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

Re: People Lose Their Employer-Sponsored Insurance Constantly

#121

Post by tomp » Wed, Apr 17, 2019, 6:55 PM UTC

dv_dt wrote: post #45

aantix wrote: post #40

Earlier quoted context omitted.

Without the U.S. subsidizing the drug research R&D, who pays for it? You could fill notebooks with worthy, approachable hypotheses for any number of diseases that could show promise if given the funding. But if everyone makes it law to cap prices - fewer scientists, labs, studies are performed. The money has to come from somewhere. I think countries take for granted the progress we've made. No progress is made withou…

This paper gives pretty interesting breakdown of how private companies are increasingly bad at paying for it. https://www.ucl.ac.uk/bartlett/public-purpose/sites/public-p... One quote from the paper: In the last ten years, Pizer has spent US$139 billion on share buybacks and dividends compared to US$82 billion on R&D. Edit: It shouldn't require massive profit margins to make the drug industry work for a basic human n…

Does the "huge margins of the healthcare industry" include all the money spent on failed pharma startups? If you spend $1bn on a drug then make $1bn profit but the other 9 drugs failed (after someone having spent $1bn for each) the margin isn't 100%, it's 10%.

Re: People Lose Their Employer-Sponsored Insurance Constantly

#122

Post by dredmorbius » Wed, Apr 17, 2019, 6:55 PM UTC

jkingsbery wrote: post #98

Glyptodon wrote: post #46

Employer sponsored health insurance is an outpost of neofeudalism. Swear your fealty to a lord or go without.

Employee sponsored health insurance is a result of "centrally planned" economics - https://www.nytimes.com/2017/09/05/upshot/the-real-reason-th... ... it has nothing to do with feudalism or even what employers wanted, but has a lot more to do with government officials who thought they could design an economy.

The reasons things start, and the reasons they persist, are often quite different.

The US doesn't seem to have subscribed to strongly-cenralised economic policy for nearly 70 years. And yet the employer-feudal healthcare system continues.

Preponderance of evidence suggests that dominant economic, financial, and power structures prefer it that way.

The origin story is an interesting footnote, no more.

Re: People Lose Their Employer-Sponsored Insurance Constantly

#123

Post by aantix » Wed, Apr 17, 2019, 6:57 PM UTC

dv_dt wrote: post #114

aantix wrote: post #104

Earlier quoted context omitted.

Food production is predictable. Finding a safe, effective treatment for Alzheimer’s is not. If you want thin margins, maybe government research wing can take its findings from idea to market (imagine waiting on a cure and that’s your only hope?) But you can’t force a private company to operate on low margins by way of capping prices, you’ll kill them. You can’t taje away their ability to control their risks (cash flo…

If you look at the paper, private drug discovery is creating drugs at a declining rate. I would suggest this is because those private efforts are much less research than development, and it's actually the public system that drives much fundamental research. And the drugs to market rate is in serious decline because of a the widespread application of increasingly austure public funding budgets for medical research cau…

When you dump a link to a 60 page pdf and you’re going to reference it, please list the page number and/graph you’re referring to. I don’t want to guess.

Re: People Lose Their Employer-Sponsored Insurance Constantly

#124

Post by luckydata » Wed, Apr 17, 2019, 6:59 PM UTC

specialist wrote: post #99

luckydata wrote: post #36

Earlier quoted context omitted.

There's no market based approach that can "fix" healthcare. Market self regulates around substitute goods, but healthcare is in the business of health and there's no substitute for that. Very few humans will say "all considered, the ROI/statistical likelhood of this procedure is not positive so I will pick death instead", it just doesn't happen. Single payer is the only way to go.

Even with single payer, there's a large thriving market. Vendors, suppliers, manufacturers, contractors, auditors, etc. Bandages need to be made, hospitals need to be cleaned, nurses need to be trained, etc.

You can make things and get paid in a non-market economy like the one connected to single payer healthcare. What you don't get is maximization of profits.

Re: People Lose Their Employer-Sponsored Insurance Constantly

#125

Post by pnutjam » Wed, Apr 17, 2019, 6:59 PM UTC

pbnjay wrote: post #81

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 findi…

This is still important. I changed insurance with no gap, but it reset my fully paid deductible.

Re: People Lose Their Employer-Sponsored Insurance Constantly

#126

Post by ThrustVectoring » Wed, Apr 17, 2019, 7:00 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…

>So then if it's supposedly more efficient, why do I waste multiple hours dealing with insurance bullshit literally every few months?

It's friction costs for splitting up the decision-making process into multiple entities. For any bill, the insurance company pays $X, the patient pays $Y, and the provider has $Z in costs. The $X that the insurance company pays is what they optimize for, not $Y and certainly not $Z. This has the side effect of somewhat optimizing $Z, since $Y is limited by how much money people have and if $Z is consistently bigger than $X + $Y, the healthcare provider loses money and goes out of business.

Honestly, the way to go is to treat the entire process as interaction with hostile bureaucracy. Document everything, and look like you'll generate a regulatory incident if you don't get what you're legally entitled to. Otherwise the insurance company will happily reduce their costs by offloading it onto you or the healthcare provider through pulling bullshit stunts.

Re: People Lose Their Employer-Sponsored Insurance Constantly

#127

Post by pnutjam » Wed, Apr 17, 2019, 7:01 PM UTC

ummonk wrote: post #109

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.

If you're in that dire an emergency you're going to max out your in-network limits anyway, so it doesn't really matter which emergency room you get taken to, you pay the same.

My in network max is around $13k, my out of network is $99,999,999.

Re: People Lose Their Employer-Sponsored Insurance Constantly

#128

Post by Skunkleton » Wed, Apr 17, 2019, 7:02 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…

Efficient? For who and what purpose? Its efficient for insurance companies, and for the purpose of making money. What do you expect? Any consumer friendliness comes from regulation.

Re: People Lose Their Employer-Sponsored Insurance Constantly

#129

Post by pxeboot » Wed, Apr 17, 2019, 7:02 PM UTC

dwater wrote: post #88

jimmy1 wrote: post #42

Earlier quoted context omitted.

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. The…

She is lucky she is getting that even partially covered if she only got a verbal agreement. My insurance policy has a clause that anything they say over the phone is not a promise to pay. You have to call AND get something in writing to even be eligible for a dispute later.

Re: People Lose Their Employer-Sponsored Insurance Constantly

#130

Post by toast0 » Wed, Apr 17, 2019, 7:02 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 worked for a startup, they were affiliated with a "professional employer organization", which allowed access to major PPO and HMO insurance plans, and also handled some of the payroll obligations.