5 ms·

You're right, we probably weren't going to disentangle the insurers. That is not an argument for handing them the keys to the nation for the sake of "doing som

You're right, we probably weren't going to disentangle the insurers. That is not an argument for handing them the keys to the nation for the sake of "doing something". Doing nothing would have been better. At a guess, doing nothing would have resulted in attempts to reform at the state level, like Massachusetts. I'd have preferred that outcome by a long way. What's on the table will, on paper at least, ensure that startup entrepreneurs like me can actually buy insurance on the private market. We didn't have that ability before, at all. That's a win, from what I can see. I do not have employer provided insurance. I buy private insurance on the market today. It costs me about $6000 a year to insure my family of four. I expect the cost of insurance, post-reform, to converge on the national average, which is around $13000. That's a loss of $7000 a year for us. Maybe somewhat less because of subsidies (we won't get much there). Maybe more, if the cost of insurance rises post-reform as it did in Massachusetts under their similar reform. It is not out of the question that we will actually give up health insurance altogether and pay the penalty instead. This would not be a win for us. If you aren't able to get individual coverage for around $6000/year now (national average), and would like to, then this bill will indeed be a win for you. Of course, if you don't like the coverage you get at that price, pay it anyway or get fined. This is getting too long, but does it seem thinkable to you that this reform might accelerate the increase in health care costs? I think it quite likely myself. If it does, too bad for everyone. We're locked in now.

tptacek 17y ago
It would have cost $14,000 to insure my family of four (adults in our 30s, kids in single-digits, no pre-existing conditions). I say "would have" because dollar figures didn't come into it: we were flatly denied coverage, first for our daughter, who had been hospitalized several years earlier for a freak seizure, and then for my wife. (Note: we tried to obtain coverage ourselves, using the Internet and a telephone. When that failed, we worked with an insurance broker friend of the family. Neither worked.) There was no dollar amount that would have bought us private insurance. We got around it first by getting Erin a job that offered group coverage, and then by setting up group health insurance at Matasano. I'm happy to say we now subsidize coverage for all our employees. The numbers are a red herring. COBRA vs. private health insurance costs are not the issue that should be scaring entrepreneurs. The possibility of getting stranded with no possible coverage option is what should be scaring them.
- mattchew 17y ago
  The numbers are a red herring. COBRA vs. private health insurance costs are not the issue that should be scaring entrepreneurs. Thousands of dollars a year in new expenses is not a red herring and is plenty scary. It's not what's important to you, but it is going to be important to a lot of other people. People who have chosen catastrophic coverage, or who chose to go without health insurance to save money are going to get hit hard by this bill. My guess is a disproportionate number of self-employed people fall into this category. People will go out of business because of this bill.
  - tptacek 17y ago
    I don't think you're correct. I've read the Senate bill, though perhaps not as carefully as you have. I don't see where it says high-deductable plans don't qualify as health insurance for the purpose of satisfying the mandate. I don't care about the people who choose to go without health insurance to save money. I wind up paying for them when they get hit by a car, when their appendix bursts, when they have a freak aneuryism, or when they fall down their stairs. The same arguments suggest that people who drive infrequently and carefully should be allowed to forgo car insurance. After all, you can always sue them when something goes wrong with their plan!
    - lrm242 17y ago
      And now we will wind up paying for you because your family has medical issues and couldn't previously get covered. The burden has simply been shifted. Good? Bad? Shrug, depends on which side of the line you sit on. I sit on the side of the line that favors less and smaller federal government. One of the beautiful results of the power we give to States to govern is that as a country we end up with 50 solutions. Our diverse populous can then choose which one fits best with their ideals and personal circumstances--and we get this while still maintaining ourselves as a cohesive country. Unfortunately, this time the government has chosen to white wall a solution across all citizens rather than to let the fundamental action of our country (States rights) do the work which would have resulted in a better solution, IMO.
joevandyk 17y ago
$6,000 a year? I was paying $1300 a month to insure my family of four (2 29 year olds, 2 babies).
- tptacek 17y ago
  In fairness: at that rate, even in Wichita, he's probably talking about high-deductable coverage. I like high deductable coverage. I like HSAs. They're a good idea. But they're irrelevant if all the insurers in your state refuse to cover your family.

tptacek 17y ago

It would have cost $14,000 to insure my family of four (adults in our 30s, kids in single-digits, no pre-existing conditions). I say "would have" because dollar figures didn't come into it: we were flatly denied coverage, first for our daughter, who had been hospitalized several years earlier for a freak seizure, and then for my wife. (Note: we tried to obtain coverage ourselves, using the Internet and a telephone. When that failed, we worked with an insurance broker friend of the family. Neither worked.) There was no dollar amount that would have bought us private insurance. We got around it first by getting Erin a job that offered group coverage, and then by setting up group health insurance at Matasano. I'm happy to say we now subsidize coverage for all our employees. The numbers are a red herring. COBRA vs. private health insurance costs are not the issue that should be scaring entrepreneurs. The possibility of getting stranded with no possible coverage option is what should be scaring them.

mattchew 17y ago
The numbers are a red herring. COBRA vs. private health insurance costs are not the issue that should be scaring entrepreneurs. Thousands of dollars a year in new expenses is not a red herring and is plenty scary. It's not what's important to you, but it is going to be important to a lot of other people. People who have chosen catastrophic coverage, or who chose to go without health insurance to save money are going to get hit hard by this bill. My guess is a disproportionate number of self-employed people fall into this category. People will go out of business because of this bill.
- tptacek 17y ago
  I don't think you're correct. I've read the Senate bill, though perhaps not as carefully as you have. I don't see where it says high-deductable plans don't qualify as health insurance for the purpose of satisfying the mandate. I don't care about the people who choose to go without health insurance to save money. I wind up paying for them when they get hit by a car, when their appendix bursts, when they have a freak aneuryism, or when they fall down their stairs. The same arguments suggest that people who drive infrequently and carefully should be allowed to forgo car insurance. After all, you can always sue them when something goes wrong with their plan!
  - lrm242 17y ago
    And now we will wind up paying for you because your family has medical issues and couldn't previously get covered. The burden has simply been shifted. Good? Bad? Shrug, depends on which side of the line you sit on. I sit on the side of the line that favors less and smaller federal government. One of the beautiful results of the power we give to States to govern is that as a country we end up with 50 solutions. Our diverse populous can then choose which one fits best with their ideals and personal circumstances--and we get this while still maintaining ourselves as a cohesive country. Unfortunately, this time the government has chosen to white wall a solution across all citizens rather than to let the fundamental action of our country (States rights) do the work which would have resulted in a better solution, IMO.

joevandyk 17y ago

$6,000 a year? I was paying $1300 a month to insure my family of four (2 29 year olds, 2 babies).

tptacek 17y ago
In fairness: at that rate, even in Wichita, he's probably talking about high-deductable coverage. I like high deductable coverage. I like HSAs. They're a good idea. But they're irrelevant if all the insurers in your state refuse to cover your family.