Why Make Life Worse for High Risk People

I feel that in the United States there is a general tendency to be more nervous about the government trying to "help" with health care support than one really needs to be, and those of us living outside the United States in countries with government-supported health care plans which are really helpful do have some insight into how useful such programs can be.

I retired a few years ago, and am now receiving a state pension from Austria as my main source of support - after having paid into the system for more than 30 years. (The minimum for receiving an Austrian state pension is 15 years - which I exceeded by more than a factor of 2.)
The Austrian state pension is very generous if compared to some countries like the United States, but I presume that you also pay much more into it during your working years.. (This is basically a good idea, I think.)
Being retired and receiving an Austrian state pension, if I were to be living in Austria (including perhaps certain other EU countries as well), I would still be eligible to be participating in the Austrian National Health Insurance.. But, living in Japan now more than in Austria I am not currently eligible to be in the Austrian National Health Insurance program. I am eligible however for the Japanese National Health Insurance program, which I have joined.

The impression I have is that with the National Health Insurance plans,
"everybody" is eligible, irregardless of whether you have the "bad luck" of falling into a high-risk group or not. But, when there is no National Health insurance program, and you must get health insurance from a "private" group, or have none at all, these companies may well discriminate against high-risk people, and they may be left "out in the cold". These people are in an "unlucky situation" anyway, and to make the situation for them even harder, that is something one should want to avoid somehow, if possible. By including a substantial fraction of the entire population of the country in a National Health insurance program of some kind, one can spread the risks over a very large number of people, so that individual people do not need to be "singled out" for difficult situations.
This is even more true in countries with large populations like the United States.

Jim McNaughton
Japan/Austria

Many countries, many health care systems

I think it is an unfortunate situation that there are many people in
the United States who do not have adequate health care coverage, and I
think many other countries I have lived in do much better in this
regard...

In Austria, for more than 3 decades, I was covered by state health
insurance, which was quite complete coverage, and the system seems to
work well. You could have supplementary health insurance in
addition, but it did not really seem necessary. When I had
appendicitis in Austria in 1981, the hospital dealt with it well, and
I didn't have to pay anything at all - it was covered by state health
insurance, and almost nothing in the way of paperwork either..

In Japan the state health insurance provides basic health care
whenever I have a visa to stay in Japan for a year or more. But,
there may be some "loopholes" - it may be better to have some
supplementary - and I have not always found a solution that I am
really satisfied with. Short-term OK, but long-term still not really solved for me.

In the Netherlands, where I lived for 3 years, I didn't understand the
situation very well really, but I think it was better than in the US,
even now. Since they thought I was "well-paid", my employer said I
should buy into "private health insurance", required, which was
considered "adequate", I suppose.

Jimmy Macnaughton

Dates: I have not resided in the US since 1971.

Netherlands: 1971-1974

Austria: since 1974 except for time living in Japan

Japan:
1981
1990-1992
2001-2004 1/2 time in Japan
up to end of 2004, no problem with state health insurance in Austria

2005- present 9 months a year in Japan...