This is the challenge with large mortgages and heath care requirements taking away people's moral agency. Maybe that's the idea.

Talking to US friends about jobs is always weird because they're so afraid of quitting/being fired, because their health insurance is tied to their jobs. This whole system conspires to make people afraid and subservient. Why you guys haven't replaced it with someone that actually frees you, is always a mystery to me.

A handful of politicians have been trying to decouple health insurance from employment the last two election cycles but for whatever reason a significant portion of the country "likes their health insurance", whatever that means. Personally I've never loved any of my health plans and dread the yearly increases and frequent provider changes as I either jump between jobs or my job eliminates or adds new plans due to rising cost. As long as I can register with a competent physician and dentist and keep the cost low I could care less who administers my plan. It truly is a mystery but I suspect resistance is tied to a belief that a government implementation would some how be more inefficient than what we have and the general disdain people in the U.S have against taking "freebies" or public assistance due to the history of social/racial stratification in the country.

It's laughable, the UK spends half as much (as a % of GDP) and has similar outcomes (and far better outcomes in areas like maternal death).

It seems the default assumption is that the US government could never run something efficiently, but this is said in the same breath as claiming the US as the greatest country on earth. One of those things must therefore not be true. For a country with the resources and know-how of the USA to not be able to run a health service is not in doubt, what is in doubt is whether bad actors will deliberately underfund it and try to point to it as being badly run as a result.

Notably the UK spends a smaller amount per person of tax money than the US. Because of how poorly the US healthcare system is regulated, Medicare and Medicaid - which only covers a small proportion of the population - costs more per taxpayer than universal healthcare costs UK taxpayers.

Americans pay twice: Once over the tax bill for a system that aims to provide some coverage, and then again for private insurance.

If the US regulated healthcare properly, they could extend Medicare and Medicaid to most of the population without increasing taxes as a starting point.

Part of the problem is absolutely ludicrous limitations such as actively restricting Medicare from using its market power to negotiate drug prices the way the NHS does, for example.

It's massive corporate welfare.

EDIT: Here's a factcheck on a claim relating to prohibition for government to negotiate for a small part of Medicare as an illustration of the kind of messed up policies that drive up these costs: https://www.politifact.com/factchecks/2017/jan/17/tammy-bald...

The kind of pretzels people will tie their brains into results in this kind of outcome. It's the view (reinforced by corporate media) that a) US corporations are the greatest force in the world and b) US Government is trying to restrain them because it's evil/incompetent.

Easy to give an (incorrect) answer if you have an entire propaganda arm willing to support you.

right now I'm getting a high deductible plan with the premiums fully paid by my employer. for a young healthy person, it's hard to complain about that. if you decoupled insurance from my employer and made them add their contribution to my salary but changed nothing else, I would be strictly worse off. the premiums would go up because it's no longer a group policy, and I would have to pay for it with post-tax income.

at least in principle, I am convinced by the argument that single-payer healthcare is cheaper on average. I do have my doubts that partisan politics in the US would actually realize that potential for efficiency, given the usual sabotage of public services in this country. I also doubt that my income bracket would end up saving much even in an optimal implementation.

so at the end of the day, I don't oppose some sort of national healthcare, but I don't really see any personal incentive to rock the boat. possible outcomes for me range from "about the same" to "a lot worse".

>so at the end of the day, I don't oppose some sort of national healthcare, but I don't really see any personal incentive to rock the boat. possible outcomes for me range from "about the same" to "a lot worse".

This answers southphillyman’s question about why people like their employer health plans. Because they don’t want to help pay for other people’s healthcare, especially the sicker population that isn’t condoned off into white collar employer health plans.

The tax advantage is also a handout to big businesses, that people who are lucky enough to be employed by them get to enjoy and support, at the expense of the rest of the country.

So summary of US healthcare political situation is everyone is all talk, but when it comes time to vote, nobody wants to pay more in taxes in case someone else gets to benefit more from it than they do.

What about all the things that aren't covered by insurance. I hear lots of nightmarish stories about things like "out of network costs", or paying for ambulances or childbirth.

I'm not sure you understand the peace of mind that comes from being able to go to hospital or use other healthcare facilities without even having to think about the cost, because there won't be one.

tbh, I just don't worry about this very much. if I did, I could pay $100-200 a month for the PPO plan.

I'm not arguing against national insurance, just trying to explain that the personal incentive isn't really there for a lot of professionals. I wouldn't vote against a candidate just because this was part of their platform, but it also isn't enough to make me overlook parts of their platform that I actually oppose.

>the premiums would go up because it's no longer a group policy, and I would have to pay for it with post-tax income.

But there would be no premiums.

maybe I'm arguing against a strawman, but the first paragraph is addressing the situation where insurance is decoupled from my employer, but nothing else changes (ie, I select and pay for a private insurance policy). all this does is delete a tax exemption and group bargaining leverage. maybe I was supposed to understand from context that this isn't what "decoupling" means?

