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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

#181

Post by jonnathanson »

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…

"It's no coincidence that laser eye surgery, teeth whitening, cosmetic surgery is all generally affordable -- markets and competition have formed."

This isn't the best example to have chosen. All of these procedures are discretionary and nonessential. If I find the cost of an elective nose job too pricey, I can take my time and shop around. Or I can just go without a nose job altogether and be totally fine. The only thing that will suffer will be my vanity, and, well, it's suffered before. :)

On the other hand, let's imagine my kidney is catastrophically failing, and I need it removed or replaced. I'm probably not going to shop around at that point; I'm going to accept my doctor's recommendation that I be hustled into the nearest ER as soon as humanly possible, and I'll be stuck with the bill after the fact. I have neither the time, nor the expertise, nor the inclination to wait and comparison shop. For another thing, nobody is generally in a "market" for emergency kidney surgery. It's not something you anticipate. It's not something you expect to have done, much less seek out and shop around for. And there are no economic substitutes for the surgery. It doesn't lend itself to a market-based system in the same way that elective goods and services do.

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

#183

Post by sageikosa »

stvswn wrote: post #106
x5n1 wrote: post #41

Earlier quoted context omitted.

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?

You apparently aren't allowed to question the rightness of socialism on a site spawned from ycombinator.

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

#184

Post by azinman2 »

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.

In CA, that's not the case. Our insurance went up maybe $50/person, but we got mental health care, acupuncture, and various other benefits we didn't have before. Oh and we have pre-existing conditions that would prevent us from being insured if we didn't have employer-based. And this is all PPO.

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

#185

Post by powertower »

mecameron wrote: post #18
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.

Personal experience with nearly all health care insurance plans since the 90's: Each year the premiums go up, the out of pocket costs increase, and benefits decrease (beyond more than general inflation).

Not like this.

Right before Affordable Care Act went into effect I checked my insurance quotes so I could later compare how much money I would save getting affordable health insurance (which is how Obamacare was sold - that it would put the insurance companies in check and make everything affordable).

It was a 300% increase.

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

#186

Post by mgkimsal »

Frondo wrote: post #116
MCRed wrote: post #105

Earlier quoted context omitted.

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…

You know what? My pre-existing condition was that I'd had my gallbladder removed in the early 2000s. That's it. Uninsurable for 10 years because of an operation which I recovered from fully in less than a week. Telling me it's "regulations" that had every insurer reject me? Pull the other one, it's got bells on.

My "pre-existing" condition was that I'd been to the doctor for heartburn in 2008 and been prescribed a 2 week course of medication.

Sorry - it wasn't quite the same as not being able to get insurance at all. Didn't mean I couldn't get insurance at all, but was 'rated' fairly higher than what was originally quoted.

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

#187

Post by lukeschlather »

stvswn wrote: post #148
lukeschlather wrote: post #107

Earlier quoted context omitted.

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...

Where in the link does it say that?

Not the clearest source, I'll admit.

These are better, and show Medicaid spending roughly $5000/enrollee vs. roughly $8000 per capita overall healthcare spending in the USA in 2011 :

http://kff.org/global-indicator/health-expenditure-per-capit... http://kff.org/medicaid/state-indicator/medicaid-spending-pe... http://data.worldbank.org/indicator/SH.XPD.PCAP

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

#188

Post by nickff »

Vendan wrote: post #175
stvswn wrote: post #133

Earlier quoted context omitted.

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…

And many people believe the draft is morally equivalent to slavery (which they do not support either).[1]

[1] http://gregmankiw.blogspot.ca/2006/11/rangel-and-friedman-on...

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

#189

Post by mgkimsal »

rconti wrote: post #81
mgkimsal wrote: post #40

Earlier quoted context omitted.

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

I believe 18-20% was the norm for the past decade or two. Nationwide, I think the growth has supposedly slowed very slightly . That doesn't make it any easier if you're one of the people who are getting screwed, though.

I've been buying insurance for a more than a decade, in multiple states. (direct, not via employers). I can't say I've seen annual rate increases of 20% year in year out for 2 decades. That's simply not sustainable.

By way of example, my $100/month policy would be $3800/month after 2 decades of 20% year on year growth.

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

#190

Post by mgkimsal »

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…

> you have to buy a plan that covers things you don't need.

Well... isn't that sort of the point of insurance all together? There's always going to be someone in an insurance plan getting some treatment that I'll never need, no?

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