Many See I.R.S. Penalties as More Affordable Than Health Insurance • Hacker News Board

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

#101

Post by [deleted] » Tue, Jan 05, 2016, 1:56 AM UTC

crikli wrote: post #79

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.

[deleted]

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

#102

Post by sehugg » Tue, Jan 05, 2016, 2:00 AM UTC

ars wrote: post #33

The plans have been a disaster. They got rid of the only plan that makes sense for young people: Catastrophic insurance (deductible of over $10,000). The plans that remain have high enough deductibles to be worthless, but low enough to be expensive. The plans helps almost nobody. The only people who gain value from the exchanges are those who get a subsidy. To make things worse insurance companies are pulling out in…

They didn't get rid of catastrophic plans, they just made them completely unusable. You need a hardship exemption and be < 30 to qualify for one, but they aren't eligible for subsidies.

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

#103

Post by MCRed » Tue, Jan 05, 2016, 2:00 AM UTC

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.

Comparing to my "free market" insurance before the ACA was passed, I had much more coverage (it was real insurance: eg: pay in advance against a risk, rather than covering pre-existing conditions which violates the definition of insurance, since you're not pooling money against risk, but paying for current liabilities.) ..... and not only did I have more coverage, but my deductibles were 1/5th what they are now and the costs were 1/5th as well.

Effectively obamacare is 25X more expensive for me (and this is comparing plans in two different states since I recently moved.)

AND! On top of that-- rather than just getting insurance when I needed it (Eg: you just sign up and buy it) you have to have enrollment periods and all kinds of arbitrary limitations and a 60 minute application process on a "marketplace" that really gives you minimal information about the plans, and demands to know far more about you than you really ever had to give up before to get insurance.

One thing about insurance-- and Warren Buffett has made a lot of money on this-- is that they invested the proceeds between when they were paid premiums and had to pay out claims-- and so insurers paid out more than %100 of their premiums, because some of the investment returns would be spent on claims. This allowed them to keep premiums low, and they still made a profit.

Obamacare basically made this illegal because now instead of selling insurance (or good insurance which was demonized as "cadillac plans" during the "Debate") you're selling "programs" -- so the incentive is to not buy until you get injured then sign up for insurance (and just claim you have a life change to get around the limited enrollment periods.) Which means the economics are on its ear and its completely unsustainable. And when it totally collapses-- I predict that people will be claiming its because "insurance companies are too greedy"

After all, they complained about "greed" when insurance companies were paying out MORE in claims than they were getting in premiums (can you name any government program that has provided more benefits than it costs-- effectively negative overhead? Hell, as I understand it welfare spends %75 of its budget on overhead and only distributes %25 as benefits.) No matter how much government screws up this situation, they will blame industry and use the utter failure as "proof" that they need even more power (and even more intrusions into our lives) and even more money to "fix" it.

None of this is a surprise- it was all predicted by those opposing the ACA.

Fortunately, the asian countries are developing first rate hospitals and medical tourism industry.

The only question is, will I be able to accumulate enough to retire to Thailand or somewhere before I get hit with a serious medical condition? Looking at how things have turned out in other countries (eg: New Zealand where if you're "old" you're just not covered and you have to leave the country for basic things like dialysis, even though there are dialysis machines in the country)... I've got a ticking clock.

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

#104

Post by douche » Tue, Jan 05, 2016, 2:01 AM UTC

chimeracoder wrote: post #89

douche wrote: post #38

Earlier quoted context omitted.

I had an emergency appendectomy done in a little rinky-dink Quebec hospital. I was driven in an ambulance 150 miles, had general anesthesia, scope surgery, and an overnight stay in the hospital. Had to pay out-of-pocket for the procedure in cash. It was, all told, less expensive than the half-hour echocardiogram I had a couple years ago. Similar surgeries in the States have cost my insurance north of twenty grand. It…

> Similar surgeries in the States have cost my insurance north of twenty grand. I'm assuming you're referring to the amount your insurance company had to pay, not the amount that you had to pay. If so, keep in mind that the prices insurance companies pay for procedures are not designed to make sense on an individual level[0]. I've explained this in more detail on previous comments, but basically, hospitals lose money…

I still had to pay my $2500 deductible on the $2600 ECG, so the insurance company didn't worry about haggling them too much.

If you're young, relatively healthy, non-clumsy, male, and childless, chances are you might not go to the doctor once in a year, so it'd be a gamble, but you might very well statistically be better off pocketing the insurance premiums.

