Money Won’t Buy You Health Insurance • Hacker News Board

Re: Money Won’t Buy You Health Insurance

#191

Post by noisebleed » Tue, Feb 22, 2011, 1:57 AM UTC

hoprocker wrote: post #98

wtracy wrote: post #73

Earlier quoted context omitted.

Actually, has anyone tried banding a group of startups together until they have several thousand employees, then buy insurance as a bloc? Another idea I've kicked around: Create a sort-of incubator where, on paper, all of the startup founders and employees are employees of the incubator group. Then the incubator can handle the whole mess of both insurance and income taxes. (Bonus: Since the "incubator" now has a ton…

Haven't much looked into this (being as it now pertains to me, maybe I should!), but the Freelancers Union was making a bit of news last year[1]. Also, there are HR-outsourcing companies like TriNet that negotiate as a group for smaller/startup companies[2]. 1. http://www.freelancersunion.org/ 2. http://www.trinet.com/about_us/default.htm

I've been using Freelancers for about a year, paying ~350/month for a decent PPO and dental. Not incredible, but it's the best option I could find apart from high deductible plans. NY only unfortunately, and I'm not aware of any similar things elsewhere.

Re: Money Won’t Buy You Health Insurance

#192

Post by noisebleed » Tue, Feb 22, 2011, 1:57 AM UTC

mrshoe wrote: post #64

Can someone please explain to me why five thousand self employed people can't form a corporation together and get group insurance? Do shell corporations like that already exist?

I mentioned it above, but the closest I've seen to this idea is Freelancers Union / Insurance ( freelancersinsuranceco.com )

Re: Money Won’t Buy You Health Insurance

#193

Post by yummyfajitas » Tue, Feb 22, 2011, 1:58 AM UTC

ible wrote: post #161

Groxx wrote: post #124

Earlier quoted context omitted.

Measurably worse results than where ? It's measurably better than many places. I say it because many many many other places subsidize healthcare at least as much as America does. And people don't seem to count the taxes they pay as part of the monthly cost. edit: edited my top comment, sources are there. Canadians, famous for cheap healthcare, pay $324 per month per person for healthcare. The government covers $227 o…

Measurably worse than the rest of the G8, according to your source ( http://en.wikipedia.org/wiki/Health_care_in_Canada ) at least on life expectancy, infant mortality, per capita expenditure, costs as % of GDP, and % of government revenue spent on health.

Not true.

We beat Japan on life expectancy, provided you restrict the comparison to people of Japanese descent. Japanese Americans live 84.5 years on average, Japanese only 82.6.

http://minorityhealth.hhs.gov/templates/browse.aspx?lvl=2&#3...

http://www.google.com/publicdata?ds=wb-wdi&met=sp_dyn_le...

(Would love to see data doing similar comparisons to other G8 nations.)

Re: Money Won’t Buy You Health Insurance

#194

Post by tptacek » Tue, Feb 22, 2011, 2:01 AM UTC

acabal wrote: post #2

This really highlights how utterly insane our system is. I'm living off of my own business, which means that I don't have an employer to cover me under group insurance. But I really only make enough to live frugally and save a tiny amount each month--to me, an affordable health insurance plan would be between $50-$100 a month. Fat chance of that happening. And if it did, the deductible would be so high as to make the…

Let's keep perspective here. Because, your critique of the health insurance system seems to simultaneously affirm and entirely miss the point of the article.

A close read of your first three grafs --- the only ones that respond to the article --- suggests that you wish you could get something better than "car-crash-emergency" insurance for 50-100. Well. Let's unpack what you're missing here.

(1) The author of this article, like my own family, can't get "car-crash-emergency" insurance for 50, 100, or 500 dollars a month. Never mind the deductable. If your records include a shred of evidence of 150+ seemingly-random conditions†, you're an automatic decline. That's the problem the article is bringing up.

(2) A system in which only "car-crash-emergency" care was automatically covered would be workable; a vast improvement over what we have today! Outside of car crashes and appendicitis††, you in fact don't spend $1200/year on health care. We're a family of four, and we don't spend $1200/year on health care, let alone $4800/year or (gak) the significantly greater amount we really spend on the low-deductable group coverage we set up for Matasano.

A $5k deductable would suit us just fine; we'd save, significantly, simply by plowing the money we would have spent on crazy bullshit low-deductable insurance into an interest-bearing vehicle and shelling out from it when we actually needed care, all the while secure in the knowledge that when someone ends up in the ICU, our liability is capped. Not for nothing, but this is a scheme that both Dems and Republicans buy into.

Health care in America is broken. But it's not "utterly, utterly" broken. Whatever the number of random medical bk's we have in the US, it's too high. But we don't need to transform our health insurance system into the National Health or the French system. We are epsilon away from a Swiss-style system of mandatory and guaranteed-issue private insurance.

† http://www.thecasongroup.com/forms/enrollment/Humana/H1%20Un... .

†† Many tens of thousands of dollars. Happened to a friend.

Re: Money Won’t Buy You Health Insurance

#195

Post by [deleted] » Tue, Feb 22, 2011, 2:02 AM UTC

nostrademons wrote: post #182

wtracy wrote: post #73

Earlier quoted context omitted.

