US Workers Are Highly Taxed If You Count Premiums • Hacker News Board

Re: US Workers Are Highly Taxed If You Count Premiums

#501

Post by pnutjam » Tue, Apr 09, 2019, 7:37 PM UTC

jimbokun wrote: post #175

exodus_de wrote: post #137

Earlier quoted context omitted.

> Who cares about the deductible? It’s still a ripoff. You should care about the deductible, cause you entered the contract, silly. Get private insurance in Germany, there's also a deductible, unless you want to pay more. > We went to an eye doctor and paid 25 Euro cash including an ointment. The US is just horribly expensive and very unpredictable. That's because of price fixing (GOÄ). It's all they can charge. And…

"You should care about the deductible, cause you entered the contract, silly." This is stupid. There is no real way to shop and bring down health insurance costs in the US. It's tied to your job, meaning you would need to get many job offers, and turn them down when you find out the actual insurance costs until you find one that's better, and ignoring other employment factors. And then everything can change the next…

When I worked at HP/HPE, we had decent insurance. My family rate was average, not too expensiv. After they spun us off to DXC they claimed to be contributing the same amount, but our rates went up to about double or triple per pay period (varied some with the different plans).

Re: US Workers Are Highly Taxed If You Count Premiums

#502

Post by pnutjam » Tue, Apr 09, 2019, 7:41 PM UTC

exodus_de wrote: post #310

jimbokun wrote: post #175

Earlier quoted context omitted.

"You should care about the deductible, cause you entered the contract, silly." This is stupid. There is no real way to shop and bring down health insurance costs in the US. It's tied to your job, meaning you would need to get many job offers, and turn them down when you find out the actual insurance costs until you find one that's better, and ignoring other employment factors. And then everything can change the next…

Insurance isn't tied to your job. You can (and often should) forego the employer's plan and purchase insurance on the open market. Most insurances have some form of deductible, it's what keeps them affordable. Insurance should be protecting you against a huge financial fallout, not against petty expenses. I agree it is a stupid system though and I'll tell you why: People want something for nothing. They want coverage…

I've priced insurance outside my job. It's never even close and your employer isn't going to hand you the money they were spending on your policy. You basically pay at least 150% and give you employer money if you want to self-insure. You still won't be able to pay your policy if you get critically injured, so what's the difference.

Re: US Workers Are Highly Taxed If You Count Premiums

#503

Post by b_t_s » Tue, Apr 09, 2019, 8:11 PM UTC

Bombthecat wrote: post #351

Gibbon1 wrote: post #280

Earlier quoted context omitted.

I've noticed that a lot of employers don't tell workers how much they are paying for health insurance. Because for large companies the number gets rolled into a negociated contract. In my case I do know. My employer pays $930 some a month. My rent used to be $860/month. The other thing the happens is just because you have insurance doesn't mean that healthcare providers aren't trying to jack more money out of you. An…

What the...? Almost a thousend a month? That's 12k a year, just paid by employers. Where is the money going?

Ha, that's cheap. Last time I checked the medical system gets over 20 grand a year from me(some via my employer). Works out to like 4 to 7 grand a visit, and that's mostly routine checkups/vaccinations for my kid. There's a reason doctors and medical/insurance execs are so wealthy.

Re: US Workers Are Highly Taxed If You Count Premiums

#504

Post by Simon_says » Tue, Apr 09, 2019, 8:37 PM UTC

blindwatchmaker wrote: post #274

Simon_says wrote: post #266

Earlier quoted context omitted.

While technically true, that's disingenuous. You paid no additional marginal cost. The incentive structures matter.

GP is not the one being disingenuous.

Who do you think is being disingenuous?

Re: US Workers Are Highly Taxed If You Count Premiums

#505

Post by AnthonyMouse » Tue, Apr 09, 2019, 8:39 PM UTC

therealdrag0 wrote: post #497

AnthonyMouse wrote: post #271

Earlier quoted context omitted.

> who are the "wrong people" that massive social programs enrich? Can you give an example? Most of federal spending is medicare, medicaid and social security; which are immensely popular with voters of all kind. If you ask people if they support the abstract idea of having a military so we're not invaded by foreign forces, or having a program to prevent the elderly from dying in the streets, they say yes. But then yo…

Military is like 15% of federal spending, social security and healthcare is 50+% of federal spending. I agree that there is military excess, but I'm skeptical that reducing it would make THAT much difference.

The military used to be a significantly larger percentage of the budget than it is now, but it's not because the military is any smaller. It's because spending on retirees is exploding. Nobody really wants to admit this because the reason the costs are exploding is that there are so many more people over retirement age, which also means that there are more voters over retirement age, which makes it politically very difficult to do anything about it. But it's a serious problem -- how are we supposed to sustain spending more than half of the government budget on retirees?

And the DoD and the VA are also considered separately, but let's not pretend they're unrelated. If you have twice as many soldiers today then you need twice the VA budget tomorrow.

