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      05-01-2019, 12:26 PM   #45
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My thoughts are health insurance companies should never be for profit organizations and not be publicly traded on the stock market. Instead health insurance companies should be limited to being not for profit businesses.

And I too thought I was invincible. Was healthy. Worked out a ton, involved in competitive volleyball, have never smoked, never tried illegal drugs, other than college...rarely drink. Yet, here I am on the other side of 2 cancer diagnosis with no prior family history nor any detectable genetic issues from testing. Yeah, I have the option of choosing care outside of my insurance's network. But I doubt any of you can survive long having to pay the costs of what it takes to go through cancer treatment. I saw the bill sent to my insurance company when I was going through chemo therapy treatment. One dose of 5FU was paid out at $3000. I went through 12 treatments. This doesn't include all of the pre-meds required nor the Oxaliplatinum co drug that was part of the FOLFOX6 treatment. That's just the standard treatment. My insurance didn't cover the use of Celebrex as a additive treatment for my colon cancer. I opted to give it a try because my oncologist felt there was some merit in its benefits. I had to pay $385 for a month and a half supply. If I ended up being stage 4, I can't imagine having to pay out of pocket for Avastin, Erbitux, Vectibix, etc. I haven't even talked about the latest treatments in immunotherapy which many are still viewed as experimental.

I was lucky that my employer at the time was understanding of my situation and didn't force me into short/long term disability with the requisite income hit. I was able to still be full time yet was given the flexibility to limit my work activities when it was my on week to get chemo therapy. I doubt many people in this country will have that option or luxury. I pray none of you ever have to face cancer because it'll turn your world upside down in an instant.
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      05-01-2019, 12:27 PM   #46
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No not at all, what I'm saying is I don't think it will affect doctors either good or bad since they are a really small piece of the wasted money. The real point was that the op was scared that he can't choose his own doctor with a new health system and I think that's false since doctors themselves won't be that affected and they will probably still be working doing the same job so your doctor probably won't go anywhere. The one who will get hit hard will be insurance company and ppl who profit a lot from waste and they are the ones putting crazy ideas on your heads because there's so much money being wasted and they collect all that money. Not doctors
So now the government and politicians will be "profiting from waste" under socialized healthcare, and let's be clear, the government will waste far more than the private sector because everything the government builds is a bloated, inefficient shit-firestorm. Is this an improvement to you?
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      05-01-2019, 12:30 PM   #47
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Originally Posted by SoCalS2k View Post
No not at all, what I'm saying is I don't think it will affect doctors either good or bad since they are a really small piece of the wasted money. The real point was that the op was scared that he can't choose his own doctor with a new health system and I think that's false since doctors themselves won't be that affected and they will probably still be working doing the same job so your doctor probably won't go anywhere. The one who will get hit hard will be insurance company and ppl who profit a lot from waste and they are the ones putting crazy ideas on your heads because there's so much money being wasted and they collect all that money. Not doctors
So now the government and politicians will be "profiting from waste" under socialized healthcare, and let's be clear, the government will waste far more than the private sector because everything the government builds is a bloated, inefficient shit-firestorm. Is this an improvement to you?
Well usually that's too true but in this case we literally cannot afford healthcare waste anymore don't you think so? So it's natural that anyone who gets older and goes thru the cost of healthcare system right now realizes it's too out of control. If you are young or still healthy maybee you don't realize how bad it is. You must agree that when you see a doctor he gets less then 8% of the money for your visit is totally insane
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      05-01-2019, 12:40 PM   #48
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Well usually that's too true but in this case we literally cannot afford healthcare waste anymore don't you think so? So it's natural that anyone who gets older and goes thru the cost of healthcare system right now realizes it's too out of control. You must agree that when you see a doctor he gets less then 8% of the money for your visit is totally insane
I don't know what the answer is. I agree the system is screwed. Adding government to the equation just adds oil to the fire though.

And for the record, I think Trump and conservatives haven't done much to help with the situation. Trump says "reduce drug costs" without a plan. When I worked in distribution, our margins were thin. It's not like we could have said "alright, alright guys, we'll stop making money hand over fist and help out". So now the public thinks the only way to move forward is with a socialized healthcare plan because loons like Bernie are acting like it's the only solution.
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      05-01-2019, 12:44 PM   #49
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Originally Posted by SoCalS2k View Post
Well usually that's too true but in this case we literally cannot afford healthcare waste anymore don't you think so? So it's natural that anyone who gets older and goes thru the cost of healthcare system right now realizes it's too out of control. You must agree that when you see a doctor he gets less then 8% of the money for your visit is totally insane
I don't know what the answer is. I agree the system is screwed. Adding government to the equation just adds oil to the fire though.

