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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

#51

Post by ultraswank »

mniejiki wrote: post #43
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 medica…

Although one big problem with COBRA is that if you go work for a start up and it fails you're ineligible, there's no one left for you to buy insurance from. That happened to me a few years ago and if the timing had been slightly different it would have left us uninsured during the birth of my son. Another point is that the difference between your employer "subsidising" your health coverage and you paying for it yourself is that under the current system you get a tax break for your employer paying for your insurance that you don't get if you pay it yourself. So not only do companies pay less in general for insurance, the tax benefits represent a huge jump in out of pocket expenses for people looking to leave their employer and strike it out on their own.

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

#52

Post by [deleted] »

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.

[deleted]

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

#53

Post by jkeel »

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…

I support my wife and 4 kids and the way I've had to deal with insurance is by getting a High-deductible Health Plan which pays 100% after the deductible is met. Then by having a HDHP I qualify for a Health Savings Account (HSA) which I can put a certain amount into each year pre-tax. The money I put into the HSA grows with decent interest if I don't use it. I get a Visa debit card which I use whenever I go to the doctor, dentist, etc. It still costs a lot of money each month, but so far so good.

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

#54

Post by tptacek »

kjackson2012 wrote: post #36
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 have Canadian friends, and although they would do anything to preserve their health care, they complain about how long it takes them to make appointments for specialists, tests, etc. I live in the Bay Area, and I have Kaiser HMO, and I love them. They seem vastly superior to Canadian health care in every respect. Even in cost, my friends in Toronto have to pay $100/month each as a Health Tax. Case in point, I got a…

Kaiser is great unless/until they refuse to cover you because your medical history includes one of hundreds of disqualifying conditions, or they decide to renege on their coverage using contract fine print and creative (re)interpretation of your medical history.

In other words, Kaiser is great if a big company that employs you is making sure you're covered.

My point is that Kaiser vs. Health Canada isn't an apples/apples comparison.

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

#55

Post by jaaron »

wissler wrote: post #44
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…

I'm likely going to regret getting into this conversation.

> Our system is the final consequence of people who want safety guaranteed by the government.

That's quite a statement and I expect you intended unjustifiable hyperbole. Yet, for a moment, let's jump down the rabbit hole of political philosophy debate.

There are no guarantees in life (aside from death) and on this we agree. Accepting this fact does not require us to be a slave to it; however. As a parent, for example, I could tell my children, life isn't fair, go out and buy your own dinner, but I chose not to. I chose to create a household that in intentionally does not simulate the harsh realities of nature.

Likewise, I decide to live in a community in which we reject the idea that we are all barbarian animals, fighting for scarce resources in a dog-eat-dog world. Instead, we chose to compromise, pool resources and worth together to create the living environment to which we aspire.

This model extends naturally to government. Indeed it is the source from which government springs. Government is the cooperation of the community to reject the harsh world in which we live and try to create a better one. We often fall short. Yet in some ways, we achieve some victory over cruel nature. We establish security from enemies with our armies. We build and protect common goods such as roads and parks.

Now at some point, we quickly start to diverge in what everyone in the community wants. Some of us believe its in our benefit to fund the education of all of our next generation. And some of us believe that it would be in the benefit of the community that all would have equal access to some form of medical care. We believe that we are a rich enough, prosperous enough community, that we can afford to ensure even the poorest among us need not worry whether or not they can afford medical care. We do not believe the government is required to coddle us. We do not believe the government will solve all our problems or eliminate all disease. Instead, we want to live in a society which cares enough for one another that we fund health care for all members.

That's the philosophical difference. Not some delusional guarantee of safety or a misplaced sense of entitlement. It's an aspiration of a better world and a rejection of idea that we are enslaved into the brutal nature in which we find ourselves.

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

#56

Post by techdmn »

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.

Seconded. I'm starting a new job Monday, a large part of being able to switch was having my wife start a job that also provided insurance. I could have bridged the gap with a spare $1500 a month, but having an alternative in place certainly helps.

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

#57

Post by tptacek »

[deleted] wrote: post #52
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.

[deleted]

Give me a break. Republicans are anti-public health care because public care sets in motion a process that moves care decisions into federal bureaucracies, which is absolutely a problem that Canada and the UK have.

Also, health care is ineluctably two things: a vital necessity and a commercial service. With a single payer, the commercial service objective is warped: patients and doctors are motivated to make care decisions that are inefficient or even harmful, and customer service or premium care for people who want it is eliminated.

Finally, from a philosophical perspective, single-payer implies that the government sets rates for care. Health care is not a natural resource; we don't sell land rights to extract health care to people who drill for it. Doctors spend years and years driving themselves into debt to become care providers, and drug companies sink billions into research for pharmaceuticals. The market for health services is fucking gigantic. It is legitimately daunting to consider replacing that market with a command economy!

I am pro-public-option. But don't pretend that Republicans, conservatives, libertarians, and people who understand health care economics are crazy or corrupted for opposing single-payer.

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

#58

Post by richcollins »

kjackson2012 wrote: post #36
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 have Canadian friends, and although they would do anything to preserve their health care, they complain about how long it takes them to make appointments for specialists, tests, etc. I live in the Bay Area, and I have Kaiser HMO, and I love them. They seem vastly superior to Canadian health care in every respect. Even in cost, my friends in Toronto have to pay $100/month each as a Health Tax. Case in point, I got a…

average wait time in Canada for an endoscopy is 9 months

Sounds like a great way to die from esophageal cancer.

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

#59

Post by tptacek »

EvanAnderson wrote: post #34
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.

We need to get rid of the unregulated, manifest "socialist" medical system that the United States has today and replace it with something that is a known quantity. A public system is one option (and one that I'm in favor of), but there could be other solutions too. In general, the current system doesn't stop people who can't pay from receiving care. If we agree that allowing someone to die because they can't pay isn'…

"Socialist" is a bad term for what we have. The insured do pay for the uninsured (mostly via taxes), but the uninsured don't get free rides: the system we have bankrupts them, often repeatedly, when they have health problems.

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

#60

Post by protomyth »

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.

Since the US acts as a safety valve for Canada (look at the number of Canadians getting treatment in the US) and the USA's version of public health care for a small subset of the population is a disaster (google: don't get sick after june), I would much rather we pick some solutions other than public health care.

I really wish the US had started with better Health Savings Accounts, Catastrophic Insurance[1], tort reform, and reforming how we pay doctors (Medicaid is having problems with new doctors not accepting it). Moving on from there would have been better.

[1 - edit] 100% paid for a cost over some figure like $50,000 - cannot remember url of proposal

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