Comment by rayiner | Hacker News Reader

Comment by rayiner | Hacker News Reader

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> An ACA silver plan means you have a $4500 deductible. You will NEVER go to a doctor.

Silver plans are eligible for Cost Sharing Reduction (reducing deductibles to $500-1,000), and pay for doctor’s visits before deductibles kick in. And preventative care has no co-pay and no deductible.

> So you pay your $500 for rent. Add 150 for utilities. Add 200 for gas and 50 for car insurance since you're gonna be living in a rural place.

How much do you think gas costs in Iowa? The median rural/town commuter travels about 1,150 miles per month. A 2000 Honda Civic gets 27 mpg. At $2/gallon for around 40 gallons a month, that’s under half your estimate.

> Now you have $600 a month for food and literally any other expense. Say you never eat out and use staples like rice and beans as the basis for every dish, thats $250 a month (maybe you can squeeze out another $50, but one must have a slight bit of slack for say, a single gallon of ice cream per month).

You are out of touch if you think $250 per month is a “rice and beans” food budget for a single person: https://mymoneywizard.com/how-i-spend-less-than-35-a-week-on... ($67 per week for two people). A weekly trip to Aldi for my family of five clocks in at about $100, and we don’t even try to save money.

> $350 for everything else. Entertainment. A gym membership. Your medical deductible. Your sanity.

In central Illinois, you can have a sit-down meal for $10, less if ethnic food. Coffee is a buck. The Y near my house is $40/month for a very nice place with heated indoor pool, and making minimum wage you qualify for financial aid. The county one, which is also nice, is $25/month. Netflix is $13/month. A Verizon MVNO is $35/month. In Iowa City, you can get $1-2 well drinks four days a week: https://www.brothersbar.com/iowacity.

Even in your best attempt to try and rationalize living off of poverty-level wages, your argument only makes things look worse.

> Silver plans are eligible for Cost Sharing Reduction (reducing deductibles to $500-1,000), and pay for doctor’s visits before deductibles kick in. And preventative care has no co-pay and no deductible.

Note that this is ignoring one massive part of healthcare: Dental care. As someone that lived in deep poverty I had to deal with teeth quite literally rotting out of my head because there were no options for me to get care and the insurance that I had didn't cover it. That's easily upwards of a few grand to fix a few teeth which no one can afford on those wages.

> How much do you think gas costs in Iowa? The median rural/town commuter travels about 1,150 miles per month. A 2000 Honda Civic gets 27 mpg. At $2/gallon for around 40 gallons a month, that’s under half your estimate.

Gas costed around ~3 dollars a gallon where I lived and our old car got around 20mpg. That alone creeps up to around $200 for gas and we couldn't afford to get a more efficient car for obvious reasons. The only reason why gas is cheaper now is because of the crash, it was not the norm at all for most people.

> You are out of touch if you think $250 per month is a “rice and beans” food budget for a single person: https://mymoneywizard.com/how-i-spend-less-than-35-a-week-on.... ($67 per week for two people). A weekly trip to Aldi for my family of five clocks in at about $100, and we don’t even try to save money.

You seem to be the one out of touch here considering what the USDA has said. Note that in your money wizard example the prices were incredibly off compared to where I live where things were easily 1.3-1.5x the price at the nearest grocery store. For example, 3lbs pound of chicken breast was easily around $2.80 compared to their example which is around $1.90. It also assumes people actually have time to cook and plan out their meals.

> In central Illinois, you can have a sit-down meal for $10, less if ethnic food. Coffee is a buck. The Y near my house is $40/month for a very nice place with heated indoor pool, and making minimum wage you qualify for financial aid. The county one, which is also nice, is $25/month. Netflix is $13/month. A Verizon MVNO is $35/month. In Iowa City, you can get $1-2 well drinks four days a week

At the very least we can reduce that remaining $350 by another $100 once we factor in internet and phone bills, both of which are required in today's environment.

So let's say you have around $250 left total. That's $250 for emergencies, for feeding your pets, for paying off dental bills, for putting towards loans, for dealing with everything else life has to throw at you.

And people wonder why your average American can't save money or put any of it towards stocks?

Dental check up is like 25$ Dental care isn't really a huge part of healthcare.

Cleanings aren't $25 though and those are recommended every 6 months. Along with exams once a year. You're looking at $100+/cleaning and $100+/exam.

From my experience of talking to people - seems like the quickest way to get cavities and ruin your teeth (beyond not brushing) is to not do the regular cleanings.

