A few months ago I had a persistent irritation on my right eye, as if some dust was stuck there. Worried about it, I went to Urgent care and got billed $3400 (dollars) for antibiotics, WHICH WERE WRONG, an actual ophthalmologist said I had it scratched and just had to apply some drops. $250 for the ophthalmologist and about $50 for the drops.
This week I am in Brazil for vacation, and my mother-in-law had a lot of back pain. We went to a private "urgent care" (or equivalent here), and it was R$ 200 for the visit, R$ 300 for the X-rays, and R$ 80 for the medicine. That's about $100 dollars. And the only reason why we went to private is because the public hospital wait was about 3 hours, otherwise it would have been free (yeah I know taxes).
And I have good health insurance in the US, but navigating co-pays vs. deductibles vs. in network vs. this particular person isn't on network (like the anesthetist for my wife's C-Section which we only learned about when we were already there at the hospital for the surgery) and just overall everything is so freaking expensive... The system is broken, and no amount of startup trying to shave off 5% of some random administrative cost using AI will save it.
I think your example illustrates how low people's expectation can be when it comes to calling health insurance "good" in the U.S.
If I were asked to pay $3400 for urgent care or $250 for an ophthalmologist I would not consider the health insurance "good" for its intended purpose of insuring against medical expenses. (It might be good for other purposes like enabling you to invest without taxes.) My health plan simply asks me to pay $35 for urgent care and $25 for a specialist like an ophthalmologist. That I consider good. Your insurance isn't.
I would demand an itemized bill from that urgent care and play hard ball with that provider. That's absurd, even by US standards. I've had ER visits that total less than that. My son had a cast that fell off while on travel in Florida, and we stopped by an ER (only place that was open and could fit a new cast). Total cost out the door _at the ER_ was less than $500, which while expensive, is nowhere near what you're talking about.
Just got my bill for a recent 20 minute doctor visit (with one of the best HC insurance coverages in my state: $1,600 cost, $1,400 adjustment, $200 out-of-pocket given my $3,000 OOP limit was not reacehd). Absurd. The USA will likely never get to an efficient govt. single pay system (unlike every other industrialized company). Given this, the option I hope for is that the FedGov passes a law that requires all Master Charge prices to be based on "Acitivty Based Accounting". ABC would provide insights for greater operational efficiency, and the 1600>1400>200 magic hand-waving would disappear. There would be a great loss of employees for health insurance portfolio analysts, but most of them could move into cost accounting roles for hospitals. Please GOP/DEM consider this.
You waited until it became a problem, then went to an expensive option instead of contacting your GP and getting a recommendation for an in-network care? And were surprised that it was expensive? This is healthcare 101 in the US. You could have gotten the same care for a reasonable price had you done 1 hour of due diligence.
We do not need to remake the system--which will result in far greater inconveniences than the 1 hour of dd you found to be unreasonable, not only for you, but for people who are perfectly capable of navigating the current system--to save you from yourself.
We shouldn’t call it a health care system. That’s an aspirational term that doesn’t match reality. We have a medical industry.
Like all industries, the goal is to return value to shareholders. If healthcare is provided as a side effect of profit maximization, that’s nice to have, but that’s not the purpose of the system.
For example, UnitedHealth is the number three company in the US by revenue. Only Apple and Amazon make more. Their entire business model is to collect money from people, then not give it back when they need health care.
The system isn’t broken. It’s working exactly as intended.
I encourage everyone to do the following simple exercise:
look at the main stock market in your country, and see how far back you must go for the main index to be half of what it is today. The answer is probably somewhere between 5 and 7 years. Then find salary statistics, and see how much the average salary has increased in the same time. The answer is probably somewhere between 20 and 30%.
And it really is as simple as that. As society we have tremendously increased productivity, and most of it is taken/given to the owner of the capital, not the provider of labour.
Protip: look for an Asian market in your area for food. I get an entire shopping cart full of food for $60-100 and that lasts for ~2 weeks.
When I go to Publix (or any other grocery store), I get like 2-3 bags for $60...
