People Lose Their Employer-Sponsored Insurance Constantly • Hacker News Board

Re: People Lose Their Employer-Sponsored Insurance Constantly

#91

Post by TOGoS » Wed, Apr 17, 2019, 6:18 PM UTC

camelNotation wrote: post #51

Medicare-for-All is some sort of "far left" fantasy in the United States, but single-payer healthcare is center-right dogma in every other developed country. I have no idea why this is so hard for the American right to grasp: single-payer healthcare is a social program, but it's not the same as socialism. We aren't trying to steal the means of production from you in some sort of revolution, we just don't want people…

> We aren't trying to steal the means of production from you

I mean, workers created them in the first place, so I'm all for "stealing" them back.

But I also wouldn't mind single-payer healthcare in the meantime.

Re: People Lose Their Employer-Sponsored Insurance Constantly

#92

Post by Gibbon1 » Wed, Apr 17, 2019, 6:19 PM UTC

helen___keller wrote: post #37

The point of health insurance is to pay into a risk pool as a collective so that the small percentage of people who end up needing the largest percentage of health care, nobody dies or goes into monumental debt. This can be done via taxes but insurance is a private market solution which should in theory make it more efficient for the sake of maximizing profit. So then if it's supposedly more efficient, why do I waste…

> If I could choose to just pay more in taxes

One of the fallacies in play is buying insurance is put in one category. Whereas paying taxes for insurance is another. The first is 'good' because it's 'free market' and the second is 'bad' because it's the government taking your money's.

Re: People Lose Their Employer-Sponsored Insurance Constantly

#93

Post by otaviokz » Wed, Apr 17, 2019, 6:21 PM UTC

maxxxxx wrote: post #59

camelNotation wrote: post #51

Medicare-for-All is some sort of "far left" fantasy in the United States, but single-payer healthcare is center-right dogma in every other developed country. I have no idea why this is so hard for the American right to grasp: single-payer healthcare is a social program, but it's not the same as socialism. We aren't trying to steal the means of production from you in some sort of revolution, we just don't want people…

"single-payer healthcare is a social program, but it's not the same as socialism" American politics is geared towards appealing to the extremes. Social programs are "socialist" and get connected to the Soviet Union, cuba and Venezuela. If you say something that's even slight politically incorrect you are immediately labeled as a "racist" that should be removed from your job and all public discussion. There is no inte…

Couldn't agree more.

Re: People Lose Their Employer-Sponsored Insurance Constantly

#94

Post by coldtea » Wed, Apr 17, 2019, 6:21 PM UTC

helen___keller wrote: post #37

The point of health insurance is to pay into a risk pool as a collective so that the small percentage of people who end up needing the largest percentage of health care, nobody dies or goes into monumental debt. This can be done via taxes but insurance is a private market solution which should in theory make it more efficient for the sake of maximizing profit. So then if it's supposedly more efficient, why do I waste…

>This can be done via taxes but insurance is a private market solution which should in theory make it more efficient for the sake of maximizing profit.

Imagine there's a single, private, insurance company, A.

Wouldn't the natural interest of A be to maximize health costs (i.e. make paying for health coverage expensive, as thus their insurance more desirable and more expensive in return)?

And if there were more smaller insurance companies competing with A, wouldn't it make sense for A to just eat them up to eliminate competition (so, having us end up with an even larger company)?

And if there were several equally large insurance companies aside A (say, B, C, D), wouldn't it make sense for them to collude and keep prices and profits high?

And since A (a single large) or A+B+C+D (several large) companies surely have considerable clout (money gives you that) isn't it their natural interest to spend on buying politicians, media, etc, to make sure things get even more in their favor?

All those seem inevitable (and profitable) in a market economy. How would insurance being a private market make it "make it more efficient for the sake of maximizing profit"?

Re: People Lose Their Employer-Sponsored Insurance Constantly

#95

Post by praneshp » Wed, Apr 17, 2019, 6:24 PM UTC

arcticbull wrote: post #86

ummonk wrote: post #57

Earlier quoted context omitted.

That actually sounds like the high deductible plan is functioning as it should though. Causing consumers to price-shop and avoid price-gouging providers.

I'll be sure to let the ambulance driver know after a car accident they should shop around :\ Maybe an Ayn Rand medicalert bracelet would help. Allergy: Socialism.

That's why the out of pocket maximum exists. (I think?)

