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People Lose Their Employer-Sponsored Insurance Constantly

peoplespolicyproject.org

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Re: People Lose Their Employer-Sponsored Insurance Constantly

#221

Post by ddingus »

Scoundreller wrote: post #172
ddingus wrote: post #168

Earlier quoted context omitted.

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.

The every day scenarios can result in permanent effects. Not everyone going through a stop sign is in a protective cage. Obviously the advanced directive solution is largely irrelevant in a 100% coverage/public system. The insurer then makes those decisions for you. But for as long as you have a system with uninsured, there’s value in having decisions made in advance as a “just in case”.

Real value is health care as human right. That we do not do it, and worse, can't even get a basic like water right is an embarrassment at the least, and rock solid cause for reform all day long.

In simpler times, a city able to provide clean water was a city of note. Worthy destination. This has been true for ages.

Flint fucked for how long now?

Our national priorities are insane! Bat shit wrong and health care, food, water, housing are all right at the top of reform agendas for damn good reason.

We can do better, and we need to.

The uninsured are uninsured because they are unable to spend. Put whatever the fuck anyone wants on that paper and it does not matter one lick.

Might as well write, "yeah, let me die, k?"

Frankly, there is zero value in the idea, and a lot of harm potential in the norms being changed for the worse: "but they consented..."

Anyone who wants to make a directive can do so today. Expecting people to do it because our system is fucked makes zero sense.

It is long past time we get our priorities in order so conversations like this are laughable, not morbid.

Re: People Lose Their Employer-Sponsored Insurance Constantly

#222

Post by conanbatt »

dragontamer wrote: post #15
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.

> Yes, people do lose their insurance constantly when they switch jobs...and then immediately sign onto their new plan. Lets say you payed for insurance, but were healthy for the 90s. So ~10-years of paying insurance. Around 2005, you are diagnosed with Diabetes, so your insurance pays for your care. Around 2007, the recession happens and you lose your job. You immediately find a new job, but you need to get new insu…

The problem with covering pre-existing conditions at all times is that you need to make insurance mandatory, due to the adver selection problem.

If insurance is optional, then only people that know they are sick or will get sick will dominate the insurance, making it more expensive, and pushing the healthy-low risk out.

Its a well known economics problem that has no silver bullet.

What is crazy to me is that insurance is involved in paying primary care doctors. That is a terrible application of health insurance, and have full faith on high deductible plans bringing sanity back into this.

Re: People Lose Their Employer-Sponsored Insurance Constantly

#223

Post by coldtea »

conanbatt wrote: post #215
coldtea wrote: post #94

Earlier quoted context omitted.

> 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. Imagine there's a single, private, insurance company, A. Wouldn't the natural interest of A be to maximize health costs (i.e. make paying for health coverage expensive, as thus their insurance more desirable and more expensive in return)? And if there were more small…

> Wouldn't the natural interest of A be to maximize health costs A, an insurance company, is the one fighting to get the cost down from B, the healthcare provider. > And if there were more smaller insurance companies competing with A, wouldn't it make sense for A to just eat them up to eliminate competition Monopolization is more dangerous from the healthcare provider side, though it happens both ways. Basically, ins…

>A, an insurance company, is the one fighting to get the cost down from B, the healthcare provider.

If the healthcare cost is zero or negligible the need for insurance is also zero. You just pay it out of pockets.

The insurance company might want to lower their bills (when they do pay for your treatment), but they have a counter-incentive to health costs being lowered too much, and a positive incentive to get health costs higher for the uninsured.

Re: People Lose Their Employer-Sponsored Insurance Constantly

#224

Post by conanbatt »

coldtea wrote: post #223
conanbatt wrote: post #215

Earlier quoted context omitted.

> Wouldn't the natural interest of A be to maximize health costs A, an insurance company, is the one fighting to get the cost down from B, the healthcare provider. > And if there were more smaller insurance companies competing with A, wouldn't it make sense for A to just eat them up to eliminate competition Monopolization is more dangerous from the healthcare provider side, though it happens both ways. Basically, ins…

> A, an insurance company, is the one fighting to get the cost down from B, the healthcare provider. If the healthcare cost is zero or negligible the need for insurance is also zero. You just pay it out of pockets. The insurance company might want to lower their bills (when they do pay for your treatment), but they have a counter-incentive to health costs being lowered too much, and a positive incentive to get health…

> If the healthcare cost is zero or negligible the need for insurance is also zero. You just pay it out of pockets.

