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

Re: People Lose Their Employer-Sponsored Insurance Constantly

#81

Post by pbnjay » Wed, Apr 17, 2019, 6:07 PM UTC

These numbers are super misleading. 72% were continuously enrolled, but 16% switched to a different employer plan! We don't know how many of those were the same employer or if the spouse just had access a better deal that year or what. Either way, 88% were covered by their employer plan. 12% is entirely different from 28%. We all have to do open enrollment, but that's entirely different from losing coverage and finding something new!

I'm totally on board with Medicare-for-All but we don't need smoke and mirrors and misleading statistics.

Re: People Lose Their Employer-Sponsored Insurance Constantly

#82

Post by majormajor » Wed, Apr 17, 2019, 6:09 PM UTC

ummonk wrote: post #57

jvagner wrote: post #44

Earlier quoted context omitted.

We have a high-deductible health plan and live in Reno. When my gf recently had the need for a CAT scan, the first choice was here in Reno, and it was priced at over $800. She cancelled her appointment, called over in Carson City (20 minutes south of Reno), and got one done, by someone in our network, for $400. The doctor's office who referred her said, "$800? Really!?" The Reno specialist made her a follow-up appoin…

That actually sounds like the high deductible plan is functioning as it should though. Causing consumers to price-shop and avoid price-gouging providers.

What if the cheaper place is cheaper cause it's not as capable? How am I supposed to know? In what other scenario are we similarly encouraged to act on price alone? Price transparency is meaningless with quality transparency.

Re: People Lose Their Employer-Sponsored Insurance Constantly

#83

Post by helen___keller » Wed, Apr 17, 2019, 6:09 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…

When I was young, my dad started a small business around the same time my mom stopped being a stay at home mom and finished her education at the local community college to pursue a nursing career. I learned later one of the main motivations for her career was that it allowed my parents to have a good healthcare plan for the family under her employer.

Re: People Lose Their Employer-Sponsored Insurance Constantly

#84

Post by organsnyder » Wed, Apr 17, 2019, 6:11 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…

I think it depends on your state's insurance market as well as the priorities of your employer. If your state has a plethora of plans available, your employer is tempted to shop around more often. In that case, it depends on the priorities of your employer, weighing the cost savings versus the cost (financial, employee morale, time) were they to switch to a cheaper plan.

I've worked for employers of varied sizes and profitability (self-employed, small nonprofit, very large health system [including its own insurance plans], midsize for-profit), and I haven't noticed a consistent pattern that would differentiate them in terms of health plan stability. In all cases, the goal is to minimize cost while providing an acceptable level of coverage.

Of course, job hopping and employer-provided coverage are a painful combination. My family had to reach our deductible twice last year, which wasn't fun (the increased salary and other benefits of the new job made it worth it).

I'd love to see health coverage detached from employment. If traditional Medicare-for-all isn't feasible, then let's go with Medicare-Advantage-for-all instead.

Re: People Lose Their Employer-Sponsored Insurance Constantly

#85

Post by dv_dt » Wed, Apr 17, 2019, 6:12 PM UTC

akhilcacharya wrote: post #53

dv_dt wrote: post #48

Earlier quoted context omitted.

I doubt your data. Just one counter example, in Orange County CA, Katie Porter, a democrat, won a competitive seat in a district that has been Republican for a long time (maybe 30+ years?).

From what I understand, she wasn't endorsed by Our Revolution (I'm strictly talking about the Bernie-aligned groups). She was endorsed by lots of other progressive groups that are more effective at this sort of thing. On the other hand, people like Kendra Horn flipped deep-red Oklahoma 5th with help of Bloomberg's Independence PAC, and Sharice Davids beat Bernie-backed Brent Welder in the primary to win the general b…

Does it matter if it's a Bernie aligned group? In CA-25, Our revolution endorsed one candidate, Justice Democrats another candidate, and a third Democratic candidate actually won yet another historically Republican district. They were helped (but not endorsed) by also progressive, but not as closely aligned to Bernie, Indivisible, by loose Bernie inspired independents, etc. I think it's a mistake to only look at strict boundaries of support by candidate name. I would consider CA-25s win with Katie Hill another progressive win in an contentious district.

Re: People Lose Their Employer-Sponsored Insurance Constantly

#86

Post by arcticbull » Wed, Apr 17, 2019, 6:12 PM UTC

ummonk wrote: post #57

jvagner wrote: post #44

Earlier quoted context omitted.

