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If you have a family, my rough experience is that a good, medium deductible, decent percentage coverage healthcare plan is about $400-500/month if it's employer subsidized. But anywhere from $1300 to $2k+/month if it isn't.

It's a pretty terrible market out there if you don't have an employer subsidizing it and using their size for negotiation leverage.

I agree. My wife's company offers better insurance than mine so I had always been on hers and declined the insurance offered by my company. Her company just implemented a policy stating that if the spouse is eligible for insurance through their own employer there would be a $200 per month surcharge for them electing to use her companies. I understand where her company is coming from but I think we as a nation (US) can do better.

>but I think we as a nation (US) can do better.

No, we can't. If we could, we would. Things are like this because we want them to be like this: it's reflected in how we vote. We've had candidates pushing for "Medicare for all", universal healthcare, etc., and who gets elected? The candidates promising to go the other direction. Clearly, American society and its voters do not want this.

People evolve. So do their opinions and beliefs.

Just because Universal Healthcare didn't catch on the first time doesn't mean it's dead forever.

It'll happen eventually. Maybe in 4 years, maybe in 40.

Maybe you're willing to wait 40 years for people to evolve, but I'm not. There's better places to live.

This is one of the main pain points of health insurance policies in the US that makes it nearly impossible to see if you're getting true value. A monthly premium, a copay per visit, a deductible, co-insurance/cost share and out of pocket maximums. Then factor in potential fees from an employer.

All of that aside, it's impossible to know how much you're actually going to visit the doctor aside from chronic ailments.

"declined the insurance offered by my company."

don't know how it is in the US, so this may look uninformed, but are you getting extra $$$ added to your salary, equivalent to what the employer was paying for the insurance?

Not typically, but it's possible that someone might be able to negotiate this with their bosses.

Typically people opt out of company insurance because of one of the following reasons: It's cheaper for them to find services through the marketplace (extremely uncommon, but possible), They have superior insurance through a spouse or family member, they feel that the insurance they're provided with isn't sufficient and they would prefer to purchase better insurance themselves.

No, I don't get the difference. The company keeps what it would pay towards my insurance but I don't have anything deducted from my check for what would be my share of the insurance either.

Edit: My wife though pays more for her company insurance as they would need to insure me as well.

It's not the norm, but I was once offered a job where if I declined health insurance they'd pay me the difference - it was a 4 person company.

The USA spends more than double the OECD average(1) in 2014, but is 28th in the world in OECD life expectancy(2) in 2016.

Personal commentary:

As someone from New Zealand, who moved to Canada, I still don't understand why people would want the responsibility of their employer and themselves to choose what health coverage they want in life, especially when employment tenure can be upended so easily.

Yes I know, USA has funky research and new drugs and whatever, but as a whole, it doesn't seem like a particularly efficient system. So if it's not efficient, what's its objective? For me it sounds like prioritising medical providers to extract the maximum amount of revenue from captive customers, in a scheme where all the prices are similar so it's not a monopoly, but none of them are cheap, so it's nearly like a cartel.

Citations: (1) https://en.wikipedia.org/wiki/List_of_countries_by_total_hea...

(2) https://en.wikipedia.org/wiki/List_of_countries_by_life_expe...

If you don't buy into the price rationing argument (I don't) then there is no objective other than enriching the incumbents, it's simply a legacy system. Incremental changes around the margins excepted nothing's going to change until something drastic upsets the apple cart.

It isn’t the employers size as much as it is the group plan risk pool. Employees are better risks than people who have to resort to individual pans. Also, employers don’t pay taxes on what they spend on health insurance, individuals do.

But also that's _if_ you can find coverage. The markets are so screwed up in some states that it's a nightmare of trying to find something you can actually get.

Yes, here in Seattle the cheapest plan on the Obamacare market is $14K/year with a $15K deductible for a family. However low income families can qualify for subsidies.

Sounds like a good reason to not have a family. Seriously: people should stop doing that until our leaders can make our society so that having kids isn't such a burden. If this means society dies out, then we're getting what we deserve, since we choose these leaders.

Absolutely agree. The idea that competition will drive up wages rests on the assumption of a labor market with enough liquidity for employees to jump freely between roles. I do not understand the purpose of pinning health care to employers beyond giving them greater leverage over employees.

It is a huge shock for those that haven't been on both sides of employer paying half (or more). But I still agree with you - but we shouldn't be paying THAT much for health care. Right now (under an employee plan) I'm paying about $200 per month (me + wife). When I was on my own I was paying something like $400 for the two of us. That was 5 years ago, looking at the same plans available now, it's no less than $550.

Health insurance is one of the strangest insurances - a single month costs more than a year or often at least 6 months of car insurance.

Honestly I wish someone would just be a whistleblower and reveal the profits and operating costs (claims) of an "expensive year" at a health insurance company. The government would likely have a price collusion case.

I love how “employer paying half” of a so-called benefit has become the norm. I’m old enough to remember when health insurance was an actual full benefit that you didn’t have to pay for at all. It never even showed up on your paystub. No payroll deduction, no or low deductible, sometimes even no copay. You go to the doctor and walk out.

Now we’re paying from our paychecks, then paying again at the doctor, then getting billed, then waiting for the EOB from insurance, then taking hours a month to manually match up the EOBs with the bills to verify who to pay and how much. And then, MAYBE by the end of the year you reach your deductible and insurance starts actually paying.

They call this a benefit??

"Amazon has the right to do whatever they want to increase Shareholder value"

No they don't, they still have to follow relevant laws.

You have a point about universal healthcare, there's a few other things that could help in this situation though. In the EU I believe this would fall foul of anti discrimination laws (this affects only part time workers, part time works are more likely to be women). There are also protections against an employer unilaterally lowering peoples compensation.

This is the vision of the ACA coming to fruition.

These employees are now put into the ACA exchanges. They can shop for insurance there, and their premiums are capped at a certain percentage of their income. The feds cover the difference. Now these employees don't have to rely on their employer for health insurance.

This was the dream of the ACA. Employers would get out of the insurance game and send their employees into the exchanges. It didn't work it out that way in reality, but this is what that looks like.

> shareholder value is the root of the modern trend of devaluing people and treating them as line items in an expense report.

Private companies also use accounting and sometimes do not look out for their employees.

This isn't to nitpick, I just think there are other parts of the problem, not just shareholder value.

Although, yes, there might be additional pressure from shareholders when a company's finances are public, I don't see how it could be the root of the problem when the same thing happens in private businesses.

> Removing the responsibility of corporations to manage health care would free up a large amount of resources they could invest in expansions, wage increases..

Why are wages in Europe lower than the US, even after adjusted for health insurance expenses? Americans have far more disposable cash than Europe even when health insurance is considered. Why is that?

There's also the retirement that are funded through taxes on salaries and all the social safety nets and the public transportation networks