The Health Insurance Marketplace is coming soon • Hacker News Board

Re: The Health Insurance Marketplace is coming soon

#21

Post by dr_ » Sun, Jul 28, 2013, 1:34 PM UTC

300bps wrote: post #14

mjn wrote: post #10

This looks a lot nicer than the websites I had to deal with last time I bought individual insurance on the open market (2010). Will be interested to see how the presentation of plan information is when it becomes available, since that was the second-worst part of the old experience [1]. Hopefully they'll get it right and lay out the choices in some kind of understandable and transparent way. [1] The worst part was th…

It looks nicer than my.company's website for open enrollment. Since Obamacare was enacted, I've gone from a PPO that pays for just about everything to a HDHP that only pays for catastrophic things. But at least the price of the coverage only went up 28% for the vastly inferior coverage. Two of the provisions that are in place already that really raised the cost of the vast majority's health bills are having to cover…

Obamacare really hasn't been fully implemented though. Until insurance companies cannot bar anyone with pre-existing conditions, and until the exchanges go into effect, it's hard to truly say what premiums and coverage will be like.

If I were to predict, I think ultimately you see more people go for high deductible / catastrophic only plans, creating a more transparent, open marketplace for most non-emergent/outpatient care. Perhaps the plans will provide some exceptions, such as coverage for cancer care - although that will probably happen over time when the government requires them to. I think that leads to lower costs for individuals. With the availability of more interesting pricing schemes, would also hope the disastrous icd-9 and cpt systems get wiped out, but less optimistic about that.

Re: The Health Insurance Marketplace is coming soon

#22

Post by larrywright » Sun, Jul 28, 2013, 2:00 PM UTC

dr_ wrote: post #21

300bps wrote: post #14

Earlier quoted context omitted.

It looks nicer than my.company's website for open enrollment. Since Obamacare was enacted, I've gone from a PPO that pays for just about everything to a HDHP that only pays for catastrophic things. But at least the price of the coverage only went up 28% for the vastly inferior coverage. Two of the provisions that are in place already that really raised the cost of the vast majority's health bills are having to cover…

Obamacare really hasn't been fully implemented though. Until insurance companies cannot bar anyone with pre-existing conditions, and until the exchanges go into effect, it's hard to truly say what premiums and coverage will be like. If I were to predict, I think ultimately you see more people go for high deductible / catastrophic only plans, creating a more transparent, open marketplace for most non-emergent/outpatie…

I really hope you're right. I think giving people visibility into what their health care actually costs is the only hope we have of fixing our health care system.

Re: The Health Insurance Marketplace is coming soon

#23

Post by YokoZar » Sun, Jul 28, 2013, 2:26 PM UTC

300bps wrote: post #14

mjn wrote: post #10

This looks a lot nicer than the websites I had to deal with last time I bought individual insurance on the open market (2010). Will be interested to see how the presentation of plan information is when it becomes available, since that was the second-worst part of the old experience [1]. Hopefully they'll get it right and lay out the choices in some kind of understandable and transparent way. [1] The worst part was th…

It looks nicer than my.company's website for open enrollment. Since Obamacare was enacted, I've gone from a PPO that pays for just about everything to a HDHP that only pays for catastrophic things. But at least the price of the coverage only went up 28% for the vastly inferior coverage. Two of the provisions that are in place already that really raised the cost of the vast majority's health bills are having to cover…

Conversely, if you had a preexisting condition, you may have just seen your health bills plumet.

Re: The Health Insurance Marketplace is coming soon

#24

Post by Weltan » Sun, Jul 28, 2013, 2:35 PM UTC

yummyfajitas wrote: post #18

Weltan wrote: post #16

Earlier quoted context omitted.

That's one of the reasons why subsidising and regulating private health insurance is not a good approach. If the government worked the way it was supposed to (rationally), then they would have voted for a public insurance option. They went half-way, and everyone will now pay the price.

300bps is complaining about the fact that as a person with a low actuarial cost, he is being forced to subsidize others with a high actuarial cost. I too share this complaint - I wake up and hit the gym from 8-9:30 every day - as a reward for taking care of myself, I'm obligated to subsidize diabetes treatment for people who wake up and eat donuts. How would a public insurance option change this?

The real solution is single-payer, a public option may have eased transition into single-payer sometime in the future, whereas a sudden transition into single-payer would have shocked the economy and been nigh impossible (it wasn't even suggested). In my country we have single-payer. Despite this, I take care of myself, perhaps not as well as you do, but I'm close. I don't expect some sort of reward for taking proper care of myself, nor do I expect others to take the same kind of care because people are often careless. Health care is a right, whether you smoke, go to the gym, eat donuts or eat broccoli.

Re: The Health Insurance Marketplace is coming soon

#25

Post by jonknee » Sun, Jul 28, 2013, 2:36 PM UTC

yummyfajitas wrote: post #19

joshmn wrote: post #3

Nice government website? Impossible. Nice government website with an API? Get out. https://www.healthcare.gov/developers/

All the API does is return healthcare.gov advertisements in json format. I'm a little less impressed.

What else could it return other than the content of healthcare.gov (that you apparently designate an advertisement)? That the government recognizes the value of an interchange format like JSON is quite a good sign. They even have CORS setup so that you can include stuff client-side.

Re: The Health Insurance Marketplace is coming soon

#26

Post by mjn » Sun, Jul 28, 2013, 2:39 PM UTC

yummyfajitas wrote: post #18

Weltan wrote: post #16

Earlier quoted context omitted.

That's one of the reasons why subsidising and regulating private health insurance is not a good approach. If the government worked the way it was supposed to (rationally), then they would have voted for a public insurance option. They went half-way, and everyone will now pay the price.