And for the record, I think Trump and conservatives haven't done much to help with the situation. Trump says "reduce drug costs" without a plan. When I worked in distribution, our margins were thin. It's not like we could have said "alright, alright guys, we'll stop making money hand over fist and help out". So now the public thinks the only way to move forward is with a socialized healthcare plan because loons like Bernie are acting like it's the only solution.
Well because we know socialized medicine works in other big rich western economies that's why everyone is looking at it. We are the model for a privatized system in a large economy, there is no one we can look to and learn from for private medicine and more and more ppl realize it's not working and bankrupting us for no reason. So of course we will look at a model that works
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      05-01-2019, 12:56 PM   #50
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Well because we know socialized medicine works in other big rich western economies that's why everyone is looking at it. We are the model for a privatized system in a large economy, there is no one we can look to and learn from for private medicine and more and more ppl realize it's not working and bankrupting us for no reason. So of course we will look at a model that works
I mean not really though. The examples I always see are the Scandinavian countries but those cultures could not be farther different from America. I majored in Kinesiology and these countries we're always used as examples of how America should be when it comes to fitness and nutrition. Tons of cardiovascular exercise, a diet rich in fish and omega-3 fatty acids, etc. Even before they implemented socialized medicine, their health care costs were stupid low.

Compare that with America, the creators of the 7-eleven Double Gulp:

(50 ounces) are “genetically engineered to quench even the most diabolical thirst.”

We are universally known for being fat. Our lifestyle-related diseases (diabetes type 2, heart disease, stroke, etc) are a crisis by any measure.

So these cultures couldn't be further opposite. And the cost difference of implementing that system here would reflect that difference.
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      05-01-2019, 12:57 PM   #51
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If I ended up being stage 4, I can't imagine having to pay out of pocket for Avastin, Erbitux, Vectibix, etc. I haven't even talked about the latest treatments in immunotherapy which many are still viewed as experimental.
.
I'll take you up on that. I've been paying out of pocket for Avastin because it is deemed to be 'experimental' for my diagnosis, yet is one of the only treatment options.

Last year, I made my doc richer to the tune of about $13,000 due to Avastin injections. Finally got onto a program and switched over to a new drug as of March of this year. My total out of pocket to date in 2019 has been less than a grand.
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      05-01-2019, 12:59 PM   #52
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You must agree that when you see a doctor he gets less then 8% of the money for your visit is totally insane

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      05-01-2019, 01:14 PM   #53
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WYou must agree that when you see a doctor he gets less then 8% of the money for your visit is totally insane
Sorry but that's not what your earlier link says. It says that individual physicians salaries make up 8% of the total healthcare costs in the USA. It says absolutely nothing about what portion of a doctor's office bill goes to the doctor's salary.
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      05-01-2019, 01:16 PM   #54
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I’ve known several private practice physicians and I can say with confidence that after paying their rent, utilities, insurance, staff, and ancillary costs (supplies, disposal, legal and accounting, collections/charge-offs, software, etc) it should be no surprise that they personally see well less than half of the amount billed, assuming Medicare or private insurance pays the stated price (they don’t). Whether it is as low as 8%, I don’t know.
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      05-01-2019, 01:22 PM   #55
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My thoughts are health insurance companies should never be for profit organizations and not be publicly traded on the stock market. Instead health insurance companies should be limited to being not for profit businesses.
Not for Profit is a term that comes from the Internal Revenue Code. Business profits are taxed, so not for profit actually means not for paying taxes. 501(c) of the tax code limits the kinds of businesses that can use this status, but using it does not make them a charity, or “good” in any sense of the word.

