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What Startups Need To Know About Health Insurance in 2013

blog.simplyinsured.com

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

#91

Post by arethuza »

MichaelSalib wrote: post #86
tptacek wrote: post #57

Earlier quoted context omitted.

Give me a break. Republicans are anti-public health care because public care sets in motion a process that moves care decisions into federal bureaucracies, which is absolutely a problem that Canada and the UK have. Also, health care is ineluctably two things: a vital necessity and a commercial service. With a single payer, the commercial service objective is warped: patients and doctors are motivated to make care dec…

There is a big difference between single-payer and a nationalized healthcare system. In the latter, doctors are government employees. The UK and Canada work that way, and choose to spend very little money on healthcare. But most peer nations have single-payer non-nationalized healthcare systems and choose to spend more than Canada and the UK, but much much less than the US. With a single payer, the commercial service…

"doctors are government employees"

Not all doctors in the UK are government employees working in the NHS - there is a private health care system here as well. Nobody makes you go or work for the NHS - but you do have to pay for it - I have private health insurance from my employer (I would never pay for it myself although I could afford it) and I'm quite happy to pay for the NHS.

NB My son was born in an NHS hospital, when he has had an accident it's the dedicated NHS childrens hospital he gets taken to, when my wife got seriously injured climbing it was an NHS hospital that treated her - all of which were awesome. The NHS is far from perfect but I like knowing that everyone in this country can get a decent standard of healthcare free at the point of delivery "In Place of Fear":

http://en.wikipedia.org/wiki/Aneurin_Bevan

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

#92

Post by tptacek »

MichaelSalib wrote: post #90
tptacek wrote: post #87

Earlier quoted context omitted.

Single payer implies that negotiations, budgeting, and coverage decisions are made by the government, who is the "single payer" the term refers to. That doctors ostensibly work for private companies doesn't ameliorate the Republican concern here.

But the existence of the French or Japanese or Dutch healthcare systems do. At some point, empty theorizing has to give way to observation of how these systems actually work in practice. In practice, all of these systems provide care that is much much cheaper than the US system with very high levels of public satisfaction. Also, I think you're wrong in claiming that the Republican party rejects single payer for those…

This comment does not respond to the issues I brought up in my comment at all. In fact, my comment ends with "I support single-payer". Did you think I was arguing that it was unworkable? My issue was with the mischaracterization of the Republican position.

The Dutch system, for what it's worth, strongly resembles the trajectory we are on with PPACA: guaranteed-issue private health insurance and Medicare.

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

#93

Post by koops »

alok-g wrote: post #64
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.)

Some of the Kaiser doctors are more evidence-based than others. But none of them take home more money if, for example, they operate on your rather than not. That is still true in many plans, even high-end ones, though they're not going to tell you about it.

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

#94

Post by DennisP »

bitcartel wrote: post #76
DennisP wrote: post #42

Earlier quoted context omitted.

A good book to continue your reading is The Healing of America by T.R. Reid. The author traveled to eight countries, checking out treatment options for his bum shoulder and learning about their healthcare systems. Canada was one and did have some advantages. He also went to the U.K. But the best systems were in France, Germany, and Japan. They all have private (but nonprofit) insurance, a mandate, and no exclusions f…

The UK should have outsourced to Germany: "£12.7bn computer scheme to create patient record system is to be scrapped after years of delays" http://www.guardian.co.uk/society/2011/sep/22/nhs-it-project... Instead they outsourced to people who outsourced to people... "Accenture; Computer Sciences Corporation, or CSC; Fujitsu and BT. They were known as local service providers, or LSPs. BT and Fujitsu picked a US softwar…

Germany, or just that V.A. system. It's not used in the rest of American healthcare because it lacks all that billing.

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

#95

Post by jacoblyles »

tptacek wrote: post #50
yaks_hairbrush wrote: post #11

Earlier quoted context omitted.

Absolutely, yes! I was and still am upset with PPACA because it reinforces the horrid employer-provided care model.

