People Lose Their Employer-Sponsored Insurance Constantly • Hacker News Board

Re: People Lose Their Employer-Sponsored Insurance Constantly

#231

Post by luckydata » Thu, Apr 18, 2019, 4:28 PM UTC

conanbatt wrote: post #219

luckydata wrote: post #36

Earlier quoted context omitted.

There's no market based approach that can "fix" healthcare. Market self regulates around substitute goods, but healthcare is in the business of health and there's no substitute for that. Very few humans will say "all considered, the ROI/statistical likelhood of this procedure is not positive so I will pick death instead", it just doesn't happen. Single payer is the only way to go.

> but healthcare is in the business of health and there's no substitute for that There's plenty of substitutes, and there are plenty of things that have little to no substitutes and don't have these issues (food, clothing..housing does have some of the same issues). Healthcare is a mess because it is the most regulated market there is .

I don't think you understand what I said.

Re: People Lose Their Employer-Sponsored Insurance Constantly

#232

Post by aantix » Thu, Apr 18, 2019, 5:17 PM UTC

munk-a wrote: post #164

aantix wrote: post #150

Earlier quoted context omitted.

The patient can egg on all they want - it’s still the doctor’s (expert) decision whether to prescribe. And as an informed patient, I want to know my options. My doctor and I will discuss trade offs, he’ll sign off if he thinks it’s appropriate.

Unless someone has a medical degree they're not an informed patient - they're someone who has been fed information through pharma PR campaigns to believe they're informed about a topic while only knowing information that would contribute to a private corporation's profit. It is amazingly difficult to find good balanced information on prescriptions in the US - even doctors have issues.

Please do not protect me from myself.

Especially in the case of if/when my life is on the line, I want to know about my options. I'd much rather have information overload, than be blind.

And between my doctor and I, we will discern what is a real option, what is BS, and what tradeoffs I am willing to make in an effort to extend my life.

Stop being The Great Protector.

Re: People Lose Their Employer-Sponsored Insurance Constantly

#233

Post by ThrustVectoring » Thu, Apr 18, 2019, 5:25 PM UTC

bitcoinmoney wrote: post #218

ThrustVectoring wrote: post #180

Earlier quoted context omitted.

>What’s special about Texas? Debt collection follows a combination of state and federal law, and Texas state law is unusually favorable to debtors. Specific important pieces: 1. Your primary residence is protected from forced sale to satisfy general creditors, up to 10 acres (urban) or 100 acres (rural). 2. Garnishment of wages is limited to certain special circumstances, such as nonpayment of taxes or child support.…

I see. What if you want to FIRE? You can’t have all your $ tied up in a house.

You can likely actually swing it between accessing IRA funds, having a paid-off duplex/triplex/quadplex, and purchasing an annuity or the like. Wouldn't lose all that much efficiency, depending on things.

Re: People Lose Their Employer-Sponsored Insurance Constantly

#234

Post by conanbatt » Thu, Apr 18, 2019, 6:41 PM UTC

rtkwe wrote: post #227

conanbatt wrote: post #213

Earlier quoted context omitted.

Only that insurance takes 3 weeks to process the claim. Delaying care 3 weeks for that guarantee would have caustic medical implications.

imgabe just said in network not that the claim gets accepted. There's been a couple cases where not everyone administering as part of the procedure was in network so there's a surprise bill for one part [0]. You can do all the right homework to make sure the principal people involved are in network and still get screwed! [0] https://www.cbsnews.com/news/out-of-network-anesthesiologist...

If the procedure is not covered it doesn't matter if its in-network. You will face the same issue: the provider doesn't know if he will get paid from insurance until at least 3 weeks later.

Re: People Lose Their Employer-Sponsored Insurance Constantly

#235

Post by conanbatt » Thu, Apr 18, 2019, 6:44 PM UTC

Can_Not wrote: post #229

conanbatt wrote: post #214

Earlier quoted context omitted.

> unfortunate reality of the private healthcare system maximizing for profit > Consumers rarely have proper choice in shopping around If you have a M4A, you have less choices not more. > That's why I think full free market healthcare simply won't work The last thing I would call healthcare in the us is free market.

I need healthcare, not an infinite number of unaffordable "options".

Less options doesn't make it more affordable. More options does.

Re: People Lose Their Employer-Sponsored Insurance Constantly

#236

Post by mkane848 » Thu, Apr 18, 2019, 6:44 PM UTC

TopHand wrote: post #184

If you want a good example of government supplied health insurance, go to your local VA hospital, and see if that is the kind of health care you really want.

