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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

#171

Post by facetube »

Laaw wrote: post #118
mschuster91 wrote: post #110

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 afterw…

Yeah, the vast majority of us have healthcare, aren't really sick, and occasionally when we do get really sick, our insurance pays the bills. I had an emergency root canal earlier last year in the US, cost me zero dollars, and I've got one of those high-deductible plans (it's the HSA that covered that). I'm actually a little surprised you (or anyone on HN) are so eager to jump at the "worst case" stories and presume…

Don't you contribute your own money to the HSA? I know there are some tax advantages, but it seems a little disingenuous to call that $0.

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

#172

Post by mratzloff »

MCRed wrote: post #109
simoncion wrote: post #90

Earlier quoted context omitted.

> 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…

Yeah, that's bullshit. The oft-quoted figure of 3% for Medicare may not take into account the premium collection that the IRS handles, but with outside agencies it's still 6-8%.[0]

[0] http://www.cahi.org/cahi_contents/resources/pdf/cahimedicare...

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

#173

Post by geomark »

graeme wrote: post #163
geomark wrote: post #127

Earlier quoted context omitted.

I'm genuinely curious about this, particularly the "easy to see a doctor" part, because I know that quite a few Canadians travel to Thailand for non-emergency medical care mostly due to long wait times. That's according to a few statistics published by some of the private hospitals in Thailand. I've seen few outbound studies published by Canadian researchers, although here's one from last year [1]. From what I unders…

I think it varies a lot by jurisdiction, proximity to foreign centers, and type of procedure. For instance, I live in Quebec. On the chart in the article, Quebec only had 6284 travelers, despite having a large population. Quebec's private medical system is more extensive than average, and I think you can buy more here than you can in some other provinces. BC also has easier travel options to Asia. It would be quite a…

That makes sense, the variation by jurisdiction. It's kind of strange that a local person would find it simpler to go abroad than navigate the complicated workings of the local care system. Although it is pretty simple when you go to a medical tourism destination - you just get off the plane, taxi to the hospital, walk in and ask for sevice, and you get it.

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

#174

Post by ghaff »

zrail wrote: post #91
mgkimsal wrote: post #76

Earlier quoted context omitted.

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). App…

We started on a $1500 indv / $3000 fam deductible PPO in 2014 for about $800/mo for two people. In 2015 the premiums went down maybe 0.5%. In 2016 the premiums have gone up 6% and the out of pocket max went up $500 per person to $4k. ACA has absolutely been a net positive in my life. I had cancer in 2012 and so it would have been literally impossible for me to get health insurance outside of a group plan. With ACA I'…

The ability to get insurance for an affordable price (the parameters of which I realize people differ on) with pre-existing conditions outside of group plans has been one of the big wins of ACA. It's at least reasonable to argue that particular problem could have been addressed outside of the massive and controversial implementation that was ACA as a whole.

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

#175

Post by Vendan »

stvswn wrote: post #133
mgkimsal wrote: post #40

Earlier quoted context omitted.

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

It's was pretty easy to predict: allowing enrollment after a diagnosis was politically popular but a terrible economic disincentive to not buy insurance (because at that point, it isn't insurance -- it's a subscription plan for your treatments). The young and healthy needed to enroll for the economics to work, but the individual mandate was delayed for years -- because coercion isn't popular politically, and there wa…

"I don't think the role of government is to take care of you, because it isn't the government taking care of you. It's the government coercing others to take care of you, against their will."

The government does a lot of coercing people to do things against their will. That's why we have police, court systems, jails, and so on. Heck, we've had drafts! That's literally coercing young men to march headfirst into combat to protect the country!

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

#176

Post by dibujante »

davidw wrote: post #73
ghaff wrote: post #57

Earlier quoted context omitted.

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, bu…

My understanding is that the Canadian system is a step above the US system but not otherwise that great on a global scale. This is pretty much Canada's national motto.

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

#177

Post by tronreg »

geomark wrote: post #122
mikeash wrote: post #66

Earlier quoted context omitted.

It's mildly terrifying. If you're unlucky enough to break a major bone or get cancer or something like that, you could literally be on the hook for millions of dollars. I lived overseas for a couple of years, and when I got back to the US one of the first things I did was obtain health insurance because of this.

This is one of several reasons I have written off moving back to the US. A unexpected bonus of being an expat is I have no Obamacare requirement. I don't have to buy US insurance (since I couldn't use it anyway) and I don't face an IRS penalty.

Where's your greener pasture?

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

#178

Post by geomark »

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…

"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?"

I was fortunate enough to do just that. Never had to be hospitalized in the US. Retired (very early) to Thailand. Ended up needing surgery. It was actually rather pleasant. And inexpensive. [1] I'm glad it didn't happen in the US.

[1] http://medicaltravelsite.com/blog/foot-surgery-at-siriraj-ho...

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

#180

Post by tshtf »

transfire wrote: post #154

Evey once in a while I have to go to the emergency room for a serious migraine. All I need is a few drop of morphine. But I also get a bill for over $3,000. Of course, it goes in the trashcan. The real problem with the medical system is its total contrivance to prevent people from treating themselves and having access to treatments at their actual cost -- the inflated pricing for the non-insured is the racket of the…

Morphine? Why not get a prescription for Imitrex?
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