Wow, 45 wasn't kidding when he said it was complicated.

Yeah, it's crazy complicated and the rhetoric can be really misleading. The Republicans mostly complain about the exchanges, but the real target is usually Medicaid since there is more money there.

I do think it's important to reiterate that most people have either employer-based insurance or Medicare/Medicaid government insurance.

And for those of us that don't, it is insanely expensive, with huge deductibles, and about everything isn't covered.

And when your source of insurance (along with your family's insurance) is your employer, you don't dare lose your job.

Yeah. I'd really like to go with single-payer or at least allow Medicare/Medicaid buy-in. I think the benefits for entrepreneurs would be tremendous and it would give people more flexibility.

At the least I'd like to have a program where you could get Medicaid for a period of time after losing a job. (Maybe paying for it above a certain previous income and a limit on how often you can get it)

I do think it's important to reiterate that most people have...employer-based insurance

It is still insanely expensive, with huge deductibles, and there is so much that still isn't covered.

Thanks for the explanation Gud - you've laid it out very clearly.

One side effect is that the number of people declaring bankruptcy because of having to pay medical bills has plummeted. And one of the problems with pre-Obamacare insurance policies was that people would pay their premiums but when they went to use insurance discovered that it didn't really cover anything. It would be cheap, but useless.

I've long thought that Republicans ought to be all about getting healthcare without an employer, as that frees people up to be entrepreneurs and start businesses and all that jazz

Of course, Congress isn't really doing anything about the basic problem that health-care is just too damn expensive.

Not too long ago I had a very painful abscess. I went to an urgent care clinic to treat it and they determined that it had to be lanced, but it was too deep for them to do and said I'd have to go to an ER. At this point I was in too much pain to start going to other urgent care clinics. At the ER a nurse practitioner did an ultrasound to locate the abscess and then lanced it. Took her maybe 40minutes. The total cost was $5,000 (after price adjustments for insurance) of which insurance covered about $3,000. That's insane.

I've long thought that Republicans ought to be all about getting healthcare without an employer

No, the people who bankroll the Republican Party literally want people to be afraid for their lives if they lose their jobs.

At the least I'd like to have a program where you could get Medicaid for a period of time after losing a job.

I can just quote the German example. National health insurance takes a certain percentage (currently 15%) of earnings, and employers have to match this. Everyone can chose which insurance company they go to, though in practice there are minimal differences between the statutory health insurance providers. If you are self-employed your contribution is also assessed according to your earnings, adjusted for the fact that you're paying both halves.

Anyone can go private, but this has the usual advantages and disadvantages, i.e. greater benefits, but your premiums rise much more steeply as you age, and the companies can refuse to take you or cover some conditions - but only beforehand, not if they already insure you.

If you lose your job, social security kicks in and you automatically join government insurance ("Medicare", I guess), for as long as necessary, or the government pays for your statutory insurance, if you have it. This makes sense because you can't pay 15% of no earnings.

Children are insured free of charge via their parents. Spouses can also be insured.

It is illegal not to have health insurance. But if you can't pay for it, the state does.

It's not perfect - which health insurance system is? - but it's a pretty good system. Certainly I think it works better than the NHS, which because it is funded from general taxation is overly subject to political pressure.

Edited for typos.