IMO, the “thin edge of the wedge” for socialized healthcare in the US is full, high quality and free services for maternity, birth and the 1st year of the kid.
The healthcare market is taxing reproduction out of existence
241–250 of 431 posts
Re: The healthcare market is taxing reproduction out of existence
#242A lot of this is an issue of insurance no longer being "insurance" in the classical sense. Insurance covers all sorts of things, my HSA pays for all sorts of things that I never would have even considered, and while that sounds great, it helps to drive up costs. It's somewhat counter-intuitive, but if you dropped all government funding of healthcare tomorrow, healthcare plans would get cheaper. It'd also be total cha…
Christian healthcare sharers do precisely this. By restricting services and the population addressed (your pastor or priest must sign off on your application), everything's extremely affordable. In particular, as we don't drink, do drugs, use contraceptives etc. we don't pay for coverage of them or their side effects. Obesity's also less of an issue. There's also the trick of telling the hospital you'll pay "in cash"…
Christians don't drink or use contraceptives? I think you have to have a pretty extreme "no true Scotsman" attitude to make such a claim. Even the drugs claim is pretty specious.
Re: The healthcare market is taxing reproduction out of existence
#243A lot of this is an issue of insurance no longer being "insurance" in the classical sense. Insurance covers all sorts of things, my HSA pays for all sorts of things that I never would have even considered, and while that sounds great, it helps to drive up costs. It's somewhat counter-intuitive, but if you dropped all government funding of healthcare tomorrow, healthcare plans would get cheaper. It'd also be total cha…
"If insurance covered brake pads they'd cost more" is an old mechanics quip. The principal agent problem just fucks the cost and incentive structure of anything insurance covers.
This is why it's unwise to send "routine" things through the insurance model.
Re: The healthcare market is taxing reproduction out of existence
#244A lot of this is an issue of insurance no longer being "insurance" in the classical sense. Insurance covers all sorts of things, my HSA pays for all sorts of things that I never would have even considered, and while that sounds great, it helps to drive up costs. It's somewhat counter-intuitive, but if you dropped all government funding of healthcare tomorrow, healthcare plans would get cheaper. It'd also be total cha…
> It's somewhat counter-intuitive, but if you dropped all government funding of healthcare tomorrow, healthcare plans would get cheaper. It'd also be total chaos, so I get why we don't do that.
But there are other things we could do that we don't.
For example, right now we have the expectation that insurers are going to "negotiate" with providers to determine the price, and then you have to use the providers your insurance has negotiated with, but who actually wants this? When you as a retail customer want to buy a pair of shoes or a piece of exercise equipment, do you call up all the manufacturers and try to haggle with them? No, they list their prices on their websites or sell them through retailers that do the same and then you choose based on who has what you want for the best price.
So make non-emergency healthcare work like that. Require them to publish their prices. Then the insurance company doesn't tell you where to go or negotiate with anybody, they only tell you how much they pay, which might be e.g. 90% of the second-lowest market price in your area, equivalent to a 10% deductible. Then you go to a website that lists every provider and their price, pick where to go and pay the difference yourself.
Suddenly they all have the incentive to publish the best price, because that's what most people are going to pick, and then you have an actual market instead of the existing opaque bureaucracy of corruption.
Re: The healthcare market is taxing reproduction out of existence
#245Re: The healthcare market is taxing reproduction out of existence
#246Earlier quoted context omitted.
Christian healthcare sharers do precisely this. By restricting services and the population addressed (your pastor or priest must sign off on your application), everything's extremely affordable. In particular, as we don't drink, do drugs, use contraceptives etc. we don't pay for coverage of them or their side effects. Obesity's also less of an issue. There's also the trick of telling the hospital you'll pay "in cash"…
So your pastor or priest conveniently rejects you if you have a chronic illness.
It’s not a death panel when it’s divinely inspired I suppose.
Re: The healthcare market is taxing reproduction out of existence
#247Earlier quoted context omitted.
> Given he has 3 children, 400% of FPL in 2026 is $150,600 so he's easily eligible for ACA subsidies I am absolutely not eligible. I earn more than $150k. And "manipulating your income" is not really feasible with a pass-through entity. > The premiums have nothing to do with the plans. Every single plan on the marketplace has to cover child-birth, that's sort of the point of the ACA. As I mention in the piece, I chec…
> And "manipulating your income" is not really feasible with a pass-through entity. I don't know if you have a CPA, but this is a sentence my CPA has never uttered. > but by simply refusing to cover the care those applicants need to survive pregnancy (legal and common.) Including...? I have never heard of this, and actually have delivered babies and worked with post-partum mothers.
The explanation of benefits simply doesn't cover child birth - this is extremely common for individual marketplace plans.
Re: The healthcare market is taxing reproduction out of existence
#248Earlier quoted context omitted.
I think OP here is just keeping a completely dominated plan (and his health insurance company knows it). He has less than 50 employees, he is not required to offer health insurance to his employees and he should go on the ACA market. Given he has 3 children, 400% of FPL in 2026 is $150,600 so he's easily eligible for ACA subsidies (which, by the way, in 2021-2026, were available to everyone) by tweaking his income (e…
> Given he has 3 children, 400% of FPL in 2026 is $150,600 so he's easily eligible for ACA subsidies I am absolutely not eligible. I earn more than $150k. And "manipulating your income" is not really feasible with a pass-through entity. > The premiums have nothing to do with the plans. Every single plan on the marketplace has to cover child-birth, that's sort of the point of the ACA. As I mention in the piece, I chec…
ACA plans absolutely cover childbirth (https://www.healthcare.gov/what-if-im-pregnant-or-plan-to-ge...). But it might not matter because you aren't on a marketplace plan according to the screenshots in your post.
You are on this plan: https://www.trinetaetna.com/pdfs/Aetna_PPO_7150.pdf
Which does cover childbirth according to page 3. And has a 7150 deductible per person - the $14300 is the family out of pocket max, so the childbirth should top out at the 7150. Other expenses might put you at the same 40K cost for the year, but not the childbirth alone.
Re: The healthcare market is taxing reproduction out of existence
#249Related: Car Seats as Contraception https://www.journals.uchicago.edu/doi/10.1086/731812 > We estimate that these laws [mandating safety seats] prevented fatalities of 57 children in car crashes in 2017 but reduced total births by 8,000 that year and have decreased the total by 145,000 since 1980.
Car seats as contraception is just a specific enumeration of the general. "busybodies as contraception" problem wherein the "has so few real problems they stop minding their business and mind other's business" classes try to force priorities on the rest of society that the rest of society can't yet afford to have. And it's not just contraception or kids. Pretty much everything in our economy gets shot in the foot by this to some extent.
Re: The healthcare market is taxing reproduction out of existence
#250Hmm, counting the insurance premiums 100% towards the birth of the child is a bit misleading. Presumably, you'd be paying those even if you didn't have the child. That said, the cost of health insurance for a family is pretty outrageous. My premiums are along the same lines as the ones here (although less noticeable since they're paid by my employer).
Also not a big impact on the message, but $200/mo for a phone is a bit disingenuous.
$200 seems to include home internet (which I think everyone needs these days to function). The $200 quote comes from the linked article [0] (speaking as a former financial analyst, this is an amazingly well done financial analysis). Maybe Aaron could have phrased this better.