Your household makes $36k and you pay $10k for drugs on a private plan and that’s somehow a better deal than an ACA plan? Yeah, that’s not making any sense to me at all.

Putting that aside, I’m not saying that’s a good life. But in the context of the article, where it’s comparing the absolute number of poor to crime rates, I’m skeptical that it’s an apples to apples comparison when defining poor in the way they do. Half the median in Japan is a very different thing than half the median in the US nationwide.

I pay 10K in total between drugs, premiums, and all other medical expenses of which about 8600 is premiums.

A plan as good in on the market in my state would have cost 1300. To be clear 1 take an inhaler which retails for $400 for asthma and my wife has an expensive chronic illness which would cost 10s of thousands to treat out of pocket. Buying a cheap plan would be disadvantageous as I can figure on trivially paying the deductible out of pocket in the first couple of months. High deductible or high copay plans just mean paying less in payroll deductions and more out of pocket.

For 2018 it was a lot less AFTER I argued for 4 months about the tax credit that initially wasn't included in the price and nobody could figure out how to fix.

This is basically a tax credit paid in installments to your medical insurance provider and is supposed to be calculated based on your expected income for the year. If in fact you make too much they can turn around and reevaluate how much they helped you and demand some of that money back. For instance they total help I received in 2018 to buy a silver plan was I think on the order of 11 or 12k this turned out to be too much by about 1k.

If as a poor person you don't actually HAVE that money to pay back they can just not offer this and then your choice is to pay $1300 for the same plan you were paying $300 for last year or pay for your employers plan.

Did you assume I was just too stupid to sign up for the ACA plan? Health care in America is a joke for the poor.

Nope. Just trying to understand the facts. I know several people on ACA plans, and I do not believe your experience is representative of the majority. Nevertheless, my comments aren't targeted at you. I maintain that half the median income can vary a great deal in quality of life between different countries.

Linking health care to taxes is a tremendously stupid idea. I wouldn't be surprised if lots of people who were already on employer provided health plans didn't even look at ACA options or were poorly served.

In America if you are really poor you are fucked if you claw your way up slightly you are barely better off or worse than when you started.

I'd bet dollars to donuts that the people you know on ACA plans aren't by most people's definition poor.

And you'd be wrong. In any event, again, your expensive illnesses are not representative, and many people in Washington at half the median income would be getting along suitably well. That same stat in Arkansas may be a very different story. It's at least hypothetically possible (and I don't have a great deal invested in the thesis) that industrious upstanding people in the bottom quartile are actually better off in Japan than in the US, and that could be precisely because of those virtues. The author takes it as a given that being in the bottom quartile is poverty everywhere and concludes those virtues don't matter (see, both countries have lots of people in the bottom quartile -- those Japanese virtues don't make them better off). But because half the median income means different things in different places, I cannot make it there. Not, at least, without more information.