Tautologic, of course, the service insurance gives is precisely the individually unforeseeable cost of disease.

> The insurance company might want to lower their bills (when they do pay for your treatment), but they have a counter-incentive to health costs being lowered too much, and a positive incentive to get health costs higher for the uninsured.

The great enemy of insurance companies is direct-to-provider pay (and insurance one of the historically great political enemies of doctors as well). It's been unfortunately regulated from its inception, but its an intuitive proposition to say that insurance companies win by how efficiently they apply the actuarial model, and how they control the risks and the payouts. Insurance companies that pay more to providers and restrict less coverage of their patients will soon be out of business.

Re: People Lose Their Employer-Sponsored Insurance Constantly

#225

Post by helen___keller »

conanbatt wrote: post #212
helen___keller wrote: post #205

Earlier quoted context omitted.

I'm not sure I follow your logic.

You can choose to have less insurance hassle by choosing a more expensive insurance plan where you don't haggle for the deductible.

Sorry what do you mean haggle? This is just one of the 3 plans offered by my employer where the deductible is much bigger and the premium is lower. I did need to open a savings account but I figured that would make things easier to pay, idk haven't used it. Otherwise my behavior as a consumer has been identical. maybe I'm missing something

Re: People Lose Their Employer-Sponsored Insurance Constantly

#226

Post by jkingsbery »

dredmorbius wrote: post #122
jkingsbery wrote: post #98

Earlier quoted context omitted.

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.

While it's true the reason things start and persist are different, many would disagree about the level of central planning in the US, with healthcare being an example odd where there is a good deal of government control (everything from pricing of procedures, drug approval, and licensing to name a few). Whether that's a good thing is another question, but I think it's oversimplifying to conclude that the problem is all due to corporate feudal overlords and not at all due to government policy. Further, there is a lesson to be learned concerning unanticipated co sequences in the origin of the current system that we're in danger of repeating by having further government control of healthcare.

Re: People Lose Their Employer-Sponsored Insurance Constantly

#227

Post by rtkwe »

conanbatt wrote: post #213
u801e wrote: 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.

Only that insurance takes 3 weeks to process the claim. Delaying care 3 weeks for that guarantee would have caustic medical implications.

imgabe just said in network not that the claim gets accepted. There's been a couple cases where not everyone administering as part of the procedure was in network so there's a surprise bill for one part [0]. You can do all the right homework to make sure the principal people involved are in network and still get screwed!

[0] https://www.cbsnews.com/news/out-of-network-anesthesiologist...

Re: People Lose Their Employer-Sponsored Insurance Constantly

#228

Post by rtkwe »

conanbatt wrote: post #199
travisoneill1 wrote: post #68

Earlier quoted context omitted.

> 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 ad…

Emergency care being expensive is not a problem of insurance. Public hospitals are also expensive. Its related to other things.

It's not the expense that's the problem the expense is a symptom and the problem is the attempt to treat healthcare like a market when consumers a) have very little ability to discover the price, b) have little option in substitution (if my appendix is ruptured my substitution to getting surgery is dying!) and c) many purchases are made under emergency situation with no time to price shop (or often the ability, no one can comparison shop unconscious in the back of an ambulance).

Re: People Lose Their Employer-Sponsored Insurance Constantly

#229

Post by Can_Not »

conanbatt wrote: post #214
fzeroracer wrote: post #66

Earlier quoted context omitted.

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…

> unfortunate reality of the private healthcare system maximizing for profit > Consumers rarely have proper choice in shopping around If you have a M4A, you have less choices not more. > That's why I think full free market healthcare simply won't work The last thing I would call healthcare in the us is free market.

I need healthcare, not an infinite number of unaffordable "options".

Re: People Lose Their Employer-Sponsored Insurance Constantly

#230

Post by sjg007 »

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…

In the future the way to avoid this is for the hospital/doctor to submit a prior auth request. Then you have it in writing.
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