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The healthcare market is taxing reproduction out of existence

aaronstannard.com

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Re: The healthcare market is taxing reproduction out of existence

#301

Post by losvedir »

Aaronontheweb wrote: post #253
evanelias wrote: post #215

Earlier quoted context omitted.

I skimmed your 2400-word article a second time just now, and I still don't understand why your math is allocating 100% of your family's health insurance premiums to childbirth. And now I additionally don't understand your abrasive tone in answering this fairly straightforward question. Multiple commenters are raising this point, so perhaps you should consider that you aren't conveying this information well?

1. I mentioned, in multiple places, that this is the cheapest PPO offered to me through a limited selection of potential brokers / marketplaces - and that's important because it covers our current health care providers AND child birth as a benefit. 2. If we weren't trying to have kids, our options for purchasing health insurance expand drastically. Individual marketplace plans become a viable, for instance, since the…

What exactly does covering childbirth mean? We've had two children now and it's not something I've considered when choosing insurance (my company's vs my wife's), so maybe we just got lucky. Is there anything different about child birth vs simply in-network hospital coverage? I assumed we'd just hit our out-of-pocket max.

Re: The healthcare market is taxing reproduction out of existence

#302

Post by vel0city »

AstroBen wrote: post #283
vel0city wrote: post #262

Earlier quoted context omitted.

> the best care in the US is the best in the world For a few Americans. Not for all Americans, and probably not even for most Americans. There's far more to the United States than New England and Southern California. Don't get me wrong, if I had some rare cancer or other strange disease, chances are I'll want to try and get in to one of these few rare ultra premium hospitals. But if I break my leg or get some normal…

> if I break my leg or get some normal infection or have a child or any of the other normal kinds of issues people have? Will that still be the best tier of care? Does it need to be? I imagine it's far easier to treat a broken bone, in most cases, vs a rare complex disease I'd have different standards when researching where to have teeth cleaning vs oral surgery

> Does it need to be?

If we're spending the most for it, shouldn't it be? Why would I want to pay more for worse outcomes?

Re: The healthcare market is taxing reproduction out of existence

#303

Post by culebron21 »

As someone from exUSSR, I'm shocked with the figures. We've given birth in Russia and in Kazakhstan, in both cases I paid nothing at all. Just taxi to the birth house (that's how the birth clinics are called), and my wife disliked the food, so I brought her some fruits and maybe corn flakes every day of 3 days she stayed there. The equipment I could see was modern, everything was clean, there was some confusion where to put her, otherwise everything was fine. If you're suspicious, you can go to private clinic at $1,5K..2K, they even send you a taxi (or who knows, maybe a private ambulance).

My libertarian friends criticise this from the point that "everything state-run is inefficient". Even if this is true, they fail to notice that state-run healthcare keeps prices of the private sector down. You don't have to sell a car if you're seriously sick.

In 1992-96 on Russian state TV, there was a translated program called something like "Rescue number 911", with nobody else but William Shattner. (We already knew him at the time.) I got an impression that the US healthcare was impeccable.

Re: The healthcare market is taxing reproduction out of existence

#304

Post by cal_dent »

barbacoa wrote: post #300
postflopclarity wrote: post #234

Earlier quoted context omitted.

car-dependent infrastructure and urban design is hostile to human life.

Car depend infrastructure is amazing to families. A mom can take her children to the grocery store in a car in relative safety without worrying about mentally ill homeless people on the subway.

wow. this thread is microcosm of how wild and polarised the internet can be.

Re: The healthcare market is taxing reproduction out of existence

#305

Post by tptacek »

CommenterPerson wrote: post #223
gishh wrote: post #161

Earlier quoted context omitted.

Which bits cost 100k? The $75 ibproufen? The $47 towel? The $19,563 bed charge? Oh, the $32,925 imaging that NFL players get instantly? Insurance in America is a fucking joke.

The charges you mention are likely all from hospitals. How about Pluvicto for advanced prostate cancer at $42,500 per monthly dose? All the players are in on it. The sound way to manage costs and avoid these games is via Medicare for all, with premiums paid by progressive rate taxation of income. Maybe even wealth beyond a very large amount.

Currently insured Americans would likely be worse off under any plausible M4A plan.

Re: The healthcare market is taxing reproduction out of existence

#306

Post by tptacek »

Aaronontheweb wrote: post #75
hparadiz wrote: post #57

Earlier quoted context omitted.

I'm a single contractor and can't really justify it. It saves me about 8k per year and this would be a bronze plan through MediCali if I got it. People would say "well what if you get a cancer or something" and yea that may be true but in that instance not only would I be out that premium but also the deductible and it won't even cover everything so maybe I'm actually better off stacking cash until the inevitable.

I'm right there with you - this is a case study in "perverse incentives." There is zero benefit to "paying into the system" to be had under the current model. Better to chance it and then sign up for a plan at the last minute since insurers can't deny you based on pre-conditions.

This strategy is why there are open-enrollment periods for ACA-compliant plans. I had a startup back in 2014 where I had us on HC.gov/ACA market insurance. A billing SNAFU on Blue Cross's part (that year was really rough for HC.gov!) ended up getting that insurance cancelled for nonpayment about a month in, which is when I discovered that our only coverage options were all non-compliant short-term policies, all of of which excluded preexisting conditions and wouldn't underwrite one of my children at all due to an unexplained seizure several years earlier.

(We resolved the situation by finding a bank-shot qualifying event that allowed us to re-enroll --- it was extremely situational and had to do with my wife and I simultaneously leaving our jobs within a short window of time.)

Re: The healthcare market is taxing reproduction out of existence

#308

Post by weregiraffe »

barbacoa wrote: post #300
postflopclarity wrote: post #234

Earlier quoted context omitted.

car-dependent infrastructure and urban design is hostile to human life.

Car depend infrastructure is amazing to families. A mom can take her children to the grocery store in a car in relative safety without worrying about mentally ill homeless people on the subway.

Men would rather build a continent-sized car-dependent infrastructure that deal with mentally ill homeless people on the subway...

Re: The healthcare market is taxing reproduction out of existence

#309

Post by SlightlyLeftPad »

autoexec wrote: post #113
godsinhisheaven wrote: post #76

A 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…

> but if you dropped all government funding of healthcare tomorrow, healthcare plans would get cheaper. I doubt it. Hospitals charge $15 for a single pill of Tylenol because they know insurance will pay for it, and that includes private insurance. The best thing we could do is ditch the private healthcare industry to the extent that the rest of the first world has and cover everyone with government plans. Those plans…

> I doubt it. Hospitals charge $15 for a single pill of Tylenol because they know insurance will pay for it, and that includes private insurance.

Did we discover a new kind of monopoly perhaps? It’s not quite full blown corruption as there still (for now) exists a somewhat adversarial relationship between insurance and hospitals. However, at the same time, they seem to be pulling each other into the abyss, and our society is the victim.

Re: The healthcare market is taxing reproduction out of existence

#310

Post by SlightlyLeftPad »

teeray wrote: post #292
phil21 wrote: post #206

Earlier quoted context omitted.

> Hospitals charge $15 for a single pill of Tylenol because they know insurance will pay for it It’s more they know insurance won’t pay for it, and negotiate discounts based off the “retail” price. Although at this point it’s gotten so ridiculously convoluted and cross-subsidized that I doubt even the insurance company or hospital knows what the actual paid amount for a Tylenol will end up being until months after th…

Meanwhile, I hand my credit card to the vet for a bottle of Gabapentin and I’m out the door.

That will be uhm, $15. Have a fantastic holiday!
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