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

#271

Post by nommm-nommm » Tue, Jan 05, 2016, 6:54 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…

>I have to pay for all sorts of treatments I'll never use -- addiction counseling, prenatal care (I'm a man), etc. --

Yeah, I know! Outrageous! Next thing you know they'll be asking me to pay to educate other peoples children!! Oh wait....

Having a society full of healthy babies (remember those babies are going to grow up to be adults someday) and people without substance dependency is beneficial to you.

Are you also upset that the people who live across town from you have roads that you never use?

The whole idea of "insurance" is to pool risk anyways. Do you also go on a rant like this every year you don't get into a car accident?

>because it was considered unfair that I should pay less for consuming less (why this argument doesn't transfer to auto insurance, where men pay higher rates, I don't know).

There are some countries (and Montana) where gender discrimination in auto insurance is illegal.

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

#272

Post by SapphireSun » Tue, Jan 05, 2016, 6:56 AM UTC

methodover wrote: post #60

privong wrote: post #49

Earlier quoted context omitted.

> It's a terrible feedback loop, one which the IRS penalties were designed to solve. But it shouldn't be surprising that the IRS penalties (in current form) could not solve this. This eventuality was predicted before the law was passed in the Senate (e.g., [0]). It seems fairly obvious that this would happen unless fines are somehow pegged to the cheapest insurance rates (as dpweb notes in this same HN story[1]). [0]…

Wouldn't the problem with that be, insurance companies would have an incentive to raise prices as high as they can, knowing that the public would basically be required by law to pay them (or an equivalent penalty)? That incentive sounds pretty terrible for the public. Great for insurance companies though.

https://www.healthcare.gov/health-care-law-protections/rate-...

Insurers are now limited to making 20% profit maximum under ACA to prevent pathological scenarios like that. Will there be a reduction in "innovation"? Maybe, but how much innovation do you need from a payment scheme? In any case, the game now is to increase their subscriber base by stealing from competitors or the uninsured, both likely to result in benefits to consumers.

I found this site helpful too:

http://obamacarefacts.com/obamacare-control-costs/

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

#273

Post by howlin » Tue, Jan 05, 2016, 7:02 AM UTC

pbreit wrote: post #207

lotsofpulp wrote: post #84

Earlier quoted context omitted.

Yes, it's funny to me how so many educated adults are in this conversation, when the problem is mostly political. On one hand, you have a population that believes that no one should be left to die if they show up at a hospital (probably due to their religion and whatnot). A significant portion of the same population also believes that everyone should stand on their own two legs and that offering healthcare to all via…

howlin: People never or almost never "die in the streets". That's just scary FUD, not reality.

They certainly do in many parts of the world. I personally saw the dead body pickups in India. Seems like the parent aspires an American health care system more similar to the developing world.

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

#274

Post by jholman » Tue, Jan 05, 2016, 7:07 AM UTC

rbritton wrote: post #230

HarryHirsch wrote: post #115

Earlier quoted context omitted.

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.

What doesn't work that way in Canada? For that matter, doesn't work what way?

If you mean that in Canada you're never ineligible for your physician because you changed insurance providers, that's basically right (except when you move between provinces, in which case you need to change physician anyway). So the whole problem cannot happen in Canada (nor in the U.K.).

I'm not saying everything's roses and perfection in commie-land... I'm saying that the U.S. system is just obviously horribly worse than all the socialist implementations.

(Well, okay, let's be fair... the U.S. system is probably better for the rich. When I was living in California, and had a medical incident, I got VERY good treatment... for which my employer's insurance company paid a HILARIOUS amount of money, and presumably charged my employer commensurate premiums. I mean, no-expenses-spared levels of treatment. I think Canadian doctors would have been slightly less cavalier about running up the bill.)

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

#275

Post by aianus » Tue, Jan 05, 2016, 7:08 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.…

If you're not literally about to die in Canada you're looking at multi-month delays to see any kind of specialist.

Meanwhile my friends in SV just whip out their credit cards, pay a small deductible, and get seen immediately.

Single payer isn't all sunshine and roses.

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

#276

Post by [deleted] » Tue, Jan 05, 2016, 7:09 AM UTC

mgkimsal wrote: post #196

Vendan wrote: post #175

Earlier quoted context omitted.

"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…

Was going to post something like this - you beat me to it. "I don't think the role of government is to protect our country, because it isn't the government protecting our country. It's the government coercing others to protect our country, against their will." Obviously, we have a volunteer force, but haven't always had that - conscription, as you brought up. It's fine to have a volunteer force, until we need more. T…

[deleted]

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

#277

Post by tracker1 » Tue, Jan 05, 2016, 7:19 AM UTC

mgkimsal wrote: post #76

Frondo wrote: post #67

Earlier quoted context omitted.

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). App…

I'm paying less out of pocket now than my share at my last job, with netter coverage... though this year I'm paying as much for a plan with $1k more for deductible... it's pretty sad... I keep it because I'm on a few medications that would be far more out of pocket.

Something needs to happen with USPTO, especially medicine at this point.

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

#278

Post by nommm-nommm » Tue, Jan 05, 2016, 7:19 AM UTC

dibujante wrote: post #25

methodover wrote: post #17

> But plenty of healthy holdouts remain, and their resistance helps explain why insurers are worried about the financial viability of the exchanges over time. They say they sorely need more healthy customers to balance out the costs of covering the sicker, older people who have flocked to exchange plans. Ah, the tragedy of the commons at work. Healthy people don't buy insurance because it's too expensive. Insurance i…

As a Canadian, I am astonished at how expensive even the cheapest of these plans are. My monthly healthcare cost amounts to $178, once you factor in the taxes I pay that go to healthcare. That's cheaper than any of the plans in this article. How do people find these prices bearable?

We don't.

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

#279

Post by SwellJoe » Tue, Jan 05, 2016, 7:22 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…

It isn't ACA that has caused me problems, or at least the law itself.

The description given matched my experience with insurers before ACA. My problem with ACA is Healthcare.gov (still). It is possible to go through the entire application process, make one mistake or fail to provide the right detail, and end up disqualified from buying insurance through Healthcare.gov (in my case, I used a mail forwarding service address, because I travel full-time). There is no do-over, no online process for correcting the problem with the application. You have to go through a protest process that involves mailing physical letters somewhere. Fuck that. I'd go back to the nightmare that is pre-ACA private insurance, before I beg some bureaucrat, by mail, for the privilege of paying too much for insurance.

Healthcare.gov got a lot of flack in the beginning for costing too much, delivering too little, and being too flakey. All of those things are still true. It's also dehumanizing.

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

#280

Post by rdtsc » Tue, Jan 05, 2016, 7:24 AM UTC

orangecat wrote: post #211

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.

There should be one plan, available to every citizen. There should be one payer, the Federal Government. Should this also be the case for food, housing, and cell phones? If not, why?

> Should this also be the case for food, housing, and cell phones? If not, why?

Because the heart transplant for your child, or elderly care of your mom, or your cancer treatment is not like a cell phone. Or is it? It is for me at least. Is that something that needs to be explained?

Single payer systems are not hypothetical utopia / sci-fi scenarios. This is already happening in many countries where people are happier and live longer.

Do you have any examples where healthcare regulated like cell phones with a good outcome?

Surely if it is such a great system, someone would have stumbled on it.

I have examples of where it is regulated like the cell phone and it doesn't work -- pretty much any third world country where regulatory agencies are practically not functional. There you go to to the doctor to get a shot of antibiotic, instead you get a shot of saline. Because antiobiotic shots cost money. Etc.