Live data from Hacker News

Employees Start to Feel the Squeeze of High-Deductible Health Plans

npr.org

161–170 of 387 posts

Re: Employees Start to Feel the Squeeze of High-Deductible Health Plans

#161

Earlier quoted context omitted.

It is corporate welfare, I remember lots of libertarian arguments to that very point. But to solve health care in the US you would eventually have to start questioning the for-profit underpinnings of the whole enterprise. That was far too much to expect from the generally pro-market Democrats in office at the time. Even after Bernie Sanders, the "Very Serious Democrats" talk more of protecting the Health Insurance In…

As I once heard it put: the US doesn't have a left and a right party, it has two parties to the left and right of capital.

I heard it once said that America is a one-party system, but in typical American excess we have two.

Both in service of capital.

Re: Employees Start to Feel the Squeeze of High-Deductible Health Plans

#162

Earlier quoted context omitted.

If you're saying the ACA didn't completely fix the US healthcare system, I strongly agree. If you're saying the ACA harmed the health care system, strong disagree. Again: the cost increases you're talking about were a fact of life before the ACA. There is no evidence that your costs would have leveled off without the ACA, and substantial evidence that the opposite would have happened.

> If you're saying the ACA harmed the health care system, strong disagree. The system? No. Corporate welfare is great for "the system." But the consumers? Absolutely harmed! > Again: the cost increases you're talking about were a fact of life before the ACA. I've been working for over a decade now. 100% increases, year-over-year have never been even close to a thing with employer plans I've held. Not even close. Typi…

Again, consumers have absolutely been harmed by the skyrocketing cost of health care. But every bit of evidence shows that the ACA slowed that growth.

The only connection you’re making here is that your own costs went up after the ACA. It’s a post hoc fallacy.

Re: Employees Start to Feel the Squeeze of High-Deductible Health Plans

#163
post #129

Earlier quoted context omitted.

Alright, if I understand you correctly, you're essentially using the HSA kind of like a Roth IRA, except that 1. Money contributed is tax free 2. There is a $3.5k contribution limit 3. Money can be withdraw tax free prior to 65, at any time, as long as there's a receipt for the qualifying medical expense that occurs after the HSA was established Then, from what I can tell, the drawback to this approach is that there…

Correct. There's a higher contribution limit ($7k in 2019) if you have family HDHP coverage. Also, after retirement, money can be withdrawn without paying the 10% penalty and just paying the regular income tax, in case you don't have receipts for medical payments from the past. I wonder how the IRS would prevent a tax evader using the same receipts for payments for medical expenses for different withdrawals in differ…

I would assume if you got audited, you would have to justify all withdraws. I doubt they would be impressed with multiple copies of the same receipt.

Re: Employees Start to Feel the Squeeze of High-Deductible Health Plans

#164
post #67

Earlier quoted context omitted.

>> just needs to be actually thought through, It's impossible because you both political parties want exclusively mutual results You can't have cheap insurance without making it mandatory since only the sick will get it You can't have easily accessible insurance without forcing healthcare companies to comply with new regulations forcing them to increase costs You can't have good insurance if you aren't willing to pay…

> You cant lower costs in the US without having a more aggressive regulatory body which 50% of political bodies strongly oppose alongside lobbying efforts Here is the fundamental problem from my point of view. Compare human medical costs to veterinary costs. Yes, people expect a slightly higher standard for themselves than they do their animals, but you can get a major knee surgery for your dog for a small fraction o…

Many many years ago, auto mechanics would gouge customers after fixing their cars. This resulted in laws in all US states requiring written estimates in advance.

We should expect hospitals to meet the minimum ethical standards of auto mechanics.

Re: Employees Start to Feel the Squeeze of High-Deductible Health Plans

#165

Earlier quoted context omitted.

Pre ACA, pre-existing conditions could disqualify you from insurance. People with pre-existing conditions are the people that need health care coverage the most. We can't under-weigh the moral obligation we have to this previously marginalized group, when considering service may be slightly worse for people who have employer coverage. How I see it: if you were in the pre-ACA pre-existing condition pool, your perspect…

AFAIK, preexisting conditions weren't a disqualifier for any employer-provided health insurance (which is why group policies are so expensive).

That's a slightly maddening thing about many these comments. If you were getting your healthcare through an employer, you had a lot more security both on the pre-existing conditions end and on the keeping coverage end.

Re: Employees Start to Feel the Squeeze of High-Deductible Health Plans

#166

Earlier quoted context omitted.

I know someone who pre-ACA had employer insurance who was dropped by that insurance after they got skin cancer. The official reason was lying during the application process (10+ years earlier). They forgot to list childhood Asthma on their application form ten years earlier.

Would the ACA prevent that kind of scam? I genuinely don't know.

You aren't required to complete an application form when you sign up anymore, so they don't even ask you medical questions.

Re: Employees Start to Feel the Squeeze of High-Deductible Health Plans

#167
post #71

Earlier quoted context omitted.

The cost to employers of very good plans massively increased after ACA went into effect. When this changeover happened, I was running a company where we paid 100% for one of the best healthcare plans available in the state for both the employees and their families -- people really appreciated this benefit. This was the polar opposite of a "crappy plan", and it wasn't inexpensive to begin with. After the ACA, this pla…

What was the lifetime max on this plan? It probably would have left people out in the cold when they most needed it. I don't think it's wrong to expect insurance to cover people when they most need it, which was largely not true with million dollar lifetime caps. Even with the ACA, employers have the best of both worlds. Expensive older people are covered by the government, and anyone who gets to expensive can be shu…

> What was the lifetime max on this plan? It probably would have left people out in the cold when they most needed it. I don't think it's wrong to expect insurance to cover people when they most need it, which was largely not true with million dollar lifetime caps.

Note that lifetime caps are a lot more generous than what they have in say the UK, where you don’t get treatment if it costs more than $50-75k per year of extended life. (So to blow through a million dollars, the treatment would have to be expected to produce 15-20 years of extra healthy life. Most treatments offered when people “need it the most” can’t make that sort of promise).

Re: Employees Start to Feel the Squeeze of High-Deductible Health Plans

#168
post #162

Earlier quoted context omitted.

> If you're saying the ACA harmed the health care system, strong disagree. The system? No. Corporate welfare is great for "the system." But the consumers? Absolutely harmed! > Again: the cost increases you're talking about were a fact of life before the ACA. I've been working for over a decade now. 100% increases, year-over-year have never been even close to a thing with employer plans I've held. Not even close. Typi…

Again, consumers have absolutely been harmed by the skyrocketing cost of health care. But every bit of evidence shows that the ACA slowed that growth. The only connection you’re making here is that your own costs went up after the ACA. It’s a post hoc fallacy.

> The only connection you’re making here is that your own costs went up after the ACA.

The connection is that the ACA rates, and rate-increases are out-of-touch with the employer-offered system, even when those firms are tiny and not nearing some kind of "scale" cost-savings.

I have been hollering about this issue for years, and I've yet to have someone say "Ya know, I actually experienced something radically different." So where is all this evidence you claim but can't be bothered to provide?

Re: Employees Start to Feel the Squeeze of High-Deductible Health Plans

#170

Earlier quoted context omitted.

Would the ACA prevent that kind of scam? I genuinely don't know.

The incentive is gone, since preexisting conditions are no longer a disqualification.

The incentive is still very much there. You just can't use a preexisting condition as your excuse anymore.
Post reply on HN