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What Startups Need To Know About Health Insurance in 2013

blog.simplyinsured.com

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Re: What Startups Need To Know About Health Insurance in 2013

#41

Post by jgon »

grecy wrote: post #32
kzahel wrote: post #2

Everything I read about healthcare recently just reinforces the notion that we need public health care. Let's just model our system after say, Canada's, and call it done.

I don't suggest you model it after Canada's system. It's good, but it could be better. I moved to Canada from Australia, so I'll compare the two systems for you. Canada: "healthcare for all" provides basic coverage of everything you need. Works pretty well. Even homeless / out of work people are fully covered. Things like dental and chiropractor are not covered, so you pay for those. Employers give "health care" whic…

While most employers do offer an "extra frills" health plan as part of employment, private insurance at fairly good rates is available to everyone. I could call up Blue Cross this afternoon and get a private health plan equivalent to my employer's if I chose to.

EDIT: I still really like the Australian system and wouldn't be upset if we started incorporating some of the ideas it contains. I just wanted to point out that for at least this one case the Canadian situation isn't quite as bad as it would appear.

Re: What Startups Need To Know About Health Insurance in 2013

#42

Post by DennisP »

kzahel wrote: post #2

Everything I read about healthcare recently just reinforces the notion that we need public health care. Let's just model our system after say, Canada's, and call it done.

A good book to continue your reading is The Healing of America by T.R. Reid. The author traveled to eight countries, checking out treatment options for his bum shoulder and learning about their healthcare systems.

Canada was one and did have some advantages. He also went to the U.K. But the best systems were in France, Germany, and Japan. They all have private (but nonprofit) insurance, a mandate, and no exclusions for preexisting conditions.

But they also have good electronic medical records systems, a government-controlled price list, and no claim denials allowed for anything on the list. Many German doctors don't even hire office staff. They swipe your card, your medical records pop up on screen, and whatever they do they're guaranteed to get paid in a week, no questions asked.

(On the other hand, another good book is Best Care Anywhere, which advocates extending the V.A. model to everyone. A nice bit from that book is the VistA medical records system, which V.A. doctors and interns built and opensourced. It's been adopted by several national healthcare systems.)

Re: What Startups Need To Know About Health Insurance in 2013

#43

Post by mniejiki »

ultraswank wrote: post #17

I've been hearing a lot of anecdotal evidence lately that the costs of private health insurance are stopping people, especially those with kids, from making the leap into their own start ups. Is anyone else getting that same impression? In my own experience on the topic I've become increasingly frustrated with the U.S. system of employer provided health care. Either give us a public option with universal coverage, or…

You can get COBRA so it's not that you won't have insurance but rather that you will pay for it yourself. And have 18 months to find a longer term option if you can. It's what I did although I am single without kids so my rate was significantly lower.

Of course that is exactly what your employer paid on your behalf before. So you're basically complaining that other people will now no longer be subsidizing your medical costs. A private system won't help you much. A public one will but merely because people who pay taxes will now be subsidizing you.

Re: What Startups Need To Know About Health Insurance in 2013

#44

Post by wissler »

kzahel wrote: post #2

Everything I read about healthcare recently just reinforces the notion that we need public health care. Let's just model our system after say, Canada's, and call it done.

The system has been screwed up to the point where it certainly appears as if we need it, as if that is the most just solution to the problems. However, that appearance is a mirage.

Unfortunately, we are so far down the path of doing things the wrong way that stating the proper solution only leads to misunderstanding. Think of a complex software system that has hack piled upon hack, and where the only programmers left are those who've been the ones piling on the hacks. These are not the people who can understand that what they've been doing is wrong.

Our system is the final consequence of people who, among other things, want safety guaranteed by the government. Unfortunately, there are no guarantees in life, so they are chasing a fantasy, and fantasies can become hideously expensive, as this one has. It is tragic that they do not comprehend what they are doing to themselves, but it is even more tragic that what they are doing isn't only to themselves, but to those of us who understand as well.

Re: What Startups Need To Know About Health Insurance in 2013

#45

Post by grecy »

paulhauggis wrote: post #6
kzahel wrote: post #2

Everything I read about healthcare recently just reinforces the notion that we need public health care. Let's just model our system after say, Canada's, and call it done.

Issues I have with public health care: 1) The government hasn't been able to run anything efficiently as long as I've been alive. It's not like we can just go back if UHC doesn't work out. 2) The more the government runs our lives (especially something like health care), the more they will be able to dictate our choices (what we eat, risky behavior, etc). 3) I haven't seen one person that supports public health care…

1) Given that the health insurance companies in America make billions in profit every year, I'm confident the government can be more efficient than that.

2) This is a naive line of reasoning. The (socialist) FDA already stops you from buying food with lead in it. The (socialist) DMV forces you to wear a seat-belt and wear a motorbike helmet and the (socialist) Police stop you beating people up on the street whenever you want.

You are basically saying you don't want "big government" to tell you want you can't do, even though those rules and limitations would make your society better for everyone overall. Everyone's happiness would go up. This is very selfish and shortsighted.

