People Lose Their Employer-Sponsored Insurance Constantly • Hacker News Board

Re: People Lose Their Employer-Sponsored Insurance Constantly

#61

Post by maxxxxx » Wed, Apr 17, 2019, 5:50 PM UTC

nogridbag wrote: post #54

maxsilver wrote: post #27

Earlier quoted context omitted.

> and then immediately sign onto their new plan Nope. Employer-provided insurance plans often have blackout dates. If you quit your job on June 2, and start your new job on June 3, your new job's health insurance might not actually take effect for up to 30, 60, or even 90 days after your start date. To cover that gap period, you either have to switch to a new plan with your old employer (commonly called COBRA) at rid…

As I painfully found out, transitioning between jobs also requires competent HR people on both ends. Our insurance was accidentally terminated a week early so our claim was denied and we got a massive bill. Not only do you have to then deal with the insurance company but you have to deal with your previous employer to fix the situation.

That's the worst because most likely you are already locked out of most systems so you can't even communicate.

Re: People Lose Their Employer-Sponsored Insurance Constantly

#62

Post by helen___keller » Wed, Apr 17, 2019, 5:51 PM UTC

jimmy1 wrote: post #42

helen___keller wrote: post #37

The point of health insurance is to pay into a risk pool as a collective so that the small percentage of people who end up needing the largest percentage of health care, nobody dies or goes into monumental debt. This can be done via taxes but insurance is a private market solution which should in theory make it more efficient for the sake of maximizing profit. So then if it's supposedly more efficient, why do I waste…

I think your phenomena might be due to startups? Obviously this is a startup focused board so I am not saying this to mean go one way or another, but I ditched the startup, job hopping life a little while ago, and had to deal with "insurance bs" roughly two times in 7 years. I am either the luckiest person alive, or maybe there is additional benefits not obviously well represented here to working for a stable, revenu…

Not due to startups necessarily so much as changing insurance a lot. I'm on my 6th insurance plan in 4 years (Job 1, not a startup, lasted 9 months. Job 2, a startup, changed insurance 2 months after I started then again the next year for a total of 3 plans over 2.5~ years on the job. Job 3, a startup, had better than average insurance (with a weird/awesome reimbursement plan so I pay 0 deductible and 0 premium and get to cover my wife for free too!). Then one month after I started we got acquired and so in 2019 I now have a normal (still good) corporate insurance policy.

On top of that insurance frustrates my wife so before we were married when she was on PhD student insurance I generally managed that too, plus her transition to my insurance after marriage.

So I'm definitely out-of-norm on this. If anything I like to think that means I'm more qualified to call out how bullshit the world of insurance is, atleast in terms of end-user UX, but obviously that's just my opinion.

Re: People Lose Their Employer-Sponsored Insurance Constantly

#63

Post by u801e » Wed, Apr 17, 2019, 5:51 PM UTC

imgabe wrote: post #52

helen___keller wrote: post #37

The point of health insurance is to pay into a risk pool as a collective so that the small percentage of people who end up needing the largest percentage of health care, nobody dies or goes into monumental debt. This can be done via taxes but insurance is a private market solution which should in theory make it more efficient for the sake of maximizing profit. So then if it's supposedly more efficient, why do I waste…

If private insurance is going to work, then every healthcare provider has to accept payment from every insurance. This clusterfuck we have where you have in-network providers with one price and out-of-network providers with a different price just has to stop. Oh you went to an in-network hospital, but this one doctor walked into the room for five minutes and she was out-of-network, so now your bill is 10x higher than…

I've always wanted to add a clause to those consent forms stating that my consent is conditional to the provider being in-network for the insurance information I provided the hospital. It is their responsibility to make that determination before they start treatment. If they provide treatment and find that they're not in network, then they forgo the right to bill for that service.

Re: People Lose Their Employer-Sponsored Insurance Constantly

#64

Post by Glyptodon » Wed, Apr 17, 2019, 5:51 PM UTC

a3n wrote: post #28

terryschiavo22 wrote: post #2

Yes, people do lose their insurance constantly when they switch jobs...and then immediately sign onto their new plan. Is the argument that switching insurance plans is stressful? What's stressful is remaining uncovered. Switching plans is hardly comparable to the transition to a Medicare-for-all program.

When I started my current job I wasn't eligible for benefits for 90 days. This is not uncommon.

One time I switched jobs the company I left was so small (I think ~ 15 to 18 people) it turned out that COBRA wasn't available and new job benefits didn't kick in for 90 days. This was between when the ACA was passed and took effect so getting private insurance for the gap was scary. (Going without coverage was not an option, I have serious medical history.)

Re: People Lose Their Employer-Sponsored Insurance Constantly

#65

Post by dudul » Wed, Apr 17, 2019, 5:51 PM UTC

pnathan wrote: post #43

One of the fundamental reasons why I haven't really bothered doing startups or running a small business myself is the radical uncertainty over health insurance for myself and my family. It's not just plain $$$ and career risk, it's the "suppose you will go bankrupt and your family has permanent medical issues now" risk. That game is for the wealthy or healthy single people In addition, each insurance plan has slightl…

This is also the reason why I've never looked seriously into starting a company. I wonder how many jobs would almost instantly be created in the US if this factor of uncertainty was lifted.