300bps is complaining about the fact that as a person with a low actuarial cost, he is being forced to subsidize others with a high actuarial cost. I too share this complaint - I wake up and hit the gym from 8-9:30 every day - as a reward for taking care of myself, I'm obligated to subsidize diabetes treatment for people who wake up and eat donuts. How would a public insurance option change this?

> people who wake up and eat donuts

Unlucky people, in addition. Some people I know currently excluded by the preexisting condition issue: a person with MS, and a person with a congenital heart condition. They can get coverage only via employer group plans and cannot work for themselves, i.e. they are mandated to work for either a government or a corporation. That's a bizarre intrusion on personal liberty, much more severe than some taxes, and the fact that it's somehow a "natural" one doesn't make an ethical difference. See F.A. Hayek for a more extensive argument on a mechanism to cover "risks common to all" as a prerequisite for an individualist society, because the alternative is forcing people into nonconsensual collectivist arrangements (like having to work for a company to get a group health plan, or having to stay affiliated with the Mormon church or family clan to receive safety nets via such groups).

But hey, continue to rationalize your greed by despising everyone less fortunate than yourself as your lesser. People with MS should've gone to the gym more; poor people should've worked harder; you are John Galt.

Re: The Health Insurance Marketplace is coming soon

#27

Post by swamp40 » Sun, Jul 28, 2013, 2:40 PM UTC

YokoZar wrote: post #23

300bps wrote: post #14

Earlier quoted context omitted.

It looks nicer than my.company's website for open enrollment. Since Obamacare was enacted, I've gone from a PPO that pays for just about everything to a HDHP that only pays for catastrophic things. But at least the price of the coverage only went up 28% for the vastly inferior coverage. Two of the provisions that are in place already that really raised the cost of the vast majority's health bills are having to cover…

Conversely, if you had a preexisting condition, you may have just seen your health bills plumet.

Group plans were/are always forced to cover pre-existing conditions.

It's only if you have a pre-existing condition and no group insurance that you will see your prices drop.

This is also exactly what is going to eventually bring down the existing US privatized health system, btw.

The accounting doesn't add up when you force a cap on premiums and allow unlimited ~10M treatments.

People will pay the yearly fine until they have a major health problem, and then join up after the fact.

Imagine if you only had to buy car insurance after you had an accident. Absolute disaster for insurance companies - monthly incoming way down while claims go thru the roof.

Re: The Health Insurance Marketplace is coming soon

#28

Post by jonknee » Sun, Jul 28, 2013, 2:46 PM UTC

cheald wrote: post #4

jerrya wrote: post #2

That's actually a very nice website, and quadruply so for being a government created website.

Of course, my question is how much we paid for it.

It appears to be an internal effort and is all open source which should make similar efforts easier. It's based on Jekyll and there's not a whole lot to it since it's informational and not interactive (like the actual marketplace will need to be). Other libraries/frameworks used include Bootstrap, Backbone and jQuery. Great work I'd say.

Re: The Health Insurance Marketplace is coming soon

#29

Post by jjoonathan » Sun, Jul 28, 2013, 2:47 PM UTC

yummyfajitas wrote: post #18

Weltan wrote: post #16

Earlier quoted context omitted.

That's one of the reasons why subsidising and regulating private health insurance is not a good approach. If the government worked the way it was supposed to (rationally), then they would have voted for a public insurance option. They went half-way, and everyone will now pay the price.

300bps is complaining about the fact that as a person with a low actuarial cost, he is being forced to subsidize others with a high actuarial cost. I too share this complaint - I wake up and hit the gym from 8-9:30 every day - as a reward for taking care of myself, I'm obligated to subsidize diabetes treatment for people who wake up and eat donuts. How would a public insurance option change this?

You've got it backwards: fat people and smokers cost less to cover because their bodies tend to fail more quickly and the most costly health care centers around slightly prolonging the lives of healthy people.

Economically speaking, you should be penalized for your healthy habits. Of course, that doesn't fit in to the "we care about your health" line that insurers like to toss around, so they often just lie about what makes them money and use fat/smoker fines as a selling point aimed at healthy people. You've been had.

http://www.outsidethebeltway.com/fat_people_smokers_have_low...

Re: The Health Insurance Marketplace is coming soon

#30

Post by yequalsx » Sun, Jul 28, 2013, 2:48 PM UTC

yummyfajitas wrote: post #18

Weltan wrote: post #16

Earlier quoted context omitted.

That's one of the reasons why subsidising and regulating private health insurance is not a good approach. If the government worked the way it was supposed to (rationally), then they would have voted for a public insurance option. They went half-way, and everyone will now pay the price.

300bps is complaining about the fact that as a person with a low actuarial cost, he is being forced to subsidize others with a high actuarial cost. I too share this complaint - I wake up and hit the gym from 8-9:30 every day - as a reward for taking care of myself, I'm obligated to subsidize diabetes treatment for people who wake up and eat donuts. How would a public insurance option change this?

It wouldn't change that and this is a good thing.

Part of being in a society is shared responsibilities. I subsidize the education of other peoples' children by paying taxes that fund k-12 education. I have no children of my own. But I'm not being cheated because a society that has universal, free k-12 education is better than one that doesn't. Similarly a society that has free, universal healthcare is better than one that doesn't.

In the current system the U.S. spends around 40% more GDP per year on healthcare than any universal healthcare system and has much lower outcomes than many. The evidence is that it would be cheaper and better to have a single payer system.

It's great that you workout and lead a healthy life. What are you doing to counter genetic defects you may possess? Perhaps you have a predisposition to cancer or some rare disease that is expensive to cover. The reward in a single payer system is that everyone gets covered regardless of genetic or life circumstances.

Every person for themself makes us all(almost all!) poorer.