Hoops to Healthcare in America by Jay Knew & ThinkDIF

Hoops to Healthcare in America is an informative thought piece written by Jay Knew, the founder of ThinkDIF.

Hoops to healthcare - Jay Knew
Wanna hear something interesting?

Most Americans don’t have access to healthcare.

You’re probably included in this. Whether you live in America now or you are thinking about moving here. So, let’s break down four major hoops to jump through to get healthcare in America.

Since healthcare in our country isn’t a right, there are a bunch of boxes we must check before we are ‘granted’ affordable access to healthcare services.

Hoops to Healthcare #1: the Job

Who is the provider?
Hoops to Healthcare
1. Got a decent job.
  • Over half of Americans rely on their employer for health insurance, and employees typically are not responsible for the full cost of insurance
  • Employer-based insurance for families costs about $20,576 in 2019

My healthcare is provided by my employer.

Before I was working full-time for a larger employer, my coverage was trash. It was a low premium, high-deductible plan that made me want to avoid getting sick all together because I never knew for sure that I would have enough to cover even the smallest things.

Hoops to Healthcare #2: the Premium

What’s a premium?
2. So, you need money from my paycheck and my employer?
  • Overall, the average premium for a single American is about $7,188 per month for 2019, with employers carrying the significantly larger portion
  • Increases in insurance premiums have grossly outpaced increases in wages; wages increased 3.4% over the last decade, premiums increased 26% over the same period

So, now I have to pay a monthly fee (i.e a private tax) to my insurance provider whether I get sick or not.

I don’t have a problem with this in principle because sharing costs makes things less expensive for everyone. In theory, I benefit from having “affordable” healthcare access when I need it (which isn’t that often) while others who need it more often don’t have to pay as much because we’re all splitting the costs. 

3. I’m not doing well. They need more money. Directly from my wallet!

Hoops to Healthcare #3: the Co-Pay

What about a co-pay?

Well, now when I do get sick or hurt, I also have to pay a co-pay (or coinsurance) which is usually about $35 each time I visit a doctor before my insurance company will pay the rest of the costs. Why? Great question. What am I paying for each month, to keep my insurance company on retainer I guess.

Hoops to Healthcare #4: the Deductible

What’s a deductible?

What if I or my wife Chanelle ever need an emergency procedure?

A Queen + Her King

If Chanelle, or I need an emergency procedure, we better have a sum of money set to the side.

The average deductible for a single coverage health care plan is $1655. That means on average we’d need to come up with almost two bands ($2K USD) before our insurance company would cover the rest of the expenses.

What if one of us develop cancer or some type of chronic illness? Or we have a child or complications from childbirth? What if we experience any number of unforeseen events?

4. I am no longer ok. This is not ok. What if Chanelle has a car accident? What if I am in a pile-up? What if I catch something at work?
What if?!?!?!?!?

Well, 4 out of 10 Americans would not be able to cover an unexpected $400 expense without going into debt.

That explains why medical bills are a contributing factor in almost 2 out of 3 bankruptcies.

Almost all of us have to jump through at least four hoops before gaining access to healthcare services:

Get a decent job or make a lot of money.

Pay a co-pay or coinsurance.

Have a monthly premium removed from a paycheck.

And still, pay a deductible for major procedures.

Even then, we may still have to do more in some situations to get our insurance companies to cover all the necessary costs.

Hoops to Healthcare #5, 6,7, 8 etc: the Everything Else

Add additional hoops if you’re a woman, LGB or T, living with or supporting someone with a disability, a single parent, working-class, speak a language other than English, or undocumented. 

The reality is that many of us (even those of us who believe we have “the best” healthcare coverage) are literally one-car-accident, one-complicated-childbirth, one-chronic-illness, one-emergency-away from our entire lives being turned upside down. You get the picture. I’m sick and it’s raining cats & dogs. Literally.

The Side Effects

This doesn’t even address the side effects of living in such a system.

The added stress of reliving open enrollment each year, knowing that it could take up to a month or more to meet with a mental health provider if you’re in crisis. Having to work a job that limits you in some way because you and your fam need healthcare.

Not being able to start a business or pursue your dreams to the fullest because you’re worried about healthcare. Or all the people who are incarcerated who have better healthcare than when they were walking free.

The Problem: Healthcare is a Business First

Did I mention that we spend per person more than any other country in the world on healthcare?

Hoops to Healthcare
Imagery courtesy of the Peterson Center on Healthcare
  • The average American household spent almost $5,000 per person on healthcare in 2018, that’s a 101% increase from 1984
  • $3,400 of that $5,000 per person, per household, is paid to insurance. Insurance costs have grown by 740% since 1984
  • The Peterson-Kaiser Health System Tracker notes that the U.S. has shorter hospital stays, fewer angioplasty surgeries, and more knee replacements than comparable countries, yet the prices for each are higher in the U.S.
Hoops to Healthcare
Imagery courtesy of the Peterson Center on Healthcare

Even so, almost half of our country has inadequate or no coverage.

That means there are MANY countries who are able to adequately cover everyone and THEY PAY LESS PER PERSON THAN WE DO!! (Learn more about the Cuban Health System).

The U.S. still has higher infant and maternal mortality rates (especially among Black people), lower life expectancy, and lower overall happiness than most developed nations. (Learn more about the rising U.S. Maternal Mortality Rate in the Harvard Review).


Why is it so HARD to get well in America?

Because healthcare is a business first in our country.

This means that people and companies benefit when people are sick and when they deny coverage to save costs. Making people well doesn’t make as much money as making and keeping people sick. The facts are that most of us can’t afford to get sick in this system. Many of us can’t even afford preventive care in this system.

Hoops to Healthcare

Are we really the land of the free and the home of the brave if we don’t have our health?


I’m no expert, but I do know that we don’t need to take any chances with this. Medicare for all — not a public option — is the best way to ensure that we can all experience a greater level of freedom to pursue the American promise: life, liberty, and opportunity for all. It’s perhaps one of the most American things we can implement. 

What are your thoughts?


Written By John Nwosu. Research & Edit By W.D. Herstun.


Healthcare in this country has become a nightmare. I have to wonder if it’s even worth it to bother. And John doesn’t even mention the dentist. I know people that have let their teeth rot out of their mouths because they couldn’t afford the co-pay at the dentist’s office. That’s sad because these are hard-working people with insurance.

I am not sure I know the solution. Healthcare is nowhere near my specialty, forte, or even in my sphere of interest. Thus far, I have been one of those people that just deals with it. Whatever ‘it’ is. There are probably solutions a lot better than what we have though. I would definitely be willing to learn more about the possibilities.

Always a pleasure doing a Herstun + Think DIF link. I am hoping to have more of that content in 2020.

#LetsGrow #LoveAlways

#Herstun #ThinkDIF

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