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

#221

Post by jonlucc » Tue, Jan 05, 2016, 4:11 AM UTC

facetube wrote: post #171

Laaw wrote: post #118

Earlier quoted context omitted.

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.

Some employers (such as mine) offer only high deductible plans, but one of the options is for them to deposit an amount directly into your HSA. This has the benefit of returning purchasing power for most low costs to the competitive capitalist system while maintaining coverage for disasters.

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

#222

Post by stordoff » Tue, Jan 05, 2016, 4:14 AM UTC

tshtf wrote: post #180

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?

Sumatriptan isn't a cure-all for migraines. I suffer from near-constant migraine-like headaches (sometimes diagnosed as migraines, some not - depends on the consultant), and they are actually worsened by sumatripan.

Morphine seems a little strong, but having tried every offered non-opiate medication (amitriptalyne, sodium valproate, gabapentin, propranolol, topiramate etc.) and only had any success with opiates (tramadol and codeine), it doesn't seem that unlikely.

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

#223

Post by clamprecht » Tue, Jan 05, 2016, 4:15 AM UTC

abawany wrote: post #200

clamprecht wrote: post #61

Earlier quoted context omitted.

I spent many hours looking for this and couldn't find any individual PPO plans that cover Austin, Texas. If you know of one, please send it my way.

I am in Cedar Park and was offered the Scott & White PPO when I was on healthcare.gov. I didn't go with it due to the state limitation.

I researched Scott & White, and it looked like you had to go to their doctors, which for me defeated the purpose of getting an PPO over an HMO (i.e., I can choose where I go, I don't need a primary care physician). Scott & White's offices weren't close to me, and their clinics got bad reviews.

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

#224

Post by rdtsc » Tue, Jan 05, 2016, 4:16 AM UTC

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 a consistent argument only if you believe that you'd be better off with single payer. Some people would be; I know I wouldn't be.

There is no need to believe or not believe. We are not talking about alternate realities, other modern, successful countries with better healthcare, longevity and quality of life have a single payer option.

> After that, let the market bring costs down by removing regulations.

Right. Point to any country where removing of regulations for healthcare has resulted in higher quality care.

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

#225

Post by pbreit » Tue, Jan 05, 2016, 4:20 AM UTC

vidarh wrote: post #159

MCRed wrote: post #109

Earlier quoted context omitted.

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…

How much healthcare do you get in the US for $2928/year? That's how much the UK National Health Service cost the UK government per person in the 2013/2014 reporting period, for a comprehensive universal healthcare system with no deductibles, no co-pays other than a minor prescription charge (7 pounds, unless you're exempt due to low income), and which is consistently ranked higher than US healthcare by the WHO. If we…

The problem is that the USA is funding a disproportionate share of the medical advances. So while it may seem absurd that we spend double for worse outcomes, I'm not sure it's so simple.

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

#226

Post by benjamcal » Tue, Jan 05, 2016, 4:23 AM UTC

jljljl wrote: post #193

maxlybbert wrote: post #125

Earlier quoted context omitted.

> 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? Well, the increased Medicaid funding is temporary, but comes with permanently higher Medicaid spending. So a state might reasonably not want to accept that offer…

Doesn't the federal government continue to cover 90% of the costs beyond 2020? That's still a pretty huge increase in funding.

To clarify, yes. After 2020, the federal government continues to cover 90% of the cost (compared with 60% normally) of the expansion indefinitely. So, for a state government, it is likely the cheapest way to ensure a large number of low income people are insured.

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

#227

Post by metasean » Tue, Jan 05, 2016, 4:26 AM UTC

x5n1 wrote: post #65

narrator wrote: post #56

Earlier quoted context omitted.

I think it would bankrupt the government if they did single payer without price caps on drugs. We already spend about double, as a percent of GDP, on health care compared to other countries. Getting the costs under control is the only way to approach reforming health care that's going to work.

So get those costs under control, it's not like you need profiteers like your boy Shkreli profiteering off this stuff. Also ban drug marketing while you are at it. They spend half that money on marketing the drugs to consumers.

But then we'd miss the entertaining statements, like:

“Do not take Stelara if you are allergic to Stelara or any of its ingredients.” (Duh?) - https://www.youtube.com/watch?v=5ZzRAGeXtgU

And many others - http://www.sluniverse.com/php/vb/off-topic/34611-crazy-drug-...

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

#228

Post by angersock » Tue, Jan 05, 2016, 4:28 AM UTC

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…

There's no guarantee that a single-payer would cost any more to you out-of-pocket than your insurance premiums. In fact, being able to draw against bonds and general taxes suggests to me that it'd do better.

In fact, giving the sheer amount of bloat the entire billing apparatus of hospitals, the machinations of health insurers, the weird regulatory captures, and whatnot of the current system, I don't think it's unreasonable at all to at least give it it's day in court.

Your writeup to me basically reads as a "Fuck you got mine" libtertarian approach to healthcare, and one that frankly falls flat on its face if you acknowledge even the slightest personal responsibility to one's civilization or even to one's older, more enfeebled self.

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

#229

Post by rbritton » Tue, Jan 05, 2016, 4:28 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…

Unfortunately, your situation must be specific to Oregon. I'm in Washington, and the closest plan we could get to what we had pre-Obamacare went from a $2500 deductible to $6300 with a premium increase of around 40-50%.

In my opinion, the problem was never the unavailability of insurance. The problem was (and still is) the out-of-control pricing of medical care -- $5000+ for non-sterile gloves [1] is a bit extreme.

[1]: http://www.rd.com/health/wellness/wildly-overinflated-hospit...

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

#230

Post by rbritton » Tue, Jan 05, 2016, 4:33 AM UTC

HarryHirsch wrote: post #115

stvswn wrote: post #106

Earlier quoted context omitted.

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

Because socialism works? Just today: change of health insurance. Need primary care physician. Takes six weeks to be seen. Six weeks, to be scheduled for minor surgery. You might choose to waste an hour on the phone to find a less booked-out physician. In Socialist Britain you are guaranteed to be seen within 48 hours! Here in the US the only thing guaranteed is the waste of time. Seems that is a feature of the plan.…

From my understanding among people I know it does not work even close to that way in Canada. It's one of those things that's definitely up to the actual implementation.