Discovering the Asian market has been one of the best financial things to happen to me. Although I'm not really sure how their prices are so low. If someone could answer, that would be awesome!
In my country healthcare is not an issue still, and in the countryside where I live housing costs are 'low enough'. But food cost used to be something only students or long term unemployed had to worry about somewhat. Now minimum wage workers and elderly have the same issues I had as a student, and I can't imagine how I would do as a student or as an unemployed. Bank of MomAndDad are probably the only way out. Social mobility should be t it's lowest in decades if I had to guess.
Exactly the things that a well meaning society should provide to its citizens. What's the point of "progress" if we can't provide the basics to the majority?
Americans confuse need with 'nice to have' which leads to the "I don't have money for food/rent/hc" problem.
You do not need cable tv or home internet. You do not need an iPhone or top end Samsung. There are many mid-range Android phones much cheaper that can add a MVNO phone plan for around $20/mo that has more than enough data for necessary internet. Key word: necessary. OTA HDTV is available to many millions at the cost of an antenna (in window/attic/roof). Free books at the library. People give away old dvds and players for free. There is a thing called 'the outside'.
Look at the cars many of the people who complain about being squeezed are driving. Pickups for the sake of driving one. Lower/mid end BMW/Lexus/Mercedes. Giant SUVs when a smaller one will more than do. There are actually still relatively low priced vehicles available but they are plain jane and looked down upon.
I mention those things as I was head of an HOA for about 10 years and we regularly had owners who were in arrears or in and out of arrears. They would come before the board asking for waivers of late fees, interest and even the basic common charge. Yet they were aghast when the board suggested they drop their cable TV or swapped their expensive car lease for a beater. And heaven forbid you suggest they stop going to Starbucks as they sit in front of you asking forgiveness with a large latte in hand.
I get your point and I generally agree with everything you've written, but I'm a bit at a loss on the home internet thing... our society is entirely tied to our connectivity at this point, so are you simply recommending people use their internet-connected mobile devices and forego another home provider? With you on the cable thing - even the streaming providers that were supposed to save us have become prohibitively expensive at this point.
Lazy Americans conflate anecdotes with reality. Make sure to hit the tropes though. The poor person with a Starbucks cup. The 'leased BMW bros are financial idiots'. The iPhone you have no idea where the person got (my son get's them as a christmas gift from his auntie). The cable bill (who under 50 has cable TV? What year is this post from?).
At best old boy discovered that human beings make inconsistent financial decisions when under stress because someone once held a latte cup, and thinks therefor people aren't struggling financially.
This is way too low effort/uninformative/nothing said to be the top comment. But it paints the correct narrative so those who don't want to see what's actually happening in this country probably love it.
This is a deeply stupid comment. Right now, the way marginal people get any work is from from the internet, and people interviewing for even awful jobs expect you to get on zoom calls with them.
Every single step you expect people who can't afford to feed themselves makes them that much more unemployable. You don't need new shoes, you don't need a haircut. Hell, you don't even have to wash your clothes that often, I'm sure no one will notice, and washing your clothes costs enough to feed you for three days.
The people I know who can't afford food or housing don't lease their cars (nor have they ever bought a car that was less than 5 years old) nor own a house, so I think we are considering a very different class of people.
I have been poor and made all the sacrifices you suggest (heck, even gave up a car for public transportation), and, looking back, it made very little difference. Housing and food are just too expensive and dwarf other concerns.
This is anecdotal but here is the truth: I have a home that I bought around 20 years ago in Cali, and the HOA tripled during that time and is now rapidly approaching $700/mo. And that's with less benefits since we lost the earthquake insurance. And not to mention the special assessments that started showing up in 2025. You could make all sort of assumptions, but there is nothing special about the community.
Health care costs are only a concern in the one developed country where it’s not universal and paid for by taxes (or completely free if you don’t work or don’t work much)
One of the reasons the US is in the mess it is comes from its inability to recognize many of its problems not only can be solved, but already have been in two dozen countries.
