Hacker News Board Hacker News, browsed like a classic message board
Live data from Hacker News

Rising health insurance deductibles fuel middle-class anger and resentment

latimes.com

Post reply on HN
Print view View original

61–70 of 91 posts

Re: Rising health insurance deductibles fuel middle-class anger and resentment

#61

Post by 1PlayerOne »

mywittyname wrote: post #47

I doubt the people in this article are middle class. Only one income is mentioned, but $40k for a family of three is below the definition of middle class for most of the USA. Lots of people who think they are middle class are really poor. We need a Federal expansion of Medicaid to be available to everyone with pricing based on income. Once wealthier people start moving over to it, the private insurance racket will co…

Poor whites think government is the problem. Wealthy people have private insurance from their employers. We are stuck with the current system, there is no impetus for change. Just a lot of stupid coming out of the white house. Sad!

Re: Rising health insurance deductibles fuel middle-class anger and resentment

#62

Post by linuxftw »

MichaelApproved wrote: post #6

I have $6,500 deductable. It's insane how much work I need to do to get healthcare. The biggest issue is price transparency. To get a price, I need the tax-id of the medical office and the procedure code. Often times the procedure code is unknown because I might have any number of different procedures, depending on what the diagnosis is. So, I take my list of codes to the health insurance company with the tax ID and…

> I agreed to pay $450 cash and no one in the office understood how to handle it. I finally get to pay the $450 cash and I still got a bill from my insurance for $600 because they also billed my insurance.

That's not how that works. If a provider submits to insurance, the insurance won't pay it, and the provider will send the unpaid balance to you. The insurance company won't send you a bill.

> Then there's the insanity of cash price being cheaper than the insurance price.

Not insane. They have to bill higher and the insurance company will have negotiated a 'discount' typically. Also, it costs more money to have people on staff to file with insurance rather than just accept cash. You have to pay for people's time.

> I also have an HSA tax free bank account that lets me pay for this stupidity tax free, yay! Dozens of more hours were thrown away trying to understand how HSA accounts work, what I can charge to the HSA account and picking a bank to handle the HSA account.

Totally agree with you on this one. It's pretty confusing to say the least.

Re: Rising health insurance deductibles fuel middle-class anger and resentment

#63

Post by germinalphrase »

linuxftw wrote: post #60
germinalphrase wrote: post #35

Earlier quoted context omitted.

This pattern of exploding healthcare costs didn’t begin with the passage of the ACA (though the ACA is also obviously not the solution). The ACA did increase costs as insurance companies couldn’t suddenly refuse service because they are actually sick (preexisting conditions), but what is our healthcare system doing if it’s NOT treating sick people?

> ACA did increase costs as insurance companies couldn’t suddenly refuse service because they are actually sick Insurance companies are in business to make a profit. What the ACA did was ensure insurance companies have captive customers. A plan with a $6500 deductible vs pay a fine, nonsense. I should be free to choose between the plan or no fine. If it's all sick people in the plan pool because healthy people opted-…

I don’t disagree. That would be a good direction to move.

Re: Rising health insurance deductibles fuel middle-class anger and resentment

#64

Post by yardie »

snarf21 wrote: post #45
MichaelApproved wrote: post #6

I have $6,500 deductable. It's insane how much work I need to do to get healthcare. The biggest issue is price transparency. To get a price, I need the tax-id of the medical office and the procedure code. Often times the procedure code is unknown because I might have any number of different procedures, depending on what the diagnosis is. So, I take my list of codes to the health insurance company with the tax ID and…

Everything you said is true and part of the problem. I do want to clarify some things though that people may not know. There are several reasons the back-office literally can't tell you what the price will be. First, is that if you have insurance, they don't know. It is up to the payor (insurance company) what the final price will be. Even though there are negotiated rates, most procedures have up to 5 service levels…

I’m typing this from a phone I know you wrote a lot and I read it all. But the system you describe seems to be needlessly complex. I think when you try and justify why it works people will see that this isn’t working.

People aren’t stupid, they travel and see how healthcare works in other countries. Eventually we will end up with a public option. At this point it’s inevitable. We are reaching a tipping point where Biden and Pelosi can’t keep dressing the current situation up.

Re: Rising health insurance deductibles fuel middle-class anger and resentment

#65

Post by Ididntdothis »

pmorici wrote: post #11

All I know is that in 2013 I was able to get insurance in the private market to cover myself. It was ~$80 a month and the deductible was $2000. Now, there is only one company left in my state that will even offer plans in the private market. The closest plan to what I used to have has gone up ~6x in price and the deductible has tripled. The prices started going up immediately after the ACA came into being I think the…

People are acting as if things were paradise before ACA. I agree that it wasn’t a good law but before it passed there were plenty of people who couldn’t get insurance due to pre existing conditions or they would get thrown off their plans once they got actually sick. Blaming all problems on ACA is rewriting history of the worst kind.

