241–250 of 407 posts
That this has been allowed to go on in a land of plenty is an utter disgrace that I can only hope will not go down well in the pages of history.
> Employer contributions to health insurance currently average $10446 per employee and cover 71% of a household’s premium. These employer premiums are equivalent to a 12.29% tax on payroll exceeding the first $2 million... Therefore, any payroll tax less than 12.29%, our upper bound in the SHIFT interface, would result in savings for employers. This excerpt makes it glaringly obvious that no economists were consulted…
If an employer decides to cut 30% of their workforce for tax resasons, who is going to do the work? Do they make the rest of the staff work overtime to cover for the people they fired? Are they just going to produce 30% less product/service and let the market sort it out?
1. Automate, invest in capital equipment to reduce labor. Instead of manually boxing a product, they can buy an automated packing machine. Or a restaurant can buy tablets to automate ordering.
2. Buy more "processed" input materials, effectively shifting labor to another country. Instead of buying raw lumber to create table legs, a furniture manufacturer would buy pre-made table legs from China.
3. Subcontract to an outside company. Under the ACA, only employers with 50 full time employees are required to provide coverage. So a larger company can effectively divide labor amongst several small companies.
4. Shift to lower labor products. Instead of a sit down restaurant, the restaurant can change to "fast casual", with no waiters.
It’s a complete scam run by insurance companies who operate with ostensibly a government mandate (although with seemingly zero oversight). I work for myself and and have historically been paying about 20k per year in premiums for my family with a family deductible which I’ve never gotten remotely close to hitting. I have an hsa which I use to pay for out of pocket expenses pre tax and there is a tax deduction for hea…
Earlier quoted context omitted.
i'm not american, so excuse me for the lack of knowledge, but i've heard that bernie plans to ban private insurance. is that right? i mean, that seems like a really bad idea -- if you have money, why wouldn't you get better health care? edit: btw i live in a country with the largest public health care system in the world https://en.wikipedia.org/wiki/Sistema_%C3%9Anico_de_Sa%C3%BA... and we never banned private healt…
Yikes, so you have higher taxes to cover universal healthcare AND you have to pay insurance premiums, deductibles and copays on top of that? That's exactly what we libertarian types are afraid of...
i just pay fixed fee per month and i can go to any doctor i want, do any procedures... i mean, i had to do a lot of stuff (including heart exams, endoscopies, blood pressure stuff) and i never had to pay anything out of pocket.
I'm paying nearly 20k (parents+child) on insurance I don't have time to use (and luckily no serious need) and once my son went to see his pediatrician and our 'private' insurance company (that i'm not going to name) sent us bill of $500, for a check-up. We disputed the charge with the insurance and they agreed to wave the payment next month. Next month comes and guess what? The same letter comes in mail. We disputed…
> And on top of it I get a better deal if I use no insurance at all for prescriptions. Interesting. So is it also the case that you can "negotiate" medicine prices? Is the actual price then different from what is on the tag?
My dog has a pulmonary condition that requires him to take Sildenafil daily (yes, generic Viagra). We got the prescription filled at a local pharmacy for a 90 count, they charged us something around $280 for. We were not expecting that high of a prescription, for a dog, for a generic medicine. Of course, since this is for a dog, we can't get our human health insurance rate for it, but the pharmacy is operating primarily for humans rather than animals. The person at the counter said that if we look at coupon sites like GoodRx, we might be able to save some money.
A coupon we pulled up on our phone while standing there brought the price down to something below $30 for the same 90 day supply. Roughly 1/10 of the price.
Clearly, the pharmacy must still be making some money even at $30. In what universe is it acceptable to charge a 900% markup above profitability on medicine? Yes, some people use this drug "recreationally", but it's also a lifesaving medicine for other humans and animals. I can't imagine what people must go through that need more expensive medicines for themselves or their families without insurance. And even with insurance, it's not much better.
And that's just one of many anecdotes. I have others, like a relative being charged hundreds of dollars per Tylenol they received while in the hospital, only for insurance to "adjust" that down to something more "reasonable" like a couple of dollars per pill.
This system is broken and needs monumental, uncomfortable, complete and total rebuilding, not repair.
I'm paying nearly 20k (parents+child) on insurance I don't have time to use (and luckily no serious need) and once my son went to see his pediatrician and our 'private' insurance company (that i'm not going to name) sent us bill of $500, for a check-up. We disputed the charge with the insurance and they agreed to wave the payment next month. Next month comes and guess what? The same letter comes in mail. We disputed…
> I am paying nearly 20k a year for possible emergencies? Kind of, yes. The vast majority of healthcare spending is, unsurprisingly, on very sick people. Insurance is for the outlier cost. The difference from other insurances is that almost everyone faces that outlier cost eventually in their lives, assuming they don't get hit by a bus in their 20s.
Earlier quoted context omitted.
> And on top of it I get a better deal if I use no insurance at all for prescriptions. Interesting. So is it also the case that you can "negotiate" medicine prices? Is the actual price then different from what is on the tag?
Drug companies are using price discrimination to maximize their profits. Charge a lot to the insurance companies but less to others with no or poor insurance. If a drug only costs $10 to make, they can mark it up to $100 for the insured people. Then insurance charges a $20 copay. The drug company now gives a $20 copay assistance card to make it "free". The net profit is $100-20-10=$70. This is why California recently…
I got the CT scan somewhere else.
I'm paying nearly 20k (parents+child) on insurance I don't have time to use (and luckily no serious need) and once my son went to see his pediatrician and our 'private' insurance company (that i'm not going to name) sent us bill of $500, for a check-up. We disputed the charge with the insurance and they agreed to wave the payment next month. Next month comes and guess what? The same letter comes in mail. We disputed…
This is where I think political leaders (Democrat or Republican) could do really well. It's not just making sure people are covered. It's the existential dread of dealing with opaque, unpredictable, and incomprehensible bureaucracy that can make life-and-death decisions or drop financially crippling bills in your lap, even if you have good insurance . The American health care system isn't just bad for the poor. It's…
Regular rank and file workers use to have HMOs but those plans have given way to HSAs and PPOs. PPOs were advertised as doctor choice but that's really misleading, all they really do is increase your out of pocket. For a condition that can't be handled in network within a reasonable distance of your house then the HMO insurer has to allow out of network access. HSAs are a great deal if you don't get sick, are rich or can put money in them... but if you need health care they aren't so good since the out of pocket is high.
If we don't get a public option or Medicare for all then I think HSAs will be the future, basically pushing insurance as catastrophic care with some legally mandated primary care covered by default (with a copay).
At least with a $25k deductible you generally won't go bankrupt and you just have to imagine paying off that imaginary new car for 5 years.
Earlier quoted context omitted.
No, but government has strong incentives to deny claims to control costs. At least at the state level, governments have gotten extremely aggressive about money collection. E.g. $50 administrative fee for not paying a $4.00 toll.
Personally, I would go for ANY system right now other than what we have. I am too pissed off at how our healthcare system is. Single Payer may or may not have the same issues but I am ready to take my chances. Status quo is not good enough for me.