Being profitable and publicly traded provides liquidity, equity and financial foundation to operate, ensuring claims can be paid as they come due. NfP status makes it much harder to raise the equity and liquidity. There are mutual insurance companies (owned by their members, who are also policyholders), which you could choose (not sure if there are mutual health insurers or just life, property and other coverages).
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      05-01-2019, 01:28 PM   #56
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If my my doctor, insurance company and I all agree that a drug available in Canada (many at a lower price), is a good choice for me, why does the U.S. government try to stop me? This seems like the opposite of a socialist idea and would quickly bring down the cost of many drugs without the government setting price controls or negotiating with drug companies (which seems to be illegal in our current system). What is the argument from the drug companies, it cuts into their profit?
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      05-01-2019, 01:46 PM   #57
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But I thought most of the money in healthcare doesn't goto doctors it goes to insurance companies and private companies. So when you say healthcare for all we are saying stop giving money to insurance companies and give more poor ppl healthcare with they money. I know doctors in damage make the same as here so they are happy. Main problem is we give away soo much money to an insurance company for what?? So someone with no medical training who pushes papers can tell me what test I'm allowed to get?

I don't think the doctors go away or the govt says you can't chose a doctor since they still need the doctors. It's all the rich and shady insurance companies we don't need.

But insurance companies give so much money to political parties so crazy republicans will protect them
you need to check on your facts a little.

majority of the money in the healthcare industry is going to the companies that provide the drugs and devices used, and a good chunk to the facilities (ex hospital)

One of the reason these costs have gotten to where they are, is because we have turned into a sue happy society. the $$ amount paid has been on the steady incline. over a 1/3 of all DRs have been sued, and over half of older surgeons (55+) have been sued. most big pharma companies have paid out millions in lawsuits. Malpractice insurance isnt cheap, and that cost gets pushed down the line until the consumer pays the price.

People always like to blame the insurance companies, but fail to realize they are a small piece of it.
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      05-01-2019, 02:05 PM   #58
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Already a personal attack so I guess you have no debate and you lost debate right
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      05-01-2019, 02:07 PM   #59
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Already a personal attack so I guess you have no debate and you lost debate right
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Well that is from left field lol. Socals2k derangement syndrome
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      05-01-2019, 02:17 PM   #60
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you need to check on your facts a little.

majority of the money in the healthcare industry is going to the companies that provide the drugs and devices used, and a good chunk to the facilities (ex hospital)

One of the reason these costs have gotten to where they are, is because we have turned into a sue happy society. the $$ amount paid has been on the steady incline. over a 1/3 of all DRs have been sued, and over half of older surgeons (55+) have been sued. most big pharma companies have paid out millions in lawsuits. Malpractice insurance isnt cheap, and that cost gets pushed down the line until the consumer pays the price.

People always like to blame the insurance companies, but fail to realize they are a small piece of it.
This is also incorrect. Hospital costs account for almost 1/3 and drug/device are just under 10%.

Per the CDC:
https://www.cdc.gov/nchs/fastats/hea...penditures.htm
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      05-01-2019, 02:18 PM   #61
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I think single-payer or whatever is ultimately inevitable in this country. What form it's to take is anyone's guess, but it has to happen as these completely out of control medical costs simply cannot continue. It's to the point now where many people pay more per month on their damned health insurance than they do on their mortgages, and the costs just keep going up year after year.
100% agree. I'm not sure what form it takes either but some shit needs to change.

Took my wife to the walk-in clinic on Sunday as her chest cold is not improving and we are skittish about pneumonia, which she had 2 years ago after a bad cold. 15 minute visit. They listened to her lungs, wrote down her story, and prescribed an inhaler. The visit was $300 and the inhaler was $200 ($40 in Canada). All out of pocket because our $5000 deductible has not been met. Can we afford that? Sure. But WTF, lots of folks cannot. Something needs to change.
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      05-01-2019, 02:23 PM   #62
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Originally Posted by zx10guy View Post
My thoughts are health insurance companies should never be for profit organizations and not be publicly traded on the stock market. Instead health insurance companies should be limited to being not for profit businesses.

And I too thought I was invincible. Was healthy. Worked out a ton, involved in competitive volleyball, have never smoked, never tried illegal drugs, other than college...rarely drink. Yet, here I am on the other side of 2 cancer diagnosis with no prior family history nor any detectable genetic issues from testing. Yeah, I have the option of choosing care outside of my insurance's network. But I doubt any of you can survive long having to pay the costs of what it takes to go through cancer treatment. I saw the bill sent to my insurance company when I was going through chemo therapy treatment. One dose of 5FU was paid out at $3000. I went through 12 treatments. This doesn't include all of the pre-meds required nor the Oxaliplatinum co drug that was part of the FOLFOX6 treatment. That's just the standard treatment. My insurance didn't cover the use of Celebrex as a additive treatment for my colon cancer. I opted to give it a try because my oncologist felt there was some merit in its benefits. I had to pay $385 for a month and a half supply. If I ended up being stage 4, I can't imagine having to pay out of pocket for Avastin, Erbitux, Vectibix, etc. I haven't even talked about the latest treatments in immunotherapy which many are still viewed as experimental.

