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Throw-away because I like to keep my financial details personal. I'm self employed and have been for about 15 years. We purchase health insurance from the sta
by singlepayer 9y ago
Throw-away because I like to keep my financial details personal.
I'm self employed and have been for about 15 years. We purchase health insurance from the state exchange. Prior to this, I'd purchased it as an individual directly from the insurers, or used the plan my wife had through her employer. Those options are no longer available to us, so we use the state exchange.
My family's health insurance rates increased 17% last year. This year, my state has approved an increase of 27% for the provider I use and a 31% increase for one of the other providers in the state.
To insure our family of four, we'll pay around $25,000 for insurance before a dollar is spent on deductibles, co-pays or other associated costs. We're generally all healthy. Have no pre-existing conditions to speak-of. We earn more than the level where you qualify for any subsidy.
This is unsustainable.
- frozenport 9y agoSucks but I'm pretty sure they'll take every penny. People said college costs were out of control in 2000, stuff kept going up for a decade.
- chrisabrams 9y agoPretty sure they are still going up
- stephengillie 9y agoI graduated in 2009. Tuition has passed double what I paid, and today is approaching 3 times what I paid.
- Synaesthesia 9y agoAgain for comparison, Germany has free tuition even at university level. And it doesn’t cost the country a great deal. These sudden rises in tuition in the US Zaire a relatively recent phenomenon too.
- seanmcdirmid 9y agoTo be fair, you do give up some things for that free tuition in Germany. You basically attend lecture and take the test at the end. It scales well, and some people do really well, but it might not be for everyone.
- brightsize 9y agoFree tuition for foreigners as well.
- quuquuquu 9y agoVery sorry to hear about the burden you and your family are bearing. I hope we can devise an alternative to the current system, as $25,000 is more costly than just buying everything up front! I did some research and found that an apendectomy is one of the most important things insurance can pay for, as it is sudden, life threatening, and generally not easily controlled by lifestyle choices. The quoted cost of an apendectomy from a variety of different countries and hospitals? "Between $3,000 and $150,000 USD" It might as well be "blank check", if this price gouging is allowed in the US.
- eganist 9y agoDid a quick look-up of appendectomy pricing based on published CMS data from 2015. Results listed here: https://docs.google.com/spreadsheets/d/1vPg1jtV8CK3pAs5EXC48AeY0J-2DW15uyeUUSvX-nwk/ https://docs.google.com/spreadsheets/d/1vPg1jtV8CK3pAs5EXC48... Source: https://www.cms.gov/Research-Statistics-Data-and-Systems/Statistics-Trends-and-Reports/Medicare-Provider-Charge-Data/Inpatient2015.html https://www.cms.gov/Research-Statistics-Data-and-Systems/Sta...
- maxerickson 9y agoA single person can easily incur more than $30,000 of medical expenses, even at a hospital with reasonable prices. So no, $25,000 isn't more expensive than buying everything up front for 4 people. It's expensive, but the US spends something like $10,000 a year per capita on health care, so it isn't an outsized chunk.
- Frondo 9y agoOver 10 years ago, I had my gallbladder taken out. I spent two nights in the hospital (one in the ER, where they diagnosed it, and one more after they took it out). I was uninsured at the time, and at the end was given a bill for $18,000. Gallbladder removal is the simplest major surgery that can be done on a person; it's a simple organ to remove, and rarely presents any challenges. I could easily see surpassing that dollar amount for anything more complicated. For comparison, the total cost to do the surgery in a developing nation (where I spent several years in my early 20s) would have been $300-400, according to friends there.
- alva 9y agoSometimes I think other nations should be a bit more pragmatic in generating revenue from the huge costs of healthcare in the US. In the UK we can charge foreigners for use of our NHS. I believe that using this private service, is significantly cheaper than the equivalent in the states. Flight costs are trivial when looking at US healthcare costs. Of course this can only deal with non-urgent and (relatively) well off people.