No it doesn't. It doesn't scrap employer-provided care, but it takes significant steps towards alternatives. The major reason employer-provided care is dominant is that employer care is guaranteed-issue and automatically deducted. Employees of large companies are not screened or given physicals before insurance is extended. Under PPACA, all health insurance is guaranteed issue. And while enrollment isn't automatic, i…

Employer provided care also comes out of pre-tax money. So employers get a big discount compared to what you would pay for the same plan.

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

#96

Post by caseyf »

tricky wrote: post #81

I got the green light to work on my startup full time. BUT, i have to figure out health care for my wife and infant before I can quit my job. We've been spoiled with a tremendous insurance for so long. Can anyone offer any advice or give helpful anecdotes about their experiences (good or bad) going solo with a family?

In my case (BCBS, Massachusetts), putting my wife and I in a group plan for our business was significantly cheaper than paying for a "personal" plan for my family.

My advice would be: price it out both ways.

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

#97

Post by tptacek »

arethuza wrote: post #91
MichaelSalib wrote: post #86

Earlier quoted context omitted.

There is a big difference between single-payer and a nationalized healthcare system. In the latter, doctors are government employees. The UK and Canada work that way, and choose to spend very little money on healthcare. But most peer nations have single-payer non-nationalized healthcare systems and choose to spend more than Canada and the UK, but much much less than the US. With a single payer, the commercial service…

"doctors are government employees" Not all doctors in the UK are government employees working in the NHS - there is a private health care system here as well. Nobody makes you go or work for the NHS - but you do have to pay for it - I have private health insurance from my employer (I would never pay for it myself although I could afford it) and I'm quite happy to pay for the NHS. NB My son was born in an NHS hospital…

The entire private health care budget in the UK is £5Bn. The second largest purchaser of private care in the UK is... wait for it... the NHS. The NHS budget is over £100Bn. The government has overwhelming control over the health care market of the UK.

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

#98

Post by baddox »

grecy wrote: post #45
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…

1) Given that the health insurance companies in America make billions in profit every year, I'm confident the government can be more efficient than that. 2) This is a naive line of reasoning. The (socialist) FDA already stops you from buying food with lead in it. The (socialist) DMV forces you to wear a seat-belt and wear a motorbike helmet and the (socialist) Police stop you beating people up on the street whenever…

> You are basically saying you don't want "big government" to tell you want you can't do, even though those rules and limitations would make your society better for everyone overall.

You're demonstrating a very common misconception, which is that people who don't want the government to perform a function do not want that function to be performed, or that certain functions can only be performed by a government.

> It's very simple. Everyone is equal. A billionaire is treated the same as a homeless person. A strongly classed society (like America) does not like this idea, because Americans define success as "better than other people". Public healthcare would take away this distinction.

Is there a competition being held in this thread to see who can make the most ridiculous generalization? Seriously, at least put forth a bit of effort into making your argument seem remotely credible.

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

#99

Post by jacoblyles »

richcollins wrote: post #58
kjackson2012 wrote: post #36

Earlier quoted context omitted.

I have Canadian friends, and although they would do anything to preserve their health care, they complain about how long it takes them to make appointments for specialists, tests, etc. I live in the Bay Area, and I have Kaiser HMO, and I love them. They seem vastly superior to Canadian health care in every respect. Even in cost, my friends in Toronto have to pay $100/month each as a Health Tax. Case in point, I got a…

average wait time in Canada for an endoscopy is 9 months Sounds like a great way to die from esophageal cancer.

It is! The US system, for all its faults, has a high cancer survival rate.

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

#100

Post by jacoblyles »

jtchang wrote: post #66

God damn health care is like a boondoggle of epic proportions. Finding healthcare should be as easy as looking up a favorite restaurant and reading the reviews. Is there anyway to FIX this?

>Is there anyway to FIX this?

No. It's a highly regulated industry with limited room for innovation. You basically have to wait for congress to fix it.

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