I was lucky that my employer at the time was understanding of my situation and didn't force me into short/long term disability with the requisite income hit. I was able to still be full time yet was given the flexibility to limit my work activities when it was my on week to get chemo therapy. I doubt many people in this country will have that option or luxury. I pray none of you ever have to face cancer because it'll turn your world upside down in an instant.
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I'll take you up on that. I've been paying out of pocket for Avastin because it is deemed to be 'experimental' for my diagnosis, yet is one of the only treatment options.

Last year, I made my doc richer to the tune of about $13,000 due to Avastin injections. Finally got onto a program and switched over to a new drug as of March of this year. My total out of pocket to date in 2019 has been less than a grand.
My mom was stage 3 Ovarian and paid for it out of her pocket. She refused to wait on the insurance company to make the decisions and recouped all but $30K on a $300K+ bill. That said, I can fully understand while most can't do this or can't navigate the brobdingnagian healthcare system to get it done for them.

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      05-01-2019, 02:27 PM   #63
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Originally Posted by SoCalS2k View Post
Well usually that's too true but in this case we literally cannot afford healthcare waste anymore don't you think so? So it's natural that anyone who gets older and goes thru the cost of healthcare system right now realizes it's too out of control. If you are young or still healthy maybee you don't realize how bad it is. You must agree that when you see a doctor he gets less then 8% of the money for your visit is totally insane
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Originally Posted by 2000cs View Post
I’ve known several private practice physicians and I can say with confidence that after paying their rent, utilities, insurance, staff, and ancillary costs (supplies, disposal, legal and accounting, collections/charge-offs, software, etc) it should be no surprise that they personally see well less than half of the amount billed, assuming Medicare or private insurance pays the stated price (they don’t). Whether it is as low as 8%, I don’t know.
I don't think 8% is all that far off. I'll have to run the numbers for my wife's practice and see. People forget that the doctor is the only one in the office that actually brings in any money. Everything and everyone else is a parasite. For many years my wife's front desk girl took home more money at the end of the month than my wife did.
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      05-01-2019, 02:52 PM   #64
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I don't think 8% is all that far off. I'll have to run the numbers for my wife's practice and see. People forget that the doctor is the only one in the office that actually brings in any money. Everything and everyone else is a parasite. For many years my wife's front desk girl took home more money at the end of the month than my wife did.
I think SoCal was trying to make it sound like all the other medical costs were absorbing all the profit and that they took everything but 8%. I'm sure if you factor in rent, PPE, depreciation, SG&A costs, interest expense, workers' comp, FUTA, SUTA, UEI, utility bills, M/P Ins, et al then the final net income number is probably 8% - but that wasn't what he was insinuating - or at least not how I read it.

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The visit was $300 and the inhaler was $200 ($40 in Canada). All out of pocket because our $5000 deductible has not been met. Can we afford that? Sure. But WTF, lots of folks cannot. Something needs to change.
This is a common complaint, but I don't think most people take the time to review the details of a statement like that (yourself) or they purposely ignore the additional facts to make a false point (many others, not you).

Insurance is not supposed to be a payment method. It's supposed to be there to help you in the event of a crisis. Just like you don't file an insurance claim for your car if you get a rock chip in the hood, the same is expected to go for insurance - but many people don't realize this or ignore this reality. Insurance isn't designed to cover a $500 walk in clinic bill.

For those that cannot afford $500, they fall into one of two categories for the most part:

1. They make very little money and have very little discretionary income to pay for an unexpected event such as the one you mentioned. Nearly all of the folks in this demographic have heavily subsidized medical care coverage through various state and federal programs such as medicaid, etc. For the folks that truly don't have enough income to support any additional expenses, current government safety nets exist to prevent them from becoming insolvent.

