Hacker News Board Hacker News, browsed like a classic message board
Live data from Hacker News

What Startups Need To Know About Health Insurance in 2013

blog.simplyinsured.com

Post reply on HN
Print view View original

111–120 of 185 posts

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

#111

Post by tptacek »

jules wrote: post #103
tptacek wrote: post #92

Earlier quoted context omitted.

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).

It appears that the model for the US more closely matches that of Switzerland, for what it's worth. That might just be me idealizing it, though.

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

#112

Post by tptacek »

arethuza wrote: post #110
tptacek wrote: post #97

Earlier quoted context omitted.

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.

I'm not saying there is a problem with it, I'm just saying that the existence of a PH market in the UK is not a strong counter to the Republican concern about a government takeover of the market for health services.

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

#113

Post by mikejharrison »

I'd like a single insurance policy to cover me for everything, driving my car, riding my motorbike, health care, critical illness, theft/damage of my possessions or property etc. I'd be happy for lots of data to be collected to refine the policy and tailor the price specifically. Put a black box in my vehicles, collect data about my activity / exercise with a fitbit type device, access my medical record. If it means I have the convenience of just one policy to renew, and I'm paying an insurance premium based on me, my lifestyle, and my driving style - not the average Joe's, I'd be more than happy.

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

#114

Post by billpaetzke »

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…

Ya the problem there is you'll pay 2-4x more per event because you don't get the health company negotiated rate.

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

#115

Post by wissler »

jaaron wrote: post #55
wissler wrote: post #44

Earlier quoted context omitted.

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 requir…

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.

Your world is one where you point a gun to my head (using the government of course) and tell me what kind of medical care I can trade with some guy you don't even know. So don't talk to me about "barbarian animals", OK? Your only means of doing what you think is "ideal" is to resort to cowardly force -- cowardly because you just pull the voting lever and somebody else does your dirty work.

Don't wonder why "resources are scarce" when your reply to someone who creates an unapproved alternative is to beat them up with the government.

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

#116

Post by tptacek »

anigbrowl wrote: post #40
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. Oh please, this is just a truism expressing your general political views. Government does lots of things well. Every time there's a relevant accident, the NTSB is on the spot within 24 hours. The FAA does an amazing job. I could go on with many other examples; and where government is slow to respond, it's often because the rules require government to engage in a lengthy public consultation process or make it easy…

It is especially amusing to see people suggest that the government can't competently administer health care given that Medicare customer satisfaction exceeds that of private health insurers. It's weird how easily people "forget" that the federal government is already an extremely accomplished health management administrator.

But I take issue with your argument about the health market not clearing. In fact, consumers have important options for how they finance the cost of care. One obvious one: they can pay higher premiums for a low-deductible policy that gives them less control over their outlays but eliminates risks, or they can opt for nosebleed deductibles offset by rolling health savings accounts.

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

#117

Post by tdfx »

mgkimsal wrote: post #30
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…

"The government hasn't been able to run anything efficiently as long as I've been alive." I'm not so sure private insurance companies and hospitals are all that "efficient" either, but define "efficient" first. Private insurance companies are motivated by making a profit, and the easiest way to do that is to take in money, but pay out as little as possible. There's very little competition in insurance, as 'the market…

> We need to get rid of employer-provided health care benefits, and focus on getting people to buy it directly themselves.

This. People are given these ridiculously expansive health care plans and most of the premium is picked up by their company or is deducted before they ever notice it. If people have to buy it themselves, they're going to choose higher deductible plans to get lower premiums. With higher deductible plans, they will want to see what their money is paying for and demand price transparency (which is sorely lacking in the US health care market). Allow companies to operate without stifling state interference and this will be a whole new market, one that actually responds to the forces of supply and demand (as opposed to the clusterfuck we deal with now).

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

#118

Post by arethuza »

tptacek wrote: post #112
arethuza wrote: post #110

Earlier quoted context omitted.

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.

I'm not saying there is a problem with it, I'm just saying that the existence of a PH market in the UK is not a strong counter to the Republican concern about a government takeover of the market for health services.

Sorry I was reacting (probably a bit emotionally) to the assertion by another poster that all doctors in the UK are government employees - which makes it all sound far too much like some kind of Soviet bloc nightmare.

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

#120

Post by tptacek »

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) You mean besides Medicare.

2) You mean besides whether you have to work for a BigCo to have health coverage.

3) You mean besides every discussion about public health care that has ever happened on Hacker News.

Post reply on HN