Actually, has anyone tried banding a group of startups together until they have several thousand employees, then buy insurance as a bloc? Another idea I've kicked around: Create a sort-of incubator where, on paper, all of the startup founders and employees are employees of the incubator group. Then the incubator can handle the whole mess of both insurance and income taxes. (Bonus: Since the "incubator" now has a ton…

I'm kinda wondering if YCombinator or one of the other incubators could do something like that. For me, a major reason why I'm not doing a startup now is that I'm not sure I could get health insurance. My last startup was done in Massachusetts when I was 25, so it was no problem to get an individual high-deductible policy. I'm not sure I could do the same thing in California, now that I'm pushing 30.

[deleted]

Re: Money Won’t Buy You Health Insurance

#196

Post by Vivtek » Tue, Feb 22, 2011, 2:02 AM UTC

kgrin wrote: post #46

keeptrying wrote: post #39

Earlier quoted context omitted.

Do you have to have lived in MA for a while to be able to get this or do you just need to live there when you apply for medical insurance?

You can do it right away - and in fact, basically have to, since the other part of the puzzle is that you MUST be insured. Ultimately it's not really that clever - the state just acts as a giant group purchaser, and the fact that it's compulsory spreads the risk around so that it's not an adverse selection problem. It seems silly to shill for it, but all the details are (more or less) explained on the site: http://ww…

Now if I could only buy into it without moving to MA...

Re: Money Won’t Buy You Health Insurance

#197

Post by pessimizer » Tue, Feb 22, 2011, 2:02 AM UTC

bzbarsky wrote: post #168

dalke wrote: post #95

Earlier quoted context omitted.

You say it, but you don't back it up with evidence. How is it that the US already pays more money per person for health care but with measurably worse results (measured as life expectancy, infant mortality, etc). How do they achieve what you call impossible?

The US pays more money because it has more health care being provided, in many cases. It just so happens that more health care doesn't necessarily translate to measurably better outcomes (e.g. cancer screening helps reduce mortality for some cancers but not others). It also just so happens that it's very rare to study whether a particular care regimen actually improves overall outcomes as opposed to just the thing it…

>The US pays more money because it has more health care being provided

Reference for this, too, please.

Re: Money Won’t Buy You Health Insurance

#198

Post by Vivtek » Tue, Feb 22, 2011, 2:03 AM UTC

ajays wrote: post #140

krschultz wrote: post #6

The subtle but crazy part about this is at the bottom when it details the author: "Donna Dubinsky, a co-founder of Palm Computer and Handspring, is the chief executive of a computer software company." I'm going to go out on a limb and say money is not an issue for Donna, yet she still can't even buy insurance if she wants to. I've always thought healthcare access was a bigger hurdle for entrepreneurs than tax rates.…

+1 If the Republicans are serious about an economic recovery and want startups to flourish, then universal healthcare is a cornerstone of such an effort. I know of other people too who are afraid of leaving their (big-company) positions because they have a wife + young kids, and lack of health insurance terrifies them.

What could possibly have given you the idea that the Republicans want an economic recovery?

Re: Money Won’t Buy You Health Insurance

#199

Post by Vivtek » Tue, Feb 22, 2011, 2:04 AM UTC

anonymous246 wrote: post #154

jrockway wrote: post #111

Earlier quoted context omitted.

You went to the wrong doctor. When I get my bills for office visits, the rate is something like $300 on average (including lab tests). My insurance company then negotiates that down to something like $75, and then I pay the $10 co-pay. Now, all these numbers could be made up, but $300 seems about right for a doctor's visit when you consider how expensive it is to run a medical practice. It's not something I'd want to…

Doctors and hospitals bill you more if you're uninsured. TFA mentions this as one of the reasons to get a high-deductible plan in which you will be paying most of the cost out of pocket.

Not in Indiana, they don't. Right now my wife is teaching, so we have insurance - but last year we normally got a 10% discount for being uninsured. Lots less hassle for the office, so they're willing to kick back a little for you.

Re: Money Won’t Buy You Health Insurance

#200

Post by tptacek » Tue, Feb 22, 2011, 2:05 AM UTC

muhfuhkuh wrote: post #110

Groxx wrote: post #22

Earlier quoted context omitted.

> to me, an affordable health insurance plan would be between $50-$100 a month. Fat chance of that happening. And if it did, the deductible would be so high as to make the plan worthless for anything short of a car-crash-emergency-type-situation. This fits a fair number of cost complaints I hear over healthcare. Who wouldn't like to pay $50-100/month to have something better than emergency healthcare support? But thi…

Japan forces their doctors to charge only what's published in a book that the government issues and negotiates prices periodically. Simple price fixing in an otherwise private healthcare market. In return, Japanese doctors and hospitals (FYI, there are more private hospitals in Japan than the US) are allowed to set whatever prices for ancillary services (like private or semi-private rooms) that they want. BTW, the av…

This is basically a recap of the Japan segment of the Frontline special "Sick Around The World", which you can watch online at: http://www.pbs.org/wgbh/pages/frontline/sickaroundtheworld/.

The Japanese system is not without its problems. More importantly, the "price fixing" approach to health insurance simply isn't going to happen in the US. What parts of it do you think we really can adopt? Because nobody is going to fix US healthcare by fiat.