Re: Rising health insurance deductibles fuel middle-class anger and resentment

#66

Post by tvjunky »

loganwedwards wrote: post #14
MichaelApproved wrote: post #6

I have $6,500 deductable. It's insane how much work I need to do to get healthcare. The biggest issue is price transparency. To get a price, I need the tax-id of the medical office and the procedure code. Often times the procedure code is unknown because I might have any number of different procedures, depending on what the diagnosis is. So, I take my list of codes to the health insurance company with the tax ID and…

I can't agree more. I also went the self employed route just after ACA went into effect and the level of stress this entire process causes every year is mind boggling. To add insult to injury, my premiums are increasing at astonishing rates - orders of magnitude more than a typical standard of living salary increase.

I agree with everything here, except the implication that this is only related to the self employed or ACA. Health Insurance companies have been pushing these high deducible + HSA plans for 15 years. They also raised the cost of the older less complicated PPO types plans. This has pushed even the biggest companies to "encourage" employees to "take control of their health care". Oh and each year, the definition of "high" keeps getting bumped. 10 years ago deductibles were $1500.

Re: Rising health insurance deductibles fuel middle-class anger and resentment

#67

Post by Ididntdothis »

stult wrote: post #59
MichaelApproved wrote: post #6

I have $6,500 deductable. It's insane how much work I need to do to get healthcare. The biggest issue is price transparency. To get a price, I need the tax-id of the medical office and the procedure code. Often times the procedure code is unknown because I might have any number of different procedures, depending on what the diagnosis is. So, I take my list of codes to the health insurance company with the tax ID and…

I used to be a lawyer (thankfully have since moved to a more rewarding career). My girlfriend at the time was erroneously billed $2000 for a procedure that the insurance company had pre-approved but later denied the claim for. She had them recorded pre-approving, and they failed to decline her claim within the statutorily specified period anyway so it was a prime facie invalid denial. I had to write several letters,…

Interesting to hear that even lawyers can’t manage this better. I can’t think of any other industry with such corrupt and flawed billing practices that doesn’t get forced by law to clean up its practices. My girlfriend has spent months fixing problems that were clearly caused by the insurance. On the way the insurance lied repeatedly but in the end she was still on the hook for 100s of thousand of dollars if she didn’t fix this.

Better to deal with a mafia loan shark than with hospitals or insurers. Mobsters probably have stronger ethics.

Re: Rising health insurance deductibles fuel middle-class anger and resentment

#68

Post by 1PlayerOne »

mises wrote: post #55
p_roz wrote: post #15

Health insurance should be decoupled from employment. Its tax advantaged treatment causes distortions in the costs and coverage offered. I’d rather see people get more of their compensation in cash rather than a health insurance benefit. It would especially help poorer workers who would have more flexibility and choice.

More employers ought to do this, for sure. If I'm a young, healthy, twenty-six-year-old man, I almost certainly don't need medical care. If I've got a good job, I can essentially self-insure. I might want to keep actual insurance , i.e. high-deductible protection for catastrophic events, but nothing more.

Think about the consequence for society as a whole if everyone did what you did.

Re: Rising health insurance deductibles fuel middle-class anger and resentment

#69

Post by 1PlayerOne »

MichaelApproved wrote: post #30
LAguy wrote: post #26

Earlier quoted context omitted.

Prior to ACA, your pricing reflected the fact that the insurance co. could refuse to cover people with pre-existing conditions (ie sick people). ACA forced them to cover everyone, which raised costs and, therefore, prices for everyone. It's true you're now subsidizing sick people, but you'll be happy to have the ACA if you're ever sick (or have a dick family member).

It's not just subsidizing sick people with pre-existing conditions, it's that they couldn't throw you off once you got sick. They would take your money while you were healthy but if you got sick, they'd throw you off. That's not insurance. That's fraud.

It is amazing that this simple logic escapes most people. Sad!

Re: Rising health insurance deductibles fuel middle-class anger and resentment

#70

Post by mAEStro-paNDa »

mises wrote: post #56
mAEStro-paNDa wrote: post #32

I used to work at a med school, and often I would be in the classroom. Once the Dean gave a presentation over the true cost of healthcare in the US. What was his final conclusion to the class? No one knows the true cost of healthcare. It's nonsensical. The situation with healthcare in the US has been beyond ridiculous for quite some time. Often the conversation centers around those without insurance, but being under-…

> single-payer system Why could I not buy my own insurance? Or why can't I self-insure? If I want to pay for the best, I ought to be able to buy it (again, if I will pay). There's a difference between actual single-payer (in which there is a single entity which pays , the government) and a government health-care plan. For which are you advocating?

>For which are you advocating?

A single-payer system, as I said.

>Why could I not buy my own insurance? Or why can't I self-insure?

These are leading questions. There exists healthcare systems that are a hybrid of single-payer/private insurance.

Post reply on HN