为什么多数美国人不满意美国的医保系统？

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Dan Sj?mann, lives in The United States of America (2014-present)
I can give both sides of the coin for you.
I moved to the US from the UK. The UK has nationalised healthcare (The NHS) that means that no one individual or company owns their hospitals or doctors offices, the government does, so they are ran as a non profit. Which means free of cost healthcare for anyone that needs it. You do have to pay for a prescxtion (some people don’t, like children, pensioners and people on welfare for example) kind of like a co-pay and I think is around $15 no matter the cost of your meds actually is.
You simply go to the hospital or doctors office and that’s it! Dentists and Eye doctor/opticians aren’t nationalised these are owned by companies (who want to make a profit).

Dan Sj?mann，住在美国（2014 年至今）
我给你看硬币的两面吧。
我从英国搬到美国。英国已将国家医疗服务体系（NHS）国有化，这意味着没有任何个人或公司拥有这些医院或诊所。它们归政府所有，作为非营利组织运营的。这意味着任何需要的人都可以免费获得医疗保健服务。你确实必须支付处方费用（有些人不需要，例如儿童、养老金领取者和其他领取福利的人），这有点像共同支付。无论实际发生的药物费用是多少，个人只需要支付大约为15 美元。
您只需去医院或诊所就可以了！另外，牙医和眼科医生/配镜师没有被国有化，它们属于私人公司（以盈利为目标）。
-------------译者：ezwf--- 审核者：龙腾翻译总管------------

Now people think that the UK has free healthcare, it’s not free, everyone has 8% of their salary deducted monthly. You pay for it, it’s called national insurance. With that money the government funds the healthcare service (in theory). All sounds great, except most hospitals are under funded, under staffed and look like they have stayed the same since world war 2. Plus the waiting lists for any major operations can run into years. British healthcare is good, you will be looked after, you aren’t going to suffer because you can’t afford it. But it is certainly not without issue.
*****^Edit, national insurance in fact doesn’t pay for the NHS, income tax does. Either way, you still pay for it.******

现在人们都认为英国有免费的医疗保健服务，错了，它不是免费的，每人每月要为此扣除工资的8%。因为你付钱，所以这叫做国民保险。政府用这笔钱资助医疗保健服务（理论上）。一切听起来都不错，除了大多数医院资金不足，人员不足，而且看起来从二战以来一直保持不变。此外，任何重大手术的等候时间都可能长达数年。英国的医疗保健很好，你会得到照顾，也不会因为负担不起而受苦。但也存在着一些问题。
编辑按，国家医疗服务体系（NHS）实际上不是用国民保险，而是用所得税支付。当然，无论哪种方式，你仍然需要为此付钱。
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Now I moved to the US, cut my hand on a Skillsaw. 100% my fault ???♂? . The hospital was great, the doctors were great, the care I received was great. My wife has pretty good insurance through her job which covered me, there was a co pay but it wasn’t much (I’ve forgotten how much so it must have been insignificant).
I totally disagree that there should be companies that profit from healthcare however in doing so American healthcare has become a business, you have become a customer not a patient and now they are competing for our business, that in itself could be good. My own experience with the US healthcare system have been good, however I have friends and neighbours that have told me horror stories.
one friend lived with a broken arm for months because he didn’t want to go to the hospital (in case it was broken!!) and have to pay for it stating his crappy insurance would ruin him. It turned out that leaving his broken arm made a minor fraction into a pretty severe one which lead to some muscle trauma and some pretty extensive surgery. (Which cost him a ton of money.)

我搬到了美国，我之前被一个锯子割伤了手，而且100%是我的错。现在这里的医院很好，医生很好，我得到的护理也很好。我的妻子通过她的工作得到了很好的保险，我也是受益人，虽然有一个共同支付的额外费用，但并不多（因为我已经忘记了具体是多少，所以它一定是微不足道的）。
我完全不同意应该有公司从医疗保健中获利，因此，美国的医疗保健已经变成了一门生意，你也已经变成了顾客而不是单纯的病人，现在他们正在这门生意里竞争，而这本身可能是件好事。总的来说我在美国医疗系统中的经历是好的，但是我有朋友和邻居给我讲过恐怖的故事。
一个朋友带着一只有伤的的手臂生活了几个月，因为他不想去医院（万一是骨折！），也不想为它付钱，说他那糟糕的保险会毁了他。事实证明，放任他的伤病，使一个小问题变成了一个相当严重的问题，导致了一些肌肉创伤和一些相当复杂的手术。(这花了他一大笔钱。）
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Janet Christian, Owner and Chief Ceramicist (2008-present)
Here’s my experience:
I left the US (and it’s crappy healthcare, rated #37 by WHO) and moved to Spain (rated #7 by WHO) mid-2017. I wouldn’t go back to the US system if you paid me.
In the US (Texas, one of the worst for healthcare costs):
My monthly premium in 2016 in Texas: $1000
My deductible: $7650
My copay: 20%
My personal out of pocket costs: $30,000
After moving to Spain:
My monthly premium in 2018 (our first full year in Spain): $225
My deductible: $0
My copay: 0%
My personal out of pocket costs: $3200 (I paid for a couple of things out of pocket)
My monthly premium in 2019 (I qualified after being here one year for NHS for a small fee): $65
My deductible: $0
My copay: 0%
My personal out of pocket costs: $780
Not to mention that the doctors are not rushed, so they take more time with each patient and actually listen. They don’t spend all their time turned away from you while they type into a computer. Each one has given me his/her cell phone number and told me to text or call any time.