2. They make a decent income but mange their money poorly and don't properly budget for unexpected life events. For these people, I feel no remorse. They chose to make poor lifestyle and fiscal choices, and as such they deserve whatever comes their way.
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      05-01-2019, 03:02 PM   #65
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I think SoCal was trying to make it sound like all the other medical costs were absorbing all the profit and that they took everything but 8%. I'm sure if you factor in rent, PPE, depreciation, SG&A costs, interest expense, workers' comp, FUTA, SUTA, UEI, utility bills, M/P Ins, et al then the final net income number is probably 8% - but that wasn't what he was insinuating - or at least not how I read it.

This is a common complaint, but I don't think most people take the time to review the details of a statement like that (yourself) or they purposely ignore the additional facts to make a false point (many others, not you).

Insurance is not supposed to be a payment method. It's supposed to be there to help you in the event of a crisis. Just like you don't file an insurance claim for your car if you get a rock chip in the hood, the same is expected to go for insurance - but many people don't realize this or ignore this reality. Insurance isn't designed to cover a $500 walk in clinic bill.

For those that cannot afford $500, they fall into one of two categories for the most part:

1. They make very little money and have very little discretionary income to pay for an unexpected event such as the one you mentioned. Nearly all of the folks in this demographic have heavily subsidized medical care coverage through various state and federal programs such as medicaid, etc. For the folks that truly don't have enough income to support any additional expenses, current government safety nets exist to prevent them from becoming insolvent.

2. They make a decent income but mange their money poorly and don't properly budget for unexpected life events. For these people, I feel no remorse. They chose to make poor lifestyle and fiscal choices, and as such they deserve whatever comes their way.

You are saying health care costs are a non problem, for the ones with issues you either make a decent amount of income and poorly manage it or the rest of them are almost all taken care of by other programs. Where did you get this idea?
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      05-01-2019, 03:02 PM   #66
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[QUOTE=Run Silent;24729805]I think SoCal was trying to make it sound like all the other medical costs were absorbing all the profit and that they took everything but 8%. I'm sure if you factor in rent, PPE, depreciation, SG&A costs, interest expense, workers' comp, FUTA, SUTA, UEI, utility bills, M/P Ins, et al then the final net income number is probably 8% - but that wasn't what he was insinuating - or at least not how I read it.

Ah, I see. Not how I read it. Maybe he will chime in and clarify.

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Originally Posted by Run Silent View Post
This is a common complaint, but I don't think most people take the time to review the details of a statement like that (yourself) or they purposely ignore the additional facts to make a false point (many others, not you).

Insurance is not supposed to be a payment method. It's supposed to be there to help you in the event of a crisis. Just like you don't file an insurance claim for your car if you get a rock chip in the hood, the same is expected to go for insurance - but many people don't realize this or ignore this reality. Insurance isn't designed to cover a $500 walk in clinic bill.
Hmm, interesting perspective as always. You are absolutely correct of course. When I step back and think about it objectively I absolutely DO approach it as if insurance should cover everything. Is that the wrong perspective? I'm not sure. Afterall, my insurance company will eventually (after my deductible is met) cover a simple prescription, a vaccination, a check up, a doctors visit for an ear ache. My policy is not set up to only cover major medical. Of course I can elect to purchase a policy that truly is set up to only cover the crisis situation. I'm not sure I agree with you that insurance is there to only cover crisis. Maybe that's how it started but right or wrong it's clearly morphed into something broader.

Quote:
Originally Posted by Run Silent View Post
For those that cannot afford $500, they fall into one of two categories for the most part:

1. They make very little money and have very little discretionary income to pay for an unexpected event such as the one you mentioned. Nearly all of the folks in this demographic have heavily subsidized medical care coverage through various state and federal programs such as medicaid, etc. For the folks that truly don't have enough income to support any additional expenses, current government safety nets exist to prevent them from becoming insolvent.

2. They make a decent income but mange their money poorly and don't properly budget for unexpected life events. For these people, I feel no remorse. They chose to make poor lifestyle and fiscal choices, and as such they deserve whatever comes their way.
There's a huge swath of folks you are leaving out. Most of my 30+ employees for example. They are making $40k to $50k / year and have $2500 deductibles for insurance. They are paying $1500 to $2000 a month in rent to live in this city if they live alone Most have to have roommates. Most chose not to have cars to save money. Most are saving for a house and putting off having kids due to costs. They contribute to their 401Ks despite money being tight. By in large they make pretty sound financial choices. More so then I did at that age. And $500 to them for a doctor visit and a Rx is a ton. It's likely their entire discretionary income for a month or more.

Last edited by DETRoadster; 05-01-2019 at 03:09 PM..
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