Hacker News Board Hacker News, browsed like a classic message board
Live data from Hacker News

Employer health plans are getting pricier and skimpier

axios.com

Post reply on HN
Print view View original

511–520 of 539 posts

Re: Employer health plans are getting pricier and skimpier

#511

Post by kmjg88nvf8 »

tomp wrote: post #501
dredmorbius wrote: post #488

Earlier quoted context omitted.

There's both historical and insurance-business (underwriting) reasons. The history: wage-price controls implemented during WWII as labour was taken up by the military and companies had to find some basis other than pay on which to differentiate. Benefits, including health care, were excluded from wage consideration. Insurance itself is the business of assessing, managing, and sharing (or "pooling") risk. In the case…

I don't think the size of the pool is that relevant. The pool from the perspective of insurance company is all insured people, so it doesn't matter whether it's a company of 5 or 5 individuals joining, it's still a huge pool. Adverse selection is the big reason. An individual signing up for insurance can be used as a signal that means "individual is sick" or "individual is likely to need insurance soon". If a company…

I think people who are already sick should be covered by a kind of charity (or social services). It doesn't make sense to ask insurance companies to insure people who are already sick.

Re: Employer health plans are getting pricier and skimpier

#512

Post by nine_k »

tails4e wrote: post #463
nine_k wrote: post #417

Earlier quoted context omitted.

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…

I agree that the "cost disease" is bad enough.

It's strange to hear about not getting an insurance if staying at home. That's exactly what my wife did when our child was small. She had the same insurance as me, because I was able to add her to my employer-sponsored insurance policy.

What really sucks is to be a small-scale entrepreneur, a garage-stage startup founder. You're cash-constrained, and there's no employer to give you a cheaper insurance plan. Obamacare is said to have helped recently.

Re: Employer health plans are getting pricier and skimpier

#513

Post by MuffinFlavored »

grecy wrote: post #412
MuffinFlavored wrote: post #170

Earlier quoted context omitted.

> An entire generation is draining their savings to keep up with premium costs. Knock on wood but, myself and pretty much everybody I know has insurance covered ~75% through our full time employers. I think my portion of my insurance is about... $100/mo? I've never had to use it way/shape/form in the past... 5-10 years. Isn't the truth that the most unhealthy people are what drives health care costs? It'd be interest…

> myself and pretty much everybody I know has insurance covered ~75% through our full time employers So your continued physical health and financial health is utterly dependant on your current employer. Do you not see any problem with that? (I'm not American, I think it's vile, and closer to slavery than I have any interest in touching)

> Do you not see any problem with that?

No. I have a set of skills that the market finds valuable. Part of that value is providing health insurance. Any employer I choose will pay me a salary, and have healthcare benefits.

Somebody has to pay for it... and it currently isn't the billionaires like Democratic candidates wish it was.

Re: Employer health plans are getting pricier and skimpier

#514

Post by MuffinFlavored »

zanny wrote: post #329
MuffinFlavored wrote: post #228

Earlier quoted context omitted.

> In many cases US doctors make 2x (or more if you're a specialist) than their European counterparts. That sounds outrageous but isn't the same for software engineers as well? Senior level software engineers in (not San Francisco/New York/Los Angeles) can easily make $80k - $160k.

The salaries given relate back to expenses paid. Doctors in Europe broadly don't pay anything for medical school and thus don't have a mcmansion of debt to recoup after graduating. Developers throughout Europe find their salaries regularly pegged to cost of living wherever they are. In the US salaries are distorted for 2 reasons - most major global tech companies are here and thus there is higher demand for developer…

> Developers throughout Europe find their salaries regularly pegged to cost of living wherever they are.

Even if that is the case, if you compare salaries for mid-level developers in cities like Miami and Amsterdam, I think the pre- and post- tax situations are pretty drastically different.

Re: Employer health plans are getting pricier and skimpier

#515

Post by basseq »

kevindong wrote: post #398
basseq wrote: post #129

Earlier quoted context omitted.

This is really important. Pulled from the underlying study[1], employers cover 82%/70% (individual/family) of the cost of healthcare. Those numbers are down just slightly from 86%/73% in 2019. Or, put another way, employers have borne 69%/80% of the cost of healthcare increases. You complain because your individual plan has gone up by $986 in 20 years? Your employer's cost has gone up $4,005 . Oh, and that's with cut…

> Finally, note the disparity between individual and family plans. Employers are offering 2.5x more benefit—nearly $9,000 more—to workers with families. Interestingly, my employer discloses the full premium that they pay to the health insurer every year. As an employee without a partner/dependents (I just graduated college/started my career), my employer spends ~$17k/year less on my health/dental/vision benefits than…

It's an interesting topic, particularly as it relates to employers being women/family-friendly. How do you feel about parental leave, for instance?

