US Workers Are Highly Taxed If You Count Premiums • Hacker News Board

Re: US Workers Are Highly Taxed If You Count Premiums

#471

Post by ceejayoz » Tue, Apr 09, 2019, 2:52 PM UTC

Bombthecat wrote: post #351

Gibbon1 wrote: post #280

Earlier quoted context omitted.

I've noticed that a lot of employers don't tell workers how much they are paying for health insurance. Because for large companies the number gets rolled into a negociated contract. In my case I do know. My employer pays $930 some a month. My rent used to be $860/month. The other thing the happens is just because you have insurance doesn't mean that healthcare providers aren't trying to jack more money out of you. An…

What the...? Almost a thousend a month? That's 12k a year, just paid by employers. Where is the money going?

To the USA's $9.5k/year per-capital healthcare spending.

Did my taxes and my family of four was well past the $30k mark for insurance, copays, dental, and optical this year.

Re: US Workers Are Highly Taxed If You Count Premiums

#472

Post by shados » Tue, Apr 09, 2019, 2:55 PM UTC

roenxi wrote: post #270

TallGuyShort wrote: post #216

Earlier quoted context omitted.

Can't even find out what stuff costs beforehand either. I had to get a blood test. I had gotten burned before where my insurance said they covered a physical, but it turns out their definition of a physical didn't include the doctor's definition, which included blood tests. So before I had my blood drawn, I asked them to tell me what the tests would cost if my insurance didn't cover it. "It depends on how it's coded,…

'You should know the price before you agree to buy the product' seems like such an innocuous principle. Why isn't their broad-based support of it for medical care? If you need emergency care then sure, there isn't time. The vast majority of interactions with the medical system aren't that type of emergency though. People have time to choose the better of two options. They can't decide on better if they don't know the…

Its even more absurd because your health, well being, and potentially life is held hostage. Like, if the choice is "you pay this or you die", it's not exactly a choice. They can charge whatever BECAUSE OTHERWISE YOU'RE DEAD.

But the mere fact that you can go get a surgery, and not only will you not know what it will cost, you don't even know who you're doing business with: you're going to get bills from the doctor, from the hospitals, from the nurses, from the anesthetist, and god know what else from, for the next 6 months. You don't even know if you're done paying all your bills or not!

Its completely absurd.

Re: US Workers Are Highly Taxed If You Count Premiums

#473

Post by taysic » Tue, Apr 09, 2019, 2:58 PM UTC

exodus_de wrote: post #310

jimbokun wrote: post #175

Earlier quoted context omitted.

"You should care about the deductible, cause you entered the contract, silly." This is stupid. There is no real way to shop and bring down health insurance costs in the US. It's tied to your job, meaning you would need to get many job offers, and turn them down when you find out the actual insurance costs until you find one that's better, and ignoring other employment factors. And then everything can change the next…

Insurance isn't tied to your job. You can (and often should) forego the employer's plan and purchase insurance on the open market. Most insurances have some form of deductible, it's what keeps them affordable. Insurance should be protecting you against a huge financial fallout, not against petty expenses. I agree it is a stupid system though and I'll tell you why: People want something for nothing. They want coverage…

It’s tied to your job because health ins through your employer gets an effective tax discount compared to that bought through the ACA market. There is no way for latter to be as economical.

Re: US Workers Are Highly Taxed If You Count Premiums

#474

Post by [deleted] » Tue, Apr 09, 2019, 3:02 PM UTC

mikeash wrote: post #224

splintercell wrote: post #215

Earlier quoted context omitted.

I really don't understand this 'labor theory of value' thinking. Just because there wasn't anything wrong doesn't mean you don't have to pay a person for their services.

That’s not what I’m saying at all. I’m saying that the cost was way too high. How much does an ER visit like that cost in a sane country? I mean the actual cost, not the “free” that the patient might see from a socialized system. It’s nowhere near that high.

[deleted]

Re: US Workers Are Highly Taxed If You Count Premiums

#475

Post by TallGuyShort » Tue, Apr 09, 2019, 3:13 PM UTC

henrikschroder wrote: post #350

TallGuyShort wrote: post #216

Earlier quoted context omitted.

Can't even find out what stuff costs beforehand either. I had to get a blood test. I had gotten burned before where my insurance said they covered a physical, but it turns out their definition of a physical didn't include the doctor's definition, which included blood tests. So before I had my blood drawn, I asked them to tell me what the tests would cost if my insurance didn't cover it. "It depends on how it's coded,…

I was at the dentist today because I managed to chip a tooth yesterday, and needed it fixed. Before the procedure, they asked if I wanted an estimate, I said sure, and got one in a minute. The dental industry works the same as the medical, I have a half-useless insurance that covers too little, and out-of-pocket expenses are always higher than you expect. But if they can do estimates before a procedure, why the hell…

Yeah I was able to get an estimate on the birth of my child, too. But then lawyers had to get involved between me and Banner Health a year later, over a bill from an anesthesiologist they said didn't exist, with contact information at which no one said I owed any money, that was never billed to my insurance company, for an epidural that ended up being done quite poorly. In the end it was considered to be my responsibility because of a paper my wife signed while in hard labor agreeing to pay the bill. Fuck the whole industry. That's not even my worst experience - just the most recent. I basically don't visit doctors or dentists anymore because the biggest health threat I see in my life is the massive surge of blood pressure I get at the mere mention of insurance companies.