Someone has to pay for it.

I've seen the odd post from people along the lines of "why should my taxes pay for someone else's healthcare? No thanks, I'll stick with insurance" and the inevitable "you do understand how insurance works, right?" responses. Always fun.

As usual, this seems to be partisan politics at work. Though I don't really understand why the right portrays universal healthcare as socialism when it's so clearly more "free".

What they seem to not realise is that they already pay more for other peoples healthcare than people in places like the UK - Medicare and Medicaid costs more per tax payer than the NHS does in the UK despite covering a small proportion of the population...

What the right really does in the US is protect massive wealth transfers from tax payers to corporations by restricting Medicare and Medicaid in ways that makes it impossible to make them cost effective.

My best description for it so far is "corporate feudalism". Modern-day serfs are tied to their employer for the health protection they provide.

What's strangest to me is seeing how many of the Americans whom I'd expect to benefit from single-payer health insurance seem to be the ones most wary of it and who argue most loudly against it.

Believe me, it's a mystery to many of us living here as well.

Well, some of us emigrated. But after I became a parent I realized my boss suddenly had far more control over me because I had to fear homelessness for the kids, not just me.

Bought a house cash last year in an extremely low col area and honestly I think I might be _too_ uppity now. Find myself commenting how sad it is that people more senior than myself work on weekends (for the usual meaningless bs reasons). The freedom from having a roof over your head that is security for no loan, and affordable health insurance (about 200 eur a month for a family of 4), is amazing.

It's especially ironic in that people are regularly ruined by health or mortgage issues even with insurance and a steady job. Once you realize this, it becomes a lot easier to look at your situation with clear eyes. More Americans should be walking away from their jobs, because it would make it easier to improve the conditions people work under if they held a credible threat to corporate stability.

This always seemed particularly bizarre to me in the Clinton and Bush eras, where US politicians were vocally obsessed with small business (I think this has faded over the last decade, and the Republicans in particular seem to have totally dropped it as a talking point). Encouraging people to form small businesses while opposing policies which would actually make this feasible always seemed odd.

Hello old colleague! It's true; I could definitely imagine starting a business here more than in the US - I get my health insrance from VHI whether or not I have a job. I would've done my last startup in Ireland if they had let me under my visa (rather annoying rule, that.)

Most people don't understand their options. If they lose their job they probably qualify for medicaid, or for a subsidized plan through the exchange. In the short term they can purchase COBRA, and keep their existing healthcare. They may be able to purchase the same healthcare privately, or through the healthcare exchange.

when I worked stateside I knew a co-worker who had an auto-immune disorder and required medication which was heavily subsidized by his workplace insurance. Without it he would be in financial hardship. He was interested in moving into Machine learning and data science (he was a software developer by profession) and asked me for advise. I told him frankly he just needs to quit and learn the material, that's when I learned that was impossible for him to do that. (I was on my way out the door anyway by that time).

This was a at a medium size traditional corp along the metro-north line of coast of Connecticut. By all accounts and my own experience was a pretty good place to work, with minimal (but some) scum baggery, good but not FAANG level salaries and excellent healthcare benefits.

I had a boss that would try to bully employees into buying expensive cars they couldn't afford, just so they had too much debt and he could exploit them... because they could no longer afford to quit.

One might be disappointed how effective this technqiue can be.

Now imagine you have car payments, a mortgage, and a family to feed.

I have always advised friends and acquaintances never to tell an employer about a new house or car purchase. The less tied down you seem, the better off you are in negotiations!

My mortgage company did an employment check with my employer, so they knew I was buying a house without me telling.

My employer and co-workers also all see me driving to/from work everyday, so they know when I get a new car.

That's a common tactic in the business world. Tell your salesmen "if you don't drive a nice car, your customers won't think that you're any good" and boom.

Feel like that has the opposite effect on me. If I interact with a salesmen who has lots of flashy items I just think about how much mark up/reverse incentives they have on the sale.

I have the same reaction, especially when I walk into a flashy store or office. My grandfather used to say, Las Vegas didn't pop up in the middle of the desert because people were winning money...

It's true though for a lot of businesses. Imagine if your lawyer pulls up in a mid-nineties Toyota Corolla, and tell me if you think you're likely to win the case.

More than likely, if you can afford another lawyer, you'll find one.

> Imagine if your lawyer pulls up in a mid-nineties Toyota Corolla, and tell me if you think you're likely to win the case.

I drove my upset and blindsided friend to her first meeting with her new divorce attorney after her husband left her. We were early so were sitting outside the Palo Alto firm in the parking lot when a pearl-white Mercedes Maybach rolls in with R&B music bumping and custom plates "MKHMPAY"

She seemed like a very good attorney, but my friend ended up going with another firm because that lady was too expensive ($1500/hr). Even the paralegal there was $500/hr.

