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Not only that, but this whole health plan debate is weird for those of us in high deductible HSA plans. My health insurance costs negative $1000 ($-1000), becau

Not only that, but this whole health plan debate is weird for those of us in high deductible HSA plans. My health insurance costs negative $1000 ($-1000), because my company pays me extra if I choose an HSA plan, and the company covers the high deductible premium. What the heck happens to those if health insurance goes single payer?

chimeracoder 11y ago
> Not only that, but this whole health plan debate is weird for those of us in high deductible HSA plans. Yes, and don't forget about the foregone tax savings from having an HSA account in the first place (which this site does not take into account). This site is a great example of how incomplete information can be misleading. For most people reading this site, the bulk of the impact would not be from the income tax or the health insurance costs, but the secondary impact that Sanders's plans would have on their other assets.
exelius 11y ago
You have to admit, it's a fucked up system when your employer is basically paying you not to use your insurance. Your employer should have no influence on health care decisions, which is one of the many reasons we need to fix our current system.
- chimeracoder 11y ago
  > You have to admit, it's a fucked up system when your employer is basically paying you not to use your insurance. That's not what an HSA plan is. I'm not OP, but OP's situation is pretty common, and it's more equivalent to employers offering 401(k) matching. They deposit a certain amount of money each month into your HSA account, though by law, you can only have an HSA account if you're on a high-deductible plan. Generally, the only employers who offer this are the ones who have the money to offer very attractive benefits (ie, tech companies). This usually includes covering part or all of employees' premiums, so their employees usually don't pick the government-mandated HMO plan option (it ends up not being any cheaper for them to choose the more restrictive plan).
  - exelius 11y ago
    HSAs in general are not a terrible idea; but they have created some scenarios (like OP's) that are pretty counter-intuitive. But HSAs are basically "small insurance" - if you max out your HSA on a high-deductible plan, you probably will never use your insurance. So you're paying for most normal medical expenses out of pocket, and your insurance plan is basically a backstop for if you get cancer, have an accident, etc. Overall though, health care should not be tied to your employment.
    - chimeracoder 11y ago
      > Overall though, health care should not be tied to your employment. Yes, I agree. > So you're paying for most normal medical expenses out of pocket, and your insurance plan is basically a backstop for if you get cancer, have an accident, etc. That's literally what insurance is supposed to be: a financial mechanism for smoothing risk. The actuarial price for insurance on routine events will be exactly the same as paying for those routine events directly. Economically and financially, "insurance" is explicitly not supposed to cover predictable, routine costs, because there is no risk associated with them. It is a really terrible and unfortunate misnomer that we call this "insurance", because it's not. You wouldn't expect your collision insurance to cover your annual DMV fees. If you want normal, routine medical expenses to be priced below cost, then you're talking about a subsidy. But a subsidy is not insurance. Insurance pools money from at-risk parties. A subsidy is a transfer of wealth. To be honest, it's perfectly fine to advocate that if that's what you really want, but it's misleading to call this "insurance", because it serves a completely different goal (wealth transfer vs. risk pooling).
fluidcruft 11y ago
FWIW, my employer's high-deductible plan comes out a wash because my daughter has an allergy. On high-deductible plans prescription drug coverage is verboten and consequently EpiPens cost $350 and you have to buy at lest two pair (one set for home and one set for the elementary school nurse) rather than $0 (manufacturer coupon designed for prescription plans). So... yes you save the $1k in premiums but all your drugs come out of the higher $4k deductible (vs being limited to $75 yearly deductible + copay).
Avshalom 11y ago
If health insurance goes single payer you stop putting money into your (presumably) now non-existent HSA and start paying it in medicare taxes. Depending on how the rates end up you might end up paying more or less. I mean that's the end result no matter what your current insurance situation is: you might end up paying more or less. Thats also true no matter what happens in the election or what happens to the ACA. There is no law anyone can pass/get passed that will absolutely guarantee every individual in the US has an equal or higher effective take home in 2020.

chimeracoder 11y ago

> Not only that, but this whole health plan debate is weird for those of us in high deductible HSA plans. Yes, and don't forget about the foregone tax savings from having an HSA account in the first place (which this site does not take into account). This site is a great example of how incomplete information can be misleading. For most people reading this site, the bulk of the impact would not be from the income tax or the health insurance costs, but the secondary impact that Sanders's plans would have on their other assets.

exelius 11y ago

You have to admit, it's a fucked up system when your employer is basically paying you not to use your insurance. Your employer should have no influence on health care decisions, which is one of the many reasons we need to fix our current system.

chimeracoder 11y ago
> You have to admit, it's a fucked up system when your employer is basically paying you not to use your insurance. That's not what an HSA plan is. I'm not OP, but OP's situation is pretty common, and it's more equivalent to employers offering 401(k) matching. They deposit a certain amount of money each month into your HSA account, though by law, you can only have an HSA account if you're on a high-deductible plan. Generally, the only employers who offer this are the ones who have the money to offer very attractive benefits (ie, tech companies). This usually includes covering part or all of employees' premiums, so their employees usually don't pick the government-mandated HMO plan option (it ends up not being any cheaper for them to choose the more restrictive plan).
- exelius 11y ago
  HSAs in general are not a terrible idea; but they have created some scenarios (like OP's) that are pretty counter-intuitive. But HSAs are basically "small insurance" - if you max out your HSA on a high-deductible plan, you probably will never use your insurance. So you're paying for most normal medical expenses out of pocket, and your insurance plan is basically a backstop for if you get cancer, have an accident, etc. Overall though, health care should not be tied to your employment.
  - chimeracoder 11y ago
    > Overall though, health care should not be tied to your employment. Yes, I agree. > So you're paying for most normal medical expenses out of pocket, and your insurance plan is basically a backstop for if you get cancer, have an accident, etc. That's literally what insurance is supposed to be: a financial mechanism for smoothing risk. The actuarial price for insurance on routine events will be exactly the same as paying for those routine events directly. Economically and financially, "insurance" is explicitly not supposed to cover predictable, routine costs, because there is no risk associated with them. It is a really terrible and unfortunate misnomer that we call this "insurance", because it's not. You wouldn't expect your collision insurance to cover your annual DMV fees. If you want normal, routine medical expenses to be priced below cost, then you're talking about a subsidy. But a subsidy is not insurance. Insurance pools money from at-risk parties. A subsidy is a transfer of wealth. To be honest, it's perfectly fine to advocate that if that's what you really want, but it's misleading to call this "insurance", because it serves a completely different goal (wealth transfer vs. risk pooling).

fluidcruft 11y ago

FWIW, my employer's high-deductible plan comes out a wash because my daughter has an allergy. On high-deductible plans prescription drug coverage is verboten and consequently EpiPens cost $350 and you have to buy at lest two pair (one set for home and one set for the elementary school nurse) rather than $0 (manufacturer coupon designed for prescription plans). So... yes you save the $1k in premiums but all your drugs come out of the higher $4k deductible (vs being limited to $75 yearly deductible + copay).

Avshalom 11y ago

If health insurance goes single payer you stop putting money into your (presumably) now non-existent HSA and start paying it in medicare taxes. Depending on how the rates end up you might end up paying more or less. I mean that's the end result no matter what your current insurance situation is: you might end up paying more or less. Thats also true no matter what happens in the election or what happens to the ACA. There is no law anyone can pass/get passed that will absolutely guarantee every individual in the US has an equal or higher effective take home in 2020.