Employees Start to Feel the Squeeze of High-Deductible Health Plans • Hacker News Board

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

#181

Post by sDlEzAtyoNAz » Fri, May 03, 2019, 7:32 PM UTC

JMTQp8lwXL wrote: post #87

mrosett wrote: post #2

You can argue that the ACA improved the healthcare system overall. But it's been tough for people who were already covered by employer insurance. I think people fail to appreciate that prior to the ACA, when the healthcare system worked, it actually worked really well. I got very sick at the age of 20 while I was still on my parents very modest insurance (pre-ACA). Within 48 hours I had an appointment at the best onc…

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…

>Pre ACA, pre-existing conditions could disqualify you from insurance.

It's not insurance if you already know you're going to make a claim.

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

#182

Post by sjb554 » Fri, May 03, 2019, 7:33 PM UTC

The ACA hasn't been what it was supposed to be since 2015. Republicans in Congress gutted the market when they took away risk corridor payments. Small health plans priced with the payments in place, then when they didn't come through, everyone in a loss position went under. The big plans could weather the storm, market consolidates, prices rise.

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

#183

Post by CarriersSuck » Fri, May 03, 2019, 7:33 PM UTC

WrtCdEvrydy wrote: post #117

LarryDarrell wrote: post #60

If you were designing a society starting from scratch today and said, "I think we should make having health insurance largely dependent on having an employer.", you would be laughed out of the room. I think we are running along some tracks that were laid long ago, and rather than all jumping off, some people in comfy Pullman cars are content with letting the train run off a cliff.

Individualism in America is the main cause... if you just got taxed and didn't have to worry about healthcare, people wouldn't care, but they all think that it could never happen to them.

Americans think the poor are slackers and they don't deserve anything. Even poor Americans think the "other" poor are slackers and don't deserve anything. Nothing will change until you change this mindset.

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

#184

Post by datavirtue » Fri, May 03, 2019, 7:34 PM UTC

Just do what I do. Don't pay the medical bills.

The banks got tired of medical bills posing a barrier to lending so they got with the credit reporting agencies and had them factor out the medical bills when calculating credit scores. I have tons of medical bills in collections and the best credit scores I have have ever had.

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

#185

Post by tfandango » Fri, May 03, 2019, 7:35 PM UTC

I have not seen mental health mentioned here yet as a factor in rising healthcare costs. My HSA/HD Plan has almost ZERO mental health doctors in network. Providers have been fleeing in droves (especially from UHC) because the insurance companies continue to lower payouts.

I went from spending a co-pay for mental health care for 3 of my kids to paying out of pocket until I reach my out-of-network deductible, which I never do because it's 10K. I spend thousands of dollars per year on this and there is not much I can do about it.

In some cases I've reduced frequencies of visits but the value of these types of doctors cannot be overstated in some cases. I credit my son's psychologist for his ability to function in society today. But she told me she can't take UHC because after costs she was making 10/hour.

Lack of in-network mental health coverage is a huge travesty.

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

#186

Post by justinmchase » Fri, May 03, 2019, 7:38 PM UTC

LarryDarrell wrote: post #60

If you were designing a society starting from scratch today and said, "I think we should make having health insurance largely dependent on having an employer.", you would be laughed out of the room. I think we are running along some tracks that were laid long ago, and rather than all jumping off, some people in comfy Pullman cars are content with letting the train run off a cliff.

If you're designing a society from scratch and you end up with employers, insurance or money at all, then you probably are doing it wrong, lol

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

#187

Post by mrosett » Fri, May 03, 2019, 7:39 PM UTC

sanderjd wrote: post #171

mieseratte wrote: post #161

Earlier quoted context omitted.

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.

I used to dabble in enjoying quips like this. They're simple and fun and sound insightful and knowing. But when I look around me I see no truth to them. We have two parties with very distinct philosophies making very different arguments for how the future of our culture and economy should function. "Capital" influences both of them, in different, sometimes overlapping, ways. But they have many differences across many…

The "above it all" smugness of quips like that is tiresome.

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

#188

Post by sDlEzAtyoNAz » Fri, May 03, 2019, 7:39 PM UTC

WrtCdEvrydy wrote: post #108

JMTQp8lwXL wrote: post #87

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…

My favorite one was pregnancy being a pre-existing condition so if your husband got fired (noone would ever fire a pregnant woman for no reason), you couldn't get insurance when you needed it the most.

Why would you expect people to want to open their own wallet to pay for your pregnancy-related medical expenses in exchange for premiums that are much smaller than the expenses you already know you're going to incur?

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

#189

Post by SilasX » Fri, May 03, 2019, 7:40 PM UTC

tptacek wrote: post #38

mrosett wrote: post #2

You can argue that the ACA improved the healthcare system overall. But it's been tough for people who were already covered by employer insurance. I think people fail to appreciate that prior to the ACA, when the healthcare system worked, it actually worked really well. I got very sick at the age of 20 while I was still on my parents very modest insurance (pre-ACA). Within 48 hours I had an appointment at the best onc…

I'm not seeing the connection to the ACA in your argument. If your argument is that the ACA raised the price of health insurance, that's incorrect: health insurance premiums had been skyrocketing prior to the ACA (that crisis was what generated the political capital to pass the bill), and the ACA in fact reduced the rate of growth in health care costs.

When all else fails, go up one derivative.

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

#190

Post by tptacek » Fri, May 03, 2019, 7:41 PM UTC

Gibbon1 wrote: post #179

refurb wrote: post #125

Earlier quoted context omitted.

The increase in costs were most certainly driven in part by the ACA changes. No longer allowed to deny based on pre-existing conditions? Insurers need higher rates to cover those costs. Require a bunch of things be added to mandatory preventive visits? Those have to be paid for as well. That said, I agree the costs would have continued to go up, but to say there is no evidence that the ACA contributed to it is just i…

My companies insurance premiums were going up 10-15% a year for years before the ACA.

Ours were going up sharply before too, at Matasano (2005-) and before we started Matasano, our health insurance at my previous employer also got slashed (2001-).