Ultimately, my friend told me her divorce was 2x as expensive as her wedding.

>R&B music bumping

One wonders what this characterization is meant to imply.

Wasn't trying to characterize with the music- mainly said that because the loud music is why we noticed the car pulling in and parking (and hence ended up seeing the custom plates!).

Why not just say, "loud music," then? I'm not questioning the validity of your experience, just what about that aspect of it made it feel pertinent to communicate.

I dunno, I also said we were in Palo Alto and that her car was pearl colored- why didn't you choose to question me about those descriptors? Your pointed question seems odd, and seems to be implying something so if you have a point, why don't you come right out and make it?

I'm not sure why you would think it odd. All I did was ask you about your word choice. I'm curious to know what you think I'm implying.

It didn't make me wonder, but now I am curious about what you're assuming it means

One of the most competent contract lawyers I've ever had the pleasure of working with came to every meeting we had in jeans and seasonally-appropriate "outdoors" shoes, coats, etc.

He charged a healthy but not exorbitant amount for his legal services, and made no secret of the fact that he liked to go for a hike during his lunch hour and return to his exurban house on a few acres to do a bit of gardening and animal care after work each day.

Dude was calm, professional, and utterly ruthless about protecting our business interests while not putting on any pretense of being a slick trial lawyer.

Law is not inherently a "flash" field any more than sales is, unless you actually spend all day every day in a courtroom before a judge.

There are other factors here though, if they have a nice watch and freshly pressed suit I see them as that they are putting their money to where they see value. A car to them is just a pay to get to a place.

FWIW my dad put two kids through college working as a consultant who would roll up in a mid-nineties Corolla. Modest style can be a strong selling point in a crisis.

I'd be sad we weren't somewhere they could cycle or take transit to a presumably city centre courthouse.

When are you even seeing the lawyer’s car? They don’t typically do housecalls.

That’s also why some people don’t provide steady schedules or part time work, in order to prevent the employee from finding another job.

Why would anybody let themselves be bullied into buying a car? That is seriously foobar

I think, if it's not done on purpose, it's very convenient to those in power, so they don't want to stop doing it.

When most people cannot afford to express morals, you have a host of hungry attack dogs. Some of them start to rationalize that having morals is wrong, that caring about people is wrong because, after all, they can't afford it, so the government can't either.

And if there weren't people desperate for careers and education, the military wouldn't get enough volunteers. So it's very convenient to that whole system.

Propagating the myth of houses as an appropriate working-class investment also sustains this. Index funds are far more liquid, far more diverse, and don't require debt or even a large amount of cash to start with, but a large mortgage is a tight leash.

> Maybe that's the idea.

It literally is. The post-war housing boom was meant to discourage activism by having workers tied to something they could lose.

I heard from someone that the "biological clock" was made up after the war to convince women to quit their careers.

Hearing all this, and hearing that homosexuality used to be tolerated, it's scary to wonder how much of the status quo is not just _a_ social construct, but purposely constructed for someone's benefit, and recently. And we're expected to presume that it's natural, or at least old, and therefore correct.

I went to poke at Wikipedia just for giggles: https://en.wikipedia.org/wiki/Age_and_female_fertility

Love the [citation needed] and lack of clarity in that second paragraph.

Sounds reasonable that it had that effect, but citation needed on the intention.

It becomes more reasonable to assume the intention when you realize how much of national infrastructure policy was meant to engineer specific social outcomes - particularly with regard to segregation. Also in how much of regulatory policy - particularly in telecommunications - was intended for the same.

Fortunately Tim is in Canada, where the health care requirements are met by default.

Absolutely. Ostensibly, we have a "free" society where people are "free" to make their own decisions. Functionally what we have looks a lot like serfdom.

Time certainly is valuable.

Six years ago I was cut to part-time but a year before that I got a raise. The raise wasn't a fortune just double minimum wage in my region. But after my hours were cut I was making essentially minimum wage with a few benefits (my country has socialized medical system).

There I was not really financially bad I had a lot of savings and a job. But going from 20 hour days, shift work, sometimes overnight, to four hour week days it felt like retirement.

I was loyal because I was at the company since day one. I ran network cable, set up equipment when the building still didn't have power or heat yet. But I didn't see the company was Theseus it was the same company but its bones were replaced many times over.

Anyway time for yourself is great intuitively people know it. But until you get to experience it you don't understand how much you're missing.

Many companies predicate things on you keeping your mouth shut, such as your severance.

How would that apply in a voluntary protest resignation scenario like this?

I wouldn't put the threshold at basic necessities. There are lots of people that are just barely better of than living from paycheck to paycheck for whom it is not easy to take the risk to quit a secure job.

But after you can afford having savings as well as a desired lifestyle it always struck me as odd to still have money as the main factor on deciding where to work and why you would ever want to deal with a workplace you actively dislike.