golbatgender:

No one in the US except the super-rich has adequate healthcare.

If you’re at a “comfortable” earning level, and you’ve got a good plan and live in an urban or suburban area, you can probably afford a yearly physical, occasional bloodwork, and maybe 1-2 specialists for your most urgent long-term problems. To a degree, you can get emergency care, but only about half of what you probably should get, before it gets too expensive. And if you have a deductible with no copay, you are basically shit out of luck. Deductibles are basically an insurance company scamming you into paying them money to do nothing unless you hit an unlikely to happen cost line; until then, financially you might as well be uninsured.

What you can’t do if you’re not rich, even with a “good” plan: You can’t check up on anything that isn’t currently drastically reducing your everyday function. You can’t usually afford a second opinion. You can’t often figure out why you’re having a problem or what’s causing it, just treat the symptoms. (A lot of “good” plans won’t even cover cancer screening procedures for younger adults.) You can’t just use as-needed medication when you need it; you have to calculate when you can next afford the refill, while you’re having a medical emergency, because companies are allowed to inflate prices so an inhaler that would cost $2-5 in the rest of the world now costs $50, or charge $600 for rescue epinephrine, or price insulin so it’s basically unaffordable to anyone without prescription coverage. (Because that’s a separate thing from procedure coverage, or dental coverage, or sometimes even vision coverage.) Instead, you have to take OTC meds and pray your trick joint won’t turn into A Thing or your glasses won’t break or chewing gum will calm down the beginnings of an asthma attack. You know why so many people waste money on supplements that do virtually nothing? Because it’s still usually cheaper than a doctor, or going through diagnostic procedures.

On a societal level? We have no real way to track the incidence of a lot of chronic diseases, because people just suffer through it or find out they can’t afford the testing. (Probably a lot of the textbook “typical” body traits of several hypermobility disorders are wrong, just because genetic testing is so expensive, and it’s easy to overlook an average-looking person who injures easily and gets arthritis in their early 40s.) We have a much higher maternal and neonate death rate than other nations with similar economies. People die of infections or cancers that should have been easily treatable because they were scared to go to the doctor. People have degenerative diseases progress for years or decades because the symptoms didn’t seem worth the cost of going to urgent care until it got to the level of losing all feeling in half their bodies.

Unless they’re extremely rich, of course. If you’re rich, what’s $40 to see a doctor one more time? What’s $500 for an MRI—a bit of a squeeze, but worth it, right? Or maybe you’re so rich that it isn’t. Heck, if you’re that rich, you could even get a full body scan every few years so your elite team of doctors can base their assessment on what’s normal for you! And meanwhile, the people that you make your wealth from, if you are that wealthy, come into work on half-dislocated joints and with smoke burns in their lungs because they stayed in a smoky room for fifteen minutes too long. And they swallow more store-brand NSAIDs at every meal and collapse as soon as they get home.

Hardly a land of opportunity. If I don’t get out of here or if we don’t get single-payer healthcare in the next couple decades, I’ll be lucky to make 50.