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They don't go into too much detail but I suspect a major source of the enrollees being unable to pay the premiums consists of small businesses owners and entrepreneurs. It's absolutely impossible to cover the costs of those increasing premiums (let-alone deductibles) when your income isn't increasing with it, simple econ. Especially for a small business when you don't even know what your income will be from year to another year. This is why other countries simplify the system so that they don't wind up with a Frankenstein-style monster like what we have here, forcing people into ruinous debt for a necessity like healthcare. I get the sense Asia is a lot smarter about this too.
To be fair: "Asia" probably looked at what went wrong in the US and Europe and was smart enough to fix some of the health care problems. Kinda like Japan did with stereos about 40 years ago and cars about 30 years ago.
They don't go into too much detail but I suspect a major source of the enrollees being unable to pay the premiums consists of small businesses owners and entrepreneurs. It's absolutely impossible to cover the costs of those increasing premiums (let-alone deductibles) when your income isn't increasing with it, simple econ. Especially for a small business when you don't even know what your income will be from year to another year. This is why other countries simplify the system so that they don't wind up with a Frankenstein-style monster like what we have here, forcing people into ruinous debt for a necessity like healthcare. I get the sense Asia is a lot smarter about this too.
Taiwan has a universal health care insurance system. So does Japan. Canada as well.
They don't involve your employer, unlike the US system.
Japan does have a very uniform fee structure that is highly regulated.
Given the strength of the US insurance and medical lobbies, it would be pretty hard to implement similar systems like these in the USA.
To be fair: "Asia" probably looked at what went wrong in the US and Europe and was smart enough to fix some of the health care problems. Kinda like Japan did with stereos about 40 years ago and cars about 30 years ago.
Hopefully so, as I think Bismark said, always better to learn from other's mistakes than one's own. Europe FWIW does seem to have fixed most of those problems with universal healthcare while in the US they only get worse with rising premiums and deductibles for lousier service and no greater income to cover them. Asia, I'd also suspect, has figured it's better to avoid such mistakes to begin with.
Taiwan has a universal health care insurance system. So does Japan. Canada as well.
They don't involve your employer, unlike the US system.
Japan does have a very uniform fee structure that is highly regulated.
Given the strength of the US insurance and medical lobbies, it would be pretty hard to implement similar systems like these in the USA.
Thanks for that info, seems like this part especially key to making the system work better-- "They don't involve your employer, unlike the US system."
I feel like a lot of the core problems with the US system come down to this dumb practice, and Europe in general has made healthcare more like a public service that has no connection to job status or employer. Whenever my team has gone to anywhere in Europe, Spain or Germany, Sweden or even Italy or Greece where supposedly the economy is having trouble, even as foreigners healthcare for us is straightforward and easy to access, and costs far less than the US (nobody going bankrupt from medical bills). This is the fallacy that a lot of opponents to universal healthcare bring up, it doesn't require extra taxes to have universal health care because it's so much cheaper and more efficient to run. And these days with people switching jobs all over, the connection between healthcare and employment is beyond foolish.
Then it sounds like at least Taiwan and Japan in Asia use the same principle, that health care providing should have nothing to do with employment or the employer. A lot of the Americans I know who've picked up and emigrated to Europe are entrepreneurs and business owners, and the healthcare is a big factor, so I absolutely wouldn't be surprised if it also figures into the factors drawing some Americans to Asia too. The employer-healthcare connection and the mess of US healthcare in general are bad for practically everyone both employees and employers who have to deal with all the extra overhead (these costs have been a measurable drag on competitiveness for practically every business I've been associated with), except for the big insurance companies. Which is probably why it won't change even with the way it's dragging down the US economy, as you said, "Given the strength of the US insurance and medical lobbies, it would be pretty hard to implement similar systems like these in the USA".
Then it sounds like at least Taiwan and Japan in Asia use the same principle, that health care providing should have nothing to do with employment or the employer. A lot of the Americans I know who've picked up and emigrated to Europe are entrepreneurs and business owners, and the healthcare is a big factor, so I absolutely wouldn't be surprised if it also figures into the factors drawing some Americans to Asia too.
Well, to be eligible for the National Health Insurance coverage in Taiwan, you have to be a citizen of that country. I don't think that will draw too many Americans to Taiwan for that reason alone, because there really is no benefit to being a citizen of Taiwan given its lack of diplomatic recognition internationally. Only ones who would go there are people who are already Taiwanese citizens. Again, I know of retired folks who are my parents' friends who have done that.
I'm not sure of citizenship eligibility for health care coverage if you are a foreign national in other Asian countries.
An example, my cousin's monthly health insurance premium this month (after the increase) for his wife and young daughter-- $1400 every month, after-tax income (premiums can't be deducted for taxes) for a healthy fit non-smoker, with an almost $10,000 deductible. And that's if he stays in network, last time he took his daughter to the ER they got billed an extra $4,000 because the doc wasn't "in the network" at a network hospital! Oh, and no dental coverage. This is US healthcare. How in the world is a small business owner supposed to afford this, especially on top of all the self employment taxes and licensing fees? (And the premiums are a tax just like any other, calling them something else doesn't change that). And the premiums keep going up. It's unsustainable.