Re: People Lose Their Employer-Sponsored Insurance Constantly

#66

Post by fzeroracer » Wed, Apr 17, 2019, 5:52 PM UTC

imgabe wrote: post #52

helen___keller wrote: post #37

The point of health insurance is to pay into a risk pool as a collective so that the small percentage of people who end up needing the largest percentage of health care, nobody dies or goes into monumental debt. This can be done via taxes but insurance is a private market solution which should in theory make it more efficient for the sake of maximizing profit. So then if it's supposedly more efficient, why do I waste…

If private insurance is going to work, then every healthcare provider has to accept payment from every insurance. This clusterfuck we have where you have in-network providers with one price and out-of-network providers with a different price just has to stop. Oh you went to an in-network hospital, but this one doctor walked into the room for five minutes and she was out-of-network, so now your bill is 10x higher than…

I agree, however this is the unfortunate reality of the private healthcare system maximizing for profit. Consumers rarely have proper choice in shopping around or choosing doctors and insurance providers take advantage of this by inventing as many different systems as they can to avoid paying out.

That's why I think full free market healthcare simply won't work. It's far too much at odds with people that need medical care, made worse if you need timely medical care.

Re: People Lose Their Employer-Sponsored Insurance Constantly

#67

Post by btown » Wed, Apr 17, 2019, 5:52 PM UTC

dv_dt wrote: post #25

davidw wrote: post #21

Earlier quoted context omitted.

Italy has a thriving market based private health care industry. You can call in and get prices and everything. Just that it's in addition to the single payer system, which means the private one is cheap because the competition is 'free'. As a % of GDP, Italy spends a lot less than the US in health care, and people live long and productive lives. I mention Italy because 1) I lived there and 2) it's not some perfectly…

All other first world nations pay less. On average they pay less than half what the US pays. The fully socialized systems, like the UK, seem to trend lower in cost, as low as one third the cost of the US. But really, the takeaway should be you need universal healthcare with significant government cost controls on drugs and procedures, after that almost any arrangement of public/private administration works (but the c…

> the more private companies are in the healthcare mix, the higher the costs seem to run

One worrying thing about single-payer healthcare in America is that we can look at other countries with a _rich history_ of single-payer healthcare from before the modern era [0] and see that they have developed efficient public healthcare systems, but it does not follow that our system, with its similarly rich history of for-profit entities developing methods to thrive in the weird world of American health insurance, can be immediately brought to a level of cost efficiency that is comparable. Consider, for instance, how much ownership of the healthcare space is held by private equity firms in the U.S. I'd love to see a great transition plan towards single payer, but it would need to be one that takes into account that the operators have no inherent incentive to reduce costs.

[0] http://www.euro.who.int/__data/assets/pdf_file/0020/96410/E7...

Re: People Lose Their Employer-Sponsored Insurance Constantly

#68

Post by travisoneill1 » Wed, Apr 17, 2019, 5:53 PM UTC

helen___keller wrote: post #37

The point of health insurance is to pay into a risk pool as a collective so that the small percentage of people who end up needing the largest percentage of health care, nobody dies or goes into monumental debt. This can be done via taxes but insurance is a private market solution which should in theory make it more efficient for the sake of maximizing profit. So then if it's supposedly more efficient, why do I waste…

> which should in theory make it more efficient for the sake of maximizing profit

There are multiple reasons why this doesn't work for healthcare even in theory.

- Emergency care can't be substituted without massive cost. Providers compete on distance not on price.

- Emergency care can't be denied (or at least we don't want this) on the basis of price.

- Health is not insurable like cars, etc. You can't predict in advance when you are going to get in a car wreck so you better buy insurance when you get the car. If you could, the price of the insurance would be the price of the car, and therefore worthless. But you could just wait until you feel sick to get health insurance. This is why the ACA has to be paired with the individual mandate to work properly.

Re: People Lose Their Employer-Sponsored Insurance Constantly

#69

Post by scarface74 » Wed, Apr 17, 2019, 5:53 PM UTC

pickle-wizard wrote: post #58

scarface74 wrote: post #22

Earlier quoted context omitted.

If you find a new job and you’re eligible under group insurance, the insurance company can’t deny a claim under pre-existing conditions. This was true before the ACA. What the ACA changed was that insurance companies couldn’t exclude treatment based on preexisting conditions if you go on the open market.

Pre-ACA group plans could deny preexisting conditions for a time period equal to the time that you were uninsured. When I switched job I would get a letter from previous insurance company stating the dates that I was insured. Once I actually had to provide that to the new company.

It seems like we are both partially correct. They could deny you for up to a year for a pre-existing condition prior to the ACA.

https://twocents.lifehacker.com/you-could-be-denied-pre-exis...

Re: People Lose Their Employer-Sponsored Insurance Constantly

#70

Post by tareqak » Wed, Apr 17, 2019, 5:53 PM UTC

jimmy1 wrote: post #42

helen___keller wrote: post #37

The point of health insurance is to pay into a risk pool as a collective so that the small percentage of people who end up needing the largest percentage of health care, nobody dies or goes into monumental debt. This can be done via taxes but insurance is a private market solution which should in theory make it more efficient for the sake of maximizing profit. So then if it's supposedly more efficient, why do I waste…

I think your phenomena might be due to startups? Obviously this is a startup focused board so I am not saying this to mean go one way or another, but I ditched the startup, job hopping life a little while ago, and had to deal with "insurance bs" roughly two times in 7 years. I am either the luckiest person alive, or maybe there is additional benefits not obviously well represented here to working for a stable, revenu…

The phenomena is linked to how often someone switches jobs in the United States irrespective of the type of company or employment (full-time, part-time, self-employes etc).

No matter what an individual’s stance is with respect to another individual’s professional history in terms of frequent changes or gaps, I don’t think that has to correspond to level of healthcare that the latter individual is able to obtain.