The goal is for government-funded, not government-run. At least in the context of M4A.

Re: People Lose Their Employer-Sponsored Insurance Constantly

#237

Post by conanbatt » Thu, Apr 18, 2019, 6:49 PM UTC

rtkwe wrote: post #228

conanbatt wrote: post #199

Earlier quoted context omitted.

Emergency care being expensive is not a problem of insurance. Public hospitals are also expensive. Its related to other things.

It's not the expense that's the problem the expense is a symptom and the problem is the attempt to treat healthcare like a market when consumers a) have very little ability to discover the price, b) have little option in substitution (if my appendix is ruptured my substitution to getting surgery is dying!) and c) many purchases are made under emergency situation with no time to price shop (or often the ability, no on…

> to treat healthcare like a market when consumers a) have very little ability to discover the price

There is HUGE price discoverability capacity in healthcare. But the US is not a free market: every single player has some sort of regulatory capture to mess it up, including workers, that get tax benefits and are blind to price through employer provided insurance.

Price sensitivity does work for high deductible plans, pointing to the basic economic principal-agency problem of the current system: if you have low copays and you cant choose insurances because your employer pays for it, you are a price insensitive patient.

My favorite example is OneMedical: one of the biggest complains patients have is "why do I have to pay 150 a year", while their healthcare plan is thousands A MONTH and a single doctor visit costs 300 U$S!

> have little option in substitution (if my appendix is ruptured my substitution to getting surgery is dying!)

Emergency healthcare is a small fraction of overall healthcare spending, and it is NOT expensive because of insurance, its expensive because hospitals are expensive. It doesn't make sense to complain to an auto-insurance company that fixing cars is expensive, its completley out of their hands, and they actually work in your favor to reduce costs if they can.

And medicine has PLENTY of substitutes. From cheaper drugs, to less accessible and lower quality healthcare. It's called the Iron Triangle of Healthcare: cost-quality-access. You can find your place in the triangle.

Re: People Lose Their Employer-Sponsored Insurance Constantly

#238

Post by conanbatt » Thu, Apr 18, 2019, 6:54 PM UTC

luckydata wrote: post #231

conanbatt wrote: post #219

Earlier quoted context omitted.

> but healthcare is in the business of health and there's no substitute for that There's plenty of substitutes, and there are plenty of things that have little to no substitutes and don't have these issues (food, clothing..housing does have some of the same issues). Healthcare is a mess because it is the most regulated market there is .

I don't think you understand what I said.

Correct me if I'm wrong:

luckydata: there is no substitute to healthcare services, so whatever you need in healthcare, whoever provides service has absolute leverage to charge whatever they want.

response: there are plenty of substitute effects in healthcare as you can deny getting treatment, or choose cheaper treatments. Moreover, even if you had no substitute effect possible, there are also other examples of markets with "no substitute effects" like food or clothing, but there is no gouging. It is a characteristic of the market but on itself is does not guarantee gouging unless other conditions are met, most typically mononopolies, and most typically gov. granted ones.

Re: People Lose Their Employer-Sponsored Insurance Constantly

#239

Post by conanbatt » Thu, Apr 18, 2019, 6:55 PM UTC

lotsofpulp wrote: post #30

gorbachev wrote: post #10

Earlier quoted context omitted.

The insurance companies have had years (decades?) to come up with one. Instead they've invested in lobbying to keep the status quo.

It mostly benefits big businesses to have employer based insurance.

I'm not too sure about that. It has signficant costs for business to run these programs. And when companies get large enough they self-insure.

Re: People Lose Their Employer-Sponsored Insurance Constantly

#240

Post by conanbatt » Thu, Apr 18, 2019, 6:57 PM UTC

helen___keller wrote: post #225

conanbatt wrote: post #212

Earlier quoted context omitted.

You can choose to have less insurance hassle by choosing a more expensive insurance plan where you don't haggle for the deductible.

Sorry what do you mean haggle? This is just one of the 3 plans offered by my employer where the deductible is much bigger and the premium is lower. I did need to open a savings account but I figured that would make things easier to pay, idk haven't used it. Otherwise my behavior as a consumer has been identical. maybe I'm missing something

If your employer has a low deductible plan with a higher premium your insurance coverage issues will be a lot lower (as you could eat the copay cost instead of negotiating).