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

Re: People Lose Their Employer-Sponsored Insurance Constantly

#161

Post by js2 » Wed, Apr 17, 2019, 8:21 PM UTC

davidw wrote: post #41

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 Economist did a nice comparison of different systems a few years back: https://www.economist.com/united-states/2017/08/10/the-fix-f...

Similarly, a Frontline episode:

https://www.pbs.org/wgbh/pages/frontline/sickaroundtheworld/

An excellent book on the subject ("The Healing of America: A Global Quest for Better, Cheaper, and Fairer Health Care"):

https://www.amazon.com/Healing-America-Global-Better-Cheaper...

And a comparison by The Commonwealth Fund:

http://international.commonwealthfund.org/

And just a reminder how long the U.S. has been having this argument:

https://en.wikipedia.org/wiki/Clinton_health_care_plan_of_19...

And a quote from that page:

The long-term political effects of a successful... health care bill will be even worse—much worse.... It will revive the reputation of... Democrats as the generous protector of middle-class interests. And it will at the same time strike a punishing blow against Republican claims to defend the middle class by restraining government.

— William Kristol, "Defeating President Clinton's Healthcare Proposal", December 1993

Re: People Lose Their Employer-Sponsored Insurance Constantly

#162

Post by nybble41 » Wed, Apr 17, 2019, 8:24 PM UTC

helen___keller wrote: post #107

Gibbon1 wrote: post #92

Earlier quoted context omitted.

> If I could choose to just pay more in taxes One of the fallacies in play is buying insurance is put in one category. Whereas paying taxes for insurance is another. The first is 'good' because it's 'free market' and the second is 'bad' because it's the government taking your money's.

>One of the fallacies in play is buying insurance is put in one category. Whereas paying taxes for insurance is another. The first is 'good' because it's 'free market' and the second is 'bad' because it's the government taking your money's. Well, I'm in favor of socialized healthcare and generally receptive to increased taxation, so that's definitely not the implication I was going for. But it is true that there does…

> A more sound statement would be "I as a consumer am willing to pay dollars equal to twice my current premiums to get healthcare coverage while avoiding hassles while receiving routine healthcare"

Ah, but are you willing to force everyone else pay twice as much so that you can get the health care you want? That's the real question. You said you were in favor of socialized healthcare, so I would guess the answer to that question is "yes", but let's at least be honest here—the private vs. public debate is never about how much you are willing to pay. Under a private system you're free to buy as much healthcare as you can afford. The point of socializing healthcare is making other people pay.

Re: People Lose Their Employer-Sponsored Insurance Constantly

#163

Post by henrikschroder » Wed, Apr 17, 2019, 8:33 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…

> 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.

I joined a startup once, but it was in Europe, so these issues weren't even on my radar or the company's radar. With government healthcare and government unemployment insurance, it's a no-brainer. The only risk is to your lifetime earning potential. Stay at a solid job with a solid salary, or take a shot at the startup lottery. Your health or your family or your home are just never on the line by taking that risk.

The amount of time and worry you have to spend on healthcare for yourself and your family in the US is absolutely off the charts, and this cost is completely hidden! Time that companies have to spend on acquiring healthcare insurance for their employees is wasted time. Time that employees have to spend on researching the insurance options their company is offering them is wasted time. Time that you spend dealing with healthcare providers to ensure that you're covered by your insurance is wasted time.

In Europe the time spent on this is, for the most part, 0. Companies don't spend time on this. Employees don't spend time on this. But noone in the US seems to regard this waste, this cost, as something fixable. Noone seems to think of the competitive edge this gives EU companies, or want to have the same competitive edge. Why? Why are US companies and US employees just completely resigned to the thought that healthcare just is a massive necessary headache for everyone?

Re: People Lose Their Employer-Sponsored Insurance Constantly

#164

Post by munk-a » Wed, Apr 17, 2019, 8:37 PM UTC

aantix wrote: post #150

munk-a wrote: post #140

Earlier quoted context omitted.

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.

Unless someone has a medical degree they're not an informed patient - they're someone who has been fed information through pharma PR campaigns to believe they're informed about a topic while only knowing information that would contribute to a private corporation's profit.

It is amazingly difficult to find good balanced information on prescriptions in the US - even doctors have issues.

