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Comment by megamike | Hacker News Reader

COBRA? COBRA is a sad expensive joke

Healthcare needs to be disconnected from the employer. Public option and private and all healthcare benefits need to go to salary. It would make workers able to change jobs easier, businesses able to start and compete with others/countries easier, and would reduce ageism as well as going direct to consumer it would help the fixed pricing market of healthcare/medical services and supplies.

We don't get our auto/home/life insurance through work, why our most private healthcare/insurance? It is a legacy thing that needs to end and is harming wage increases, competition and worker/labor freedom.

Removing healthcare from employer responsibilities is actually pro-business and pro-worker and encourages the competition we need in that industry/service.

Side note: For some reason I really don't like Dropbox color schemes and fonts/typography. Feels like it was made in a machine with billions of AB tests but ultimately looks jarring. I miss the nice clean branding and the little illustrations.

I don't understand why this doesn't get more discussion. It's a much more conservative step than "medicare for all" and would do a lot of good.

As I understand it, you need collective bargaining against insurers to keep individual premiums down. Employers do that today, and if employers just pay out their insurance spend to employees, the employees will get less insurance as a result. A single payer system means the government negotiates on behalf of all of the citizens, allowing it to keep costs down much more than our current system.

Or you mandate that the insurers can only rate on certain variables (e.g. zip code) and/or you mandate a pooling system so that insurers who have many low risk people on their books subsidise insurers who have many high risk people.

Right, there are other solutions, but "just cut the insurance check to employees" isn't a good option for employees.

It has no clear advantages over M4A, and the critical problem is it has no cost-control consequence.

It astonishes me that a global health crisis can ironically trigger loss of healthcare for millions. That's such an abject failure of a system.

You're right, healthcare has no business being tightly coupled to employers -- or employment, in my opinion. Everyone should have healthcare.

My health insurance isn't taxed, or at least effectively not anywhere near what my top salary bracket is. Our tax law means there would be no short-term advantage for either me or my employer to shift that compensation into cash.

If my employer offered additional desirable insurance to replace an equal amount of pre-tax salary, I would gladly except that extra compensation too.

Self employed and businesses get a tax break/expense for that. It could be the same with personal insurance. Doing things only for the tax break leads you to all sorts of finagling twisted fixed markets.

I'd always take real wages over total/real compensation which is supposedly about 30-35% of your pay.

Binding healthcare to employers also makes for less competitive consumer markets as the target customers of medical services are insurers and employers, not the actual users of the service, individuals.

A good first step to break this legacy grip and fixed market would be allowing individuals to expense out their healthcare cost, it would also benefit people that have health issues and not make it so detrimental to their quality of life.

Right now healthcare is a cartel borg bureaucracy because of being tied to employers and not a direct consumer service.

COBRA's joke is just the joke of the most expensive healthcare in the world and a system that largely ties healthcare to employment. It's not like there's anything extra expensive about COBRA; it's just all the questionable expense of American healthcare without an employer subsidizing it.

They say “NAMER-based employees will be eligible for up to six months of COBRA”. Note that by law, a former employee is eligible to pay for up to 18 months of continuation health coverage under COBRA. So perhaps they mean that Dropbox will pay the premiums for up to 6 months, but it’s awfully unclear as written.

(Also I assume “NAMER” means North America. It’s a funny way to say “The United States” in this context, given that presumably Canada and Mexico, which are in North America, don’t have a law called COBRA which is about this.)

That's exactly what they mean. 6 months of cobra subsidization.

It's the lesser of three evils: losing coverage altogether, having to buy it as part of an open risk pool, or continuing coverage as part of the company's risk pool and rates the company has negotiated for its employees. It would be nice to have better options, but they will all be very expensive for the taxpayer. Either way, the money has to come out of someone's pocket.

By getting more people insured, Obamacare was expected to have bent down the rising curve of healthcare costs. I am not sure if that has actually happened...

Out of curiosity, is there something lower cost/better that employees who have recently quit or been laid off should look into?

Lower cost, sure any number of options on the market. I used https://www.ehealthinsurance.com years ago between jobs

Lower cost premiums maybe, but I doubt any low-premium marketplace plans will be lower deductible than the corporate/COBRA plans offered by a company like Dropbox.

They're covering 6 months of it, so it's free for 6 months. After those 6 months it does get expensive, yes.

> COBRA? COBRA is a sad expensive joke

COBRA and supplemental insurance as primary are great late stage capitalism for sure

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