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

Re: Employer health plans are getting pricier and skimpier

#141

Post by Pfhreak » Wed, Sep 25, 2019, 8:25 PM UTC

kaibee wrote: post #80

Pfhreak wrote: post #39

Earlier quoted context omitted.

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.

Sure. But how many people know how much their employer is paying on their behalf, and could use that to effectively have the same earning power? I know I had no idea until the Affordable Care Act put it on my tax documents.

Re: Employer health plans are getting pricier and skimpier

#142

Post by celdon25 » Wed, Sep 25, 2019, 8:25 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…

> and the government should provide for those who require serious, expensive treatments (after a payment that is some percentage of their income).

I'm for it as long as it doesn't involve the government micromanaging how the health care providers perform their services. This is a problem with all health insurance, public or private, but the micromanagement is done on a more direct level with government-provided insurance, with doctor report cards and so on. They do this now for at least some Medicaid and Medicare implementations, and some of the provisions of Obamacare even accelerated this process.

Re: Employer health plans are getting pricier and skimpier

#143

Post by ceejayoz » Wed, Sep 25, 2019, 8:25 PM UTC

makomk wrote: post #103

ceejayoz wrote: post #40

Earlier quoted context omitted.

Plans jumped in 2017-2018 because insurers had to factor in the possibility of Obamacare repeal. Last year saw a drop (down 1.5% in the 39 states using Healthcare.gov), and 2020 looks small thus far as well. https://www.politico.com/story/2019/06/03/obamacare-rate-hik... I, quite frankly, trust my state more than my employer in a fight against my insurer. I obtain coverage via the NY exchange.

The price of insurance jumped massively every year from the start of Obamacare to 2018. The fact that this has apparently mostly stopped now is the unusual thing; 2017-18 was a pretty typical year despite Trump's meddling. The article you linked suggests that this is because insurers have finally increases the cost of insurance to be in line with how much it actually costs them.

> The price of insurance jumped massively every year from the start of Obamacare to 2018.

It was doing that for decades prior, too. Obamacare didn’t change it much in either direction.

Re: Employer health plans are getting pricier and skimpier

#144

Post by cafebabbe » Wed, Sep 25, 2019, 8:25 PM UTC

nickgrosvenor wrote: post #110

This is absolutely the biggest story in America, and most people aren't talking about it. An entire generation is draining their savings to keep up with premium costs. Not to mention the millions of people locked into careers they would otherwise get out of, if not for the health coverage. This situation is probably going to lead to unbelievable outcomes.

It's rather painful to watch from this side of the Atlantic.

I guess that I need to acknowledge this is really what most people want in America.

Re: Employer health plans are getting pricier and skimpier

#145

Post by arcticbull » Wed, Sep 25, 2019, 8:25 PM UTC

29_29 wrote: post #131

Is it possible for an American to move to Switzerland?

You can get permanent residency in Canada within 6 months via Express Entry, unless there's something you're particularly looking for in Switzerland you won't find in Vancouver ;) [1] You can then apply for citizenship after having lived there for 3 years out of the most recent 5.

[1] https://www.canada.ca/en/immigration-refugees-citizenship/se...

Re: Employer health plans are getting pricier and skimpier

#146

Post by Someone1234 » Wed, Sep 25, 2019, 8:26 PM UTC

nickgrosvenor wrote: post #110

This is absolutely the biggest story in America, and most people aren't talking about it. An entire generation is draining their savings to keep up with premium costs. Not to mention the millions of people locked into careers they would otherwise get out of, if not for the health coverage. This situation is probably going to lead to unbelievable outcomes.

I just want to tack on: People being forced to skip simple preventative medicine, potentially building up a ticking time bomb when those conditions become more expensive to treat.

Re: Employer health plans are getting pricier and skimpier

#147

Post by atemerev » Wed, Sep 25, 2019, 8:26 PM UTC

29_29 wrote: post #131

Is it possible for an American to move to Switzerland?

Yes, it is possible. Our health insurance is only slightly less expensive, though (and can only be paid with post-tax money). We hold the proud second place in healthcare costs.

You’ll also have some issues with opening a bank account here — Swiss banks are not particularly fond of US customers, because of reasons.

Re: Employer health plans are getting pricier and skimpier

#148

Post by eric_b » Wed, Sep 25, 2019, 8:26 PM UTC

The problem is that there is not a single reason that healthcare is so expensive. Even if you list the top 15 reasons, you still have to apply the "5 whys" to each of them to find root causes and possible solutions.

- Doctor's are paid too much... why? - Well they need to be paid a lot because medical school debt is 250k or more... why? - Medical schools/the AMA are artificially limiting the number of students and residents for their own ends (keeping wages and scarcity high) so they need to charge a lot... why? - I honestly don't know.

But the current political climate in the US is incapable of dealing with any kind of multifaceted problem.

One thing that will not make healthcare less expensive is "Medicare For All". It will just shift the bill to different people. Now, you can argue it's the morally correct course of action, or those people who will be forced to foot the bill (upper middle class taxpayers) are more capable of doing so, but you cannot credibly claim with a straight face that it will make anything cheaper. In fact, the opposite will occur.

(I don't want to hear one thing about negotiating power. That is a debunked line of reasoning. Medicare/Medicaid cover more people than many single payer systems in other countries, and their costs are still outrageous)

Re: Employer health plans are getting pricier and skimpier

#149

Post by idoh » Wed, Sep 25, 2019, 8:26 PM UTC

tempguy9999 wrote: post #134

afarrell wrote: post #126

If any of y'all have questions about the process for getting a Tier-2 visa in the UK, I know waaaay more about that than I wish I did. (I'm an American living and paying income taxes in the UK as a software engineer. It is an option.)

Genuine question, what is the link between a tier-2 visa in the UK, and the subject of the story. Thanks.

I was curious too and Googled it. Something about how healthcare in the UK is free, and if you are on that visa then you can get that health care.

Re: Employer health plans are getting pricier and skimpier

#150

Post by lotsofpulp » Wed, Sep 25, 2019, 8:27 PM UTC

ceejayoz wrote: post #75

lotsofpulp wrote: post #69

Earlier quoted context omitted.

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.

Yes, I agree. I don’t see why Medicare should only apply to those 65+. But until it applies to everyone, insurance companies have to serve that purpose. I worded it confusingly, but I meant to imply that insurance companies’ work is not all waste, since they’re doing a task that someone has to do, even if all healthcare was taxpayer funded.