Employer health plans are getting pricier and skimpier • Hacker News Board

Re: Employer health plans are getting pricier and skimpier

#71

Post by throwaway_law » Wed, Sep 25, 2019, 7:24 PM UTC

mywittyname wrote: post #51

throwaway_law wrote: post #14

Earlier quoted context omitted.

I hear this statement all the time...but what does it mean? If employers didn't provide health insurance to employees wouldn't we just wind up with 40% of the insured uninsured? Its not like Corporate America is going to make up the difference and start paying cash to compensate for the lost benefit, at least thats what happened as pensions got stripped away from the workplace. Even if the employer's did make up the…

Having a critical mass of uninsured people is the foundation we need to resolve the healthcare crisis in America. Those uninsured people still need healthcare. If enough people start calling up small clinics asking for pricing, a cottage industry of small health providers will pop up to service these people with transparent pricing. The insurance industry has perverted our healthcare system. The major reason doctors…

>Having a critical mass of uninsured people is the foundation we need to resolve the healthcare crisis in America.

Thats actually exactly what I think the thought is for most people who advocate this...remove employer provided insurance and there will be so many uninsured that someone will have to do something. I think the hope is that something would be "Universal single payer healthcare coverage."

That may be right, but we already had 50 million uninsured american's and Obamacare barely passed and was pretty insurance friendly. I just don't see the political will to get it done, then we are just stuck with 40% of the currently insured uninsured.

Re: Employer health plans are getting pricier and skimpier

#72

Post by ceejayoz » Wed, Sep 25, 2019, 7:25 PM UTC

rukittenme wrote: post #58

taurath wrote: post #32

Earlier quoted context omitted.

You can pay execs $100mm a year and have that not be profit. This is why they lobby so hard.

Yes because shareholders love paying executives tons of money so they don't have to collect it themselves... /s

A lot of insurers are non-profits without shareholders, dividends, etc.

Re: Employer health plans are getting pricier and skimpier

#73

Post by [deleted] » Wed, Sep 25, 2019, 7:25 PM UTC

lotsofpulp wrote: post #62

war1025 wrote: post #57

Earlier quoted context omitted.

I believe the pre-tax post-tax thing is actually wrong. The difference is that you pay for the plan with post-tax money until tax season rolls around, when if I remember correctly (from having an individual plan for several years) you get to deduct those costs. So really, it's just the typical American thing of people being terrible at understanding tax codes and adjusting their withholdings correctly.

Source? IRS specifically states: https://www.irs.gov/taxtopics/tc502 >You may deduct only the amount of your total medical expenses that exceed 7.5% of your adjusted gross income. You figure the amount you're allowed to deduct on Form 1040, Schedule A. It’s another subsidy for big business in the US. If you work for a small employer that doesn’t offer health insurance, you’re paying with after tax money.

[deleted]

Re: Employer health plans are getting pricier and skimpier

#74

Post by tasty_freeze » Wed, Sep 25, 2019, 7:25 PM UTC

jbeckham wrote: post #17

vkou wrote: post #13

Of course they are, healthcare costs are growing in an unbounded manner, way ahead of inflation.

And the largest portion of that is due to specialty drugs.

I would like some evidence of this. I've read and heard many people confidently pin the high cost of health care on: too much administration, greedy doctors, undocumented immigrants, over use of tests, over prescription of drugs, too much paperwork causing inefficiency, and probably others I'm forgetting. They can't all be the primary cause.

[ and before someone replies, it is a mix of those, of course ]

Re: Employer health plans are getting pricier and skimpier

#75

Post by ceejayoz » Wed, Sep 25, 2019, 7:28 PM UTC

lotsofpulp wrote: post #69

Ididntdothis wrote: post #27

Earlier quoted context omitted.

It’s not only profit. They also cause a lot of administrative overhead. For example if doctors had to deal only with one insurer or at least one coding system they wouldn’t need four billing assistants as I have seen. In essence insurance companies do a lot of unnecessary stuff. Their profit is only a small part of that cost.

Much of the administrative stuff insurers do to prevent healthcare providers from doing unnecessary stuff. In a taxpayer funded system, there would still have to be an entity to double check healthcare providers’ billing.

Such an entity already exists. They're substantially more efficient at it.

https://www.healthaffairs.org/do/10.1377/hblog20110920.01339...

> According to the Kaiser Family Foundation, administrative costs in Medicare are only about 2 percent of operating expenditures. Defenders of the insurance industry estimate administrative costs as 17 percent of revenue.

