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

'A full-blown crisis': Americans brace for a surge in healthcare costs

ft.com

Post reply on HN
Print view View original

231–240 of 269 posts

Re: 'A full-blown crisis': Americans brace for a surge in healthcare costs

#231

Post by johnnienaked »

beej71 wrote: post #137
johnnienaked wrote: post #120

Earlier quoted context omitted.

Your taxes would double, and don't even bother trying to say they wouldn't literally every country with public health care pays twice as much as we do in tax

We pay more tax for healthcare in the US than virtually anyone else. Last I looked, only Norway had us beat in terms of taxes for healthcare.

The average cost per person is more in the US (quite a bit more), but as with all statistics the devil is in the details. In a public system like Canada, while the average cost for health care per person is lower, if you make above average income you are paying more than average in taxes, and hence more for (everyone else's) health care. Combine that with a far lower average income across the whole country than even the poorest US states, and the relative impact on you can actually be far higher. In my case my effective tax rate was about 45%, which meant I was paying 4-6x average taxes, most of which went to health care. I haven't lived in European countries, but it's virtually certain to be a similar story.

Re: 'A full-blown crisis': Americans brace for a surge in healthcare costs

#232

Post by johnnienaked »

ArtemZ wrote: post #147
beej71 wrote: post #137

Earlier quoted context omitted.

We pay more tax for healthcare in the US than virtually anyone else. Last I looked, only Norway had us beat in terms of taxes for healthcare.

Then how our taxes are lower on average than most other developed countries?

Our incomes are far higher too. Health care in the US isn't perfect, but public systems aren't either. The flaws of private health care seem to be a favorite target by people who are biased against the US.

Re: 'A full-blown crisis': Americans brace for a surge in healthcare costs

#233

Post by johnnienaked »

ryandrake wrote: post #205
Ekaros wrote: post #172

Earlier quoted context omitted.

Does it really matter if cost is in "insurance" or in tax? Wouldn't overall lower total be better?

Some people would rather pay $4000/mo to an insurance company than $2000/mo in taxes. I don't get it, either but here we are.

That's obviously a false dichotomy. Almsot no one is paying $4k/mo for insurance premiums.

Re: 'A full-blown crisis': Americans brace for a surge in healthcare costs

#234

Post by johnnienaked »

jswelker wrote: post #203
johnnienaked wrote: post #120

Earlier quoted context omitted.

Your taxes would double, and don't even bother trying to say they wouldn't literally every country with public health care pays twice as much as we do in tax

Even if my taxes doubled, it would be less than just the premiums on my current family health coverage.

How much of those premiums are paid for by your employer?

Re: 'A full-blown crisis': Americans brace for a surge in healthcare costs

#235

Post by jjav »

choeger wrote: post #208
jjav wrote: post #196

Earlier quoted context omitted.

> Where does all that money go to, though? Nearly all of it goes to grifters who hang on to the system but don't contribute anything. The obvious ones are all the insurance company employees who don't provide any healthcare, just push paperwork to try to find ways to deny coverage. And all the oberpaid administrators, and of course those multi-million bonuses to all executives involved need to be paid somehow. If tha…

> But I get billed $500 for that visit. That does not match your earlier statement about administrators or health insurance, though. Or does your primary care doctor work in a big hospital that takes a 400% margin?

I don't know where the majority of the money goes, if you're looking for a precise breakdown.

The point I'm making is that only a very very tiny fraction of the bill goes to the people actually providing healthcare (the nurse and the doctor).

Of course some overhead is inevitable, but there is very clearly a vast amount of waste here that could be eliminated. A nurse + a doctor provide $30 of their time, and $470 of overhead is tacked on to that. That's why healthcare is so insanely expensive in the US.

Re: 'A full-blown crisis': Americans brace for a surge in healthcare costs

#236

Post by stephen_g »

johnnienaked wrote: post #233
ryandrake wrote: post #205

Earlier quoted context omitted.