Making out like everyone puts up with the same dysfunction leads to people shrugging and saying “yeah, sucks this can’t be better” which is dangerously wrong and leads to inaction
We have an insurance system similar to Obamacare here in Switzerland but not the same problems as the USA. (Healthcare is expensive here but everything is expensive here so it's difficult to make the comparison)
> About half the public identify the cost of groceries as a major source of financial stress.
And some other portion of the population, anecdotally much larger than what I would have thought, orders DoorDash/UberEats regularly, what a stark contrast.
I am in a good financial situation, but I still could never stomach the prices of those apps, $30-40+ for any item once one includes fees and everything. I recently got a promotion through my credit card that led me to take another look at DoorDash, and my local grocery store deli sandwich, which is already very expensive at about $10, would have been $25+ on there.
Yet it’s full of people using them, multiple times a week and for an entire family. I had coworkers casually mention that they spend $2k+/mo on DoorDash orders. It’s one aspect of the American consumerism that always baffles me.
Despite early success I'm truly no closer to stability [in terms of housing]. With the wrong landlords, I'm practically living with Mom/Dad while nearing my 40s. Fiefdom-building isn't helping at all.
I can deal with the responsibility of a leaky roof. I can't deal with another year of No Dogs Allowed.
The current financial system and various corporations see the majority of consumers like livestock - a kind of resource to be exploited. It's better to be free range organic though, in my humble opinion, but the majority seem to be trending towards battery/cage chickens.
With "free range organic" are you describing people or food? As in, "it's better to be a free range organic human [vs. battery/caged livestock human-like resource for exploitation]", or "it's better to _eat_ free range organic [food]"? These are two different things, and in either case I'd argue not an option for the people who struggle affording food that is health(ier) by modern standards.
40 million Americans live below the poverty line of $15,000 per year. [1]
Total U.S. household net worth (excluding real estate) is around $54 trillion. [2]
If every household above the poverty line donated 2.5% of their net worth annually to people living below the poverty line, we could erase poverty instantly.
Here’s the math:
2.5% of $54 trillion = $1.35 trillion
$1.35 trillion ÷ 40 million Americans = $33,750 per person
Without in any way drawing a direct comparison, my impression is that everyone is stressed out by whatever is next on their Maslov pyramid. If it's food and housing, it will be food and housing. If it is achieving great showbiz success rather than moderate, it will be that.
Of course it's not the same, and being well fed and rested makes whatever psychological stress easier to bear.
But look at all the rich people seeing their shrinks. Or look at poor people in the UK, who really have it tough, but at no point seek to think, gee, we're better off than 90% of the world population, arent we lucky.
I am not equating the objective lack of basic life necessities to far fetched flights of fancy, but I have a feeling (huh) the subjective psychological feeling might feel the same.
Housing and health care are really expensive and are increasing in price in the usa. And yet, the prices of almost everything else (entertainment, clothes, cosmetic surgery, etc) is going down over time in the usa. I wonder if it has something to do with how much the local, state, and federal governments involves themselves and regulate housing and healthcare? (hint: it does)
More interesting analysis of where things stand: "Spending is being held up by the wealthy, while consumption from middle and lower income groups continues to fade."
I have a bit of a gripe with this "food insecurity" metric.
The stat comes from people reporting that they have felt hungry without having enough food to satiate their hunger. Totally makes sense at first pass.
But here is the rub, obesity is out of control in the US, and it is especially bad in poorer populations.
So now we have two conflicting stats: Poor people are food insecure while simultaneously being overweight...
The reconciliation is easy, when you are obese, you get hungry more and eat more. A 325lb average height male has to eat ~50% (!) more food per day than a healthy weight male of the same stature.
I know this is a bit of the stick in the spokes of the stat, but its blatantly obvious that America does not have a low income hunger problem, it has a low income obesity problem.
I'm a fairly well to do/employable person, and so is my wife.
Together, we should be all kinds of financially stable.
But the two largest costs to our finances are ridiculously outsized: Child Care and Health Care. We pay more for our children and health insurance / care, than our house + cars (+student loans) combined.
These seem like two areas where intervention is not only possible but likely to help just about everyone. And, if those are solved, I wonder if this "fertility crisis" I keep hearing about goes away too.
