https://news.ycombinator.com/item?id=21074455 is a related article, whose thread we merged into this one.
Employer health plans are getting pricier and skimpier
261–270 of 539 posts
Re: Employer health plans are getting pricier and skimpier
#262Earlier quoted context omitted.
No doubt. The tough questions are around where will the sacrifices be made?
Marketing, claims denial, billing and executive compensation budgets that together amount for 20% of the expenditure of an average US insurer after they were legally capped to that level.
Even eliminating those expenses doesn't really help much. It just changes the numbers in the headlines. $16k in premiums is still tough for most US families.
Re: Employer health plans are getting pricier and skimpier
#263This is the first year I have had to really utilize my healthcare coverage to its fullest due to a cancer diagnosis in my family. I work at a very small company doing its best to provide a decent healthcare plan, but with our numbers we have very high monthly premiums plus a high out-of-pocket maximum for me to reach (which will now likely happen every year).
I can't help but wonder if I am paying WAY more with my current healthcare plan than if I didn't have any insurance at all and negotiated the "uninsured" price per each service myself.
Re: Employer health plans are getting pricier and skimpier
#264This 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 realize the avg YC visitor will not want to hear this, but when you are taking care of 1) literally tens of millions of foreign nationals that have washed up on America's shored with all manner of maladies and even diseases that never existed in the USA before, and others that have been eradicated for decades, and all those people bring in multiples of their family members with all manner of other maladies and are…
Hi. Do you have any sources for any of this? Otherwise it sounds like quite the racist rant against anything foreign
Re: Employer health plans are getting pricier and skimpier
#265The 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 re…
> 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... That sounds like a strange conspiracy, do you have evidence to support that? Keep in mind 20+ years ago that insurance was much cheaper, deductibles were almost nonexistent, and care networks were giant. Talk to your US parents or grandparents ab…
Look up what "match day" and the NRMP is.
Re: Employer health plans are getting pricier and skimpier
#266Earlier quoted context omitted.
I like single payer, but I haven't had the luxury of living under either system of universal care. I think in the US we have different issues than face Germany/Switzerland/France, and for the US to contain costs my opinion is we would have to rip private insurance out completely. Our main Government provided system (Medicare for the elderly) is a combination of government and private, and to put that system in perspe…
I am a U.S. citizen. Yes, cost is a huge issue. We would not have to rip out private insurance, but we would probably have to regulate pricing, which is how it works in Germany. Folks should be welcome to buy supplemental insurance as they do with Medicare. There's basically four models[1] for providing health care, and the US has all of them: The Bismarck model like Germany with multiple payers, but they are non-pro…
Sorry, I figured you were German.
As long as people are covered it would be a good start (I won't bother engaging further on the single payer/private insurance/hybrid systems, not enough room and not the right forum)...it just scares me to hear the game plan to get there is political pressure after a critical mass of people are uninsured. I know that is not attributable to you, and you seem optimistic we get there anyway, I hope you are right.
One last thing I will note, is there are all kinds of hidden costs through other insurance that hopefully would come down under a single payer (maybe even under a public/private hybrid like Medicare Part D) , take car insurance one reason premiums and deductibles are so high is because a lot of that goes towards personal injury claims (medical costs). The same can be said for odd things like homeowners insurance for example. A lot of these insurance policies people already pay for in some ways supplement health care coverage.
>We use all of these in the U.S. and it's insane.
Well said.
Re: Employer health plans are getting pricier and skimpier
#267The 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 re…
> (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) It is illegal for Medicare to negotiate drug prices. That needs to be fixed.
I was going to comment the same thing. Pointing to Medicare/Medicaid as examples for why drug negotiation doesn't work is an impressively incorrect line of thought.
Re: Employer health plans are getting pricier and skimpier
#268Earlier 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…
Getting insurance as an individual is expensive because you’re not part of a group plan. With a group plan the insurance company has some reason to believe you’re not collectively a bunch of dying people committing moral hazard, you’re just one of a generally similar looking company workforce. If employers stopped providing it, I think it is presumed that the mentality towards individual plans would change
I think it is unfair to call a dying people seeking healthcare 'moral hazards'
Re: Employer health plans are getting pricier and skimpier
#269This is why I feel the "most Americans like their health insurance" cliche is complete garbage.
That statement was a stumbling block in one of the recent Democratic debates. I have no idea why none of the candidates drive the point that insurance != doctor home(in most cases) .
Warren did, with a pretty decent line something like "I've talked to a lot of people about this and I'm not sure I've ever heard someone say they like their insurance. Their doctor? Their hospital? Sure, but not their insurance. People care about having access to the providers they like—they don't care about their insurance".
I had to tune out after that part of the debate. Watching a bunch of candidates, and especially the frontrunner, claim not that MFA was OK but their plan was better, but that MFA is some kind of impossible dream that can't work, just pissed me off too much. Screw them. Seriously.
Re: Employer health plans are getting pricier and skimpier
#270The entire health insurance industry makes ~$25B in profits a year, correct? That doesn't seem overly large considering it is the entire insurance industry.
The money isn't being pissed away into insurance industry profits.
It's being pissed away when the hospital, and the insurer spend 2 hours arguing over how to bill a $500 procedure. Net cost? $640. $500 for the procedure, $35/hr * 4 hours for the paper-pushers.
Net benefit to the patient? Minus $100, out of their premiums. Would you like to pay cash, or discuss with us a financing plan?
It's being pissed away when the hospital buys bus ads, and the insurer buys superbowl ads. I've not seen a single hospital ad in Canada... Because the hospitals weren't competing for my business.
It's being pissed away when a hospital tries to sneak in a $100 bill for two aspirins, and justifies it by citing how much they spend on charitable care. (Hint: That charitable care is the hospital writing off some other poor bastard's $100 bill for two aspirins.)