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Many See I.R.S. Penalties as More Affordable Than Health Insurance

nytimes.com

361–370 of 383 posts

Re: Many See I.R.S. Penalties as More Affordable Than Health Insurance

#361

Earlier quoted context omitted.

The plan I have currently has a $6k deductible for my family, for in-network care - $10k outside of network. This would not bankrupt us currently, no, but it would have as recently as a few months ago, and almost all other times in my life.

I thought that the vast majority of healthcare providers are amenable to payment plans and other forms of assistance.

Definitely, they'd much rather collect late or partially than have you try to evade collection or declare bankruptcy.

However, your room for negotiation is much smaller when you're paying a huge insurance deductible than if you're completely uninsured. Hospitals charge outrageous prices for the uninsured, partly so they have room to make a profit when insurance companies negotiate down, partly to make up for the fact that a lot of uninsured people will never pay, and partly because some people will pay it so they might as well try.

If you're insured with a high deductible, the insurance company has already negotiated prices down by an order of magnitude. Any further negotiation with your deductible starts to really hurt their bottom line, and might run into problems with their arrangement with the insurance company too.

I have to imagine that a payment plan could be arranged without too much difficulty, but actually reducing the total amount could be challenging.

Re: Many See I.R.S. Penalties as More Affordable Than Health Insurance

#363

Earlier quoted context omitted.

If you don't go to the doctor and don't need medicine, the "something" isn't valuable especially if it's more expensive than the "nothing". (I say that as someone with a preexisting condition who is happy to pay my premiums and get the medicine I need; I also grew up in a family where we didn't have insurance but somehow always had cigarettes and cable TV, so I know multiple perspectives)

I'm 30 years old and haven't been to a doctor in about 10 years outside of simple things that I paid out of my own pocket. Nothing that a year of healthcare would cover, and considerably lower than it'd cost. I'd have paid in tens of thousands of dollars over the course of that time, and for what? What ifs?

Do you know how insurance works?

Re: Many See I.R.S. Penalties as More Affordable Than Health Insurance

#364
post #47

Earlier quoted context omitted.

For what it's worth, I have talked to doctors who want single payer just as much as some of us.

It is vastly less hassle for doctors to have to deal with a single entity for all reimbursements. No hiring collection agencies to hassle patients, no mysterious nonpayments, no switching networks, one set of rules to learn and that is it. They'll also probably end up paid a bit less under such a system. The tradeoff is worth it.

Paid less maybe but save a massive amount on costs. Overall they'll come out with more margin and more time.

Re: Many See I.R.S. Penalties as More Affordable Than Health Insurance

#365
post #109

Earlier quoted context omitted.

And what will happen is you will not get much health care. Certainly much less than you got in 2005, for much more than you paid in 2005. Insurers routinely pay out over %100 of premiums in claims. Meanwhile government programs with benefits- like welfare- blow %75 of their budget on overhead and only pay out %25. Economics is like physics. You can wish it wasn't so. You can look at optical illusions, but the reality…

"The bottom line: Government spends about 70% of tax dollars to get 30% of tax dollars to the poor. The private sector does the opposite, spending about 30% or less to get 70% of aid to the poor." https://www.theadvocates.org/effective-government-welfare-co...

Two of those three works cited to arrive at the "~70%" figure are ~thirty years old. It's not looking good for the author. Let's look at the paper by Edwards that's only ~9 years old...

Edwards's first citation for his "~70%" figure is one of those two thirty-year old studies. His second is one is a paper by Tanner from 1996. So, let's look at that one...

Sadly, the Tanner work is a dead-tree book, page 136 isn't available in the Google Books preview, and Mr. Edwards doesn't bother to mention the source of Tanner's numbers.

So. Two out of three sources for that "Government welfare programs spend 70% of every dollar on overhead" claim are ~thirty years old. One of those sources can't be easily verified. It's not looking good for the basis of that claim.

