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

#371

Post by pg_bot » Sun, May 05, 2019, 1:21 AM UTC

tptacek wrote: post #368

pg_bot wrote: post #366

Earlier quoted context omitted.

First: I know you're not stupid so I have no idea what you aren't understanding when it comes to veteran care costs increase during wartime. Of course they have a separate payer and provider system. That system is included in the growth rate statistics. It should be fairly obvious that people being regularly shot at have higher healthcare costs. Bankruptcy Law: In 2005 there were 2,000,000 bankruptcy filings, in 2006…

No, I do not believe veteran health care is included in the statistics you are citing, and I am similarly dubious of your explanations for how each of those other 4 events impacted health care costs, because everything I've read suggests that the impacts are way more complicated than they look (for instance, much of the health cost impact from the "Great Recession" wasn't felt until years after).

Here's the dataset that I'm referencing.[0] From the summary documents, "DOD spending in the NHEA excludes spending that occurs outside of the United States." I'm not certain whether this does or does not include forward operating bases. (Post offices count those as being in the United States so I believe they are included; but I could be wrong) Nevertheless it does include domestic spending on veterans.

Also, many veterans get care outside the VA. From my own experience working with these people, they cite long waiting times or broken relationships with the government for not wanting to take part in that system.

I'm not trying to downplay the complexity of the healthcare market, it's really complex. However, it I were to pick the things the government had control over and impacted the marketplace the most over the last 15 years, I still would pick the same things I did. I could fill several books with other changes that impacted the cost of American healthcare. (switching to e-prescriptions, subsidies for electronic medical records, medicare part D, certificate of need laws, FSA changes, HSA changes, consolidation of pharmacy benefit managers, health system consolidation, the opioid epidemic, the rise of the physicians's assistant, the expanding role of nurse practitioners, etc.)

I'd rather spend my time continuing fixing the things I know I can make better.

[0]: https://www.cms.gov/Research-Statistics-Data-and-Systems/Sta...

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

#372

Post by tptacek » Sun, May 05, 2019, 1:42 AM UTC

pg_bot wrote: post #371

tptacek wrote: post #368

Earlier quoted context omitted.

No, I do not believe veteran health care is included in the statistics you are citing, and I am similarly dubious of your explanations for how each of those other 4 events impacted health care costs, because everything I've read suggests that the impacts are way more complicated than they look (for instance, much of the health cost impact from the "Great Recession" wasn't felt until years after).

Here's the dataset that I'm referencing.[0] From the summary documents, "DOD spending in the NHEA excludes spending that occurs outside of the United States." I'm not certain whether this does or does not include forward operating bases. (Post offices count those as being in the United States so I believe they are included; but I could be wrong) Nevertheless it does include domestic spending on veterans. Also, many v…

Can you give me a deeper link to the specific data from which you drew the table you posted above? There's a lot of stuff hanging off the link you just posted.

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

#373

Post by pg_bot » Sun, May 05, 2019, 1:53 AM UTC

pg_bot wrote: post #371

tptacek wrote: post #368

Earlier quoted context omitted.

No, I do not believe veteran health care is included in the statistics you are citing, and I am similarly dubious of your explanations for how each of those other 4 events impacted health care costs, because everything I've read suggests that the impacts are way more complicated than they look (for instance, much of the health cost impact from the "Great Recession" wasn't felt until years after).

Here's the dataset that I'm referencing.[0] From the summary documents, "DOD spending in the NHEA excludes spending that occurs outside of the United States." I'm not certain whether this does or does not include forward operating bases. (Post offices count those as being in the United States so I believe they are included; but I could be wrong) Nevertheless it does include domestic spending on veterans. Also, many v…

Here are some more links, since I can't nest further.

https://www.cms.gov/Research-Statistics-Data-and-Systems/Sta...

https://www.chcf.org/publication/us-health-care-spending-who...

The main one you might be interested in is this one though, https://www.cms.gov/Research-Statistics-Data-and-Systems/Sta...

I've excerpted this from page 34 for your convenience.

