What Startups Need To Know About Health Insurance in 2013 • Hacker News Board

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

#101

Post by protomyth » Wed, Jan 09, 2013, 8:05 PM UTC

grecy wrote: post #45

paulhauggis wrote: post #6

Earlier quoted context omitted.

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…

"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."

Given this theory, explain Indian Health Service.

Point 1 is bad reasoning and demonstrated to be false. On point 2, rules are not inherently socialist (Capitalism actually requires a strong rule of law).

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

#102

Post by wheaties » Wed, Jan 09, 2013, 8:08 PM UTC

3825 wrote: post #28

rayiner wrote: post #12

Earlier quoted context omitted.

Really, we have two separate problems that unfortunately get lumped together. First, is how to provide healthcare for the working age population and children. Nearly all the evidence points to public healthcare being better for this problem. Insurance discourages people from getting preventative care and ultimately costs more in the long run. Second, is how to provide healthcare for the boomer generation. I don't thi…

>Second, is how to provide healthcare for the boomer generation. There absolutely has to be a dollar cap on how much the government will spend on health care on an individual . Then, we must absolutely stick to it. If the limit is reached, then no more money for that person. I'd support such a limit on baby boomers only since those idiots are the ones who got us into this mess but I can't think of a way to implement…

The boomers are not the ones who got us into this mess. It was actually their parents. They paid for their parents and then expected their children (us) to likewise pay for them. In that time, the average life expectancy and cost to prolong life grew enormously.

I do not have hate for the baby boomers. What I have hate for is solutions which foist upon OTHER generations costs and expenses associated with THIS generation.

I see that public care is perfect in a perfect world. We are not living in such a dream. Policiticians are elected today. Tomorrow they retire. As such there is very little long term planning because the incentive structure is not there to promote long term thinking. Hence, the ability to actually have a limit or cap would never last. Just look at copyright to see the types of things that could happen.

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

#103

Post by jules » Wed, Jan 09, 2013, 8:12 PM UTC

tptacek wrote: post #92

MichaelSalib wrote: post #90

Earlier quoted context omitted.

But the existence of the French or Japanese or Dutch healthcare systems do. At some point, empty theorizing has to give way to observation of how these systems actually work in practice. In practice, all of these systems provide care that is much much cheaper than the US system with very high levels of public satisfaction. Also, I think you're wrong in claiming that the Republican party rejects single payer for those…

This comment does not respond to the issues I brought up in my comment at all. In fact, my comment ends with "I support single-payer". Did you think I was arguing that it was unworkable? My issue was with the mischaracterization of the Republican position. The Dutch system, for what it's worth, strongly resembles the trajectory we are on with PPACA: guaranteed-issue private health insurance and Medicare.

Note, for what it's worth, the Dutch system does not work as well as that of our neighboring countries. Here people often have to wait a long time to have something done, whereas for example in Belgium you are helped much quicker (resulting in some Dutch people going to Belgium for healthcare).

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

#104

Post by [deleted] » Wed, Jan 09, 2013, 8:14 PM UTC

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…

[deleted]

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

#105

Post by jbp » Wed, Jan 09, 2013, 8:16 PM UTC

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 would prefer it to be modelled after Kaiser(non-profit) and add no exclusions for preexisting conditions.

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

#106

Post by driverdan » Wed, Jan 09, 2013, 8:17 PM UTC

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…

It's a good thing they don't pay for pseudoscientific quackery like chiropractors.

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

#107

Post by caseysoftware » Wed, Jan 09, 2013, 8:17 PM UTC

mrbird wrote: post #83

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.

David Goldhill wrote an excellent piece in The Atlantic a few years ago on this topic. The fix is quite simple, but nearly impossible to implement: Stop using insurance for health care, and buy actual insurance (you know, for catastrophes). How often do you use your car insurance? Fire insurance? That's because insurance is designed to never be used, by most people. Health insurance has been unfortunately recast into…

That's the core concept behind a Health Savings Account and has been excellent in my case.

If you think of it as a 401k - put money when you're young before you need it - I think it is viable for many people under in their 20's and early/mid 30's.

But HSA's were eviscerated until Health Care "Reform" so it probably doesn't matter now anyway..

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

#108

Post by ollybee » Wed, Jan 09, 2013, 8:21 PM UTC

MichaelSalib wrote: post #86

tptacek wrote: post #57

Earlier quoted context omitted.

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 dec…

There is a big difference between single-payer and a nationalized healthcare system. In the latter, doctors are government employees. The UK and Canada work that way, and choose to spend very little money on healthcare. But most peer nations have single-payer non-nationalized healthcare systems and choose to spend more than Canada and the UK, but much much less than the US. With a single payer, the commercial service…

Most Family doctors in the UK are self employed anf their surgeries have contracts with an local primary care trust. There are other models as well and big changes in the arrangements this year. The organisation of the NHS is complex (this is not a criticism).

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

#109

Post by OldSchool » Wed, Jan 09, 2013, 8:21 PM UTC

tptacek wrote: post #54

kjackson2012 wrote: post #36

Earlier quoted context omitted.

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/ap…

Reminds me of the ONE truly profitable piece of legal advice I've ever received from a lawyer: Having an insurance policy really only guarantees you the right to sue your insurance company if they refuse to pay a claim. He said this as we walked outdoors in a large American city and then pointed out the tallest building on the skyline - an insurance company HQ. This wasn't health insurance but the point is the same.

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

#110

Post by arethuza » Wed, Jan 09, 2013, 8:22 PM UTC

tptacek wrote: post #97

arethuza wrote: post #91

Earlier quoted context omitted.

"doctors are government employees" Not all doctors in the UK are government employees working in the NHS - there is a private health care system here as well. Nobody makes you go or work for the NHS - but you do have to pay for it - I have private health insurance from my employer (I would never pay for it myself although I could afford it) and I'm quite happy to pay for the NHS. NB My son was born in an NHS hospital…

The entire private health care budget in the UK is £5Bn. The second largest purchaser of private care in the UK is... wait for it... the NHS. The NHS budget is over £100Bn. The government has overwhelming control over the health care market of the UK.

But as a consumer of health care in the UK I'm struggling to see what the problem is - the NHS is cost effective and generally available and if you want a slightly nicer room and to jump the NHS waiting queues (which do happen) then you can go private and get any kind of treatment pretty much when you want it.