- dethstar 9y agoThat's why a lot of people at the border go to a private dr in Mexico instead.
- yardie 9y agoMy family has employer provided healthcare. But at this point if the premiums go up faster than we can afford I'm switching to an HSA. I can easily afford to fly my family to Cent/South America to have a checkup or surgery compared to the money I'm throwing into the wind with our HMO. We're young, healthy, with no chronic issues. Just the type of people insurance companies would want to insure.
- knz 9y ago> This is unsustainable. It's not just unsustainable, it's absurd! $25,000 USD is most of, if not the entirety, of the TOTAL income taxes many people pay in other OECD nations. How are these other nations providing all of the functions of government, including universal health care, for what Americans are paying just for insurance? This shouldn't be a partisan issue - even the most conservative of Americans should be outraged that we are being ripped off. https://data.oecd.org/healthres/health-spending.htm https://data.oecd.org/healthres/health-spending.htm - the US spends $9,800/year per capita, clearly an outlier, and yet we still can't cover everyone in a reasonable way?! I took my child in for a regular 15 minute doctors appointment recently and the cost of seeing the provider (no tests) was $350. Does it really cost $1,400/hour to operate a medical clinic? Google tells me that the average GP salary in the US is $189,000 ($90/hour), average salary for a nurse is $67,000 ($32/hour), and average for a receptionist is $27,000 ($12/hour). Add another nurse for administering shots/drawing blood and the total payroll per hour is about $166/hour. Where is the other $1,234/hour going? I'm sure there are reasonable explanations for some of it (cost of the building, cost of medical equipment in the clinic, professional insurance, and maintenance on the fish tank) but the ridiculous cost of everything is the elephant in the room that no amount of "cracking down on fraud" or "incentivizing healthy behaviors" will solve. As an immigrant to the US, it's maddening. It just doesn't have to be this way, there is half a century of evidence showing that alternative systems are cheaper and more effective. I also look at that $9,800/year per capita and wonder what our economy looks like if everyone had an extra $2-4,000/year in their pocket. Or if we eliminated the burden of health care from businesses and individuals trying to start a business.
- athenot 9y agoNot to take away from any of your points, but just a minor correction that in many OECD nations (Europe specifically), it's payroll taxes that pay for the healthcare, not income taxes. The former can be double what the latter are.
- malandrew 9y agohttps://slatestarcodex.com/2017/02/09/considerations-on-cost-disease/ https://slatestarcodex.com/2017/02/09/considerations-on-cost...
- nugget 9y agoWould it be more cost effective to buy a catastrophic insurance policy and self-insure (pay cash) for routine services?
- singlepayer 9y agoProbably the option we'll explore when reviewing plans. Or go back to work for a company which provides coverage as part of the employment package.
- njarboe 9y agoUnder ACA medical plans deductibles are capped at "For 2017, your out-of-pocket maximum can be no more than $7,150 for an individual plan and $14,300 for a family plan before marketplace subsidies."[1] [1] https://obamacarefacts.com/health-insurance/out-of-pocket-maximum/ https://obamacarefacts.com/health-insurance/out-of-pocket-ma... Not sure if only plans in the ACA system must meet this requirement or that private companies cannot even offer say a $50,000 deductible plan with a $3 mil cap.
- epmaybe 9y agoIt's worse than that. With the biologics on their way to market today, and with guidelines changing, we could be treating relatively common diseases with absurdly expensive drugs, and insurance companies will have no choice but to cover these therapies. That will in turn cause premiums to skyrocket.
- Navarr 9y agoAt that cost would you not be better off saving it?
- singlepayer 9y agoIt might be. But then you either get hit with a penalty for not buying insurance, or you get hit with a penalty and also a bill for $500,000 when you find out you've got some illness you didn't know about and hospital bills bankrupt you.
- rabboRubble 9y agoJust noticed your throwaway user ID. Clever. I'm guessing that you support single payer?
- singlepayer 9y agoSeems to work reasonably well in other countries.