Some people would rather pay $4000/mo to an insurance company than $2000/mo in taxes. I don't get it, either but here we are.

That's obviously a false dichotomy. Almsot no one is paying $4k/mo for insurance premiums.

And nobody is paying $2K a month for healthcare taxes either!

Re: 'A full-blown crisis': Americans brace for a surge in healthcare costs

#237

Post by ryandrake »

stephen_g wrote: post #236
johnnienaked wrote: post #233

Earlier quoted context omitted.

That's obviously a false dichotomy. Almsot no one is paying $4k/mo for insurance premiums.

And nobody is paying $2K a month for healthcare taxes either!

One again, HN rat-holes on a detail rather than the overall message. Replace what I wrote with "Some people would rather pay $2X/mo to an insurance company than $X/mo in taxes." Jeez!

Re: 'A full-blown crisis': Americans brace for a surge in healthcare costs

#238

Post by _DeadFred_ »

nradov wrote: post #221
_DeadFred_ wrote: post #217

Earlier quoted context omitted.

Percentage wise profits might not increase, but 10% profits on a $2000 plan make an insurance company (and execs) more than 10% profits on a $200 plan. It's in their interests and income stream for costs to constantly go up so they can get their 10% take. Efficiencies and price savings would actually hurt them (can't have plan rates go back down and only get their 10% off of $200).

That ignores competitive pressures. Commercial health plans aggressively negotiate rates with their network providers in order to get market share with cost sensitive customers. If your claim was accurate then insurers would just take whatever rates that providers set but the reality is that doesn't happen. Health plans routinely drop more expensive providers from their networks.

Rental companies have incentives to get market share with cost sensitive customers too. They would totally never have a system (or use colluding software) where everyones rates just go up.

Fun fact, people in fact can't just 'do without' for housing/medical care, so can't act in a manner that keeps the market in check. Therefor neither of those two segments can be treated as actual markets, or expect the typical benefits of actual, working markets.

Re: 'A full-blown crisis': Americans brace for a surge in healthcare costs

#239

Post by protocolture »

harmmonica wrote: post #126
protocolture wrote: post #108

I find the US healthcare "system" to be an interesting topic. More nuanced than people think. It honestly seems like the worst way to run anything. Like I honestly cant see who its for, other than maybe US Corporations on the list of approved medical vendors. Like, putting on my "Lives in a free(ish) healthcare country" hat, it looks bonkers from that angle. But even from a more libertarian mode, the whole thing look…

The US, today, is set up very well for wealthy people. The health care system works great for them. Their doctors are amongst the best in the world. Same with the hospitals they use. The costs are manageable if not reasonable for all of those people. And you can actually go beyond health care and find that almost everything in the US is pretty high quality for wealthy people. Housing, their neighborhoods, their schoo…

A mate of mine (who allegedly has decent health insurance but that seems questionable) was trying to get a simple surgical procedure done, and the quotes he received ranged from anywhere between "We cant tell you" to multiple thousands, ultimately he found a small private hospital that sorted it out for him for 700 USD.

I actually think the 700 USD price is very reasonable. But I dont care how rich you are thats a terrible consumer experience.

Re: 'A full-blown crisis': Americans brace for a surge in healthcare costs

#240

Post by protocolture »

venturecruelty wrote: post #115
protocolture wrote: post #108

I find the US healthcare "system" to be an interesting topic. More nuanced than people think. It honestly seems like the worst way to run anything. Like I honestly cant see who its for, other than maybe US Corporations on the list of approved medical vendors. Like, putting on my "Lives in a free(ish) healthcare country" hat, it looks bonkers from that angle. But even from a more libertarian mode, the whole thing look…

If you want to know whom US healthcare is for, look at who makes the most money from it. There's your answer.

>other than maybe US Corporations on the list of approved medical vendors.

Think I hung a lantern on that

Post reply on HN