Re: Employer health plans are getting pricier and skimpier

#76

Post by mieseratte » Wed, Sep 25, 2019, 7:30 PM UTC

tempsy wrote: post #64

mieseratte wrote: post #59

Earlier quoted context omitted.

> I'm not sure many people that work at large companies realize that their employer knows every diagnosis, procedure, and prescription you've ever picked up, and actively trying to incentivize you to use as little healthcare as possible. I work for such a company, and it's great. I pay about $30 per month for a plan with a tiny deductible ($2,500), and they offer great wellness perks like weekly classes (yoga, kick-b…

I don’t understand your comment. If the company is large it is likely self-funded, so it is taking on the risk, whether they are doing it in house or hiring a benefits consultant to do it for them. I didn’t say anything about the quality of a self-funded plan, simply just pointing out that a self-funded plans means your relationship with your company is not merely just a worker but you morph into this insurance risk…

> I don’t understand your comment. If the company is large it is likely self-funded, so it is taking on the risk, whether they are doing it in house or hiring a benefits consultant to do it for them.

Because they partner with a larger provider for the doctor / hospital / pharmacy networks and specialist support. This is a very common pattern insofar as I'm aware.

Has your experience differed?

Re: Employer health plans are getting pricier and skimpier

#77

Post by alistairSH » Wed, Sep 25, 2019, 7:31 PM UTC

taurath wrote: post #30

KoftaBob wrote: post #12

This is why I feel the "most Americans like their health insurance" cliche is complete garbage.

Nobody does. The real translation is old people don’t want to change doctors.

And to top it off, old people (actual old people) are already using socialized medicine. They aren't using private insurance (or, if they are, it's used to cover coinsurance/deductibles).

Re: Employer health plans are getting pricier and skimpier

#78

Post by js2 » Wed, Sep 25, 2019, 7:32 PM UTC

throwaway_law wrote: post #26

tempsy wrote: post #20

Earlier quoted context omitted.

We would do what every other country does and offer healthcare as a basic right? The whole point of "Medicare for All" is to divorce employers from their employee's healthcare. The gov't negotiates on behalf of everyone.

Its not exactly a chicken and egg problem then, and the solution doesn't start with divorcing insurance from employment. Put that "Medicare for All" into play first.

MFA is a single-payer option but there are plenty of multi-payer healthcare systems in the world which achieve universal coverage and contain costs. Germany would be the prime example, but see also Switzerland and France.

Re: Employer health plans are getting pricier and skimpier

#79

Post by mywittyname » Wed, Sep 25, 2019, 7:33 PM UTC

throwaway_law wrote: post #71

mywittyname wrote: post #51

Earlier quoted context omitted.

Having a critical mass of uninsured people is the foundation we need to resolve the healthcare crisis in America. Those uninsured people still need healthcare. If enough people start calling up small clinics asking for pricing, a cottage industry of small health providers will pop up to service these people with transparent pricing. The insurance industry has perverted our healthcare system. The major reason doctors…

>Having a critical mass of uninsured people is the foundation we need to resolve the healthcare crisis in America. Thats actually exactly what I think the thought is for most people who advocate this...remove employer provided insurance and there will be so many uninsured that someone will have to do something. I think the hope is that something would be "Universal single payer healthcare coverage." That may be right…

Specialists that operate outside of most insurance networks, such as plastic surgeons do pretty well. As do specialties like dentists, orthodontics, and optometrists where insurance coverage is limited and a significant number of people pay out-of-pocket.

And I'd argue that the US is moving towards a similar system for healthcare. Lots of small clinics are popping up around the nation to provide limited care to individuals for price-conscious individuals.

What we need is something to cut the tether that insurance companies have. Insurance is nearly as important for determine the rates you pay for care as it is for covering costs.

Re: Employer health plans are getting pricier and skimpier

#80

Post by kaibee » Wed, Sep 25, 2019, 7:33 PM UTC

Pfhreak wrote: post #39

badrequest wrote: post #5

The sooner we can completely divorce healthcare from employment, the better.

Do you think that companies would give you a raise equivalent to what they were paying on your behalf for healthcare? I suspect not. I mean, it's one thing if we moved to a single payer system, which would be great, but just moving out of the employer's hands and into the general public seems like a disaster. (Also, I am not a fan of the employer healthcare model.)

> Do you think that companies would give you a raise equivalent to what they were paying on your behalf for healthcare? I suspect not.

Its anecdotal, but my company and the company my mom works for, both already do this if you choose to opt out of the employer plan. Total compensation is not a foreign concept to most businesses.