251–260 of 363 posts
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Except UK is a disaster, 6M people waiting for service. Some longer than a year. Heartbreaking stories if you are paying attention.
How many millions are waiting in the US because they can't afford care?
I happen to think the UK is not close to the best example.
Honestly this is a great sign IMO. Rather than forcing this kind of system on a nation-wide scale, something that would undoubtedly make a lot of people unhappy for a bunch of different reasons, we can trial this kind of system on a smaller scale and see how it goes. Obviously the good people of California are okay with paying high taxes, and this is just the kind of thing that the majority of CA people seem to want…
> Rather than forcing this kind of system on a nation-wide scale, something that would undoubtedly make a lot of people unhappy for a bunch of different reasons California is nation-scale. You are still forcing this kind of system into a nation-amount of people.
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I suppose you are joking. NHS in the UK has 6M folks on waiting lists for things like cataract surgery, knee replacements etc. The wait time is in range of 18 weeks for many and for 300K+ > 52 weeks. Private providers in the US will see you MUCH more quickly than one year (!!). Some place like Europe are not really single systems. They do work well though in a lot of ways. They will have statutory mandated and the pr…
I don't follow. "The minimum insurance that they get is inadequate to my needs" seems like a poor argument when the alternative is "absolutely nothing, which is inadequate for everyone". In the US, instead of wait times, we have people who just go without entirely. I know if I was unemployed, I'd much prefer an 18 week wait time to a "no". And for anyone privileged to be able to afford good insurance in the US, you c…
Places like Germany have taken a very different approach. Govt stays out of delivery of care entirely, but everyone has coverage basically (80% public/20% private maybe).
Public care is pretty good with low waits. But govt not delivering it.
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It’s very hard to do the math here. It’s largely invisible to me how much my employer is paying in health insurance premiums and it’s unknown that they will add that sum to my salary.
I've got access to employer numbers. Grandfathered plans are an absolutely screaming deal. You can do an HSA plan with a $2000 deductible and low OOP max, fully fund the HSA ($7,200) and come out way ahead at modest cost. This let's you do things like vision / dental / chiro / accu / whatever day to day stuff on the HSA, then keep costs controlled (after 2K) for a major issue. If you don't end up using the HSA you ca…
That's an easy one, Obamacare mandated that insurance companies couldn't charge more than X times as much for their most expensive plans vs. their cheapest plans, The people pushing it were either tremendously ignorant or outright lying and claimed that this would make plans cheaper, while critics rightly predicted that instead of making the most expensive plans cheaper they would make their cheapest plans more expensive.
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The ACA prohibits pre-existing condition exclusions for all insurance plans, not just Obamacare plans.
And prior to the ACA rule taking effect, denial for preexisting conditions was common practice. See more here https://en.wikipedia.org/wiki/Pre-existing_condition
Bigger than denial was recission, where if you ended up with an expensive to cover condition, your insurer would fine-tooth-comb your history for evidence that you had a preexisting condition that has not been revealed, cancel your coverage, and leave you uninsured and uninsurable; recission for reasons other than proven intentional fraud was prohibited by the ACA, which is a pretty big deal.
As a taxpayer I don't actually have a problem with this. However, as a California resident who has seen this state's inability to think through regulations effectively or solve housing problems, I'm incredibly skeptical of California's ability to implement single payer healthcare effectively. I would likely leave the state because I assume California would fail to deliver, and taxes would get raised for nothing.
A few things to keep in mind/think about... - Employer-sponsored healthcare is aggressively anti-entrepreneurial and any universal program would be a massive boon to independent workers and those who own or want to start their own business. - In addition to the $400-$600 us and/or our employer pay every month (for one person), we also have to pay for copays, coinsurance, deductibles and so on. I'd hope that under any…
Can't emphasize this too much.
I'd rather start a small startup of my own, but the only thing that always keeps me away is health insurance in the US. I have enough savings that I could afford to pay all my expenses for many years so I'd be comfortable with no revenue for a long time.
Except for health insurance, which currently is $2500/month through company group plan, surely even more expensive for a new tiny startup. Can't do it.
I guess I need to wait until I qualify for medicare to try my hand at my own startup.
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I've got access to employer numbers. Grandfathered plans are an absolutely screaming deal. You can do an HSA plan with a $2000 deductible and low OOP max, fully fund the HSA ($7,200) and come out way ahead at modest cost. This let's you do things like vision / dental / chiro / accu / whatever day to day stuff on the HSA, then keep costs controlled (after 2K) for a major issue. If you don't end up using the HSA you ca…
It’s the preexisting injury part that jacked up the prices. They aren’t allowed to deny enrollment or charge significantly higher premiums if some was has cancer or something. And that totally makes sense morally, but that causes the risk burden to be offset on the aggregate of the subscribers resulting in higher premiums for everyone. It would be kind of similar to forcing auto insurance carriers to afford coverage…
And the requirement that 80% of premiums paid had to go to paying for care was supposed to prevent insurance companies from jacking up prices to increase profits.
Neither actually made an attempt at fixing the underlying problem of health care being expensive.
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This is my thought, as well. When your private insurance company stinks, you find a new insurer. When you're forced to pay the government for health insurance, you're stuck without options. Health insurance isn't one of the services that I trust the government to be able to run well. They don't have a particularly great track record where efficiency, customer service, and speed are concerned.
> This is my thought, as well. When your private insurance company stinks, you find a new insurer. You can't, because the health insurance is provided by your employes so you get whatever they give you. My health insurance (blue shield) is absolutely terrible (right now I need some medicine they refuse to let me have because it cuts into their profit margins) but there's nothing I can do about it. And that's after pa…
Basically, get in contact with them, try and get an override, or get them to explain why you are not covered. If it isn't in the formulary your employer opted into, you're hosed; but there is usually one way or another to get them to give in, they will just make you go through maximum hoops.
Ask for their clinical people if you can't get any traction. They will likely be the ones with hand on the knob for whether a drug is "worthy of coverage" or not.
Magic words: Override,coverage decision appeal, utilization management/formulary question.
They will tell you to check a website. Look up your thing in their formulary, if not there, abort. If in there, but high-tier, prepare for the prior-auth gauntlet.
I gave up on BCBS and have resigned to paying out of pocket, but you might get luckier than me. They will generally fight tooth and nail to be difficult, but just keep a cool head and keep escalating. It's been a while since my last butting of heads but I'm gearing up for round 2.
Also remember: You can pay out of pocket, but you'll be at the whims of that pharmacy. They'll generally help you work through coupons.
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Another thing that people are missing is that a net zero change, or even a small loss would be worth it in terms of freedom. You're no longer compelled to stay at your current job just to keep your healthcare, and if you lose your job then you only have one problem rather than two -- especially in the middle of a pandemic, when lots of people are getting laid off and needing to go to the hospital due to covid
HN and VCs ought to be extremely interested in single-payer for this reason. Healthcare (for themselves and their families) is a big reason why, in practice, people stick around at stable employers. Also, private stock valuation can't simply pay health insurance bills.