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People Lose Their Employer-Sponsored Insurance Constantly

peoplespolicyproject.org

141–150 of 246 posts

Re: People Lose Their Employer-Sponsored Insurance Constantly

#141

The fundamental problem is no body knows the cost of anything beforehand. Neither insurance company not doctors tell the cost of the care. Its really frustrating ! The first step to fix the problem is getting the cost of the care transparently. Without this i am not sure how any of the scheme works whether it is done by govt or private insurance companies !

There is no single cost. It depends entirely on who asks, which is why you cannot get an answer beforehand.

Re: People Lose Their Employer-Sponsored Insurance Constantly

#142
post #63

Earlier quoted context omitted.

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.

A great alternative strategy is to structure your finances so that it's impossible for creditors to seize your assets - that way, your practical liability is limited to the up-front costs. Which, by being up-front, you can actually reason about and make informed decisions on. This is less difficult than it sounds. Move to Texas, and keep all your assets in retirement accounts, home equity in your primary residence, a…

> A great alternative strategy is to structure your finances so that it's impossible for creditors to seize your assets

It is absolute insanity that this is even a thing to consider.

The funniest thing about it is that if you do this, you are effectively socializing your personal losses and letting everyone else insured through your provider bear the cost for your healthcare. If that's not an argument for actually socializing healthcare costs for everyone, I don't know what is.

Re: People Lose Their Employer-Sponsored Insurance Constantly

#143
post #88
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…

My previous employer had my insurance totally wrong. According to everything I signed at open enrollment, I had a $6k deductible and $6.6k Out-of-pocket max. This was for the family, no individual deductible.

When I go to the insurance site, it lists me with a $2k individual & $4k family deductible. It says my OOPM is $7.5k. Of course I hit my deductible this year, so I'm getting billed an extra thousand.

My employer and insurance company both swear it's the other one's fault and even filing a complaint with the state insurance commission doesn't seem to have helped. :(

Re: People Lose Their Employer-Sponsored Insurance Constantly

#144
post #33

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.

I don't understand why you're downvoted. It's an important observation. In my case, my employer was bought and sold 3 times. All three cases involved a sudden and abrupt termination of my insurance. It was "okay" when I was single, but once I carried my wife, and then my entire family, it became a huge problem. Throughout my tenure at my job, I had major surgery and two children. Sudden insurance changes immediately…

Europe also has a broader fix for this, called Transfer of Undertakings rules, the UK version is "TUPE" the "Transfer of Undertakings (Protection of Employment) Regulations".

The broad overview of TUPE is that employees whose actual job doesn't change shouldn't have to put up with any negative consequences at all for the fact that at some higher level their employer changed. e.g. the office building switches from Ace Cleaning Corp. to Best Cleaning Limited, but it's still Jenny and Achmed actually doing the cleaning, just in blue overalls instead of yellow now. It makes no sense to be allowed to tell Jenny now she's only getting minimum wage because Best Cleaning Limited doesn't pay as much as Ace Cleaning Corp, she's doing the same job so she should continue to get the same pay.

But I don't mean just obvious stuff like they can't cut your pay, it's everything - your seniority is preserved, shift priorities, rules for how much paid leave you get, or how pensions are paid - if it was part of the job, then it moves with the job. If employment-based health insurance was a big thing here, that would undoubtedly be covered.

Re: People Lose Their Employer-Sponsored Insurance Constantly

#145

One thing this article doesn't discuss: at least some of the times where I "lost" my employer-sponsored insurance (either because I switched jobs or because my start-up decided to switch providers), it went to something better than what I had before, and most of the time it was a change that was a matter of indifference (from one major plan provider to another where everything was pretty similar). In most universal h…

It is highly unlikely that you will be left with no options. Under most universal health care systems, private insurance plays a complementary role[1]. Also, if we go the public option route, it would compete against, rather than replace, the private insurance market.

[1] https://www.vox.com/health-care/2019/2/12/18215430/single-pa...

Re: People Lose Their Employer-Sponsored Insurance Constantly

#146
post #118
post #65

Earlier quoted context omitted.

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.

I think you'd see a bump upwards, followed by a slow fall downwards as people realize that there's a hell of a lot more to running a small business than just healthcare costs.

There's no shortage of morons staring businesses doomed to fail in our current system. This would just put self employment in reach for millions.

Re: People Lose Their Employer-Sponsored Insurance Constantly

#147

Earlier quoted context omitted.

A great alternative strategy is to structure your finances so that it's impossible for creditors to seize your assets - that way, your practical liability is limited to the up-front costs. Which, by being up-front, you can actually reason about and make informed decisions on. This is less difficult than it sounds. Move to Texas, and keep all your assets in retirement accounts, home equity in your primary residence, a…

> A great alternative strategy is to structure your finances so that it's impossible for creditors to seize your assets It is absolute insanity that this is even a thing to consider. The funniest thing about it is that if you do this, you are effectively socializing your personal losses and letting everyone else insured through your provider bear the cost for your healthcare. If that's not an argument for actually so…

If I could cap my downside risk from medical events through insurance, I would do that instead. And this is not a replacement for insurance, since many medical providers will refuse to provide non-emergency care if they didn't expect that they could bill my insurance for services rendered.

But, unfortunately, it's currently impossible to set a maximum price you could wind up owing due to receiving medical care. Any provider you go to could end up incurring out-of-network charges and wind up balance billing you. The only fix is to cap the actual damage of creditor judgements in general.

Re: People Lose Their Employer-Sponsored Insurance Constantly

#148

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.

With the current love for High deductible plans, it can get much riskier. I just walked away from a plan where I had paid the full Out of pocket max for the year (around $7k), in January. That hurt, but the other offer was good enough.

None of that money translates to the new plan, I'm back to paying deductibles for everything.

Re: People Lose Their Employer-Sponsored Insurance Constantly

#149
post #117
post #105

Earlier quoted context omitted.

That was fixed long ago by ACA. Emergency services are treated as in-network regardless of whether they were actually in-network.

Well yes, but you make it sound so easy. You'll have to go multiple rounds with the insurance and aca reps in many cases to get it approved after the fact.

Yes, and that is the biggest issue. Hospitals and insurance companies playing hot potato with each other while the hospital tries to pin whatever the insurance company doesn't pay for on the consumer. We need more punitive regulatory action for such situations.

Re: People Lose Their Employer-Sponsored Insurance Constantly

#150
post #140
post #110

Earlier quoted context omitted.

Of course it does. Because people don’t buy and use the drug if they don’t know about it..? Money matters. Marketing to recoup costs matters. Piles of cash to get every dollar of return on an investment matters. That allows the company to turn around and invest in future promising drugs, trials, other companies, marketing to bring awareness to the solution and hopefully get people to buy and use it.

Making sure doctors are well informed about treatment options are one thing... egging patients on to request a possibly mismatched medication and taking doctors out to lunch to encourage the prescription of a possibly mismatched medication is entirely different. The ideal case for drugs is that no one actually needs them so no one takes them - this is a large contributor as to why this market should be heavily nation…

The patient can egg on all they want - it’s still the doctor’s (expert) decision whether to prescribe.

And as an informed patient, I want to know my options. My doctor and I will discuss trade offs, he’ll sign off if he thinks it’s appropriate.

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