I thought it was fairly common among tech companies to provide 100% paid health, dental, vision for the employee and dependents?
(Current company does, and I’ve had this at previous jobs also)
Employer health plans are getting pricier and skimpier
461–470 of 539 posts
Re: Employer health plans are getting pricier and skimpier
#462Imagine 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 rate…
Can you explain to a Non-American what forces this system of employer insurance onto the US? Why don't independent insurance companies emerge that offer other models of insurance?
Re: Employer health plans are getting pricier and skimpier
#463Earlier quoted context omitted.
This isn’t a very good analogy. In a just world, nobody would go hungry, nor would anyone die prematurely or suffer needlessly due to lack of care. We can obviously afford both, in this country, just like they can everywhere else in Europe or Canada. So this entire argument about insurance is a straw man. It’s not the doctors who set up this world. It’s people who want to pay less taxes, but blame doctors.
Regarding Europe, which I happen to have friends all over: it's not exactly as rosy. European countries do have more doctors per capita, which is good. They don't have nearly as much resources in the system, though. Come to a doctor with a bad cough, get a prescription for Paracetamol. You got to have a pretty bad infection to get a prescription for an antibiotic. Endure a long discussion with a doctor to renew an an…
I think you are mis- characterizing the European systems. I say systems as each country is different - some better than others for sure, but from what I've seen from both the US and European systems, I prefer the ones where my family going bankrupt does not depend on one of us getting seriously sick or not.
The cost of healthcare per capita is way higher in the US, and outcomes generally poorer (see infant mortality rates for example).
The state of insurance for health in the US has far reach ing, society altering negative effects too which are often not considered. My sister in law would like to stay at home for a few years woth her young kids taking a career break - but cannot as she'd loose her insurance, despite her husband's income being enough to support them, it's the insurance holding her back. This absolutely would not be an issue anywhere in Europe I can think of.
Re: Employer health plans are getting pricier and skimpier
#464Earlier quoted context omitted.
Then imagine that there are some people who can't afford the food they need in the grocery store and are going to die. Alternatives and transparent pricing isn't going to make brain surgery affordable to the average consumer.
According to Wikipedia, there are only .5% of all physicians in the US who can perform neurosurgery. So it's probably safe to say the demand for brain surgery is much higher than the supply. This incentivises people to become doctors that perform such complecated procedures as it takes a lot of time and a lot of money to be able to do those things. If you were to force doctors to perform work on people that can't aff…
There are two parts here that are not clear, and potentially misleading for folks unfamiliar with how doctors are minted in the US. The first is the cost to the individual to become a neurosurgeon. The second is around the supply side of the health market.
First, to become a practicing doctor of any sort one first completes med school then a residency and (depending on specialty) fellowship. The med school part is more or less the same for all physicians from your GP to brain surgeons to psychiatrists. Many folks take out loans to cover med school.
The residency and fellowship parts are paid. In practical terms this means a person becoming a neurosurgeon needs no more loans or upfront cash than a person becoming a GP. (I assume everyone is familiar with opportunity cost so will leave that part unsaid)
As an aside, much of the funding for these programs comes from the public (via Medicare).
All this means, the cost of becoming a neurosurgeon is about the same as any other specialty.
As for the supply side entry to med school and selection to residency programs are the big bottlenecks.
Med schools are accredited via doctors trade bodies. This means doctors (not market forces) decide how many new folks can become doctors.
As previously mentioned, residencies are largely funded via Medicare already. However, the number of residents has been capped since 1996. In that period of time the US population has grown by about 60 million (25%).
You may have been familiar with all this, but I think the context is important for discussing market solutions to healthcare — there are a lot of distortions around the US having anything resembling market behaviors.
Re: Employer health plans are getting pricier and skimpier
#465The 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…
> 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.
That explains our highly competitive, low profit margin defense industry.
Re: Employer health plans are getting pricier and skimpier
#466Earlier quoted context omitted.
This isn’t a very good analogy. In a just world, nobody would go hungry, nor would anyone die prematurely or suffer needlessly due to lack of care. We can obviously afford both, in this country, just like they can everywhere else in Europe or Canada. So this entire argument about insurance is a straw man. It’s not the doctors who set up this world. It’s people who want to pay less taxes, but blame doctors.
Regarding Europe, which I happen to have friends all over: it's not exactly as rosy. European countries do have more doctors per capita, which is good. They don't have nearly as much resources in the system, though. Come to a doctor with a bad cough, get a prescription for Paracetamol. You got to have a pretty bad infection to get a prescription for an antibiotic. Endure a long discussion with a doctor to renew an an…
> You got to have a pretty bad infection to get a prescription for an antibiotic
That's because of antibiotic resistance. Increased use of antibiotics means they're less effective in the long term.
Re: Employer health plans are getting pricier and skimpier
#467ITT: people who can’t accept that Medicare for All is the only answer. I am sorry it isn’t some complicated problem to wonk over. Healthcare is a human right. Give it to everyone and lay for it through taxes.
Re: Employer health plans are getting pricier and skimpier
#468Earlier quoted context omitted.
In the USA, at least in my experience. If I have a cold I still had to make an appointment which would be 2 to 3 days later. I got around this by joining a doctor in a clinic and they'd let me see any doctor if my doctor wasn't avaiable but i'd have to sit in the waiting room for 1 - 2 hrs. In Japan I have had mixed experiences: Good: * It's relatively cheap. Apprently the government sets prices. The government offer…
>> In Japan I have had mixed experiences: Replace ‘Japan’ with ‘metro cities in India’ and its almost the same. I can’t still fathom why there would be no walk in facilities for ailments like cold. I still remember my shock when in US I realised from a colleague that for my cold I need to wait because I can’t walk in and need to take an appointment.
What does a doctor do for a cold? In the UK and I wouldn't dream of going to the doctor's for a cold. You just wait it out don't you?
Re: Employer health plans are getting pricier and skimpier
#469Earlier quoted context omitted.
But why those nations have lower costs isn't so simple. If you remove all profit and admin overhead from the US system, its still something like $5000/person more expensive than other countries (I think that that was vs Canada). A large component of healthcare cost in the US is simply healthcare use. We are deeply, deeply unhealthy with 75% overweight rates and absurd levels of pre/diabetes, which are the largest com…
In the UK the NHS negotiates prices for drugs. NICE have to approve all drugs and if a drug is too expensive, the manufacturer either has to lower the price so that the benefit outweighs the cost, or they lose a large market. This is why hand waving away "bargaining power" ignores one of the sources of high costs. The other is that our doctors are mostly either employed by the NHS, or employed by a private provider w…
Doctors should earn enough to pay the loan off
Re: Employer health plans are getting pricier and skimpier
#470Earlier quoted context omitted.
>> In Japan I have had mixed experiences: Replace ‘Japan’ with ‘metro cities in India’ and its almost the same. I can’t still fathom why there would be no walk in facilities for ailments like cold. I still remember my shock when in US I realised from a colleague that for my cold I need to wait because I can’t walk in and need to take an appointment.
What does a doctor do for a cold? In the UK and I wouldn't dream of going to the doctor's for a cold. You just wait it out don't you?
YES?! What the hell? Especially considering, the kind of sinus clearing pills which are forbidden (classed as a narcotic) in Sweden, they handed out in jars like candy at the US office.