"Other public programs include health insurance coverage provided by the Department of Veterans Affairs (VA) and the Department of Defense (DOD). Enrollment for other public programs for 1987-2011 was estimated using the levels from the enhanced CPS (SHADAC) and for 2012, 2013, and 2014 estimates were extrapolated using the CPS. "

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

#374

Post by CydeWeys » Sun, May 05, 2019, 4:13 AM UTC

mikeash wrote: post #336

danans wrote: post #335

Earlier quoted context omitted.

Right, a limit on how much the insurance company will pay to cover your healthcare expenses

I don’t understand the distinction you’re making.

There was a somewhat common misconception that the limit was per person, not per policy.

Although, the distinction wasn't very meaningful because you could be denied for pre-existing conditions, so if you had hit a lifetime limit on one policy, good luck being able to get another one anywhere else.

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

#375

Post by tptacek » Sun, May 05, 2019, 4:27 AM UTC

pg_bot wrote: post #373

pg_bot wrote: post #371

Earlier quoted context omitted.

Here's the dataset that I'm referencing.[0] From the summary documents, "DOD spending in the NHEA excludes spending that occurs outside of the United States." I'm not certain whether this does or does not include forward operating bases. (Post offices count those as being in the United States so I believe they are included; but I could be wrong) Nevertheless it does include domestic spending on veterans. Also, many v…

Here are some more links, since I can't nest further. https://www.cms.gov/Research-Statistics-Data-and-Systems/Sta... https://www.cms.gov/Research-Statistics-Data-and-Systems/Sta... https://www.cms.gov/Research-Statistics-Data-and-Systems/Sta... https://www.chcf.org/publication/us-health-care-spending-who... The main one you might be interested in is this one though, https://www.cms.gov/Research-Statistics-Data-and-S…

None of these appear to contain the table you posted at the root of the thread, the table you now claim also includes the increased cost of veteran care due to the wars in Afghanistan and Iraq. Can you just tell me how you made that table, so I can look at the source and evaluate your claim that it incorporates increased costs in the VA along with private health care?

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

#376

Post by pg_bot » Sun, May 05, 2019, 4:54 AM UTC

tptacek wrote: post #375

pg_bot wrote: post #373

Earlier quoted context omitted.

Here are some more links, since I can't nest further. https://www.cms.gov/Research-Statistics-Data-and-Systems/Sta... https://www.cms.gov/Research-Statistics-Data-and-Systems/Sta... https://www.cms.gov/Research-Statistics-Data-and-Systems/Sta... https://www.chcf.org/publication/us-health-care-spending-who... The main one you might be interested in is this one though, https://www.cms.gov/Research-Statistics-Data-and-S…

None of these appear to contain the table you posted at the root of the thread, the table you now claim also includes the increased cost of veteran care due to the wars in Afghanistan and Iraq. Can you just tell me how you made that table, so I can look at the source and evaluate your claim that it incorporates increased costs in the VA along with private health care?

The raw data comes from the following sublink from the first link in that group "NHE Summary including share of GDP, CY 1960-2017 [ZIP, 27KB]"[0] I computed the table by hand. You can recompute it if you like.

[0]: https://www.cms.gov/Research-Statistics-Data-and-Systems/Sta...

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

#377

Post by tptacek » Sun, May 05, 2019, 3:13 PM UTC

pg_bot wrote: post #376

tptacek wrote: post #375

Earlier quoted context omitted.

None of these appear to contain the table you posted at the root of the thread, the table you now claim also includes the increased cost of veteran care due to the wars in Afghanistan and Iraq. Can you just tell me how you made that table, so I can look at the source and evaluate your claim that it incorporates increased costs in the VA along with private health care?

The raw data comes from the following sublink from the first link in that group "NHE Summary including share of GDP, CY 1960-2017 [ZIP, 27KB]"[0] I computed the table by hand. You can recompute it if you like. [0]: https://www.cms.gov/Research-Statistics-Data-and-Systems/Sta...

