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

Re: Employer health plans are getting pricier and skimpier

#351

Post by ohyes » Wed, Sep 25, 2019, 11:36 PM UTC

nostrademons wrote: post #345

mullen wrote: post #218

Earlier quoted context omitted.

> 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 oc…

> Having every person under the same plan that has the negotiating power of 327.2 million people will definitely drive costs down. Don't want to pay what the government says it is going to pay? Good luck finding customers then, because the government is bargaining on behalf of all of the customers in the US. So my mom and her boyfriend are both under Medicare now, as was her late 2nd husband. My mom and I had both ge…

This sounds like an ignorant view of getting proper healthcare.

There are more things to check because older people have more medical problems, therefore more tests, more treatments, etc.

We would have to see what would happen if you gave a 25 year old medicare in this country, I doubt it would be the same experience that an elderly person would have.

Re: Employer health plans are getting pricier and skimpier

#352

Post by drspacemonkey » Wed, Sep 25, 2019, 11:41 PM UTC

ytNumbers wrote: post #338

romwell wrote: post #279

Earlier quoted context omitted.

If only we had examples where the government running something like healthcare resulted in a better outcome for citizens. Perhaps a country in Europe, as developed as the US is. I mean, a country that we literally border with would be too much to ask for. Perhaps some of us would be less amused by the concept of government-run healthcare. Too bad we don't have the example of literally all of Europe, Australia, and Ca…

In my opinion, the best yardstick for a health care system is how long you have to wait to be treated for cancer. By that yardstick, countries like Canada and England stack up quite poorly when compared to the USA. Canadians don't come to the US to save money on health care. They come to the US because they have an expensive potentially fatal medical condition, and they might not survive a six month waiting period fo…

>In my opinion, the best yardstick for a health care system is how long you have to wait to be treated for cancer. By that yardstick, countries like Canada and England stack up quite poorly when compared to the USA

I don't know who told you that about Canadian healthcare, but it's simply not true.

When my mom was diagnosed, she underwent surgery within days, and was getting chemo/radiation as soon as was medically safe.

Re: Employer health plans are getting pricier and skimpier

#353

Post by nostrademons » Wed, Sep 25, 2019, 11:42 PM UTC

ohyes wrote: post #351

nostrademons wrote: post #345

Earlier quoted context omitted.

> Having every person under the same plan that has the negotiating power of 327.2 million people will definitely drive costs down. Don't want to pay what the government says it is going to pay? Good luck finding customers then, because the government is bargaining on behalf of all of the customers in the US. So my mom and her boyfriend are both under Medicare now, as was her late 2nd husband. My mom and I had both ge…

This sounds like an ignorant view of getting proper healthcare. There are more things to check because older people have more medical problems, therefore more tests, more treatments, etc. We would have to see what would happen if you gave a 25 year old medicare in this country, I doubt it would be the same experience that an elderly person would have.

There is a very strong correlation between which additional tests are requested and what the hospital can charge under Medicare reimbursement codes. (My mother's boyfriend is a former doctor, and intimately familiar with the health-care system from the other side of the table.) Both of them are also in fairly good health (my mom has no pre-existing conditions, her boyfriend has some issues with his back but nothing unexpected for an 80-year-old), and were definitely not treated like this while on private health insurance.

What do you think would be different between 25-year-olds and elderly people? The incentives are the same in both cases, produced by the billing code.

Re: Employer health plans are getting pricier and skimpier

#354

Post by Gibbon1 » Wed, Sep 25, 2019, 11:43 PM UTC

payne92 wrote: post #238

I just got my renewal quote: $2,372/month for a family of 4 is going to $2,883/month. That's a ~20% increase, to $34,595 PER YEAR. (And this is while benefits continue to be cut back: $150/month for many prescriptions, etc.) As others have written, there's no single reason. But, I think there's a major unintended structural problem: under US law, insurance companies are required to pay a high percentage (like ~90%) o…

> WORSE, the admin overhead is pushed onto the providers, so the overhead cost gets hidden. It's not uncommon for a family medicine general practitioner to have a back office of 3-5 people dealing with billing and insurance paperwork.