We have a high-deductible health plan and live in Reno. When my gf recently had the need for a CAT scan, the first choice was here in Reno, and it was priced at over $800. She cancelled her appointment, called over in Carson City (20 minutes south of Reno), and got one done, by someone in our network, for $400. The doctor's office who referred her said, "$800? Really!?" The Reno specialist made her a follow-up appoin…

That actually sounds like the high deductible plan is functioning as it should though. Causing consumers to price-shop and avoid price-gouging providers.

I'll be sure to let the ambulance driver know after a car accident they should shop around :\ Maybe an Ayn Rand medicalert bracelet would help. Allergy: Socialism.

Re: People Lose Their Employer-Sponsored Insurance Constantly

#87

Post by munk-a » Wed, Apr 17, 2019, 6:13 PM UTC

btown wrote: post #67

dv_dt wrote: post #25

Earlier quoted context omitted.

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-pro…

It might be hard to find... unless you take a gander up north, Canadian public health care is a recent thing and the transition was flow and began with regional efforts. This[1] is a nice little rough timeline of things that happened. And, to be honest, it's not done yet, Canada lacks national pharma coverage (most places having provincial coverage of a sort) and entirely lacks dental & vision coverage, the later is a bit arguable but poor dental care has been strongly linked to heart disease.

[1] https://www.healthcoalition.ca/tools-and-resources/history-o...

Re: People Lose Their Employer-Sponsored Insurance Constantly

#88

Post by dwater » Wed, Apr 17, 2019, 6:14 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…

My partner has been employed with the same large international company for 8 years. She had an elected procedure done that is required by law to be fully covered by insurance. She had 3 calls leading up to the procedure with her health insurance company each time asking them if they were certain it would be covered 100%. I thought that this was overkill but she was worried to the point of being paranoid about it. They assured her each time she would not have to pay any money at all for anything.

The procedure was in December. After the procedure she received a 6-figure bill, which she then had to follow up with hours of phone calls back and forth to the insurance company, hospital, and doctor's office. They sent her a revised bill for somewhere around $8,000, and then another revised bill for around $4,000.

The insurance company says it's because the doctor coded the procedure incorrectly. The doctor says the hospital coded it incorrectly. She has had to file an appeal with the insurance company, and the only reason it looks like it will work out is because the insurance company records all phone calls and was able to get records of her original calls before the procedure asking if it would be fully covered. She has still been told to expect that they will deny her first appeal and she'll have to appeal a second time in order to get it covered. This has been causing her immense stress for the past 4 months as she does not have enough money to pay even the $4,000 bill out of pocket.

My experience is that your experience actually is extremely uncommon in America today. Most people who have to interact with the health care system beyond annual checkups have to deal with something like this.

Re: People Lose Their Employer-Sponsored Insurance Constantly

#89

Post by dv_dt » Wed, Apr 17, 2019, 6:15 PM UTC

majormajor wrote: post #82

ummonk wrote: post #57

Earlier quoted context omitted.

That actually sounds like the high deductible plan is functioning as it should though. Causing consumers to price-shop and avoid price-gouging providers.

What if the cheaper place is cheaper cause it's not as capable ? How am I supposed to know? In what other scenario are we similarly encouraged to act on price alone? Price transparency is meaningless with quality transparency.

And quality transparency isn't that much help either - if you have cancer are you really going to shop around if chemo treatment drug group A is more effective then drug group B? A patient cant even begin to be able to shop around for something like that.

Re: People Lose Their Employer-Sponsored Insurance Constantly

#90

Post by arcticbull » Wed, Apr 17, 2019, 6:15 PM UTC

krapht wrote: post #80

munk-a wrote: post #77

Earlier quoted context omitted.

Sure, in the case of a scan that isn't urgent. If you were in a car accident and have a piece of metal embedded in your kidney are you in a level, clear-minded state to price shop about which emergency room won't gouge you? Health care is an inelastic good, we need it. So this is a market (much like having a military) that really benefits from the government stepping in and making things sane.

Not that I disagree, but the majority of health care expenses are not time-critical emergencies. I saw a statistic somewhere where it's around 15%?

IMO the biggest problem is that you're not really qualified to judge medical practitioners. How am I supposed to know if what they're recommending is actually necessary? The market price of an MRI? How do I know they're not skipping care I should have to offer a lower price? Or if they're offering unnecessary procedures?

The reality is you need an M.D. to make a reasonable evaluation. This is why at an HMO we have primary care physicians. Or in any other country, GPs. They decide if you need specialized care. However, how am I supposed to pick one of them? It's Russian nesting doctors.

It's probably the most complicated thing we have to deal with in our non-professional lives.