Re: US Workers Are Highly Taxed If You Count Premiums

#506

Post by b_t_s » Tue, Apr 09, 2019, 8:57 PM UTC

petronio wrote: post #362

ben_w wrote: post #66

Earlier quoted context omitted.

$300 [1] is more than I’ve spent on (non-dental) helthcare, in total, over my entire life. That includes one count of general anaesthetic and emergency surgery because of testicular torsion which happened while I wasn’t registered with any local doctor, one burned arm, one being knocked unconscious by a trampoline, and one being hit by a car. [1] “after premiums” is roughly the same as “after taxes”, right?

I left the US recently with a few thousand in an HSA (a pre-tax account designated for healthcare expenses). I have no idea how I'm going to get that out of there now.

you can just withdraw it. Their website should have a way to do a bank transfer or write you a check. You will owe taxes, but if you're never coming back to the US, then whatever. If you're coming back, then you can generally invest your HSA in a mutual fund(most have some limited investment options accessible via their website) and then your HSA basically turns into an IRA retirement fund at age 65.

Re: US Workers Are Highly Taxed If You Count Premiums

#507

Post by alexiazf » Tue, Apr 09, 2019, 10:15 PM UTC

I think I'm privileged to live in Australia where I do not need to pay for my visits to the hospital and for my operation when I had appendicitis. Whereas in the US I've seen it is 30-70k. It's also interesting that there is a range of prices depending on the hospital. Would this be representative of treatment quality? How much one can pay shouldn't be the determinant of the optimal treatment that one deserves to receive.

Re: US Workers Are Highly Taxed If You Count Premiums

#508

Post by exodus_de » Wed, Apr 10, 2019, 12:05 AM UTC

taysic wrote: post #473

exodus_de wrote: post #310

Earlier quoted context omitted.

Insurance isn't tied to your job. You can (and often should) forego the employer's plan and purchase insurance on the open market. Most insurances have some form of deductible, it's what keeps them affordable. Insurance should be protecting you against a huge financial fallout, not against petty expenses. I agree it is a stupid system though and I'll tell you why: People want something for nothing. They want coverage…

It’s tied to your job because health ins through your employer gets an effective tax discount compared to that bought through the ACA market. There is no way for latter to be as economical.

> It’s tied to your job because health ins through your employer gets an effective tax discount compared to that bought through the ACA market.

There is often some insurance package tied to a job, but that doesn't mean health insurance in general is tied to it. You have a choice.

> There is no way for latter to be as economical.

Yes there is and I'll tell you why: Insurers know you are likely to take the bait so they get make the plans worse (often in terms of coverage, not necessarily cost). It's effectively a small monopoly for them to exploit. Some of the plans I've seen are complete jokes. A total waste of money.

Re: US Workers Are Highly Taxed If You Count Premiums

#509

Post by exodus_de » Wed, Apr 10, 2019, 12:25 AM UTC

jimbokun wrote: post #463

exodus_de wrote: post #310

Earlier quoted context omitted.

Insurance isn't tied to your job. You can (and often should) forego the employer's plan and purchase insurance on the open market. Most insurances have some form of deductible, it's what keeps them affordable. Insurance should be protecting you against a huge financial fallout, not against petty expenses. I agree it is a stupid system though and I'll tell you why: People want something for nothing. They want coverage…

Thanks for engaging, your comments are interesting and thought provoking. "If there was a compulsion to purchase, the system could work, as it does in many other countries." Wasn't that one of the major points of Obamacare, to make strides in that direction? And it did pass Supreme Court scrutiny, who decided yes it is a tax, and yes the government is allowed to tax us. "Lastly you have "Medicare for all" which would…

> Wasn't that one of the major points of Obamacare, to make strides in that direction? And it did pass Supreme Court scrutiny, who decided yes it is a tax, and yes the government is allowed to tax us.

It decided that the penalty was constitutional "as a tax", not a compulsion to purchase insurance. The problem is that the penalty was too low. If you know you can buy insurance with a pre-existing condition and the penalty is far cheaper than the insurance, it makes sense to just pay the penalty.

Also, unlike with a compulsory purchase, the penalty didn't go into the funds of the insurers, so prices had to go up regardless.

> So an intelligent "Medicare for All" system could be designed to incentivize innovation and cost cutting and overall patient health, if implemented intelligently.

What are the odds of an intelligent solution coming out of the political process?

Re: US Workers Are Highly Taxed If You Count Premiums

#510

Post by jnbiche » Wed, Apr 10, 2019, 1:38 AM UTC

Spooky23 wrote: post #298

jnbiche wrote: post #178

Earlier quoted context omitted.

If you're poor in the US, insurance is free. It's the lower middle class and middle class who are frequently bankrupted by these costs.

Hahaha. Sure. Good luck finding a Medicaid provider.

Every doctor I see is a Medicaid provider. Yes, there are doctor who don't accept it, but it's not hard where I'm from to find a doctor who does (perhaps we have an oversupply of doctors?).