My plan is to be on my wife's plan | Hacker News Reader

My plan is to be on my wife's plan

kyleshank.com

8 pointsMaysonL12 comments

You missed a very important one. Veterans have VA health care which, despite some loud media screaming to the contrary, is actually very good.

I have been a professional programmer since 1974. In 2000 I had a job with no health benefits, and a situation arose such that I needed to see a doctor. So I went to the VA asking if I could be seen there and the response was that I should have been going to the VA all along.

Long story short, I have been going there ever since and it is far better than any corporate health plan that I have ever been enrolled in.

TL;DR if you are running a startup, hire veterans. They do not need your health care plan, you probably get some kind of tax credit, and many veterans have worked under more pressure than you will ever encounter.

When I was on my own for health insurance, I went with Kaiser. It cost $120/month or so, which is definitely affordable (you may have to make a choice though - do you really need a cell phone with a data plan, or cable TV?). Many people bad-mouth Kaiser, even though it is an NPO, for their service, but I actually had good experiences with them (including a surgery). Our healthcare system actually is pretty great, if you do not believe me try getting a major surgery done in another country. We do need to work on reducing costs (particularly the cost of drugs and medical equipment), but there will always be a certain cost for healthcare until AI takes over (it already is doing accurate diagnoses, if you have trouble believing that). Many people make the mistake that healthcare is a "right" -- it is actually a commodity, like food, or trash service, or...you name it. I'm not against universal healthcare, but the money for it has to come from somewhere, and maybe our government is not the best solution for it given their track record of screwing up budgets.

"Our healthcare system actually is pretty great, if you do not believe me try getting a major surgery done in another country."

I'm amazed that on a website full of such thoughtful sensible people, an American would still have this world view of "there's America and there's the rest of the world, and ours is the best of possible countries".

To give a counter-example to your amazingly broad claim: in Belgium I can have surgery done, spend 4 days in hospital and have everything except 150 euros paid by our universal health-care.

Or were you implying that surgery elsewhere is of lesser quality? A lot of Americans don't seem to agree [1].

[1] 6 Million Americans Travel Abroad Each Year for Surgeries, Medical Treatments: http://news.health.com/2009/04/08/traveling-treatment/

It is not my intention to insult any other countries, or put the US in competition with them. I am simply stating things as I see them -- I do not think America is great, we are actually a pretty idiotic country (at least our government is) and we need to get our act together. So long as it is private (probably not for long), our healthcare system will be "the best" -- in terms of quality, but not necessarily cost. Its like comparing a private school to a public school, or a private bathroom to a public bathroom. You get what you pay for - which is good and bad for US citizens (good in that we get an option, bad in that its not free). When you distribute something of a limited quantity (in this case, healthcare) to everyone for free, you have to make sacrifices -- or raise taxes even higher. Many countries in Europe pay over 50 percent income tax at the maximum rates. In Canada, doctors only make 42 percent of what US doctors do, so they come here. 800,000 Canadians are on waiting lists for longer than 18 weeks to see a doctor annually. Britain cancels about 100k operations annually because it does not have enough doctors to meet the demand. Many Americans do travel abroad for surgery because it is cheaper (not necessarily better) - for example here in San Diego it is not uncommon for people to get Dentistry done in Mexico. All of these numbers I pulled from Wikipedia, which may or may not be a good source but you can probably (in)validate the numbers elsewhere.

Ok, I'll take the bait.

When I was just getting started, I did in-home computer "repair". Because of my location, I had the opportunity to work for many former executives of large companies; our zip code has one of the highest densities of former-CEOs in the nation. One of my customers was/is the former CEO of a pharmaceutical company that you'd find in the top 3 of the largest pharmaceutical companies in existence. I've become close (closer than one would expect for a "IT tech" relationship) with their family. We spend time talking about plenty of things that aren't computer related, so about a year ago, I was shocked to hear that he has Alzheimer's.

He is one of the most down-to-earth, most open-minded, most generous people I've ever met. I genuinely count him as one of the greatest people I've ever met. As you can imagine, he is well-liked and very well-connected in the medical industry. Guess where he's getting treatment? Not in the US.

So here is a man with more money than he could ever spend in a lifetime, and more connections than any average person has, yet he has to go outside the US to get "cutting edge" treatment for a disease that is far from a fringe case.

I recognize that this is just an anecdote, but it is a superlative one to be sure. His case is an amalgamation of every factor that one would believe could lead to a positive result within the healthcare system we have here in the US, yet that goal has not been reached. If you can't look at that example and recognize that what we have here is broken, then I don't know what to tell you.

A lot of people I know are choosing to have significant medical treatments performed in Singapore instead of the U.S. due to cost, quality of care and choice. Another anecdote, but I find it to be fascinating.

Thanks, this is an interesting story. As I mentioned, I think there are plenty of things wrong with our healthcare system, and I only use the word "best" in a very broad sense - for example, the US has the highest rate of success for therapies and surgery (In Britain, for example, only half as many people survive colon cancer, although that could be related to any number of factors). I am sure there are many experimental areas of medicine where the US does not excel, because we have to wade through so much red tape to get anything approved.

"So long as it is private (probably not for long), our healthcare system will be "the best" -- in terms of quality, but not necessarily cost"

And again a overly broad claim that you don't back up with facts.

Instead of keeping slapping each other over the head with anecdotes - which, to be fair, could only prove my point and not yours, since you made those unqualified claims - let's look at what comparative studies say.

A quick web search gives e.g. [1] and [2]. The general conclusion seems to be that the US health-care system is okay, but certainly not better than that in many other developed countries.

You brought up the "you get what you pay for" argument. In fact, the only thing that stands out for the US system, is its cost. See specifically the second page of [2]. Government costs for health care in the US are higher than in any of the compared countries, even though government spending covers a far smaller part of the total costs.

[1] http://www.pbs.org/newshour/updates/health/july-dec09/insura... [2] http://conversations.psu.edu/docs/calkins_comparison.pdf

My cousin's friend was insured with Kaiser. She was mis-diagnosed for over a year. When she attempted to get a referral for a second opinion, it was denied.

She subsequently died from cancer.

Anecdote cuts both ways.

EDIT: I'm thinking now that my wording above sounds overly harsh or confrontational.

Let me restate: We have systemic failure.

In one aspect, a large fraction of the population is shut out of the system, outright. One might argue that better health would foster better outcomes also in other domains, e.g. employment. But we do nothing to explore much less create this circumstance.

In another aspect, participants can be reduced to "the luck of the draw". Get a bad doctor -- worse, an autocratic, bad doctor -- and you can be effectively screwed. As happened to my cousin's friend.

This is not a "system". It is a medieval landscape of fiefdoms, varyingly ruled and also more concerned with their competition than with their populations.

I'm not sure what point he's trying to get across, beyond a description of the current American healthcare situation wrt. founders.

My wife is an entrepreneur. I've thought about starting up at various points in recent years and health insurance is one issue that has given me pause. Right now, I'm happy to have a great job doing what I love that provides benefits for us both.

Well, here in Germany I pay 400 eur for health insurance. And if I quit, I'll pay even more if I ever want to go back to it.

In Spain, the public health system is free and works surprisingly well (believe it or not). If you want private coverage, I think the montly payments all hoover around 60 eur.

Why Germany is x10 as expensive, I'd like to know.

So are you saying this is demeaning to yourself in some way?

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