6 ms·

Oh, I'd agree completely that, as an implementation of universal health care, Obamacare falls far short. I always say, it's better than what preceded it, but t

by Frondo 10y ago

Oh, I'd agree completely that, as an implementation of universal health care, Obamacare falls far short. I always say, it's better than what preceded it, but that is a pretty low bar to achieve. (My own story: I had my gallbladder out in 2004, and from that time on was denied personal health insurance for BS "pre-existing condition" reasons...until Obamacare.) But while the implementation is pretty poor, the idea behind it is significant: everyone should have access to health care. Not just tied to a job, not just if you've got lots of money. It isn't working great, but that's the goal at least. I know there are still lots of people who come back with opposition to that idea (even in these comments a few people are trotting out the whole "universal health care is slavery" junk), but whatever, there are people who oppose all kinds of things. Obama shifted the playing field of expectations, and good things will come as a result of that. That's all I'm trying to say.

harryh 10y ago
(My own story: I had my gallbladder out in 2004, and from that time on was denied personal health insurance for BS "pre-existing condition" reasons...until Obamacare.) Probably you were denied personal health insurance not for BS reasons, but because the insurance companies knew they would (probabilistically) lose money insuring you. But now under Obamacare, if they participate on the exchanges, they are obligated to sell to you. So, shockingly, we see that most companies operating on the exchanges lose money doing so. Your inability to get coverage before and the problems that Aetna is having today are very closely related.
- eecc 10y ago
  you're suggesting the guy should throw himself off a cliff?
  - harryh 10y ago
    I'm not suggesting he do anything. In fact, I think his story is a great example of what makes the economics of health care so challenging. I was merely pointing out a connection from his personal story to the general topic of conversation that a lot of people don't seem to realize.
    - seanp2k2 10y ago
      When the marker they use to draw a dot on where they need to cut you during surgery costs $50, it's hard for me to believe that the problem with health care is insurance companies not making enough money. Why does all this stuff cost so much in the first place? Medical equipment prices seem so far separated from reality that it's seriously laughable, and it'd be funny if it wasn't everyone who had to find a way to afford this junk. Go look at some prices for medical equipment (where you can even find prices) and see if those prices seem reasonable to you for the equipment. Let's find a way to fix that? This doesn't even touch how some hospitals / networks must buy from a specific vendor, or how vendors sell packages which include things the buyer doesn't need (at the same exorbitant prices).
      - wtbob 10y ago
        > When the marker they use to draw a dot on where they need to cut you during surgery costs $50, it's hard for me to believe that the problem with health care is insurance companies not making enough money. The insurance companies are the ones paying for that $50 dot. Well, after their discounts it's probably a $10 dot. It was either Time or Newsweek a few years back which had an excellent long-form article on where health-care spending goes. As I recall, it's not the insurance companies: it's the hospitals, physicians, nurses, other staff and an army of hangers-on and middlemen.
        infinite_beam 10y ago
        Bitter Pill: Why Medical Bills Are Killing Us By Steven Brill Time Magazine Feb. 20, 2013. http://www.uta.edu/faculty/story/2311/Misc/2013,2,26,MedicalCostsDemandAndGreed.pdf http://www.uta.edu/faculty/story/2311/Misc/2013,2,26,Medical...
- Broken_Hippo 10y ago
  Well, not really. I had my gall bladder out about '08. I couldn't eat properly before it got out. It wasn't emergency, but the pain put me in the emergency room more than once. I didn't have gallstones, it quit working. It has been years since I got it out. I still have a few problems eating greasy foods (especially meat), but now generally avoid those and am mostly vegetarian. No other complications, and I have not required any sort of care for that surgery outside of that. Neither has my brother, who got his out about 5 years ago. Neither has my mother, who got hers out in 1978. This type of thing isn't so much a pre-existing condition as much as they are "I had a health issue that was more severe than a simple infection". It isn't the same as "I have diabetes" or "I have chronic issues with x", which can cause expenses.
  - harryh 10y ago
    See #2 here: https://news.ycombinator.com/item?id=12308243 https://news.ycombinator.com/item?id=12308243 I'm actually quite curious about this.
    - Frondo 10y ago
      About being rejected from buying my own health insurance, based on a surgery I'd had, I think that the question of whether it's "smart" or "dumb" for insurers to do so is irrelevant. Especially in a modern society, that decision-making process is no more relevant than asking whether it's OK to dump toxic waste into the river, because the fines could be cheaper than processing such waste safely.
      - harryh 10y ago
        Private companies refusing to sell insurance to someone where they will lose money on the transaction is not at all like dumping toxic waste into a river. If insurance companies can't make money (or at least break even) for a certain population then they are't a viable means of making sure care is payed for, and we need to develop alternate policies to make things work. So it's actually very very relevant to understand the decision-making process of insurance companies in these situations.
lemmsjid 10y ago
Same exact scenario here, except a kidney problem. It was a nightmare to get back into coverage and required ultimately working for a large company. Since that happened I've always thought the lack of universal healthcare was a major cultural lever against entrepreneurship and small business ownership, because stable healthcare coverage is probably the number one draw of working a corporate job. It seems so culturally odd to me that employment and healthcare are so linked in the U.S. Unfortunately I think some people don't understand how existentially frightening it is to get a bunch of rejection letters from insurance companies until it happens to them.