Better yet, put on a furry suit, bark convincingly, and go to a vet if you need some common medications or procedures that are mind-bogglingly expensive when prescribed for humans.

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

#105

Post by MCRed » Tue, Jan 05, 2016, 2:02 AM UTC

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…

The reason nobody could sell you insurance with your pre-existing condition before is that regulations prevented making plans for conditions. EG: You couldn't make a national diabetes insurance plan for people with diabetes (and the economies of scale that go along with a pool of all people with diabetes) because it was effectively illegal.

If the ACA had merely fixed that, then your premiums would be going down more and you'd be getting better insurance.

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

#106

Post by stvswn » Tue, Jan 05, 2016, 2:02 AM UTC

x5n1 wrote: post #41

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.

And so it goes, National Healthcare like Britain or Canada is what America needs and what the medical establishment does not want. But somehow I think America would screw that up as well.

When a little bit of socialism fails, why is the answer always more socialism?

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

#107

Post by lukeschlather » Tue, Jan 05, 2016, 2:06 AM UTC

iofj wrote: post #94

yetanotherone wrote: post #44

Earlier quoted context omitted.

It's a little offtopic, but this reminds me of Lessig's "the corrupting influence of money is the first problem facing this nation. That unless we solve this problem, we won’t solve anything else." In my opinion the public option wouldn't have cost us much as a nation on the whole, and could have possibly worked out to great advantage, but was not going to happen because health insurance companies are too powerful fo…

> In my opinion the public option wouldn't have cost us much ... If you look at the margins the insurers are using (the maximum a public option might be cheaper), they're not much. 10% is rare. Given government inefficiency, I'd expect a public option to have been at least as expensive, and probably more expensive. So why would a public option be cheaper ?

It varies significantly by state, but existing public options are similarly priced or cheaper in terms of cost per person than private healthcare.

https://www.cms.gov/research-statistics-data-and-systems/sta...

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

#108

Post by zrail » Tue, Jan 05, 2016, 2:06 AM UTC

MCRed wrote: post #103

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.

Comparing to my "free market" insurance before the ACA was passed, I had much more coverage (it was real insurance: eg: pay in advance against a risk, rather than covering pre-existing conditions which violates the definition of insurance, since you're not pooling money against risk, but paying for current liabilities.) ..... and not only did I have more coverage, but my deductibles were 1/5th what they are now and t…

What was the lifetime cap on your pre-ACA insurance? Could you get it if you had been sick before applying?

Here's a sadly common scenario: you have a baby born prematurely and they end up in NICU for a month because of a heart condition. They exceed their lifetime cap after two weeks because NICU has always been atrociously expensive. Because they have a heart condition, they are never able to get insurance on their own.

Basically, your pre-ACA insurance was an implied one-shot deal. You have one chance to get sick and get better, because after that you'll never have insurance again.

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

#109

Post by MCRed » Tue, Jan 05, 2016, 2:07 AM UTC

simoncion wrote: post #90

ploxiln wrote: post #50

Earlier quoted context omitted.

Well, that's not traditionally how health insurance works in the US, but it's how all types of "insurance" should work - it should not be for routine costs. Insurance, generally, should be for unlikely unexpected costs. Otherwise, it's just involving an extra middle-man in payment, and that middle-man is going to make a profit. It's unfortunate that in the US, even for completely routine medical costs, you can't skip…

> I think the fixation on "everyone should have good health insurance" is making this dysfunctional situation permanently unfixable. Nah. Every citizen should have good health insurance that requires no out-of-pocket expenditures. There should be one plan, available to every citizen. There should be one payer, the Federal Government. Anything else is a recipe for price-gouging and ballooning costs.

And what will happen is you will not get much health care. Certainly much less than you got in 2005, for much more than you paid in 2005.

Insurers routinely pay out over %100 of premiums in claims. Meanwhile government programs with benefits- like welfare- blow %75 of their budget on overhead and only pay out %25.

Economics is like physics. You can wish it wasn't so. You can look at optical illusions, but the reality is always there.

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

#110

Post by mschuster91 » Tue, Jan 05, 2016, 2:08 AM UTC

Every time I see one of these articles (or anything related to US healthcare) and read the comments, I can't help but ask myself how rotten a country can be. In this case, as a German, I dare say "rotten to the core".

It apparently is impossible to move the US healthcare system to a system where every person in the US is eligible to even the most expensive emergency healthcare without having to fear bankruptcy afterwards, and that's shocking.