Well, to be eligible for the National Health Insurance coverage in Taiwan, you have to be a citizen of that country. I don't think that will draw too many Americans to Taiwan for that reason alone, because there really is no benefit to being a citizen of Taiwan given its lack of diplomatic recognition internationally. Only ones who would go there are people who are already Taiwanese citizens. Again, I know of retired folks who are my parents' friends who have done that.
I'm not sure of citizenship eligibility for health care coverage if you are a foreign national in other Asian countries.
Interesting situation. From what you're saying sounds like citizenship is required for full eligibility for healthcare benefits. On flip-side I'm always hearing about Americans going to Taiwan as a popular medical tourism destination these days, so curious if there's some sort of middle ground? Like an arrangement for foreigners to get access that's maybe not what natives have, but still well more affordable than US? Maybe requiring some sort of special visa application?
I don't know much in details about the medical tourism angle but it's been fascinating me the more I hear about it, usually it seems like Americans going to Costa Rica, or maybe something like Brazil or Argentina for dental work or basic procedures because it's so much cheaper, even without insurance. Many even going to Europe where I'd presume it wouldn't be as cheap. I think there was some article a while back on the droves of Americans heading to, I think it was France or Belgium, or maybe Germany or Italy to get hip transplants or orthopedic procedures-- I'm thinking they must be charging the Americans a lot more than natives because no citizenship or insurance, but it must still be a whole lot cheaper even for insured Americans to go overseas, even with all the travel and hotel costs (which I guess shows how messed up and scammy the costs and billing of the US health system have gotten). So central/South America and Europe as far as know, must have a built-in infrastructure for medical tourism.
But among people I know seems like more and more it's Asia that's drawing the Americans for medical tourism. It's true some have roots back in home countries in Asia (maybe some still with citizenship?) but tons of European Americans with no such ties too. I'm hearing a lot about the clinics in Thailand, but also Korea (for surgery) and occasionally Japan, and more and more people love going to Taiwan and a few places in China. Again they're doing this even with the travel costs going from the US to Taiwan, so I'm thinking Taiwan must be offering a pretty sweet deal even to the non citizens for medical care at affordable cost. (If they are more power to them, I can't think of anything else that would apply pressure on the US healthcare system to finally reign in the crazy costs here).
Interesting situation. From what you're saying sounds like citizenship is required for full eligibility for healthcare benefits. On flip-side I'm always hearing about Americans going to Taiwan as a popular medical tourism destination these days, so curious if there's some sort of middle ground? Like an arrangement for foreigners to get access that's maybe not what natives have, but still well more affordable than US? Maybe requiring some sort of special visa application?
I don't know much in details about the medical tourism angle but it's been fascinating me the more I hear about it, usually it seems like Americans going to Costa Rica, or maybe something like Brazil or Argentina for dental work or basic procedures because it's so much cheaper, even without insurance. Many even going to Europe where I'd presume it wouldn't be as cheap. I think there was some article a while back on the droves of Americans heading to, I think it was France or Belgium, or maybe Germany or Italy to get hip transplants or orthopedic procedures-- I'm thinking they must be charging the Americans a lot more than natives because no citizenship or insurance, but it must still be a whole lot cheaper even for insured Americans to go overseas, even with all the travel and hotel costs (which I guess shows how messed up and scammy the costs and billing of the US health system have gotten). So central/South America and Europe as far as know, must have a built-in infrastructure for medical tourism.
But among people I know seems like more and more it's Asia that's drawing the Americans for medical tourism. It's true some have roots back in home countries in Asia (maybe some still with citizenship?) but tons of European Americans with no such ties too. I'm hearing a lot about the clinics in Thailand, but also Korea (for surgery) and occasionally Japan, and more and more people love going to Taiwan and a few places in China. Again they're doing this even with the travel costs going from the US to Taiwan, so I'm thinking Taiwan must be offering a pretty sweet deal even to the non citizens for medical care at affordable cost. (If they are more power to them, I can't think of anything else that would apply pressure on the US healthcare system to finally reign in the crazy costs here).
I haven't heard of medical tourism for Taiwan, but I know it's a big deal for Thailand, India, and Singapore (which has promoted medical tourism for decades - it has been a favorite place for wealthy Indonesians to get treatment) for major procedures. But this really tells more about how costly medical treatment is in the USA
"So what if some of them are frustrated by discrimination and ceilings on upward mobility.
Welcome to the club. Being a minority in America wasn't meant to be a cakewalk. Deal with it, persevere through it, or take advantage of opportunities elsewhere. At least Asians have that option."
Thank you, and when people of African decent say the same things we're "crying or whining". I feel people are programmed subconsciously to feel a certain way about a certain group and they don't even know it.
"So what if some of them are frustrated by discrimination and ceilings on upward mobility.
Welcome to the club. Being a minority in America wasn't meant to be a cakewalk. Deal with it, persevere through it, or take advantage of opportunities elsewhere. At least Asians have that option."
Thank you, and when people of African decent say the same things we're "crying or whining". I feel people are programmed subconsciously to feel a certain way about a certain group and they don't even know it.
The problem with this that it tends to frame Asian Americans (some of us who have been in this country for generations) as perpetual foreigners, and not really "American".
I speak from experience as an Asian American who did go to Asia for work/career, enjoyed it for awhile, but it wasn't really home for me.
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