Re: People Lose Their Employer-Sponsored Insurance Constantly

#165

Post by helen___keller » Wed, Apr 17, 2019, 8:40 PM UTC

nybble41 wrote: post #162

helen___keller wrote: post #107

Earlier quoted context omitted.

>One of the fallacies in play is buying insurance is put in one category. Whereas paying taxes for insurance is another. The first is 'good' because it's 'free market' and the second is 'bad' because it's the government taking your money's. Well, I'm in favor of socialized healthcare and generally receptive to increased taxation, so that's definitely not the implication I was going for. But it is true that there does…

> A more sound statement would be "I as a consumer am willing to pay dollars equal to twice my current premiums to get healthcare coverage while avoiding hassles while receiving routine healthcare" Ah, but are you willing to force everyone else pay twice as much so that you can get the health care you want? That's the real question. You said you were in favor of socialized healthcare, so I would guess the answer to t…

> generally receptive to increased taxation

Re: People Lose Their Employer-Sponsored Insurance Constantly

#166

Post by munk-a » Wed, Apr 17, 2019, 8:42 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%?

The majority in terms of cost or volume? Also is this figure including oncology treatments - those drugs can run 1k/pill and while some are potentially cures many more are just pushing eventual death a bit further off. These drugs would quite possibly skew any statistic that isn't designed precisely to account for them.

Also I think it's not really fair to take full lifetime costs into consideration at once. As you get older you'll be looking at those much more expensive treatments and covered by expensive insurance but the insurance tends to be of a higher quality when it comes to reducing sudden costs - I am more concerned about younger people who generally have terrible insurance and may get hit with 4 months of 20k physio due to a sudden injury but generally have low "normal" costs.

Re: People Lose Their Employer-Sponsored Insurance Constantly

#167

Post by ddingus » Wed, Apr 17, 2019, 8:45 PM UTC

arcticbull wrote: post #86

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.

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.

#BAM!

Funny! Pointed too.

Getting the best dealz runs in basic conflict with needing to stay alive.

This is why markets do not work well for primary care. They can work well higher up the chain where life basics are not really in play.

Re: People Lose Their Employer-Sponsored Insurance Constantly

#168

Post by ddingus » Wed, Apr 17, 2019, 8:49 PM UTC

Scoundreller wrote: post #103

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.

That’s what an advanced directive is for. We just need to extend it beyond CPR/no CPR and heroic measures vs no heroic measures, etc. Kinda how like insurance companies negotiate prices for everything in advance of you showing up. Let users watch a series of videos and choose what kind of risk and benefit they tolerate/want and how much they’re willing to spend. It’s morbid, but we do such assessments constantly. Do…

Seriously?

The difference in your "every day" scenarios is recoverability. Your actual health put at risk means you die, unrecoverably.

Then there is always people not being able to spend. So they just die?

A poll on that policy would be instructive.

Re: People Lose Their Employer-Sponsored Insurance Constantly

#169

Post by alexmingoia » Wed, Apr 17, 2019, 8:49 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…

Ask your employer to pay your benefits amount in salary. That way you don’t need to change insurance when changing jobs.

Re: People Lose Their Employer-Sponsored Insurance Constantly

#170

Post by jfk13 » Wed, Apr 17, 2019, 8:51 PM UTC

nybble41 wrote: post #162

helen___keller wrote: post #107

Earlier quoted context omitted.

>One of the fallacies in play is buying insurance is put in one category. Whereas paying taxes for insurance is another. The first is 'good' because it's 'free market' and the second is 'bad' because it's the government taking your money's. Well, I'm in favor of socialized healthcare and generally receptive to increased taxation, so that's definitely not the implication I was going for. But it is true that there does…

> A more sound statement would be "I as a consumer am willing to pay dollars equal to twice my current premiums to get healthcare coverage while avoiding hassles while receiving routine healthcare" Ah, but are you willing to force everyone else pay twice as much so that you can get the health care you want? That's the real question. You said you were in favor of socialized healthcare, so I would guess the answer to t…

> are you willing to force everyone else pay twice as much

Comparisons to other (first-world) countries with socialized healthcare systems suggest that it shouldn't be necessary for everyone to pay twice as much. If everyone paid exactly the same amount as they currently do (in tax + insurance premiums) there should be plenty to fund a first-world-standard national health system.

> you're free to buy as much healthcare as you can afford

It's difficult to know what you can afford when you can't find out even an approximate price until it's over and the bill arrives.