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.

Thanks for that, Fiona! I've heard that Germany has a hybrid system, but I didn't know that actually meant.

Oh I forgot to say, if you're unemployed you pay a flat rate which is so low as to be virtually symbolic. A couple of hundred Euros a month, I think. And it isn't really you paying, it's the state and the insurance company picking up the slack.

I fear it will never catch on in the States.

Even this is being chipped away at, many treatments which used to be available no longer are, we have to pay more for prescriptions and so forth.

But, importantly, everything is free for children, and the extras we have are minimal. If both Mr. Fiona and I end up having expensive dental work done in the year, we may pay up to 500 Euros on top of our premiums. Otherwise we'll be hard-pushed to hit 100 Euros.

That's good about children. I get really upset that there are children here without coverage just because their parents can't afford it. Children are people, not property.

There are also state programs- so in a state like NY, there was a CHIP(Child Health Plus) program before the ACA. It is still there, but funded differently and now there is a penalty for not using it.

That's fantastic, thank you Gud. Wow, 45 wasn't kidding when he said it was complicated. It might be the most accurate thing he's ever said!

Well -- and I don't mean this as a slam on Gud at all -- Gud was able to sum it up in 2 posts (although clearly the details of the system are almost endless). So it's complicated, but not impossible to understand for anyone with even the most rudimentary intellectual curiosity. (So, not Trump. He doesn't give a shit about it because the citizens of the country he "leads" don't mean a thing to him.)

The issue was Trump actually believing at some point that it wasn't complicated! It is extraordinarily complicated with a lot of greedy players at all levels.