I agree, and I feel it used to work even better in that respect, when educated Americans typically had lifetime employment. I would guess that's one reason the debate is growing louder lately. The West basically solved the healthcare problem via collective coverage, but in different ways: the European countries did it nationwide, but the US did it with employer group plans. That was almost equivalent, for people with good jobs, as long as people stayed in jobs for life: having the IBM group plan was about as good as having state health coverage, as long as the IBM job was more or less for life.
It's more broken if you're middle-class-or-below (as you mention) or an entrepreneur who isn't either early-20s-and-healthy or raking in huge piles of cash. The part that seems most out of keeping with the American ethos is how anti-entrepreneur it is: you get good collectivized coverage if you work for IBM or Microsoft or Google (because it's socialized across their employee base), but if you start your own company or are trying to buy insurance for a 10-person company's employees, well then you're screwed.
Interesting. I mostly know people trying to buy individual health insurance, whose difficulty really varies, depending on age and health history. Is even a 10-person company big enough that buying it isn't a problem, if you're willing to pay the "10-person company" premium? In particular, do they inquire into the distribution of health among those 10 people? I would've guessed that if 1 of your 10 employees happened to have some disqualifying condition you'd be SOL.
Not entirely a theoretical question, b/c one of my friends has a congenital heart defect, and is himself not 100% sure how his condition would impact a small company. They aren't allowed to inquire into such things when hiring, but could it possibly tank their group health-insurance plan, if 1 of [small-N] members had a major preexisting condition?
You can get group coverage (by which I mean, "insurance plans in which individual members of the team will not need to fill out applications") for teams smaller than 10 people, but probably not much smaller.
In the US, group health coverage is distinguished in part by not "qualifying" patients, so that latter example doesn't really come up. There are horror stories about companies being forced out of their insurance plans by prohibitive cost spikes after major medical events, but I don't have any of them ready to deploy on this thread.
It's more broken if you're middle-class-or-below (as you mention) or an entrepreneur who isn't either early-20s-and-healthy or raking in huge piles of cash. The part that seems most out of keeping with the American ethos is how anti-entrepreneur it is: you get good collectivized coverage if you work for IBM or Microsoft or Google (because it's socialized across their employee base), but if you start your own company or are trying to buy insurance for a 10-person company's employees, well then you're screwed.