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Comment by kiicia | Hacker News Reader

it's connected via vicious cycle

private healthcare is getting more and more expensive due to private prices available to bulk insurers but not for private person

even if this is not completely deliberate, effect is that you are "serf of whomever pays your insurance" or go bankrupt the moment you have any kind of emergency

in europe some private healthcare providers are showing their colors from different perspective, they outright refuse or cancel private contracts when you are above certain age

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> effect is that you are "serf of whomever pays your insurance"

That's why in normal countries public healthcare is a thing and it competes with the private healthcare sector, forcing it to offer relatively affordable premium services.

It's private health insurance that's getting more expensive. Private healthcare is a different beast: https://www.econtalk.org/keith-smith-on-free-market-health-c...

It’s not connected at all in the US since 2011. The only thing employer provided health insurance gets you is the ability to pay for it with pre-tax income (which is a significant saving). Otherwise, you can go to healthcare.gov and buy it without an employer.

> Otherwise, you can go to healthcare.gov and buy it without an employer.

using what money? Most people get their money from their employer.

We don’t describe shelter, food, entertainment as being employer provided, even though those are also acquired with money obtained from an employer.

The distinction in the US before 2011 is that couldn’t buy health insurance as an individual, hence it was a benefit dependent upon being employed. Post 2011, health insurance became attainable without an employer.

What are you basing that on? The ACA did not make individual insurance legal, it was already legal and widespread, it was not dependent on employment. The ACA made improvements, the ACA made individual insurance more accessible.

I’m basing that on reality. While health insurance for an individual was legal, it was basically inaccessible. Also, there were pre existing condition clauses and benefit maximums that made the insurance pretty worthless without a well funded employer willing to pay the costs.

ACA made it so anyone can get it, with standardized metal levels to make comparing plans possible, and out of pocket maximums and the inability to use health risks to deny insurance coverage to ensure one can actually buy and use it as long as premiums were paid. There were even generous tax credits to help pay the premiums.

Obviously, it is still very expensive, but the situation is far different than pre-2011. There would have been no “bank a few million at a tech company and be financially independent at 40” people without ACA.

You're just flat out wrong, it was not "basically inaccessible". Tens of millions of people had individual health insurance prior to the ACA, over 30 million in 2010, averaging 10% of all insured people from 2000 to 2010. The ACA, while very important and valuable legislation, only increased the number of individually insured people by around 25%.

https://www.census.gov/data/tables/time-series/demo/health-i...

But that was not the same "health insurance" that was sold post-ACA. The product itself was completely different, due to the pre existing condition clauses and benefit maximums. Paying $x premiums to only receive a maximum of $y of healthcare and only in certain cases is not what people refer to as the health insurance available in various European countries, which is ostensibly what the situation is compared to.

Even now, when I write health insurance, I mean "ACA complaint health insurance", because the limitations in other kinds of products labeled "health insurance" are useless to the point of not being worth discussing.

Please revisit your original comment:

> The distinction in the US before 2011 is that couldn’t buy health insurance as an individual, hence it was a benefit dependent upon being employed. Post 2011, health insurance became attainable without an employer.

More than 30 million people had individual health insurance in 2010. If it were useless, 30 million people would not have paid $5k - $10k per year for it out of their own pocket.

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