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Comment by boplicity | Hacker News Reader

The U.S. healthcare system traps people in companies, for fear of losing access to reliable healthcare. A system that was completely independent from employers would be much more beneficial to employees. Plus, it would save huge administrative costs for private companies. This would especially benefit small companies, but, really, it would make the job of running any company much easier.

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I have noticed several people in my life seeming to vastly overestimate the cost of getting healthcare through the healthcare.gov exchanges. If you leave your job, you can just do that. It’s much cheaper than the COBRA price, which I think people are looking at. For many people, it shouldn’t be a huge problem to get insurance this way. (I would still prefer single-payer!)

Depends if you quality for the subsidy or not. Mine's $2400/month (family of four) through the exchange. Going up 10% next year, too.

> healthcare.gov exchanges. It’s much cheaper

Interesting... I've heard it's the opposite, price-wise.

A lot of folks compare the amount they pay in premiums against it, which is a mistake, because that's almost always only part of the cost; employers tend to pay all or some.

I ran into someone who genuinely thought their health insurance ran $100/month, because that's how much got deducted in their paycheck.

I'm curious what prices you are seeing and considering no big deal; because I'm not sure if you're seeing different prices than I've seen, or just have a different threshold for what would be a huge problem for most people?

I've seen like $600/month for an individual, and this is just kind of ok probably good enough insurance (with a non-trivial deductible). For a family, even more, $1800 or more a month. Again for not great insurance. For me that'd already be a significant problem, but maybe not for an ex twitter engineer? Or maybe if you are a single person in your 20s (or I forget, do they still charge different for different ages post obamacare?), or in a different state than me, it's a lot cheaper?

Those are normal prices.

https://www.kff.org/report-section/ehbs-2022-section-1-cost-...

> The average annual premiums in 2022 are $7,911 for single coverage and $22,463 for family coverage.

People get shocked by COBRA pricing, but it’s literally just your existing plan’s cost plus a max of 2% for administration. The real cost of health insurance is hidden from almost all Americans.

Maybe an extra $22K/year isn't a "huge problem" for the average twitter engineer with a family (although if you have enough to afford it, you probably want better insurance than that not-top-of-the-line $22K/year one), but I am confident saying it would be for most people!

Those numbers to me confirm that health insurance is part of what makes it hard for Americans to quit jobs.

Healthcare.gov. We've had that system for 12 years. I've never had employer healthcare, it was way more expensive than private insurance in Hawaii, which anyone can get and you auto-qualify for enrollment if you change jobs or move.

https://www.navapbc.com/insights/twelve-years-of-healthcare-...

Are you saying you’ve declined your employer sponsored healthcare and just signed up at healthcare.gov and it ended up being cheaper?

Yes. The plan my employer had in Hawaii was $700/mo for pretty average coverage. On Healthcare.gov the best possible plan I could get, $0 deductible, full coverage, etc, was $510/mo.

I think the difficulty is that most people who have employer healthcare have never checked healthcare.gov because they didn't need to, but it's hard to keep seeing people perpetuate this idea that hasn't been true for over a decade.

Ah, you might not have kids? I just went through the sign up process. All the plans were about the same for me on Healthcare.gov: $1,400 a month with no coverage until after a $14k deductible. This is for a family of four in Georgia.

I suspect you're also putting in your current income, rather than something much lower that you'd be experiencing if you just lost your job.

I do this, because I need one of the higher-end plans with the low cap on out-of-pocket expenses. It'd be more expensive to take my work's; cheaper on monthly premium, but my family OOP max would be $14k instead of $4k.

In that universe people might possibly work for lower wages. It’s an income effect. Plus the present value of future healthcare costs goes far down too (individually and in aggregate).

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