In Houston, I share a car with my girlfriend since I work from home. But some days I don't feel very independent when I want to run an errand while she's at work.
I'll look up the price of a used Corolla and think about all the additional expenses, and I'm immediately disabused of the idea.
Instead, I decided to book some motorcycle lessons so I can use a $3000 moto. But then I need to pay for life insurance!
I'm surprised that the cost of groceries is a bigger source of stress for most people than the cost of housing. I guess, generally, it's weird to break these things into categories because money is fungible, but food vs housing is the one that stood out to me.
Also: Of course people under financial stress rely on credit more! Of course younger people use newer sources of credit that older people are less familiar with!
[+] [-] inerte|7 months ago|reply
This week I am in Brazil for vacation, and my mother-in-law had a lot of back pain. We went to a private "urgent care" (or equivalent here), and it was R$ 200 for the visit, R$ 300 for the X-rays, and R$ 80 for the medicine. That's about $100 dollars. And the only reason why we went to private is because the public hospital wait was about 3 hours, otherwise it would have been free (yeah I know taxes).
And I have good health insurance in the US, but navigating co-pays vs. deductibles vs. in network vs. this particular person isn't on network (like the anesthetist for my wife's C-Section which we only learned about when we were already there at the hospital for the surgery) and just overall everything is so freaking expensive... The system is broken, and no amount of startup trying to shave off 5% of some random administrative cost using AI will save it.
[+] [-] kccqzy|7 months ago|reply
I think your example illustrates how low people's expectation can be when it comes to calling health insurance "good" in the U.S.
If I were asked to pay $3400 for urgent care or $250 for an ophthalmologist I would not consider the health insurance "good" for its intended purpose of insuring against medical expenses. (It might be good for other purposes like enabling you to invest without taxes.) My health plan simply asks me to pay $35 for urgent care and $25 for a specialist like an ophthalmologist. That I consider good. Your insurance isn't.
[+] [-] ipython|7 months ago|reply
[+] [-] ruralfam|7 months ago|reply
[+] [-] marcusverus|7 months ago|reply
You waited until it became a problem, then went to an expensive option instead of contacting your GP and getting a recommendation for an in-network care? And were surprised that it was expensive? This is healthcare 101 in the US. You could have gotten the same care for a reasonable price had you done 1 hour of due diligence.
We do not need to remake the system--which will result in far greater inconveniences than the 1 hour of dd you found to be unreasonable, not only for you, but for people who are perfectly capable of navigating the current system--to save you from yourself.
[+] [-] siliconc0w|7 months ago|reply
Very easy to end up with hundreds or thousands of dollars in bills if your provider codes something wrong or your insurance denies payment.
Much less an actual medical issue that requires repeated trips to a specialist, an expensive medication (even generic), or hospitalizations.
[+] [-] dimal|7 months ago|reply
Like all industries, the goal is to return value to shareholders. If healthcare is provided as a side effect of profit maximization, that’s nice to have, but that’s not the purpose of the system.
For example, UnitedHealth is the number three company in the US by revenue. Only Apple and Amazon make more. Their entire business model is to collect money from people, then not give it back when they need health care.
The system isn’t broken. It’s working exactly as intended.
[+] [-] bluedino|7 months ago|reply
[+] [-] mathiaspoint|7 months ago|reply
[+] [-] Epa095|7 months ago|reply
look at the main stock market in your country, and see how far back you must go for the main index to be half of what it is today. The answer is probably somewhere between 5 and 7 years. Then find salary statistics, and see how much the average salary has increased in the same time. The answer is probably somewhere between 20 and 30%.
And it really is as simple as that. As society we have tremendously increased productivity, and most of it is taken/given to the owner of the capital, not the provider of labour.
[+] [-] whatamidoingyo|7 months ago|reply
When I go to Publix (or any other grocery store), I get like 2-3 bags for $60...
Discovering the Asian market has been one of the best financial things to happen to me. Although I'm not really sure how their prices are so low. If someone could answer, that would be awesome!