Re: People Lose Their Employer-Sponsored Insurance Constantly

#96

Post by munk-a » Wed, Apr 17, 2019, 6:25 PM UTC

arcticbull wrote: post #90

krapht wrote: post #80

Earlier quoted context omitted.

Not that I disagree, but the majority of health care expenses are not time-critical emergencies. I saw a statistic somewhere where it's around 15%?

IMO the biggest problem is that you're not really qualified to judge medical practitioners. How am I supposed to know if what they're recommending is actually necessary? The market price of an MRI? How do I know they're not skipping care I should have to offer a lower price? Or if they're offering unnecessary procedures? The reality is you need an M.D. to make a reasonable evaluation. This is why at an HMO we have pr…

Actually that raises an additional interesting point... if the market price is varying from doctor to doctor it could be for many factors - how am I supposed to judge the relative quality of an MRI that would be read by two different specialists. If the quality is different then how can I be informed as to the efficacy and truth of that difference?

With a bank, Bank of America has terrible service - so I just don't use them, with a doctor though... what if I'm paying a premium price but receiving substandard care, given how complex human bodies are most illnesses compound over time and only in very select circumstances could you get a doctor to come in post defacto look at an X-Ray and say "This doctor was terrible, that's totally a tumor" maybe the real issue is that a tingling in your finger tips when you sit down that you asked your doctor about went unnoticed and twelve years later your heart gave out over totally preventable causes.

Re: People Lose Their Employer-Sponsored Insurance Constantly

#97

Post by jkingsbery » Wed, Apr 17, 2019, 6:25 PM UTC

One thing this article doesn't discuss: at least some of the times where I "lost" my employer-sponsored insurance (either because I switched jobs or because my start-up decided to switch providers), it went to something better than what I had before, and most of the time it was a change that was a matter of indifference (from one major plan provider to another where everything was pretty similar). In most universal health care proposals I've seen, "leaving," isn't really an option, you're just stuck with The Healthcare Option.

Whatever the merits of the more general arguments for or against, it seems like we should at least not put a finger on the scale.

Re: People Lose Their Employer-Sponsored Insurance Constantly

#98

Post by jkingsbery » Wed, Apr 17, 2019, 6:28 PM UTC

Glyptodon wrote: post #46

Employer sponsored health insurance is an outpost of neofeudalism. Swear your fealty to a lord or go without.

Employee sponsored health insurance is a result of "centrally planned" economics - https://www.nytimes.com/2017/09/05/upshot/the-real-reason-th... ... it has nothing to do with feudalism or even what employers wanted, but has a lot more to do with government officials who thought they could design an economy.

Re: People Lose Their Employer-Sponsored Insurance Constantly

#99

Post by specialist » Wed, Apr 17, 2019, 6:29 PM UTC

luckydata wrote: post #36

aNoob7000 wrote: post #5

Health insurance in the United States is a shit show. The Medicare for all that Bernie is proposing is a reaction to the inability of Congress to meaningfully fix the issue. I personally would prefer a market based approach to fixing the issues with obtaining medical care, but Congress can't do anything because there's just too much money and influence involved.

There's no market based approach that can "fix" healthcare. Market self regulates around substitute goods, but healthcare is in the business of health and there's no substitute for that. Very few humans will say "all considered, the ROI/statistical likelhood of this procedure is not positive so I will pick death instead", it just doesn't happen. Single payer is the only way to go.

Even with single payer, there's a large thriving market. Vendors, suppliers, manufacturers, contractors, auditors, etc. Bandages need to be made, hospitals need to be cleaned, nurses need to be trained, etc.

Re: People Lose Their Employer-Sponsored Insurance Constantly

#100

Post by tomp » Wed, Apr 17, 2019, 6:31 PM UTC

ummonk wrote: post #57

jvagner wrote: post #44

Earlier quoted context omitted.

We have a high-deductible health plan and live in Reno. When my gf recently had the need for a CAT scan, the first choice was here in Reno, and it was priced at over $800. She cancelled her appointment, called over in Carson City (20 minutes south of Reno), and got one done, by someone in our network, for $400. The doctor's office who referred her said, "$800? Really!?" The Reno specialist made her a follow-up appoin…

That actually sounds like the high deductible plan is functioning as it should though. Causing consumers to price-shop and avoid price-gouging providers.

That's not the purpose of deductibles though... it's to put people's skin in the game - if you use insurance, you also pay for it, so it's not free for you.

On the other hand, if a provider is charging too much, they shouldn't be included in the plan in the first place, as they're simply a bad option.