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

What Startups Need To Know About Health Insurance in 2013

blog.simplyinsured.com

Post reply on HN
Print view View original

61–70 of 185 posts

Re: What Startups Need To Know About Health Insurance in 2013

#61

Post by Dylan16807 »

EvanAnderson wrote: post #34
kzahel wrote: post #2

Everything I read about healthcare recently just reinforces the notion that we need public health care. Let's just model our system after say, Canada's, and call it done.

We need to get rid of the unregulated, manifest "socialist" medical system that the United States has today and replace it with something that is a known quantity. A public system is one option (and one that I'm in favor of), but there could be other solutions too. In general, the current system doesn't stop people who can't pay from receiving care. If we agree that allowing someone to die because they can't pay isn'…

You haven't even mentioned the fact that people without insurance are forced to use the most expensive services (and then go bankrupt and not pay) because that's the only kind they can get.

Re: What Startups Need To Know About Health Insurance in 2013

#62

Post by euroclydon »

[deleted] wrote: post #52
rayiner wrote: post #8

Earlier quoted context omitted.

I don't even need public healthcare. I just want something that does away with the current employer-sponsored system. We should make it easier, not harder, for people to move between jobs, take gaps to start companies or get new training, etc. We shouldn't be discouraging younger workers from getting preventative care so they can stay healthy and keep contributing to the economy.

[deleted]

The reason Republicans are not for single payer healthcare is because it will require raising taxes to pay for, not because they want to immobilize labor.

Re: What Startups Need To Know About Health Insurance in 2013

#63

Post by jgon »

mniejiki wrote: post #43
ultraswank wrote: post #17

I've been hearing a lot of anecdotal evidence lately that the costs of private health insurance are stopping people, especially those with kids, from making the leap into their own start ups. Is anyone else getting that same impression? In my own experience on the topic I've become increasingly frustrated with the U.S. system of employer provided health care. Either give us a public option with universal coverage, or…

You can get COBRA so it's not that you won't have insurance but rather that you will pay for it yourself. And have 18 months to find a longer term option if you can. It's what I did although I am single without kids so my rate was significantly lower. Of course that is exactly what your employer paid on your behalf before. So you're basically complaining that other people will now no longer be subsidizing your medica…

This is exactly why a public system would help. Because the amount you pay for healthcare is scaled to your ability (via progressive taxes). Buying a private plan is not.

To see why this matters, imagine embarking on your "conquer the world" startup. You've saved up enough money for 12 months of runway. In a public system you are making 0 dollars and thus won't be taxed. However you will still have full health care. In a private system you will need to pair a fairly substantial amount (but probably not too much more than the amount of taxes that would go to healthcare in a public system) to receive coverage. You now have the following consquences: a) less runway or, b) more time saving up to get an equivalent amount of runway or, c) not having coverage and praying nothing goes wrong d) you just don't pursue your idea because it would be too hard.

Then, in a public system, when your startup succeeds and you make 10 million, you are taxed progressively on that money so as to fund the next hungry young graduate with a dream and a compiler.

I think it is pretty clear that the public system allows for more risk-taking. It is also important to note from your own example that private insurance is pretty expensive unless you are young, single, and without kids. This eliminates a huge swath of the population, all of whom might have different and awesome ideas. We bemoan the lack of gender and racial diversity in the computer field, but I think that the lack of age, lifestyle diversity in start-ups is just as important an issue.

Re: What Startups Need To Know About Health Insurance in 2013

#64

Post by alok-g »

koops wrote: post #27

I would recommend Kaiser coverage to anyone thinking about switching from one of those plans with big increases. Their doctors don't get extra money for performing extra procedures as is the case in a lot of plans, so there is more incentive to just do what's necessary.

Would that mean that they would send the patients back home unless they can provably identify some issue? (This has happened to me a few times (with the issue re-discovered at a later point), though I have never been with Kaiser.)

Re: What Startups Need To Know About Health Insurance in 2013

#65

Post by baddox »

grecy wrote: post #32
kzahel wrote: post #2

Everything I read about healthcare recently just reinforces the notion that we need public health care. Let's just model our system after say, Canada's, and call it done.

I don't suggest you model it after Canada's system. It's good, but it could be better. I moved to Canada from Australia, so I'll compare the two systems for you. Canada: "healthcare for all" provides basic coverage of everything you need. Works pretty well. Even homeless / out of work people are fully covered. Things like dental and chiropractor are not covered, so you pay for those. Employers give "health care" whic…

Does anything legally tie your optional health insurance to your employment in Canada and legally prohibit Australian employers from providing private health insurance, or is that simply the way the two markets have developed?

Re: What Startups Need To Know About Health Insurance in 2013

#67

Post by IanDrake »

rprasad wrote: post #25
paulhauggis wrote: post #6

Earlier quoted context omitted.