[+] [-] orwin|7 months ago|reply
[+] [-] Steve16384|7 months ago|reply
[+] [-] beezle|7 months ago|reply
You do not need cable tv or home internet. You do not need an iPhone or top end Samsung. There are many mid-range Android phones much cheaper that can add a MVNO phone plan for around $20/mo that has more than enough data for necessary internet. Key word: necessary. OTA HDTV is available to many millions at the cost of an antenna (in window/attic/roof). Free books at the library. People give away old dvds and players for free. There is a thing called 'the outside'.
Look at the cars many of the people who complain about being squeezed are driving. Pickups for the sake of driving one. Lower/mid end BMW/Lexus/Mercedes. Giant SUVs when a smaller one will more than do. There are actually still relatively low priced vehicles available but they are plain jane and looked down upon.
I mention those things as I was head of an HOA for about 10 years and we regularly had owners who were in arrears or in and out of arrears. They would come before the board asking for waivers of late fees, interest and even the basic common charge. Yet they were aghast when the board suggested they drop their cable TV or swapped their expensive car lease for a beater. And heaven forbid you suggest they stop going to Starbucks as they sit in front of you asking forgiveness with a large latte in hand.
[+] [-] poulsbohemian|7 months ago|reply
I get your point and I generally agree with everything you've written, but I'm a bit at a loss on the home internet thing... our society is entirely tied to our connectivity at this point, so are you simply recommending people use their internet-connected mobile devices and forego another home provider? With you on the cable thing - even the streaming providers that were supposed to save us have become prohibitively expensive at this point.
[+] [-] _DeadFred_|7 months ago|reply
At best old boy discovered that human beings make inconsistent financial decisions when under stress because someone once held a latte cup, and thinks therefor people aren't struggling financially.
This is way too low effort/uninformative/nothing said to be the top comment. But it paints the correct narrative so those who don't want to see what's actually happening in this country probably love it.
[+] [-] pessimizer|7 months ago|reply
This is a deeply stupid comment. Right now, the way marginal people get any work is from from the internet, and people interviewing for even awful jobs expect you to get on zoom calls with them.
Every single step you expect people who can't afford to feed themselves makes them that much more unemployable. You don't need new shoes, you don't need a haircut. Hell, you don't even have to wash your clothes that often, I'm sure no one will notice, and washing your clothes costs enough to feed you for three days.
> head of an HOA
You sound like it.
[+] [-] rconti|7 months ago|reply
[+] [-] aidenn0|7 months ago|reply
[+] [-] standardUser|7 months ago|reply
This fully explains the rest of your screed against the working class.
[+] [-] BobaFloutist|7 months ago|reply
The rest I largely agree with.
[+] [-] Exoristos|7 months ago|reply
[+] [-] ge96|7 months ago|reply
[+] [-] colingauvin|7 months ago|reply
[+] [-] M4R5H4LL|7 months ago|reply
[+] [-] testing22321|7 months ago|reply
One of the reasons the US is in the mess it is comes from its inability to recognize many of its problems not only can be solved, but already have been in two dozen countries.
Making out like everyone puts up with the same dysfunction leads to people shrugging and saying “yeah, sucks this can’t be better” which is dangerously wrong and leads to inaction
[+] [-] comrade1234|7 months ago|reply
[+] [-] deanmoriarty|7 months ago|reply
And some other portion of the population, anecdotally much larger than what I would have thought, orders DoorDash/UberEats regularly, what a stark contrast.
I am in a good financial situation, but I still could never stomach the prices of those apps, $30-40+ for any item once one includes fees and everything. I recently got a promotion through my credit card that led me to take another look at DoorDash, and my local grocery store deli sandwich, which is already very expensive at about $10, would have been $25+ on there.
Yet it’s full of people using them, multiple times a week and for an entire family. I had coworkers casually mention that they spend $2k+/mo on DoorDash orders. It’s one aspect of the American consumerism that always baffles me.
[+] [-] bravetraveler|7 months ago|reply
I can deal with the responsibility of a leaky roof. I can't deal with another year of No Dogs Allowed.
[+] [-] N_Lens|7 months ago|reply
[+] [-] hackrmn|7 months ago|reply
[+] [-] shlant|7 months ago|reply
it's not a trend - 99.96% of chicken sold in the US is factory farmed[1]
[1] https://ourworldindata.org/data-insights/almost-all-livestoc...