by Frondo 10y ago

harryh 10y ago

(My own story: I had my gallbladder out in 2004, and from that time on was denied personal health insurance for BS "pre-existing condition" reasons...until Obamacare.) Probably you were denied personal health insurance not for BS reasons, but because the insurance companies knew they would (probabilistically) lose money insuring you. But now under Obamacare, if they participate on the exchanges, they are obligated to sell to you. So, shockingly, we see that most companies operating on the exchanges lose money doing so. Your inability to get coverage before and the problems that Aetna is having today are very closely related.

eecc 10y ago
you're suggesting the guy should throw himself off a cliff?
- harryh 10y ago
  I'm not suggesting he do anything. In fact, I think his story is a great example of what makes the economics of health care so challenging. I was merely pointing out a connection from his personal story to the general topic of conversation that a lot of people don't seem to realize.
  - seanp2k2 10y ago
    When the marker they use to draw a dot on where they need to cut you during surgery costs $50, it's hard for me to believe that the problem with health care is insurance companies not making enough money. Why does all this stuff cost so much in the first place? Medical equipment prices seem so far separated from reality that it's seriously laughable, and it'd be funny if it wasn't everyone who had to find a way to afford this junk. Go look at some prices for medical equipment (where you can even find prices) and see if those prices seem reasonable to you for the equipment. Let's find a way to fix that? This doesn't even touch how some hospitals / networks must buy from a specific vendor, or how vendors sell packages which include things the buyer doesn't need (at the same exorbitant prices).
    - wtbob 10y ago
      > When the marker they use to draw a dot on where they need to cut you during surgery costs $50, it's hard for me to believe that the problem with health care is insurance companies not making enough money. The insurance companies are the ones paying for that $50 dot. Well, after their discounts it's probably a $10 dot. It was either Time or Newsweek a few years back which had an excellent long-form article on where health-care spending goes. As I recall, it's not the insurance companies: it's the hospitals, physicians, nurses, other staff and an army of hangers-on and middlemen.
      - infinite_beam 10y ago
        Bitter Pill: Why Medical Bills Are Killing Us By Steven Brill Time Magazine Feb. 20, 2013. http://www.uta.edu/faculty/story/2311/Misc/2013,2,26,MedicalCostsDemandAndGreed.pdf http://www.uta.edu/faculty/story/2311/Misc/2013,2,26,Medical...
Broken_Hippo 10y ago
Well, not really. I had my gall bladder out about '08. I couldn't eat properly before it got out. It wasn't emergency, but the pain put me in the emergency room more than once. I didn't have gallstones, it quit working. It has been years since I got it out. I still have a few problems eating greasy foods (especially meat), but now generally avoid those and am mostly vegetarian. No other complications, and I have not required any sort of care for that surgery outside of that. Neither has my brother, who got his out about 5 years ago. Neither has my mother, who got hers out in 1978. This type of thing isn't so much a pre-existing condition as much as they are "I had a health issue that was more severe than a simple infection". It isn't the same as "I have diabetes" or "I have chronic issues with x", which can cause expenses.
- harryh 10y ago
  See #2 here: https://news.ycombinator.com/item?id=12308243 https://news.ycombinator.com/item?id=12308243 I'm actually quite curious about this.
  - Frondo 10y ago
    About being rejected from buying my own health insurance, based on a surgery I'd had, I think that the question of whether it's "smart" or "dumb" for insurers to do so is irrelevant. Especially in a modern society, that decision-making process is no more relevant than asking whether it's OK to dump toxic waste into the river, because the fines could be cheaper than processing such waste safely.
    - harryh 10y ago
      Private companies refusing to sell insurance to someone where they will lose money on the transaction is not at all like dumping toxic waste into a river. If insurance companies can't make money (or at least break even) for a certain population then they are't a viable means of making sure care is payed for, and we need to develop alternate policies to make things work. So it's actually very very relevant to understand the decision-making process of insurance companies in these situations.

lemmsjid 10y ago

Same exact scenario here, except a kidney problem. It was a nightmare to get back into coverage and required ultimately working for a large company. Since that happened I've always thought the lack of universal healthcare was a major cultural lever against entrepreneurship and small business ownership, because stable healthcare coverage is probably the number one draw of working a corporate job. It seems so culturally odd to me that employment and healthcare are so linked in the U.S. Unfortunately I think some people don't understand how existentially frightening it is to get a bunch of rejection letters from insurance companies until it happens to them.