--珍妮特-克里斯蒂安，所有者, 首席陶瓷师（2008年至今）。
这是我的经验:
我离开了美国（以及它蹩脚的医疗保健，被世卫组织评为第37位），并在2017年中期搬到了西班牙（被世卫组织评为第7位）。即使你付钱给我，我也不会再回到美国的系统中。
在美国（德克萨斯州，医疗费用最差的地区之一）。
2016年我在德州的月保费：1000美元
我的免赔额：7650美元
我的共付额：20%。
我的个人自付费用。$30,000
搬到西班牙后
我在2018年（我们在西班牙的第一个完整年度）的每月保费：225美元
我的免赔额：0美元
我的共付额 0%
我的个人自付费用。3200美元（我自掏腰包买了几样东西)
我在2019年的月保费（我在这里一年后符合国家卫生系统的资格，只需支付少量费用）：65美元
我的免赔额：0美元
我的共付额 0%
我的个人自付费用。$780
更不用说医生们并不急于求成，所以他们会花更多的时间与每个病人交谈，并真正倾听。他们不会把所有的时间都花在对着电脑打字上，而不去理会你。每个人都给了我他/她的手机号码，告诉我可以随时发短信或打电话。
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My one time in a hospital here was for some elective surgery (with an overnight stay). Total cost was $900 — actually that’s not true. The hospital called the day after I got home and asked for my CC again, explaining there was an issue and something in Spanish I didn’t understand but knew it was something about $20. I’d had an irritation in my eye (probably from the O2 mask pressing near it) so I figured they needed to charge extra for the eye ointment. Nope. When we checked our account, they’d REFUNDED $20. I never did find out why. Can you even for a minute imagine a US hospital refunding any amount?

我有一次在这里的医院是为了做一些选择性的手术（需要过夜）。总费用是900美元--实际上并非如此。医院在我回家后的第二天打电话来，再次要求我出示信用卡，解释说有一个问题, 还说了一些我不懂的西班牙语，但我知道那是关于20美元的东西。因为我的眼睛受到了刺激（可能是由于O2面罩的压迫），所以我想他们需要额外收取眼药膏的费用。结果并不是, 当我检查账户时发现，他们已经退还了20美元。而我一直没有找到原因。你敢想象美国医院会因为什么退还任何金额吗？
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Sasha An?eli?, Interested in US politics
Why would they be?
It''s a system that purely exists to generate profit and that puts money before people. It''s a system where things as simple as calling the ambulance can financially crush you, and I have heard countless stories of Americans not calling the ambulance because they were afraid of the costs.
It''s a system where people are expected to go into debt or beg for donations to be able to pay for their childrens surgery.
It''s a system that has some of the best medical care in the world, but is largely only financially available to wealthy and well earning Americans.
Over 500.000 Americans file for bankruptcy every year as a result of being crushed by medical debts. That''s an astronomical number - a number that could be prevented by implementing a single payer, universal healthcare system, that not only is affordable for America, but would actually be way more beneficial.
The reason it''s not implemented is greed. Pure and simple. It''s not a matter of whether it''s affordable, it never was, because it absolutely is affordable.
But why would the people in charge, Republicans and Democrats alike, stop something that generates money? Even if that money, as repulsive as it sounds, was generated on peoples'' health.
They have no interest in ending that.

Sasha An?eli?（对美国政治感兴趣）
他们为什么会是如此？
这是一个纯粹为创造利润而存在的系统，它将金钱置于人之上。在这个系统中，像叫救护车这样简单的事情都会在经济上压垮你，我听说过无数美国人不叫救护车的故事，因为他们担心费用问题。
在这个系统中，人们被要求举债或乞求捐款，以便能够支付他们孩子的手术费用。
这是一个拥有世界上最好的医疗服务的系统，但在很大程度上只有富裕和收入丰厚的美国人可以享受到。
每年有超过50万美国人因被医疗债务压垮而申请破产。这是一个天文数字--这个数字可以通过实施单一付费的全民医疗保健系统来避免，这个系统不仅是美国人可以负担得起的，而且实际上也更加有益。
它没有实施的原因是贪婪。纯粹而简单。这不是一个是否负担得起的问题，它从来不是，因为它绝对是负担得起的。
但是，当权者，无论是共和党还是民主党，怎么会阻止能赚钱的事情呢？即使这些钱，听起来令人厌恶--是以人们的健康为代价的。
他们对结束这种情况没有兴趣。
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Harry Roberts, Former SAC Trained killer / Current ANTIFA brewmaster
Well, gee. I do wonder why.
I’m a 60 year old man who, when he had a job and had “insurance”, still had to pay $400 per month just to be told he could not afford surgery.
Now, I have no job - So if I get sick, I either go to the ER and let them destroy me financially while they try to NOT treat me because they know I can’t pay - or I just wait to die.
Is that enough information for you?

嗯，老天。我确实想知道为什么。
我是一个60岁的人，当我有工作并有 "保险 "时，仍然不得不每月支付400美元，但依然无法承担手术费用。
现在，我没有工作了--所以如果我生病了，我要么去急诊室，让他们在经济上摧毁我，而且他们会试图不治疗我，因为他们知道我不付不起所有钱--要么我就等着死。
这些信息对你来说足够了吗？