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Many See I.R.S. Penalties as More Affordable Than Health Insurance

nytimes.com

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Re: Many See I.R.S. Penalties as More Affordable Than Health Insurance

#71

Post by djeikyb »

graeme wrote: post #54

I'm a Canadian. I'm curious to know what it would cost to match my level of coverage in the US. 1. Public medical care. Good care, normally easy to see a doctor. Excellent quality. Can use this as much as you need. 2. Occasional use of the parallel private billing system. Costs less than $300 Canadian to see a specialist. 3. Private coverage for paramedical claims (Physio, massage, drug plan, dental, vision, etc.). P…

I live in Arizona. My employer only offers high deductible health plans with a pre-tax health savings account. So, I pay ~350 USD per month for the plan to cover my wife and I. Then I also contribute to this health savings account, my employer kicks nothing in. For this, we get basic vision and dental completely covered. That is, routine checkups, cleanings, basic prescription eyewear. Everything is else is subject to a high deductible, ~10,000 USD. The insurance covers something like 20% of certain kinds of expenses until we hit the deductible, then it covers 80-100%, per year.

A few weeks ago I had an asthma attack and went to see a doctor. The office refused to tell me in advance what I would be charged, or even what my insurance would be charged. I ended up being charged $200 after insurance, and then an additional $100 for prescriptions.

Because I had not previously selected a primary care physician, it was difficult to see a doctor in a reasonable amount of time. The doctor I did find gave wrong instructions for one of the prescriptions, and forgot to call or even write down the other.

Re: Many See I.R.S. Penalties as More Affordable Than Health Insurance

#72

Post by 0xcde4c3db »

At least in retrospect, this doesn't surprise me. If Kafka had been a 21st-century American, he probably would have written a novel about medical billing instead of The Trial. An incomprehensible cost structure represents, in some sense, infinite risk. Why wouldn't people be hesitant to engage?

Re: Many See I.R.S. Penalties as More Affordable Than Health Insurance

#73

Post by davidw »

ghaff wrote: post #57
dibujante wrote: post #53

Earlier quoted context omitted.

No, I factored taxes into my calculation. I am aware that "free" healthcare is not "free" unless you do not pay tax.

According to this [1] which is fairly consistent with other things I've read, US costs are maybe 25% higher than in Canada. What that means is debatable in the context of waiting times, etc. [1] https://en.wikipedia.org/wiki/Comparison_of_the_healthcare_s...

Looks like it's almost double in the US:

https://en.wikipedia.org/wiki/List_of_countries_by_total_hea...

Anecdotally, waiting to see a regular old doctor was faster in Italy than in the US. Some specialist visits involved longer waiting times in Italy. Going private in Italy was generally both fast and cheap: something like 100 euro for a chest X-ray done the next day.

Canada's health care system is good, I guess, but it's generally not ranked quite as highly as places like France and Italy, IIRC. More comparisons tend to be made with Canada and the UK because of the common language.

Re: Many See I.R.S. Penalties as More Affordable Than Health Insurance

#74

Post by dplgk »

dpweb wrote: post #5

I'm against Obamacare, but if I was for it, I would peg the penalties at 2x the avg basic exchange coverage price. Also, people with high deductibles should make sure you take advantage of tax benefits, HSA for instance. The $6000 deductible may really only be a $4800 deductible once you figure in the tax deduction. If you're talking Obamacare coverage being 20% higher than the penality (I'm assuming the penalty is n…

It seems like you're saying you can write off any medical expenses which doesn't seem to be true according to the internet

> The IRS allows you to deduct qualified medical expenses that exceed 10% of your adjusted gross income for the year.

Re: Many See I.R.S. Penalties as More Affordable Than Health Insurance

#75

Post by dplgk »

tomohawk wrote: post #32

Inevitable result of thinking that adding even more government intervention would result in better, cheaper plans. If they were really interested in making better, cheaper plans, they would roll back most of the ACA, eliminate the restrictions on buying across state lines (actually allow competition), and transfer the tax incentives for getting insurance from employers to employees. Basically, all they had to do to m…

> eliminate the restrictions on buying across state lines

What's the law that prevents that? (honestly wondering)

> It would have been about a 10 page bill. It would never pass in the current gov't.