Issues I have with public health care: 1) The government hasn't been able to run anything efficiently as long as I've been alive. It's not like we can just go back if UHC doesn't work out. 2) The more the government runs our lives (especially something like health care), the more they will be able to dictate our choices (what we eat, risky behavior, etc). 3) I haven't seen one person that supports public health care…

Issues with private health care: 1) Private health insurers haven't been able to run anything efficiently as long as I've been alive. My premiums go up by double digit percentages every year because "costs" keep increasing, but at the same time, insurers' profits go up by double digit percentages every year. It seems like this is simply a money transfer to health care executives. 2) The more private companies run our…

Total BS.

Have any figures to support your first point? Here's CIGNA: http://yhoo.it/TLkvyd increase in Net Income: 2010 - 3.3%, 2011 - (1.3%)

>the more they will be able to dictate our choices

Private companies can't force you do to anything, only government can do that. http://bit.ly/Q4lj1s http://nbcnews.to/rK90ox

>government control is that we actually have some say in how the government controls us because at the end of the day we control the government.

That was a joke right?

As it is there is a shortage of nurses and doctors. Partly because it costs a lot of money and effort to enter that profession. How many people will be motivated to go that direction if they'll be slaves to government decree? It will take some time, but the effect of government controlled healthcare will be a race to the bottom.

Also, the profit motive is what keeps costs down and service levels high. The less regulated an industry is, the better the service and products are available to consumers who now have choice.

Re: What Startups Need To Know About Health Insurance in 2013

#68

Post by Dylan16807 »

rprasad wrote: post #25
paulhauggis wrote: post #6

Earlier quoted context omitted.

Issues I have with public health care: 1) The government hasn't been able to run anything efficiently as long as I've been alive. It's not like we can just go back if UHC doesn't work out. 2) The more the government runs our lives (especially something like health care), the more they will be able to dictate our choices (what we eat, risky behavior, etc). 3) I haven't seen one person that supports public health care…

Issues with private health care: 1) Private health insurers haven't been able to run anything efficiently as long as I've been alive. My premiums go up by double digit percentages every year because "costs" keep increasing, but at the same time, insurers' profits go up by double digit percentages every year. It seems like this is simply a money transfer to health care executives. 2) The more private companies run our…

> My premiums go up by double digit percentages every year because "costs" keep increasing, but at the same time, insurers' profits go up by double digit percentages every year.

The raw profit values in dollars? If the costs go up 20%, the premiums go up 20%, and the profits go up 20% all together I'm not going to cry foul. The problem is the fact that costs are going up because of bad management.

> at the end of the day we control the government

You also control which insurance company you use. You have even more power; think about how hard it is to switch countries.

> downsides of a private health care system outweigh the downsides of a public health care system

I agree there, at least when it comes to basic care.

Re: What Startups Need To Know About Health Insurance in 2013

#69

Post by r0s »

paulhauggis wrote: post #6
kzahel wrote: post #2

Everything I read about healthcare recently just reinforces the notion that we need public health care. Let's just model our system after say, Canada's, and call it done.

Issues I have with public health care: 1) The government hasn't been able to run anything efficiently as long as I've been alive. It's not like we can just go back if UHC doesn't work out. 2) The more the government runs our lives (especially something like health care), the more they will be able to dictate our choices (what we eat, risky behavior, etc). 3) I haven't seen one person that supports public health care…

1) How efficient is Medicare now? Private healthcare will always be an option. The existing private system would still be very good, and very competitive.

2) You can say the same for private industry.

3) The downsides are taxes. Expand the existing government payer system with minimal logistic cost. Remove the tax burden from employees (or employers passing it on to same) and watch the economy flourish. The biggest risk is to private insurance, which will never fully recover. Some may opt for the nonprofit model.

Re: What Startups Need To Know About Health Insurance in 2013

#70

Post by MichaelSalib »

[deleted] wrote: post #52
rayiner wrote: post #8

Earlier quoted context omitted.

I don't even need public healthcare. I just want something that does away with the current employer-sponsored system. We should make it easier, not harder, for people to move between jobs, take gaps to start companies or get new training, etc. We shouldn't be discouraging younger workers from getting preventative care so they can stay healthy and keep contributing to the economy.

[deleted]

The problem is not so much big companies wanting to lock in employees as the political nightmare of ending a tax-break. Right now, people who get employer based health care get a tax break: their compensation used to pay for health insurance doesn't get taxed. The more money you make, the more valuable that tax break is. People with employer based health care tend to be richer than people without. Every year, the government foregoes $80 billion in tax revenue by refusing to tax employer provided health benefits, and most of that money goes to middle and upper-middle class workers.

Congress isn't going to threaten an $80 billion/year tax cut that is almost entirely consumed by middle and upper middle class professionals.

Post reply on HN