Oh, for God's sake. The Kaiser foundation just tracks the stat we're actually talking about directly. Here's the numbers for employees covered by group insurance provided by their employers:

    1999  2196 
    2000  2471 12.52%
    2001  2689 8.82%
    2002  3083 14.65%
    2003  3383 9.73%
    2004  3695 9.22%
    2005  4025 8.93%
    2006  4242 5.39%
    2007  4479 5.59%
    2008  4704 5.02%
    2009  4824 2.55%
    2010  5049 4.66%
    2011  5429 7.53%
    2012  5615 3.43%
    2013  5884 4.79%
    2014  6025 2.40%
    2015  6251 3.75%
    2016  6435 2.94%
    2017  6690 3.96%
    2018  6896 3.08%

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

#378

Post by [deleted] » Sun, May 05, 2019, 6:48 PM UTC

tptacek wrote: post #377

pg_bot wrote: post #376

Earlier quoted context omitted.

The raw data comes from the following sublink from the first link in that group "NHE Summary including share of GDP, CY 1960-2017 [ZIP, 27KB]"[0] I computed the table by hand. You can recompute it if you like. [0]: https://www.cms.gov/Research-Statistics-Data-and-Systems/Sta...

Oh, for God's sake. The Kaiser foundation just tracks the stat we're actually talking about directly. Here's the numbers for employees covered by group insurance provided by their employers: 1999 2196 2000 2471 12.52% 2001 2689 8.82% 2002 3083 14.65% 2003 3383 9.73% 2004 3695 9.22% 2005 4025 8.93% 2006 4242 5.39% 2007 4479 5.59% 2008 4704 5.02% 2009 4824 2.55% 2010 5049 4.66% 2011 5429 7.53% 2012 5615 3.43% 2013 5884…

[deleted]

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

#379

Post by pg_bot » Sun, May 05, 2019, 7:10 PM UTC

tptacek wrote: post #377

pg_bot wrote: post #376

Earlier quoted context omitted.

The raw data comes from the following sublink from the first link in that group "NHE Summary including share of GDP, CY 1960-2017 [ZIP, 27KB]"[0] I computed the table by hand. You can recompute it if you like. [0]: https://www.cms.gov/Research-Statistics-Data-and-Systems/Sta...

Oh, for God's sake. The Kaiser foundation just tracks the stat we're actually talking about directly. Here's the numbers for employees covered by group insurance provided by their employers: 1999 2196 2000 2471 12.52% 2001 2689 8.82% 2002 3083 14.65% 2003 3383 9.73% 2004 3695 9.22% 2005 4025 8.93% 2006 4242 5.39% 2007 4479 5.59% 2008 4704 5.02% 2009 4824 2.55% 2010 5049 4.66% 2011 5429 7.53% 2012 5615 3.43% 2013 5884…

Can you provide a reference for this data, I'm not 100% sure what I'm looking at. I deleted a previous comment on why I think the data I used is better for analysis but I want to confirm that this is what I think it is before I comment further.

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

#380

Post by tptacek » Sun, May 05, 2019, 7:46 PM UTC

pg_bot wrote: post #379

tptacek wrote: post #377

Earlier quoted context omitted.

Oh, for God's sake. The Kaiser foundation just tracks the stat we're actually talking about directly. Here's the numbers for employees covered by group insurance provided by their employers: 1999 2196 2000 2471 12.52% 2001 2689 8.82% 2002 3083 14.65% 2003 3383 9.73% 2004 3695 9.22% 2005 4025 8.93% 2006 4242 5.39% 2007 4479 5.59% 2008 4704 5.02% 2009 4824 2.55% 2010 5049 4.66% 2011 5429 7.53% 2012 5615 3.43% 2013 5884…

Can you provide a reference for this data, I'm not 100% sure what I'm looking at. I deleted a previous comment on why I think the data I used is better for analysis but I want to confirm that this is what I think it is before I comment further.

It's the chart data from:

https://www.kff.org/interactive/premiums-and-worker-contribu...

I'm sorry for getting snippy, I just couldn't untangle your numbers from your source even after you pointed to the raw XLS you got it from.

If we just stay focused on commercial health care, we don't have to litigate whether the Iraq War (materially) impacted health care costs prior to the ACA. And: this thread is about whether employer shifts to HDHPs and (more broadly) the ACA has impacted those specific costs, not the total government cost of providing all health care services.