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>> Health insurance isn't like auto or home insurance, because it's not purely insurance. True but you still shouldn't get that from the employer, that is par

>> Health insurance isn't like auto or home insurance, because it's not purely insurance. True but you still shouldn't get that from the employer, that is part of the pricing problem. >> ...because you're insuring against the risk of rare and catastrophic conditions, but a good chunk of it is covering routine care I'd argue that individual insurance is closer to auto insurance as they have high deductibles and you still do have to pay for routine care mostly out of pocket. Maybe health insurance is changing into more of a catastrophic level like auto/home/life where it really only covers above your deductible, which will be high, so routine health checkups are paid mostly by the customer. Not all companies offer health, dental or vision insurance but people still pay those out of pocket or on individual plans. I'd argue most routine work in most plans today, unless cadillac level, involve the customer paying most of the routine care either as a small part of their premium or at the service as it is below deductible (prescriptions aside, you need insurance to get special backdoor pricing). Health insurance can be massive in cost, much of that is due to the disconnect from reality as it is hooked through companies/employment. I think fixing that will change how people view health insurance and the prices will match market value better, it could also change perception of how to use healthcare. Personally I have never felt that routine care is acceptable to use too much as it harms the group/work policy. So even people that have it are sometimes not feeling like they can use it. When it is independent and personal, if you need it you need it and you can use it without affecting your company group policy, probably paying out of pocket most likely for routine work as your deductible will be high. Why have the added stress of health issues possibly affect your job's insurance group for menial routine work? I've had independent insurance for 5+ years now and that was the first time I actually felt like I could use it even though it paid for little, where the work plans I had I never felt like I could use. Even if you think health insurance is different, it still doesn't mean it should be linked through your job/employer, that causes much of the pricing issues and many other issues associated with employment/survival. It is an ancient way to look at things when people change jobs every 2 years.

chimeracoder 10y ago
> True but you still shouldn't get that from the employer, that is part of the pricing problem. I never said that should be the case, but it should also be mentioned you don't need get your insurance from your employer anymore, under the ACA. Employers may provide it as a benefit (just like many other non-cash benefits employers may provide), but nothing's stopping you from purchasing your own insurance separately instead. > I'd argue that individual insurance is closer to auto insurance as they have high deductibles That's only true of HDHPs - you can get PPO or HMO plans instead if you prefer. > Maybe health insurance is changing into more of a catastrophic level like auto/home/life where... routine health checkups are paid mostly by the customer. Yes, that's how health insurance would operate under an actual insurance model. Routine health checkups involve no risk, so there's nothing to insure against[0]. > Personally I have never felt that routine care is acceptable to use too much as it harms the group/work policy. This is a moral hazard problem, and it's part of why it's a bad idea to consider coverage of routine care as "insurance". > [health insurance being] linked through your job/employer... causes much of the pricing issues and many other issues associated with employment/survival. I'll agree that having health insurance being tied to one's employer is bad (though as I mentioned, that's not really the case anymore). Though the pricing issues are more to do with using an insurance model to price something that is fundamentally not about risk, as well as the problems with the way the billing system is setup. I don't think the fact that having health insurance provided by the employer makes a meaningful impact on pricing in the aggregate (as opposed to in individual cases). [0] The fact that you can choose whether or not to have your annual checkup is not 'risk' in the insurance sense; it's an issue of either adverse selection or moral hazard, depending on the point at which it occurs.
- drawkbox 10y ago
  >> I never said that should be the case, but it should also be mentioned you don't need get your insurance from your employer anymore, under the ACA. You could before the ACA it is just the plans were not as robust. I have had independent insurance since 2009. I did it and it was actually scary starting business with this fear. I was initially rejected even though I was healthy, 30 and was applying to the same insurance I just left at my employer. The ACA, for better or worse, made this much, much easier and the plans can't be pulled out from under you or prevent you from getting one. The ACA could be a start to removing insurance from employment and benefit pricing/understanding of market value in health. >> This is a moral hazard problem, and it's part of why it's a bad idea to consider coverage of routine care as "insurance". Maybe we need health insurance and healthcare plans separate, it is moving that way in the independent insurance area. The only way for this to happen is to separate it from the employer. Side note, I worked in games and agencies previously and I saw on two occasions (right to work state) where people were let go who just had health issues that were more serious (heart, one sales guy, one developer). So when people get insurance through their company they think they are covered, but in reality insurers and companies want to pull out of that as soon as possible leaving the individual not insured and not safe. Both were let go shortly after their issues and left with now having to find a plan with a condition (before the ACA). So really, independent insurance is really closer to insurance than employer provided insurance that ends with employment or can be taken from you when you actually need it. Yes there is some buffer with CORBA and other temporary things but it is not safe in terms of being an individual who actually wants insurance in case bad things happens. If everyone got independent insurance there would be massive changes to pricing and understanding of healthcare and the insurance part (catastrophic). It might even spawn two types of insurance (catastrophic and routine) out of it or industries. Noone should lose the catastrophic side when they leave a job, it is seriously unsafe and not really insurance.
ghaff 10y ago
>Personally I have never felt that routine care is acceptable to use too much as it harms the group/work policy. I've worked for large companies and small ones. Never once has it occurred to me nor would I entertain the idea of not taking full advantage of a benefit that is explicitly provided as part of my compensation package. I don't necessarily disagree about your broader point of insurance and its connection to jobs, but so long as that's the reality I'm going to work within that reality.