They may be "recommended" every 6 months, but practically nobody does that. In fact, in surveys, only about half of respondents see a dentist once a year. There's also little evidence to support the necessity of twice-annual dental checkups.

> They may be "recommended" every 6 months, but practically nobody does that.

Source?

It's pretty routine in my circle that everyone does it. If they don't, cavities appear not too long after.

And btw - argument from "oh the masses don't do it, therefore it isn't important" isn't very strong.

You are being lied to by the medical industry in the US.

I think heredity plays into this. I’ve gone 10 years without and zero cavities. My maternal grandmother had all her natural teeth at the age of 94. Not everyone gets cavities

Cavities are caused primarily by too much sugar combined with inadequate home care. There is also a genetic component - some people are going to get more cavities than others no matter what they do. Cleanings and checkups don’t really prevent cavities, they screen for them.

The country i come from with free healthcare doesnt even suggest cleanings after reachign adulthood. You get a few free ones once every 5 years. Thats not a major part of healthcare lol

> Silver plans are eligible for Cost Sharing Reduction (reducing deductibles to $500-1,000), and pay for doctor’s visits before deductibles kick in

You’re right about the deductible - after doing the math I saw that youd qualify for the 150->400% bracket of the federal poverty level. But can you afford 3 weeks pay for that $750 deductible? On top of other stuff?

> You are out of touch if you think $250 per month is a “rice and beans” food budget for a single person

I didn't say it was only rice and beans, but a cheap diet consisting of the cheapest carbs. The USDA has it around $180 as the absolute cheapest per person. Your money wizard person lives in the cheapest area of the country. I'll bet they have a stocked kitchen as well so they never need to buy spices.

https://fns-prod.azureedge.net/sites/default/files/media/fil...

> In central Illinois

Having been thru Normal/Bloomington and Champaign, it’s extremely reasonable in price as rentals are dirt cheap, as long as you’re going to aldi. $1-2 well drinks aren’t a thing in a lot of the country. Coffee isn’t a dollar since the 90s. Your original example was between DC and baltimore. Things aren't so cheap there.

Oh, and I forgot about the actual premium cost of the silver plan, which is around $200 per month.

Sorry, but you're going into debt or homelessness the second your hours get cut. You have no stability. The smallest thing going wrong will ruin you. Have you seen the absolute hordes of people going into just APPLY for section 8? https://youtu.be/Q5ocjZ9GatA?t=140

> You’re right about the deductible. But can you afford 3 weeks pay for that deductible, and then your car breaks down because you can’t afford to maintain it?

What percentage of people suffer both an adverse health event in their 20s or 30s and a car maintenance event in the same year? I don't understand these types of arguments: you can't establish whether something is a "living wage" or not by reference to worst case scenarios achieved by piling on conjecture upon conjecture. Again, in France the minimum wage works out to $10/hour, and they have 20-30% co-insurance if someone has an adverse health event, and outside Paris most people have cars. It still works out fine for almost everyone.

> The USDA has it around $210 as the absolute minimum per person. Your money wizard person lives in the cheapest area of the country.

The USDA food budget is used as the basis for SNAP benefits, so it has to accommodate costs in high-COL areas. It is, in fact, designed to allow a healthy, balanced diet that most people can follow and is not an "absolute minimum" number. The person I linked to is not some wizard: https://www.thrillist.com/eat/nation/how-save-money-grocerie.... Regardless, the point is that $250 is not a rice-and-beans diet, like you claimed. This guy is eating lean meats, fruits and vegetables within the sub-$200 USDA Thrifty budget.

> While Trader Joe's stocks no shortage of reasonably priced pre-packaged indulgences, I stuck to my health-conscious diet of fruits, vegetables, eggs, and lean meats. For $39.68 I bought more than enough for the week.

Note that the co-insurance framing doesn't work out in your favor, because in France the costs for medical procedures or emergencies is far, far cheaper than the US. An emergency room visit might cost you around €10 while in the US visiting the emergency room is likely to bankrupt you.

Hell, it would likely put a big shock in my finances and I actually have good health insurance right now. You can't compare co-insurance costs like you are because it's apples to oranges.

Do you want to know how much it cost me to get my dental work done in the US versus how much it costs in France?

$250/month sounds about right for me for food+drink for a month, shopping at Jewel in Chicago, just getting whatever I want without caring about the price (based on about $300/month in total spent at Jewel, which includes cleaning supplies, toiletries, etc).

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