Re: US Workers Are Highly Taxed If You Count Premiums

#476

Post by JshWright » Tue, Apr 09, 2019, 3:35 PM UTC

wolco wrote: post #315

JshWright wrote: post #288

Earlier quoted context omitted.

With insurance, more complicated births aren't that much more. We were out of pocket $4k for the birth of our twins (maxed our deductible). The total 'sticker price; was over a million USD (they spent a combined 10 weeks in the NICU).

Over a million for 10 weeks in nicu? Who sets these rates?

To be "fair" that also includes the c-section delivery...

Re: US Workers Are Highly Taxed If You Count Premiums

#477

Post by harrumph » Tue, Apr 09, 2019, 3:36 PM UTC

Markets such as the US health care market, characterized by ineslastic demand and secret prices, should never, ever be tolerated under any circumstances. This arrangement is here to benefit the supply side and screw the demand side and it has to be stopped. The only pathway out of this crisis starts with the federal government replacing private insurers, relegating them to selling supplemental coverage. Such companies also should be legally compelled to run as mutual insurance companies, where any profit deriving from good risk management is sent back to policyholders. It is long past time everybody in the US admitted that markets have completely failed in US health care.

Re: US Workers Are Highly Taxed If You Count Premiums

#478

Post by tptacek » Tue, Apr 09, 2019, 3:51 PM UTC

Vinnl wrote: post #416

tptacek wrote: post #126

Just a quick note that health insurance premiums do not in fact get plowed directly into rents and administrative redundancies; we pay more than Europe (and Medicare) does in administrative costs, but far-and-away the largest components of health care expenditures in the US are in inpatient and outpatient procedure billings (outpatient by a factor of almost 2x inpatient, itself something like 3-4x all administrative…

I'm not from the US and had to look up "inpatient" and "outpatient", so to share what I've found: as I understand it it's different ways of recording what a patient is suffering from, with "inpatient" being used when a cause is known, and "outpatient" when a doctor can only describe the symptoms, without knowing what they are caused by. And I guess the relevance is that discerning and switching between the two when a…

"Inpatient" means you've been admitted to the hospital. "Outpatient" means you're home the same day as your procedure.

Re: US Workers Are Highly Taxed If You Count Premiums

#479

Post by dandare » Tue, Apr 09, 2019, 3:59 PM UTC

fabricexpert wrote: post #438

dandare wrote: post #434

Tangential: As a non-native speaker, I find the word PREMIUM highly problematic. You need a lot of contexts to understand that the article is talking about health care costs not covered by health insurance.

It's not because you are a non-native speaker. It's not a widely used English term without the word Insurance in front of it, however it is a standard American English term. It is also not the costs "not covered by health insurance", rather the insurance premium is the cost of the policy itself.

Interesting, thanks! But from what I know people in US often end up paying extra cash (on top of their health insurance) for procedures, checkups, and drugs. This is rather rare in EU. That should be included in whatever international comparison.

Re: US Workers Are Highly Taxed If You Count Premiums

#480

Post by MertsA » Tue, Apr 09, 2019, 4:00 PM UTC

dsfyu404ed wrote: post #448

MertsA wrote: post #303

Earlier quoted context omitted.

My son just had a laceration that needed closed up a week ago. We didn't even take him to the ER, just his pediatrician who saw him for all of 5 minutes. She didn't even use any skin adhesives to close up the wound, she just taped it together and called it good. $120 for literally putting on a bandaid that came apart before we even finished the car ride home leaving us to tape it up properly ourselves.

You didn't pay $120 for the doctor to slap on a band-aid. You paid $120 for the peace of mind of having a "trained professional" do it and tell you that was an acceptable solution. It's the same reason people call plumbers to snake drains and pay mechanics to change brakes. Those are basic things that the least trained workers in those industries are capable of doing but you pay a premium to not have to think about i…

Nothing about the situation required an expert opinion and the pediatrician made a pretty poor decision to boot. It was abundantly clear that the wound just needed stitches, that's not something I can do myself. In the future I might just get some Vetbond, because if I had that on hand that would have been preferable to the care received from paying an expert $120. No other developed country on the planet is this backwards when it comes to health care.

I'm fine with paying a premium for trained professionals, I'm fine with paying doctors a high wage. $120 is crazy for a doctor who already has an opening in their schedule taking less than 10 minutes to glance at a wound and slap some steri-strips on it.