Earned Income Tax Credit, Supplemental Security Income, Temporary Assistance for Needy Families, the Child Care and Development Fund, housing assistance, Low Income Home Energy Assistance Program, Medicaid and Children’s Health Insurance Program, Special Supplemental Nutrition Assistance Program, and the Supplemental Nutrition Assistance Program for Women, Infants and Children
Those safety nets have huge gaps. The government doesn't want to be accused of harboring freeloaders (or, perhaps more accurately, a significant chunk of the population would rather people be homeless than a few "welfare queens" be permitted to cheat the system), so many who are genuinely in need can't get it.
It is, although it disproportionately affects people who are poor but not broke. If you’re truly broke, there’s Medicaid, if you’re old there’s Medicare, 4% by some form of military healthcare, many people covered by their employers, and so on. 90% of Americans are insured.
As a Britisher, obviously I’m in favour of universal healthcare, and I think the US system would benefit from it. But let’s not pretend it’s perfect there either
I'm one of those 90%. My health insurance (family of 4) costs more than my house payment, and the annual deductible is over $6000 (for one person). Either the premiums or my deductible goes up every year. In terms of total cost (monthly premiums plus annual deductible) it's also pretty much the least expensive plan that I can get.
It's not that health care here is bad, it's that it's ridiculously expensive compared to most other places in the world.
That doesn't matter for this discussion, because the average American spends way more on healthcare as a percentage of their income than the average European.
~25% of the federal budget goes to medicare and medicaid, i.e. healthcare for other people. On top of that, you're paying for your own medical insurance as an implicit deduction on your salary for your employer-sponsored healthcare plan, or you just pay for your plan directly if you're self-employed.
Those percentages add up.
Whereas in the UK, or in Sweden where I'm from, you only pay once through your taxes for healthcare for everyone, including yourself.
On top of that, copays are higher in the US, annual deductibles are much higher, procedures are much more expensive, medication is much more expensive. Healthcare in the US is simply disproportionally more expensive than in the rest of the world, as a percentage of people's income, and as a percentage of GDP. It's got nothing to do with salary levels.
The medium income is about $48k vs £38k which is much more realistic than averages when a select few make millions per year. Healthcare costs can easily exceed this difference.
Which doesn't prevent nearly 40% of americans from being forced to put off needed medical care because of the expense they're still subjected to. (https://www.cnbc.com/2023/01/20/americans-put-off-health-car...) Medical debt is the leading cause of bankruptcy.
Again, with the caveat that I much prefer the British system...
> nearly 40% of americans from being forced to put off needed medical care
Hard to interpret UK NHS waiting-time figures, especially given the political weight given to them, but these[0][1] paint a picture of 6 month to >1 year waiting times.
Medical debt for non-elective treatment feels barbaric, although digging into the figures (2m personal bankruptcies a year, 60% medical) gives 0.3% of the US population declaring medical bankruptcy a year, possibly going up to 1% if you do fancier maths involving households vs people.
It might be worth stressing for US audiences that the UK NHS waiting times quoted are for elective non life threatening procedures; osteoarthritis surgeries that decrease pain for people already with a degenerative joint disease, hip and knee replacements, etc.
The long wait times, 22 weeks mean average, > 63 week in 8% of extreme waits, are regrettable but not indicitive of waiting for urgent emergency life threatening required non elective procedures which are relatively prompt and immediate for the most part.
I don't think your portrayal captures the reality of this well. Again, generalizing about numbers when it's such a hot political issue is difficult, and it's super-easy to cherry-pick, but take three NHS trusts in the South East, which for non-Brits is the rich part of the country -- I've chosen these three because I'm somewhat familiar with the hospitals themselves, and they're all big enough to have multiple specialties. I suspect if anything they understate rather than overstate the problem.
For each specialty, there's a waiting time, which is the time between you seeing your local doctor and then seeing a specialist, and then there's a waiting time given from when the specialist refers you for a treatment -- they need to be added together. Cardiology is 17+21 weeks, 10+12 weeks, and 25+28 weeks, urology is 12+18 weeks, 18+23 weeks, and 25+20 weeks. Orthopedics (for your osteoarthritis example) is at 17+24 weeks, 22+46 weeks, and 20+25 weeks.
> not indicative of waiting for urgent emergency life threatening
Hospitals in the US can't turn you away if you show up presenting urgent, emergency, life-threatening symptoms either, and I suspect those are not the types of medical care that people in the US are generally putting off for cost reasons (although I'm sure there are a few cases where they are).
The US in fact has a gigantic welfare state support system. The US spends more of its GDP on social welfare than either Canada or Australia, and we spend it poorly unfortunately (our return on investment is not great, we spend too much for too weak of results, as with healthcare).
To add to your list: housing, healthcare, food programs exist at the local + state + federal levels. The US state government system is huge unto itself, like having an entire other federal government nearly.
There are thousands of government support programs between the state + federal levels of government.
People outside of the US are almost entirely ignorant of how large the government systems in the US are. They're not as big as in France or Denmark obviously, they are still sizable compared to the median peer nation (on a GDP % basis).
We do some stuff (often not the right stuff) to prop up people struggling as adults. We do very little, relatively speaking, to enhance people's childhoods (or even just ensure that it's OK).