Re: Many See I.R.S. Penalties as More Affordable Than Health Insurance

#76

Post by mgkimsal »

Frondo wrote: post #67
mgkimsal wrote: post #40

Earlier quoted context omitted.

I understand premiums going up annually. I don't understand 30-50% increases year on year.

When I read this stuff, I'm a little astounded about how bad the situation must be in other states. Here in the Pacific Northwest, my premiums have actually been going down and the plan offerings are getting better. The provider I was on did go out of business so I had to switch, and I'm now paying less for more services. And, to be totally frank, having had a pre-existing condition that kept me from buying any insur…

Yeah, it's pretty crappy in NC. First year of ACA we only had one company even offering any insurance in my county. And yeah, it's county-based for some reason - if I lived 2 miles in another direction I'd have had multiple options about 10-15% cheaper than what I had available.

Second year we had another option in our county which was about 15% higher than BCBS (which had gone up about 25% from the year before).

Apparently some/much of this has to do with our state choosing to opt out of dealing with increased medicaid funding, so... yay... I guess they get to show obama how bad ACA is by... digging in their heels while we all just pay insanely increasing pricing?

We are > 100% from where we were wrt premiums from 2012. I expect some increase every year. I don't expect > 100%.

Colleague of mine is now facing > $1800/month health insurance pricing. He's... early 50s, married, 3 kids. This is with a $10k deductible. Another colleague with just one spouse and a child was facing going from $1300->$1650 this year, again with a fairly hefty deductible.

Given that this is effectively only something you'll get any benefit from if you're in a horrific accident of have a massive illness, this is now just really expensive catastrophic insurance.

I might feel slightly better about some of this if I actually knew anyone personally (beyond Frondo now!) who's benefitted. In my social circles, this has not even been close to a win for anyone. Either insurance has gone way up for people who can afford it, or it's still too expensive for some of my friends who are still unable to afford it (because they don't make enough money to qualify for the 'subsidized' pricing).

Bring on single payer...

Re: Many See I.R.S. Penalties as More Affordable Than Health Insurance

#77

Post by parfe »

clamprecht wrote: post #7
jhulla wrote: post #4

Personal experience with ACA: As of 2016, we're onto our 3rd insurer. Each prior one has dropped our local doctors, physicians groups and hospital. With each insurance change, our deductible has gone up, our premium has increased and our co-pay, co-insurance has increased. In effect, our ACA plan has become an extremely expensive catastrophic insurance plan.

You're not alone. In Texas, they cancelled almost all (or maybe all) individual PPO plans (affecting about 367k people), leaving us to choose HMO or EPO plans (the lesser of two evils). And about a 20% increase (per year) in insurance cost for the last 3 years. I at least hope some folks are benefiting from the ACA, I'm certainly not.

What'd you have before the ACA?

Re: Many See I.R.S. Penalties as More Affordable Than Health Insurance

#79

Post by crikli »

jhulla wrote: post #4

Personal experience with ACA: As of 2016, we're onto our 3rd insurer. Each prior one has dropped our local doctors, physicians groups and hospital. With each insurance change, our deductible has gone up, our premium has increased and our co-pay, co-insurance has increased. In effect, our ACA plan has become an extremely expensive catastrophic insurance plan.

Same here. Texas resident on to our 3rd insurer after BCBS dropped PPO. Twice as much for less coverage with twice the deductible. F*cking Obamacare.

Re: Many See I.R.S. Penalties as More Affordable Than Health Insurance

#80

Post by chimeracoder »

dplgk wrote: post #74
dpweb wrote: post #5

I'm against Obamacare, but if I was for it, I would peg the penalties at 2x the avg basic exchange coverage price. Also, people with high deductibles should make sure you take advantage of tax benefits, HSA for instance. The $6000 deductible may really only be a $4800 deductible once you figure in the tax deduction. If you're talking Obamacare coverage being 20% higher than the penality (I'm assuming the penalty is n…

It seems like you're saying you can write off any medical expenses which doesn't seem to be true according to the internet > The IRS allows you to deduct qualified medical expenses that exceed 10% of your adjusted gross income for the year.

> It seems like you're saying you can write off any medical expenses which doesn't seem to be true according to the internet

He's referring to an HSA, which comes with triple tax advantages (contribute pre-tax, pay no tax on gains, and pay no tax on usage).

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