars out of pocket before insurance pays much of anything.

I also have what’s called a ‘Health Savings Account’, which allows me to put pre-tax dollars into an account (up to $4,100/year, which carries over, and I can invest the funds). The pre-tax nature means I essentially get a 33% discount on everything I pay for out of pocket. I can also deduct my contributions to this account from my tax bill at the end of the year. All of these things benefit Rick people over the poor, who don’t have $4,100 extra per year to put into fancy accounts.

Interesting, because in Switzerland everyone has to pay 3'600$/y for the basis insurance (no choice given), and my employer pays 11'000$/y for me. So the insurance are more expensive than in the US. However the health cost are way lower.
So either the US insurers are able to bring the bill down and don't pay for everything, or it's the Swiss insurers that make a stratospheric margin.