My old doctor from when I was a baby till he retired had a practice with three to four other doctors. They had a nurse and one of the doctors wives did all the office work, billing, and answering phones. Current doctors practice has two doctors, four nurses, and eight office staff.

Old doctors office could would take x-rays and set a simple fracture. Or stitch up a simple cut. New doctor won't do any of that.

Re: Employer health plans are getting pricier and skimpier

#355

Post by Avshalom » Wed, Sep 25, 2019, 11:44 PM UTC

forrestthewoods wrote: post #339

mullen wrote: post #218

Earlier quoted context omitted.

> 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 oc…

There are 60 million people on Medicare. If you can’t negotiate with twice the population of Canada I don’t think the problem is not enough beneficiaries.

https://duckduckgo.com/?q=medicare+negotiate+prices&t=fpas&i...

Re: Employer health plans are getting pricier and skimpier

#356

Post by mdorazio » Wed, Sep 25, 2019, 11:44 PM UTC

forrestthewoods wrote: post #339

mullen wrote: post #218

Earlier quoted context omitted.

> 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 oc…

There are 60 million people on Medicare. If you can’t negotiate with twice the population of Canada I don’t think the problem is not enough beneficiaries.

You know Medicare sets separate prices from normal insurance, right? See [1]. For most procedures, there's the "we make up a number to charge to insurance companies" price and then there's the negotiated Medicare price with associated billing codes.

[1] https://www.healthcaredive.com/news/cbo-reports-show-private...

Re: Employer health plans are getting pricier and skimpier

#357

Post by tamaharbor » Wed, Sep 25, 2019, 11:46 PM UTC

eric_b wrote: post #148

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 re…

Have you ever been on Medicare? It is not that good.

Re: Employer health plans are getting pricier and skimpier

#358

Post by nof1 » Wed, Sep 25, 2019, 11:48 PM UTC

Cadillac plans getting taxed?

Re: Employer health plans are getting pricier and skimpier

#359

Post by arcticbull » Wed, Sep 25, 2019, 11:50 PM UTC

bdcravens wrote: post #262

arcticbull wrote: post #249

Earlier quoted context omitted.

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.

It’s still $0.6 trillion dollars saved per year, and a solid place to start. There’s all sorts of other places that a socialized system saves of course. This would at least make the US no longer far and away the worlds worst.

Bringing everyone under a single umbrella should reduce everyone’s cost of coverage to the per capita cost, $10K (now $8K after savings). Then as a progressive tax system yields costs that scale according to your income the least able to afford it pay much less than that and the most able pay much more. Done and done. This is what the rest of the world does, no new ground is being broken here.

Re: Employer health plans are getting pricier and skimpier

#360

Post by comnetxr » Wed, Sep 25, 2019, 11:50 PM UTC

Imagine if grocery stores forced us to choose one of a few dozen grocery "insurance" memberships to buy groceries, and negotiated directly with the insurers. No prices are labeled in store, they just detect whatever you take and send you a bill at the end of the month. (Differing brands of the same food product are not available in store of course.) Individuals are charged 3-100x more per product than negotiated rates, but can't find out until afterwards. Grocery "insurance" would then become a necessity. People would trade away disproportionate amounts of their salary to get good grocery benefits from their employers, i.e. to not get price-gouged by virtue of being an individual on the market. Stores would run discount programs for the very poor, which they could point to when people get outraged (as drug companies do now.) When politicians would threaten the system, grocery stores would fund ads about the "long lines" and limited food availability that would occur. Instead laws would get passed reinforcing the system by making sure everyone gets grocery insurance, as its a necessity (and it would _be_ a necessity).

I'm not saying that health care _could_ be exactly like grocery stores, with many alternatives, transparent pricing, and customers making the final decisions, but that it would have to be much _more_ like grocery stores to call it a free market. What we are working with now is just a system of pricing cartels supported by fear and lobbying. It needs to go.