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Greg Knauss's 10-year-old son's $23,800 bug bite

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Re: Greg Knauss's 10-year-old son's $23,800 bug bite

#61
post #58

The US healthcare system combines everything that is bad about a state-run socialized system with everything that is bad about privately funded care. To add insult to injury, we do not pay substantially less taxes than, say, Canadians. If we paid Costa Rican taxes I'd be fine with it, but we don't.

Costa Rica has universal health care funded by their not having a military, IIRC

Re: Greg Knauss's 10-year-old son's $23,800 bug bite

#62
post #49
post #36

Earlier quoted context omitted.

Then they are grossly misunderstanding relative risks and shouldn't be launching their own startup. And its terrible reasoning. Existing law already provides for cobra, giving them an 18 month window of coverage in which they can retain your employer's insurance (by paying the full premiums). That's more than enough time to validate an idea and secure insurance in the new company, or fail and spend 6 months finding a…

sure, if you are using the "build a prototype, get investment, move from there" model... that's fine. Personally, I think bootstrapping, taking no outside investment at all is also a completely reasonable model (and often ends up with a more sustainable business, and can be executed by people that lack the sales skills to get investment) If you are bootstrapping? 18 months is not a reasonable period of time to get so…

My company bootstrapped and we just initiated a group policy 13 months after our doors opened. This is, of course, anecdotal, but I think it's very well in the realm of possibility. Regardless, even in states like CA high-deductible plans (i.e. catastrophic care plans) are very much attainable both by small businesses and by individuals.

Contractors in the US get hit with a fairly sizable self-employment tax. This tax would no doubt go up to fund any sort of universal health insurance.

Regardless, I don't see the need to 'scratch your entrepreneurial itch' as a valid reason to stick you neighbor with your medical bills.

Re: Greg Knauss's 10-year-old son's $23,800 bug bite

#63
post #36

Earlier quoted context omitted.

You know what's a huge barrier to entrepreneurship? Needing the insurance that comes with a BigCo job, so you're not ruined financially when your kid gets bit by a bug. I know many people who have this explicit rationale for not founding or joining a startup.

Then they are grossly misunderstanding relative risks and shouldn't be launching their own startup. And its terrible reasoning. Existing law already provides for cobra, giving them an 18 month window of coverage in which they can retain your employer's insurance (by paying the full premiums). That's more than enough time to validate an idea and secure insurance in the new company, or fail and spend 6 months finding a…

By relative risks you mean the possibility that an event occurs that requires medical care?

If so, there are many cases where a founder or their family member has a pre-existing condition that makes them uninsurable. If someone loses the genetic lottery and has a severe case of asthma it can greatly change their calculus. Would you advise someone to start a company if they knew that in 12 months they'd have to hit it big or give up due to the prospect of future medical bills?

Re: Greg Knauss's 10-year-old son's $23,800 bug bite

#64
post #56
post #36

Earlier quoted context omitted.

Then they are grossly misunderstanding relative risks and shouldn't be launching their own startup. And its terrible reasoning. Existing law already provides for cobra, giving them an 18 month window of coverage in which they can retain your employer's insurance (by paying the full premiums). That's more than enough time to validate an idea and secure insurance in the new company, or fail and spend 6 months finding a…

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[deleted]

Re: Greg Knauss's 10-year-old son's $23,800 bug bite

#65
post #62
post #49

Earlier quoted context omitted.

sure, if you are using the "build a prototype, get investment, move from there" model... that's fine. Personally, I think bootstrapping, taking no outside investment at all is also a completely reasonable model (and often ends up with a more sustainable business, and can be executed by people that lack the sales skills to get investment) If you are bootstrapping? 18 months is not a reasonable period of time to get so…

My company bootstrapped and we just initiated a group policy 13 months after our doors opened. This is, of course, anecdotal, but I think it's very well in the realm of possibility. Regardless, even in states like CA high-deductible plans (i.e. catastrophic care plans) are very much attainable both by small businesses and by individuals. Contractors in the US get hit with a fairly sizable self-employment tax. This ta…

>Regardless, I don't see the need to 'scratch your entrepreneurial itch' as a valid reason to stick you neighbor with your medical bills.