3) It's very simple. Everyone is equal. A billionaire is treated the same as a homeless person. A strongly classed society (like America) does not like this idea, because Americans define success as "better than other people". Public healthcare would take away this distinction.

Re: What Startups Need To Know About Health Insurance in 2013

#46

Post by grecy »

jgon wrote: post #41
grecy wrote: post #32

Earlier quoted context omitted.

I don't suggest you model it after Canada's system. It's good, but it could be better. I moved to Canada from Australia, so I'll compare the two systems for you. Canada: "healthcare for all" provides basic coverage of everything you need. Works pretty well. Even homeless / out of work people are fully covered. Things like dental and chiropractor are not covered, so you pay for those. Employers give "health care" whic…

While most employers do offer an "extra frills" health plan as part of employment, private insurance at fairly good rates is available to everyone. I could call up Blue Cross this afternoon and get a private health plan equivalent to my employer's if I chose to. EDIT: I still really like the Australian system and wouldn't be upset if we started incorporating some of the ideas it contains. I just wanted to point out t…

Right, but your employer is still deducting that amount from your paycheck, so you are losing out.

(At the Canadian company I work for, they estimate the 'benefits' overhead is around 26% of my salary - Yes, that is extremely high, because I can't choose the plan or coverage, the company dictates it for me. Married people with 10 kids pay the same amount I do... so you can see I'm getting a shit deal and would much rather just have my own money to spend)

Re: What Startups Need To Know About Health Insurance in 2013

#47

Post by dalore »

EvanAnderson wrote: post #39
jacoblyles wrote: post #26

Earlier quoted context omitted.

poppycock. Not everybody is going to need the same amount of healthcare. You can insure against the risk that something dire is going to strike you. Your argument may work for old-age care, where the cost of care for most people soars off the charts for last-ditch, cutting-edge efforts to stay alive. But there is no reason the insurance model can't work for most of the population.

Agreed. Insuring against inevitability is silly, and health insurance shouldn't cover those events. A friend of mine uses the analogy of "food insurance" to describe the dysfunctional nature of attempts to insure against the inevitable.

So life/death insurance is silly?

No, insuring against an inevitability isn't silly because there are other factors to consider. Like when the inevitable occurs. Insurers are taking a risk that you put more in before that happens.

Re: What Startups Need To Know About Health Insurance in 2013

#48

Post by AngryParsley »

eloisius wrote: post #18
kzahel wrote: post #2

Everything I read about healthcare recently just reinforces the notion that we need public health care. Let's just model our system after say, Canada's, and call it done.

I think bundling most healthcare under the idea of insurance is a big problem. Insurance works because there's profitability in calculated risk. Everyone doesn't get in a wreck every day, everyone's house doesn't burn down regularly. Dissimilarly, everyone gets old, everyone gets sick, everyone is going to need healthcare.

Companies make money off life insurance, even though mortality rates tend to 100% over time. It's similar with health insurance. This works due to several factors:

1. Insurance companies can invest payments from young people to cover costs when those people are older.

2. Not everyone gets old and sick. Healthy people who die in car accidents contribute much more than they take out.

3. While many people get old and sick, medical costs vary significantly and aren't very predictable for a given individual.

4. People are risk-averse. They would rather pay $1,500 every year than have a 1% chance of losing $100,000 in any given year. This is true even though 0.01 * $100,000 = $1,000 expected loss per year.

Re: What Startups Need To Know About Health Insurance in 2013

#49

Post by cma »

rayiner wrote: post #8
kzahel wrote: post #2

Everything I read about healthcare recently just reinforces the notion that we need public health care. Let's just model our system after say, Canada's, and call it done.

I don't even need public healthcare. I just want something that does away with the current employer-sponsored system. We should make it easier, not harder, for people to move between jobs, take gaps to start companies or get new training, etc. We shouldn't be discouraging younger workers from getting preventative care so they can stay healthy and keep contributing to the economy.

The new plan does make it easier to move between jobs, take gaps etc.: pre-existing conditions no longer matter when getting insurance, and the employer tax break for providing insurance is now extended to individual health insurance as well (which used to only happen if medical expenses exceeded X% of your income).

Re: What Startups Need To Know About Health Insurance in 2013

#50

Post by tptacek »

yaks_hairbrush wrote: post #11
rayiner wrote: post #8

Earlier quoted context omitted.

I don't even need public healthcare. I just want something that does away with the current employer-sponsored system. We should make it easier, not harder, for people to move between jobs, take gaps to start companies or get new training, etc. We shouldn't be discouraging younger workers from getting preventative care so they can stay healthy and keep contributing to the economy.

Absolutely, yes! I was and still am upset with PPACA because it reinforces the horrid employer-provided care model.

No it doesn't. It doesn't scrap employer-provided care, but it takes significant steps towards alternatives.

The major reason employer-provided care is dominant is that employer care is guaranteed-issue and automatically deducted. Employees of large companies are not screened or given physicals before insurance is extended.

Under PPACA, all health insurance is guaranteed issue. And while enrollment isn't automatic, it's enforced; you're fined if you don't get insurance.

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