How healthcare regulations affect even those who have good insurance plans | Hacker News Reader

How healthcare regulations affect even those who have good insurance plans

newyorker.com

33 pointsLord_Yoda33 comments

I think this article does touch on something that's always bothered me regarding healthcare. Specifically on the problem that insurance is tied to healthcare. To me insurance is about covering risks that are liable to occur no matter how much one may minimize them. In contrast, healthcare is about routine and extraordinary care of human beings. It's not something I believe follows properly with insurance business models which is why often they cut corners to make it profitable. Otherwise, I suspect many health insurance companies today would be bankrupt if they didn't attempt their corner cutting. Rather than leaving healthcare to insurance business models we need to finally admit that maybe it's no different than roads or other infrastructure and have it handled by the US federal government for better or worse.

I pay $800 for rent and once my monthly insurance cost got to $800 a month I canceled it and claimed "religious exemption" on my taxes.

Including deductibles, I would have paid over $12000 a year. Plus my wife used a birth center instead of a regular OB for delivery. That wasn't covered by insurance either, so my potential max per year on "healthcare" was $16,000.

That basically means that unless I get cancer, it is cheaper to forgo insurance, which is what I did. Now I'm actually saving money and getting ready to finally build/buy a house.

Screw healthcare.

And then when you do get cancer or some other expensive disease, the rest of us get to pay for your treatment.

Costs need to come down, but opting out of the system because you're currently healthy isn't good.

  And then when you do get cancer or some other expensive disease, the rest of us get to pay for your treatment.

Yes, that's the exact strategy that Obamacare rewards.

The Democrats could have limited "preexisting condition" protections to those who obtained coverage in the first year for as long as they retained coverage (in any form, including MedicAid). They chose not to.

The mandate is what prevents this. The only failing is that the penalty was too small.

Really, there should be a default (probably public, but perhaps just the lowest-cost bronze plan you could buy off the exchange) option, for which you pay the premium, rather than a penalty.

If you want coverage to be mandatory, make it really mandatory.

That seems like a good solution. Or, of course, stop pretending it's market-based and start taxing people for it instead. Unfortunately, the ACA had to be watered down a lot just to get the more conservative Democrats to accept it.

Well, not really.

You can only start a new insurance plan for a few months around the new year, or if you move from one state to another, get married, or some other list of major life events.

I mean, if you want to have no insurance, and then expect to make a go of treating your cancer by waiting for a plan to kick in after the new year...

It's again his religious beliefs to have healthcare, so I hardly see how you would/should pay for that.

They claimed a religious exemption so the government wouldn't punish them. If they actually get cancer then I'd bet they'll seek treatment.

Then they should have to pay.

There are people who legitimately do not want medical care, because of religious beliefs, because they're 85, or just because f--- off.

It might sound harsh, but there should be a way for these people to really-for-really opt out.

That's such a tired old argument. I don't have kids, why do my taxes go to schools? Because it's a requirement for a functioning society. The current system isn't good either, but we need to start by ensuring everyone participates in the healthcare system, use it or not.

> I don't have kids

Education taxes aren't for parents; they are for kids. And young children cannot yet plan or provide for their education.

Contrast that with retirement, healthcare, life insurance, auto insurance, etc. These are all decisions made by people who should have the right to choose to participate.

> And young children cannot yet plan or provide for their education.

But young children can plan for their own healthcare, or the healthcare of their providers?

> retirement

Exactly, we have social security here in the US. You can't opt out of that.

You can opt out of social security if you are Amish.

Mandatory auto insurance isn't for the buyer, it's for the people the buyer might potentially harm due to negligence.

And yet you can opt out of even this "mandatory" insurance. How? Don't drive an automobile.

Does this make sense for your situation? Maybe it does, maybe doesn't. But no one will force you to spend your life working to pay auto insurance.

You can't opt out of the healthcare system though. If you're in a serious accident they're going to take you to the hospital healthcare or not.

They don't have to treat you if you have a DNR order on file or are lucid enough to refuse treatment.

I agree in theory, but I fear it's incompatible with ubiquitous emergency care. If someone collapses on the street, I don't want paramedics refusing care because they don't know if the person has opted out.

I wouldn't either. But emergency response is a very small portion of total healthcare costs.

Would that still be the case for people who are completely uninsured?

It's a come to Jesus moment.

No, I die. <- period

But there are 15 million people (5%) living with cancer in the USA right now. Almost 40% of people will get a cancer diagnosis in their lifetime. https://www.cancer.gov/about-cancer/understanding/statistics Medical bills are the #1 cause of bankruptcy filings in this country. That means for a lot of people, paying for high-deductible insurance makes sense.

I'm rolling the dice.

My high deductible plan is now $400/month (I'm fully out of pocket for the first $6500); its $750 to cover my wife and my daughter on their own low deductible PPO plan. That's $1150/month | $13800/year. I spend $500/month to cover my disabled mother's health insurance and some of her medical expenses. I'm still paying off hospital bills from my daughter's birth in August.

With Trump's executive action, I can now drop my $400/month high deductible plan and still receive my tax refund next year. If I have a catastrophic emergency medical expense, I'll declare bankruptcy (Florida protects your primary residence and your retirement accounts from all creditors except the bank with your mortgage). If I get cancer? That's what my life insurance is for.

Disclaimer: I fully support single payer. These are the perils of healthcare in America.

Is there a significant difference between paying for healthcare with insurance premiums & deductibles vs. paying with taxes? (I realize this is a big question, just looking for a starting point because it's not clear to me.)

https://www.reddit.com/r/investing/comments/61431g/healthcar...

"Socialized healthcare is by far and large better. Don't believe me, just compare the US to any other OECD country on public health metrics, including:

* Cost per capita (that's important yo!)

* Child Mortality before Age 5

* Current Life Expectancy (for someone born in this cohort)

* Number of bankruptcies due to health issues per capita

I'm a huge fan of the bootstrapping ideals of the US; emigrated from Europe to the US and one of the appeals is the strong push against building an entitlement culture.

But if we get beat on every metric when it comes to healthcare, let's please admit that other systems simply work better. If someone can come up with a purely capitalistic system (our current system is far from that) which provides equal or better public health stats, I'm all for that too.

I'm just not for spending more than anyone else while receiving less than anyone else in return."

Yes, insurance premiums and deductibles also funds a vast bureaucracy and profits for the insurance industry...

Sometimes I wonder if it would make sense to have a healthplan that covers cancer and absolutely nothing else. I honestly have zero concern about any other ailment and figure I could make due, but I know enough about cancer to realize it is a completely different story.

You're complaining about the cost of insurance and not healthcare. Not the same thing.

If healthcare is bad enough, insurance becomes mandatory, at which point it's basically the same thing.

My family's $5k deductible plan was $400/month. Then Obamacare came along. $1,100 a month first year, then second year goes to $1,400 so I cancel and get short term coverage for $200/month, same deductible! But now I owe over $1k more in taxes.

This year cheapest plan in my state is $1,800 a month. Obamacare is a disaster.

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