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

Employer health plans are getting pricier and skimpier

axios.com

Post reply on HN
Print view View original

81–90 of 539 posts

Re: Employer health plans are getting pricier and skimpier

#81

Post by [deleted] »

mieseratte wrote: post #76
tempsy wrote: post #64

Earlier quoted context omitted.

I don’t understand your comment. If the company is large it is likely self-funded, so it is taking on the risk, whether they are doing it in house or hiring a benefits consultant to do it for them. I didn’t say anything about the quality of a self-funded plan, simply just pointing out that a self-funded plans means your relationship with your company is not merely just a worker but you morph into this insurance risk…

> I don’t understand your comment. If the company is large it is likely self-funded, so it is taking on the risk, whether they are doing it in house or hiring a benefits consultant to do it for them. Because they partner with a larger provider for the doctor / hospital / pharmacy networks and specialist support. This is a very common pattern insofar as I'm aware. Has your experience differed?

[deleted]

Re: Employer health plans are getting pricier and skimpier

#83

Post by 2sk21 »

throwaway66920 wrote: post #22
throwaway_law wrote: post #14

Earlier quoted context omitted.

I hear this statement all the time...but what does it mean? If employers didn't provide health insurance to employees wouldn't we just wind up with 40% of the insured uninsured? Its not like Corporate America is going to make up the difference and start paying cash to compensate for the lost benefit, at least thats what happened as pensions got stripped away from the workplace. Even if the employer's did make up the…

Getting insurance as an individual is expensive because you’re not part of a group plan. With a group plan the insurance company has some reason to believe you’re not collectively a bunch of dying people committing moral hazard, you’re just one of a generally similar looking company workforce. If employers stopped providing it, I think it is presumed that the mentality towards individual plans would change

Well, one way of looking at it is that the general population is the biggest group possible :-)

Re: Employer health plans are getting pricier and skimpier

#84

Post by opportune »

Even at famously generous employers they will try very hard to push you towards high deductible plans by giving you 1-2 thousand extra dollars per year in your HSA. Of course the high deductible plans discourage you from seeking care so it saves your employer peanuts it can add to its war chest in Ireland

Some of this probably has its roots in the ACA adding extra taxes onto “Cadillac insurance plans” though which I didn’t even learn about until recently. Yes, apparently you may need to pay extra taxes for extra good insurance

Re: Employer health plans are getting pricier and skimpier

#85

Post by black6 »

The American health insurance system is not insurance--it's a long-term payment plan. Why does insurance need to get billed when I go for a yearly checkup with my doc, or when I pick up some prescription-strength ibuprofen? My auto insurance company doesn't get billed when I get the oil changed in my truck. My homeowners insurance company doesn't get billed when I have to recharge the refrigerant in my heat pump. The insurance companies have taken all the monetary interactions between clinics and patients away, except for the (oftentimes criminal) balance billing that occurs when your claim was denied for some ass-hat reason like "You didn't tell your insurance company whether or not you had other insurance."

Re: Employer health plans are getting pricier and skimpier

#86

Post by mbesto »

throwawaysea wrote: post #19

The entire health insurance industry makes ~$25B in profits a year, correct? That doesn't seem overly large considering it is the entire insurance industry.

And another 9% of their revenues is for useless administration (relative to a single payer system). They estimate that if administration and premiums get cut (and thus no profits) as a result of a single payer system, then we would save $615B per year.

https://www.peri.umass.edu/publication/item/1127-economic-an...

Re: Employer health plans are getting pricier and skimpier

#87

Post by ng12 »

opportune wrote: post #84

Even at famously generous employers they will try very hard to push you towards high deductible plans by giving you 1-2 thousand extra dollars per year in your HSA. Of course the high deductible plans discourage you from seeking care so it saves your employer peanuts it can add to its war chest in Ireland Some of this probably has its roots in the ACA adding extra taxes onto “Cadillac insurance plans” though which I…

There are a ton of hidden taxes tacked onto ACA but everyone I know with a marketplace plan hates theirs. I'm really not sure where that money is going.

Re: Employer health plans are getting pricier and skimpier

#88

Post by swagasaurus-rex »

tasty_freeze wrote: post #74
jbeckham wrote: post #17

Earlier quoted context omitted.

And the largest portion of that is due to specialty drugs.

I would like some evidence of this. I've read and heard many people confidently pin the high cost of health care on: too much administration, greedy doctors, undocumented immigrants, over use of tests, over prescription of drugs, too much paperwork causing inefficiency, and probably others I'm forgetting. They can't all be the primary cause. [ and before someone replies, it is a mix of those, of course ]

Perhaps the primary cause is a profit motive.

In competitive markets, competition will keep costs and profits from ballooning.

What kind of market conditions are required for spending to increase in all sorts of directions? I can immediately point to education as an example where both lenders and colleges both have a vested interest in growing eachother's businesses, paid for by the customer.

Re: Employer health plans are getting pricier and skimpier

#89

Post by tempsy »

mieseratte wrote: post #76
tempsy wrote: post #64

Earlier quoted context omitted.

I don’t understand your comment. If the company is large it is likely self-funded, so it is taking on the risk, whether they are doing it in house or hiring a benefits consultant to do it for them. I didn’t say anything about the quality of a self-funded plan, simply just pointing out that a self-funded plans means your relationship with your company is not merely just a worker but you morph into this insurance risk…

> I don’t understand your comment. If the company is large it is likely self-funded, so it is taking on the risk, whether they are doing it in house or hiring a benefits consultant to do it for them. Because they partner with a larger provider for the doctor / hospital / pharmacy networks and specialist support. This is a very common pattern insofar as I'm aware. Has your experience differed?

The network of providers available to you is a separate issue from whether your company manages the risk or an insurance company does. Didn’t mention anything about provider networks.

Re: Employer health plans are getting pricier and skimpier

#90

Post by weberc2 »

throwaway_law wrote: post #14
badrequest wrote: post #5

The sooner we can completely divorce healthcare from employment, the better.

I hear this statement all the time...but what does it mean? If employers didn't provide health insurance to employees wouldn't we just wind up with 40% of the insured uninsured? Its not like Corporate America is going to make up the difference and start paying cash to compensate for the lost benefit, at least thats what happened as pensions got stripped away from the workplace. Even if the employer's did make up the…

> Its not like Corporate America is going to make up the difference and start paying cash to compensate for the lost benefit, at least thats what happened as pensions got stripped away from the workplace.

They may not have compensated in cash (although surely some did), but they compensated elsewhere in the total compensation package. Benefits got better or salaries grew or vacation improved or 401K matches were introduced or etc etc.

As for insurance pools, what is stopping people from forming groups that can negotiate their own rates? If there is a law, why can it not be changed?

Post reply on HN