Of course, this is a benefit that's within your control: just get a partner/dependent! And the flip side is that even individual employees might value knowing that the company "has your back" as your family situation changes.

Or, more bluntly, your company has to offer disparate benefits, because other employers do, and no employee with a family would work for your company otherwise.

Of course, all this masks the REAL problem that employers and healthcare are so intertwined. Even this article puts some of the blame on employers, when really it's the healthcare companies and the overall rising cost of care.

Re: Employer health plans are getting pricier and skimpier

#516

Post by sheeshkebab »

throwaway22424 wrote: post #186
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.

> Not to mention the millions of people locked into careers they would otherwise get out of, if not for the health coverage. Replying with a throwaway for obvious reasons. I work at one of the big tech companies -- I'm paid well, but the benefits are very good. I just got an offer from a startup that I really like. It's a job I would like to take. I'm going to have to turn down the offer. Part of the reason I'm going…

Insurance on healthcare.gov is really not bad - just get $20k more from startup and buy your own insurance. Assuming idiot republicans don’t fuck it up in the next few months.

Re: Employer health plans are getting pricier and skimpier

#517

Post by ytNumbers »

romwell wrote: post #343
ytNumbers wrote: post #338

Earlier quoted context omitted.

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. To quote a famous movie: well, you know, that's just like uh, your opinion. Why would the wait time (and not treatment outcome, or rate of occurrence) for one group of diseases be a good metric for evaluating the overall performance of a healthcare system? In my opinion, it's a horrible metric. To give a…

Rather than pull up the specific data regarding US/UK/Canada, I'll just reply with a link to a general overview of how free (but rationed) government provided health care compares to what exists in the USA:

https://www.forbes.com/sites/johngoodman/2019/03/05/what-soc...

Re: Employer health plans are getting pricier and skimpier

#518

Post by ohyes »

nostrademons wrote: post #435
ohyes wrote: post #381

Earlier quoted context omitted.

25 year olds have fewer health problems that need treatment than 80 year olds.

My point is that people are being treated for health problems that are not problems because the provider can then bill Medicare for it. That's not going to go away because there are fewer health problems; the whole issue is that it doesn't matter if there are health problems, the provider will find or create some that they can bill for.

Oh, okay. I can't speak to that specifically, that seems like an unethical healthcare provider if they're genuinely performing unnecessary procedures. They should probably be reported to the state medical board.

I think there is also a matter of what you view as 'necessary medical care'. Preventative medicine is vastly cheaper (and more effective) than reactive procedures to fix things that have become serious issues.

(It makes practical sense, right? You properly maintain your roof so it doesn't leak, that's cheaper than fixing the damage caused by the leaking roof).

This is particularly true with older people who have higher incidence of cancer, heart disease and major organ problems.

So yeah, they may send you for a battery of tests that they can charge the state for, but it might be preventing a much more expensive (and traumatic/painful) surgery down the line.

But people seem to focus on the collective bargaining and price aspect of everyone having proper healthcare, which is weird because it shouldn't be about that, it should be about increasing the efficiency of the overall system and quality of life of the people involved.

Re: Employer health plans are getting pricier and skimpier

#519

Post by gbacon »

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…

When you don’t pay for a service, you are not the customer but the vector to get to the real customer.

Think: Television, radio, Google, Facebook, healthcare.

There are gigantic pools of funds out there in quasi-private insurance, Medicare, and Medicaid. Costs explode. Similarly, gigantic pools of funds are available thanks to subsidized student loans that cannot be bankrupted. College costs explode. Being uninsured is terrifying because the individual healthcare buyer is competing with deep-pocketed insurers and government programs who are much less price-sensitive.

Healthcare is expensive because the patient is not the customer. Insurance is going crazy because insurance is legally compelled to pay for oil changes and basic maintenance, so insurers must accept more exposure.

Re: Employer health plans are getting pricier and skimpier

#520

Post by grecy »

MuffinFlavored wrote: post #513
grecy wrote: post #412

Earlier quoted context omitted.

> myself and pretty much everybody I know has insurance covered ~75% through our full time employers So your continued physical health and financial health is utterly dependant on your current employer. Do you not see any problem with that? (I'm not American, I think it's vile, and closer to slavery than I have any interest in touching)

> Do you not see any problem with that? No. I have a set of skills that the market finds valuable. Part of that value is providing health insurance. Any employer I choose will pay me a salary, and have healthcare benefits. Somebody has to pay for it... and it currently isn't the billionaires like Democratic candidates wish it was.

Do you not see how much this limits your mobility and freedom to do as you please?

If health care (and insurance) were de-coupled from your employment, you would have much more freedom to move around jobs, or even go without a job for a time if you so chose, etc.

Would you be OK with your employer paying for your housing? education? food?

Your employer being in control of your health (and those other things) is sickening. They are just taking power and choices away from you.

Post reply on HN