But, let's be charitable. Let's presume that the claims of the twenty-year-old paper were based on then-recent information that was correctly interpreted and is still valid, twenty years later... [0]

Remember that Tanner is talking about all US government welfare programs. We're talking -specifically- about Medicare. As mentioned here [2] the worst case overhead for Medicare is 8%. That's a far cry from the 75% figure cited by MCRed, and far better than the 25%->35% overhead figure cited by Mr. Edwards for private-sector charities.

Medicare is really well run and gives really good outcomes per dollar spent. It's a shining example of a long-standing, effective, well-run government program. Sure, if you look, you can find horror stories of bureaucratic failures and mismanagement... but the same is very true (and happens far more frequently) when dealing with private sector "health insurance" companies.

[0] Some reasonable contemporary scholars found much to complain about in the work. A choice quote from one criticism in 1997: "Tanner uses the familiar tactic of dividing this spending by the number of poor people ... [t]he intended inference is either that a lot of the money goes inappropriately to people who are not poor or that the bureaucracy siphons off most of the funds. Neither is correct. Most of the resources do go to the intended beneficiaries, but are not counted; about 80 percent of welfare spending takes the form of in-kind transfers, and poverty is defined in terms of cash incomes only. Administrative costs of most government welfare programs are under 12 percent." [1]

[1] http://www.independent.org/publications/tir/article.asp?a=42...

[2] https://news.ycombinator.com/item?id=10840804

Re: Many See I.R.S. Penalties as More Affordable Than Health Insurance

#366
post #258
post #188

Earlier quoted context omitted.

And many people believe the draft is morally equivalent to slavery (which they do not support either).[1] [1] http://gregmankiw.blogspot.ca/2006/11/rangel-and-friedman-on...

That's fine, I personally don't support the draft, but still. What about the legal system? Don't you see there is a problem with forcibly locking a portion of our population away behind bars? After all, that's what the government does, "for your own safety". Do you really feel safe in a country where the government can decide that murder is a "crime" for which you should be inhumanely LOCKED AWAY FOR LIFE? P.S. Extre…

You admit to sarcasm, but say the murder victim was an 3rd trimester fetus... now you have yourself a modern day political issue.

Re: Many See I.R.S. Penalties as More Affordable Than Health Insurance

#367
post #287

Earlier quoted context omitted.

So you're prepared to invalidate close to 100% of all employment contracts in the US?

Quite the contrary. Those are entered into willfully and not coercively.

Does financial coercion exist? If wage slavery doesn't count, what does count as financial coercion?

Re: Many See I.R.S. Penalties as More Affordable Than Health Insurance

#368

Earlier quoted context omitted.

If you read the document in your link, you will see that that regulation expired last July.

That was just the emergency amendment. It's codified: https://govt.westlaw.com/calregs/Document/IE282722688B248DFA...

That's just another emergency amendment that expires in less than 3 weeks. Scroll to the bottom of your link.

Re: Many See I.R.S. Penalties as More Affordable Than Health Insurance

#369

Earlier quoted context omitted.

> Apparently some/much of this has to do with our state choosing to opt out of dealing with increased medicaid funding, so... yay... I guess they get to show obama how bad ACA is by... digging in their heels while we all just pay insanely increasing pricing? Let's be fair here. The ACA said that the feds would match the expanded medicaid enrollment for a few years, but after that the states would need to continue to…

If your state can't sustain something with the federal government funding 90% of your expanded costs, then maybe you need to rethink the state you're in. It's no doubt, most likely in the "south" in some form, so I'm not surprised the government can't operate correctly.

[deleted]

Re: Many See I.R.S. Penalties as More Affordable Than Health Insurance

#370

Earlier quoted context omitted.

If a insurance network can't meet its obligations it will be fined or shut down What are you claiming its obligations are? Its obligations are to pay valid claims made by covered parties. It does not have a legal obligation to add provider capacity to a given region.

> Its obligations are to pay valid claims made by covered parties No, its obligations are to operate legally within the state. > What are you claiming its obligations are? https://govt.westlaw.com/calregs/Browse/Home/California/Cali... > It does not have a legal obligation to add provider capacity to a given region. Correct. The other option is it could not operate in that given region at all.

  The other option is it could (choose to)
  not operate in that given region at all
This was the choice taken by UnitedHealth, Aetna, Cigna, ...
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