chimeracoder 10y ago

> True but you still shouldn't get that from the employer, that is part of the pricing problem. I never said that should be the case, but it should also be mentioned you don't need get your insurance from your employer anymore, under the ACA. Employers may provide it as a benefit (just like many other non-cash benefits employers may provide), but nothing's stopping you from purchasing your own insurance separately instead. > I'd argue that individual insurance is closer to auto insurance as they have high deductibles That's only true of HDHPs - you can get PPO or HMO plans instead if you prefer. > Maybe health insurance is changing into more of a catastrophic level like auto/home/life where... routine health checkups are paid mostly by the customer. Yes, that's how health insurance would operate under an actual insurance model. Routine health checkups involve no risk, so there's nothing to insure against[0]. > Personally I have never felt that routine care is acceptable to use too much as it harms the group/work policy. This is a moral hazard problem, and it's part of why it's a bad idea to consider coverage of routine care as "insurance". > [health insurance being] linked through your job/employer... causes much of the pricing issues and many other issues associated with employment/survival. I'll agree that having health insurance being tied to one's employer is bad (though as I mentioned, that's not really the case anymore). Though the pricing issues are more to do with using an insurance model to price something that is fundamentally not about risk, as well as the problems with the way the billing system is setup. I don't think the fact that having health insurance provided by the employer makes a meaningful impact on pricing in the aggregate (as opposed to in individual cases). [0] The fact that you can choose whether or not to have your annual checkup is not 'risk' in the insurance sense; it's an issue of either adverse selection or moral hazard, depending on the point at which it occurs.

drawkbox 10y ago
>> I never said that should be the case, but it should also be mentioned you don't need get your insurance from your employer anymore, under the ACA. You could before the ACA it is just the plans were not as robust. I have had independent insurance since 2009. I did it and it was actually scary starting business with this fear. I was initially rejected even though I was healthy, 30 and was applying to the same insurance I just left at my employer. The ACA, for better or worse, made this much, much easier and the plans can't be pulled out from under you or prevent you from getting one. The ACA could be a start to removing insurance from employment and benefit pricing/understanding of market value in health. >> This is a moral hazard problem, and it's part of why it's a bad idea to consider coverage of routine care as "insurance". Maybe we need health insurance and healthcare plans separate, it is moving that way in the independent insurance area. The only way for this to happen is to separate it from the employer. Side note, I worked in games and agencies previously and I saw on two occasions (right to work state) where people were let go who just had health issues that were more serious (heart, one sales guy, one developer). So when people get insurance through their company they think they are covered, but in reality insurers and companies want to pull out of that as soon as possible leaving the individual not insured and not safe. Both were let go shortly after their issues and left with now having to find a plan with a condition (before the ACA). So really, independent insurance is really closer to insurance than employer provided insurance that ends with employment or can be taken from you when you actually need it. Yes there is some buffer with CORBA and other temporary things but it is not safe in terms of being an individual who actually wants insurance in case bad things happens. If everyone got independent insurance there would be massive changes to pricing and understanding of healthcare and the insurance part (catastrophic). It might even spawn two types of insurance (catastrophic and routine) out of it or industries. Noone should lose the catastrophic side when they leave a job, it is seriously unsafe and not really insurance.

ghaff 10y ago

>Personally I have never felt that routine care is acceptable to use too much as it harms the group/work policy. I've worked for large companies and small ones. Never once has it occurred to me nor would I entertain the idea of not taking full advantage of a benefit that is explicitly provided as part of my compensation package. I don't necessarily disagree about your broader point of insurance and its connection to jobs, but so long as that's the reality I'm going to work within that reality.