[+] [-] bix6|7 months ago|reply
To be free range you need significant wealth for the free range.
To be organic you need significant wealth for farmers market type food.
So in both cases you must be wealthy to avoid the cage or am I missing something?
[+] [-] SketchySeaBeast|7 months ago|reply
This is assuming the majority of chickens have a choice.
[+] [-] unknown|7 months ago|reply
[deleted]
[+] [-] tropicalfruit|7 months ago|reply
they are fed, housed and cleaned by their owners
still hoping for the WEF to confirm my livestock status and begin the UBI payments
[+] [-] phyzix5761|7 months ago|reply
40 million Americans live below the poverty line of $15,000 per year. [1]
Total U.S. household net worth (excluding real estate) is around $54 trillion. [2]
If every household above the poverty line donated 2.5% of their net worth annually to people living below the poverty line, we could erase poverty instantly.
Here’s the math:
2.5% of $54 trillion = $1.35 trillion
$1.35 trillion ÷ 40 million Americans = $33,750 per person
That’s more than double the poverty threshold.
Sources: [1] https://www.census.gov/newsroom/stories/poverty-awareness-mo... [2] https://fred.stlouisfed.org/series/BOGZ1FL152090045Q
[+] [-] rich_sasha|7 months ago|reply
Of course it's not the same, and being well fed and rested makes whatever psychological stress easier to bear.
But look at all the rich people seeing their shrinks. Or look at poor people in the UK, who really have it tough, but at no point seek to think, gee, we're better off than 90% of the world population, arent we lucky.
I am not equating the objective lack of basic life necessities to far fetched flights of fancy, but I have a feeling (huh) the subjective psychological feeling might feel the same.
[+] [-] diet_jerome|7 months ago|reply
[+] [-] aredox|7 months ago|reply
https://www.axios.com/2025/08/08/stock-market-us-economy-ric...
[+] [-] bawana|7 months ago|reply
1 out of 7 US inhabitants have food insecurity. And this is a govt website likely to underestimate the statistic
[+] [-] emushack|7 months ago|reply
[+] [-] Workaccount2|7 months ago|reply
The stat comes from people reporting that they have felt hungry without having enough food to satiate their hunger. Totally makes sense at first pass.
But here is the rub, obesity is out of control in the US, and it is especially bad in poorer populations.
So now we have two conflicting stats: Poor people are food insecure while simultaneously being overweight...
The reconciliation is easy, when you are obese, you get hungry more and eat more. A 325lb average height male has to eat ~50% (!) more food per day than a healthy weight male of the same stature.
I know this is a bit of the stick in the spokes of the stat, but its blatantly obvious that America does not have a low income hunger problem, it has a low income obesity problem.
[+] [-] conductr|7 months ago|reply
[+] [-] t1234s|7 months ago|reply
[+] [-] jvanderbot|7 months ago|reply
But the two largest costs to our finances are ridiculously outsized: Child Care and Health Care. We pay more for our children and health insurance / care, than our house + cars (+student loans) combined.
These seem like two areas where intervention is not only possible but likely to help just about everyone. And, if those are solved, I wonder if this "fertility crisis" I keep hearing about goes away too.
[+] [-] hombre_fatal|7 months ago|reply
In Houston, I share a car with my girlfriend since I work from home. But some days I don't feel very independent when I want to run an errand while she's at work.
I'll look up the price of a used Corolla and think about all the additional expenses, and I'm immediately disabused of the idea.
Instead, I decided to book some motorcycle lessons so I can use a $3000 moto. But then I need to pay for life insurance!
[+] [-] rconti|7 months ago|reply
Also: Of course people under financial stress rely on credit more! Of course younger people use newer sources of credit that older people are less familiar with!
[+] [-] krapp|7 months ago|reply
Most people pay for groceries more often than they pay rent, and the cost of food rises more quickly than rent.
Also, you can survive being homeless, but no one survives being foodless.
[+] [-] tossandthrow|7 months ago|reply