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Is my advice too mercenary?

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Re: Is my advice too mercenary?

#81

Post by CameronNemo »

sidewndr46 wrote: post #42
fellowniusmonk wrote: post #5

It truly is shocking that health insurance is tied to employment status. I really think this is a large part of the trend towards overt ruthlessness in the USA, no one has their back so they have no ones back, as people age and experience medical bankruptcy (or narrowly avoid it at great cost) they are realizing this ruthlessness in our system.

As an American who has worked closely with the Federal government, I'm significantly more afraid of the idea that the government would be responsible for my medical care.

Just because health care is untethered from your employment status does not mean it is single payer or fully nationalized.

See this plan for example: https://en.m.wikipedia.org/wiki/Healthy_Americans_Act

It would transition away from employer-provided health insurance, to employer-subsidized insurance, having instead individuals choose their health care plan from state-approved private insurers. It sought to make the cost of health insurance more transparent to consumers, with the expectation being that this would increase market pressures to drive health insurance costs down.

Re: Is my advice too mercenary?

#82

Post by lotsofpulp »

fellowniusmonk wrote: post #5

It truly is shocking that health insurance is tied to employment status. I really think this is a large part of the trend towards overt ruthlessness in the USA, no one has their back so they have no ones back, as people age and experience medical bankruptcy (or narrowly avoid it at great cost) they are realizing this ruthlessness in our system.

Health insurance is not tied to employment status. Anyone can go to healthcare.gov and buy an equivalent BCBS or Kaiser or whatever gold/silver/bronze insurance. Unless you are in a particularly shitty state.

What employers do have is the ability to sell you health insurance with pre tax dollars, which is also available to self employed individuals. But the people who are screwed are those who are employed by employers that do not offer health insurance. They have to buy insurance with post tax dollars.

There is similar bullshit with retirement funding, where employer sponsored retirement account limits are drastically more than individual ones (401k vs IRA), and especially if you are a married couple with 1 spouse with 401k access and one spouse without.

Re: Is my advice too mercenary?

#83

Post by 121789 »

uoaei wrote: post #36
121789 wrote: post #27

Earlier quoted context omitted.

I think you are framing it as a top down objective, but I think it's the opposite. Employers themselves offer healthcare because it's a way to attract employees. You can get other health plans (e.g. Obamacare) but they are not as competitive as employer-sponsored plans. To not have employer-sponsored plans, you would have to either 1) ban employer-sponsored plans 2) offer other plans that are competitive. #1 seems un…

I want to point out that the above analysis is completely ahistorical and does not track the path dependence and latent contexts of the development of the modern US healthcare system. The above is not an explanation, it is a post-hoc rationalization.

I find this comment to be too ambiguous to be helpful. Could you elaborate on your points?

Re: Is my advice too mercenary?

#84

Post by syedkarim »

randrews wrote: post #63

One of the wisest pieces of career advice I ever heard was "you cannot change an organization by leaving it." It works both ways: if you're leaving in hopes that it'll be a wake-up call to management that a valuable person left, then it probably won't be. And, if you leave your workplace to improve your own life, you've also necessarily chosen not to try and improve the workplace. Leaving means giving up on trying to…

Why would you even want to change an organization?

Re: Is my advice too mercenary?

#85

Post by sidewndr46 »

dangerlibrary wrote: post #53
sidewndr46 wrote: post #42

Earlier quoted context omitted.

As an American who has worked closely with the Federal government, I'm significantly more afraid of the idea that the government would be responsible for my medical care.

Medicare (single payer healthcare in the US for everyone over age 65) has a lower fraud rate than private insurance, serves millions of seniors and has for decades, and as an American there is a big discontinuity in actuarial data where your life expectancy literally goes up at 65 because you get access to it. Maybe don't generalize from a few personal anecdotes to the functioning of the entire 4 million employee fed…

Why would I care about the fraud rate of anything? I'm not a fraudster.

Re: Is my advice too mercenary?

#86

Post by anm89 »

Was really on board with everything he'd written in both articles so its sad to see it devolve into a "late stage captialism" rant.

There is so much interesting critique to make of our current system, sad to see people going for these lazy, of the moment, arguments.

Re: Is my advice too mercenary?

#87

Post by nobody9999 »

replygirl wrote: post #45
kube-system wrote: post #41

Earlier quoted context omitted.

Having had both, this is not my experience. My experience is that employer plans have fewer choices and similar or higher rates. They're cheap because my employer is paying most of the bill.

I haven't had insurance for five years because the (major, national) providers who cover what I need aren't available on my state's marketplace (NY).

>I haven't had insurance for five years because the (major, national) providers who cover what I need aren't available on my state's marketplace (NY).

As someone who purchases insurance from the NY marketplace, that hasn't been my experience.

Initially, I had a plan from one of those (Anthem/BCBS), which provided pretty good coverage because they increased my premiums by more than 50%.

Now I have a local (New York State) provider (Fidelis Care) which costs less and has a (fairly) low deductible through the state's marketplace.

That said, many providers are actively hostile to marketplace plans. Back when I still had an employer-based plan, my company changed insurance providers. I called up my GP to make sure they accepted insurance from the new company, but before I could even describe the scenario, the office person at my doctor's office raised her voice and said, "We don't take any Obamacare plans!"

Which was quite interesting, since back then many of the major national insurance companies were offering such plans, including the companies (both old and new) my employer was contracting with.

All in all, I've been fairly satisfied with Fidelis Care, although I wish I could do database queries of their "Explanation of Benefits" records rather than having to wade through PDFs for each visit to a provider.

All that said, I don't know your circumstance (none of my business) so you may have needs that I don't. I wonder what those might be that a "national" insurer might offer than an in-state provider doesn't, especially since the ACA specified requirements for all health insurance plans, not just those on marketplaces.

Although I'm not sure how no insurance could be better than some, unless you're against medical care in general. But my use case isn't yours and I'm sure you make decisions that are best for you.

Edit: Added a few thoughts to address parent's issues, clarified my point about coverage to be more clear that I'm emphatically not calling anyone a liar.

Re: Is my advice too mercenary?

#89

Post by sidewndr46 »

idiotsecant wrote: post #62
sidewndr46 wrote: post #42

Earlier quoted context omitted.

As an American who has worked closely with the Federal government, I'm significantly more afraid of the idea that the government would be responsible for my medical care.

I guess you should probably tell that to the entire rest of the civilized world where state insurance seems to work quite well.

I have no problem believing that other nations governments do a great job. I also do not live there nor am I a citizen of those countries.

American government is a uniquely incompetent form of government. Despite being one of the largest & most expensive governments it gets little to nothing done. Anything that is 'done' is often done far over the original projected budget.

Re: Is my advice too mercenary?

#90

Post by dangerlibrary »

sidewndr46 wrote: post #85
dangerlibrary wrote: post #53

Earlier quoted context omitted.

Medicare (single payer healthcare in the US for everyone over age 65) has a lower fraud rate than private insurance, serves millions of seniors and has for decades, and as an American there is a big discontinuity in actuarial data where your life expectancy literally goes up at 65 because you get access to it. Maybe don't generalize from a few personal anecdotes to the functioning of the entire 4 million employee fed…

Why would I care about the fraud rate of anything? I'm not a fraudster.

A common right-wing criticism of Medicare that I was trying to pre-empt is that it is rife with waste, fraud, and abuse.

But to directly answer your question: if you want your dollars spent effectively, you should care about fraud rates in services you pay for (public or private).

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