Problem is that with two employees, you can get a group plan, and yeah,you've gotta pay your five hundred bucks per person a month or what have you, it's not cheap, but you can buy insurance.

My problem is that two employee minimum. I mean, am I that much lower of a risk because I work at a company with two employees, rather than just one? sounds unlikely.

Re: Greg Knauss's 10-year-old son's $23,800 bug bite

#67
post #59

Earlier quoted context omitted.

Many countries bill for emergency stays. US emergency rooms definitely send bills, even if it's acute live-saving treatment. Even Canada, which has national healthcare for residents, will bill nonresidents who visit an ER. If you're from another country, you may get away with just not paying one of those bills, because if it's life-saving care they have to provide it before verifying you can pay. But they'll still tr…

You're still stuck with a bill, if you're a foreigner. They will treat you, like they will in most of the world. But you're still stuck with a bill afterwards. Also, unless my memory is totally off, each country has to pay up for EHIC, depending on who used what, and visa versa. So the cost should be evened out. Edit, because I cannot reply to you later down: I think we have a different view on what emergency medical…

That isn't the case; Denmark simply does not charge for acute emergency visits, and does not send a bill. In addition, they pay for their own residents who incur such bills within the EU on trips under 30 days [1], which is part of the controversy: a French person who ends up in a Danish ER is not billed, but a Danish person who ends up in a French ER is billed, with the bill paid by the Danish government. Most Danes would prefer that each country provide free emergency care to all, like they do with fire and police.

[1] http://www.sos.dk/en/Corporate/OurNetwork/ForMedicalFaciliti...

Re: Greg Knauss's 10-year-old son's $23,800 bug bite

#68
post #25

Even though I've been researching with interest, so far I haven't run across much in the American healthcare system that makes me question my decision (as an American) to move to Denmark. My taxes are higher, but my costs are very predictable, and by design cannot ever bankrupt me: I pay a flat 8% of my income to support the national healthcare system. I won't end up with a charge equal to 20% or 50% or 500% of my in…

What is your legal status in Denmark, and how did you achieve it? Are you a "resident alien" or an immigrant or what? What restrictions/hoops did you have to jump to get permanent residence status? What did it cost?

It's almost impossible to get a permanent citizenship in any of the scandinavian countries (besides Svalbard, which is a part of Norway, but really strange case). You either have to be some sort of highly educated person or marry someone with a permanent citizenship, and even then there are some restrictions.

Inside of EU and Schengen you should be able to get a limited work permit. Then you are usually covered by local health care after a couple of months paying tax.

Re: Greg Knauss's 10-year-old son's $23,800 bug bite

#69
post #44

The question no one ever asks is "why is the bill $23,000?". The only question that ever gets asked is "who should pay this $23,000 bill?". I charge $200/hr for my time at a minimum. Did this child really receive an equivalent of 2.8 weeks of my time in services? Or did an unecessary middle man negotiate ridiculous prices with the provider, leaving the consumer out of the equation but responsible for the bill? And ye…

You can figure try to figure out the "why" for specific cases but it's tedious work and comes down to subjective opinions that can't be generalized to other cases. The theoretical worth of the shadowy middlemen (whether they gov't or insurance companies) and where the blame lies can be debated. All these arguments rely upon theoretical simplifications of very complex systems--meaning they are almost impossible to model.

What's more important is the "what" as in what are our alternatives. Luckily, we have tons of empirical data from other countries and they all tell the same story: America pays more money, with poorer results.

So why not just copy the models of other countries?

Re: Greg Knauss's 10-year-old son's $23,800 bug bite

#70
I don't think kidney stones are really going to get someone denied for insurance. There is no reason I should have to pay for your healthcare. I pay for my healthcare. You pay for your own damn healthcare. (note that I am self employed and had no problems getting a high deductible health plan).

Now if when you say you are short and stout (or however you worded it) you actually mean you are 500 pounds and obese, then get on treadmill. Absolutely no reason I should have to pay for your healthcare because of your poor life decisions.

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