4 ms·

We’re Getting Ripped Off

35 points by TheAlchemist 7y ago

ordinaryradical 7y ago
This is a useful way to discuss the cost of healthcare. Premiums are a silent tax we pay out of our paychecks. I actually think the most capitalist solution is to remove this burden from businesses entirely and create some public alternative to live alongside the private system. There should not be some magic number of employees where your startup suddenly has to put together a benefits package for everyone. That's not good for growth or competition.
- jandrese 7y ago
  If we really want to get politicians on board we should bring up how much our current healthcare system hurts small businesses. There is not a politician in the US that doesn't kiss up to the small business owner, yet we have what is probably the worst possible system for someone trying to start a home business. If you have a family it's borderline irresponsible to quit your job and leave behind that employer sponsored health plan. As an individual you're at the mercy of the insurance companies and they are merciless.
- kgwxd 7y ago
  I can't even image who would argue against it. What was the point of tying health insurance to work in the first place? I'm finally in a situation where I'm managing my own insurance and being compensated for the "lack of benefits" directly. I got a plan way better than my last one, for $5 more than what my side of the cost was. And I no longer feel chained to my employer. Even if you like where you work, that's not a good situation to be in. Companies get the worst options, and it still cost both parties a horrible amount, and now the employee is stuck with that crappy plan when they could have shopped around for a much better deal directly.
  - cannonedhamster 7y ago
    The current system is because of wage fixing by the government during WW2. It was a way for employers to differentiate at a time when wages weren't available as an option. I agree that the free market is the place to do this.
thinkingkong 7y ago
Let's just say people could agree that a public system or option was actually the right course of action. I think the most interesting / challenging part would be the transition into that system from what we currently have. To me, that would be more interesting to read about than arguments about how to change peoples minds.
- nugget 7y ago
  I support Medicare for all but I’m also realistic that it will result in a two-tiered public/private system, similar to what the UK has with the NHS and separate cash pay services and private insurance. The key is to disconnect the private system from employment where the costs and purchase decisions are obfuscated from the end consumer. When a critical mass of consumers pay out of pocket for services, the market will drive down prices and increase transparency. At least that’s the best shot at it, based on what I’ve seen.
  - sharemywin 7y ago
    Here's a couple list of top healthcare systems in the world: https://fr.april-international.com/en/healthcare-expatriates/which-countries-have-best-healthcare-systems https://fr.april-international.com/en/healthcare-expatriates...
  - ameister14 7y ago
    I would be careful likening that system to the NHS - the NHS is much more fully nationalized than a medicare for all system would be
    - nugget 7y ago
      It would be at first. But if almost all of a hospital’s revenue comes from CMS, why wouldn’t CMS simply run the hospital? If it can run provider networks more efficiently, why not hospitals? At least that’s how I predict the political discussion will evolve.
      - 7y ago
sharemywin 7y ago
Another thing to point out. We pay for the un/under-insured through high medical prices. And as for high deductible plans. People tend to put off routine procedures and tests which then compound into more expensive procedures and care.
- ASalazarMX 7y ago
  I can't force myself to understand this Ferengi-like mindset. Paying for the un/under-insured through for-profit intermediaries is what lead to high medical prices. If it's a social service, if should be funded through taxes. And people putting off routine procedures and tests, which then compound into more expensive procedures and care, can be explained not just by apathy, but by the high cost of doing routine medical care. My dad slightly burned his forearm opening the radiator cap of his car. He drove to the hospital, where they washed his arm, put gauze, tape and sent him home with a non-negotiable $600 USD bill. He's Mexican, but they can collect in Mexico too. As a side note, this would have cost him $0 in Mexico, because taxes.
dang 7y ago
https://news.ycombinator.com/item?id=21073443 https://news.ycombinator.com/item?id=21073443
- theandrewbailey 7y ago
  Is this a repost? Because that one doesn't look like this one.
  - TheAlchemist 7y ago
    Not a repost, but indeed the same topic and data
d--b 7y ago
I just moved from the US to France, and thought that I would get ripped off by the taxes here. But I did the exact same calculation. If you factor in Health insurance I'm much better off here (even without factoring the $4000 deductible I had in the US). If you add free school and free university, there is no comparison, France is way cheaper.
Sam_Odio 7y ago
I wish conversations about public healthcare in the US included discussions about innovation in the healthcare industry. We don't need to argue that consolidating buyers (e.g. single payer) has more market power and can negotiate prices down. This is an accepted principle among economists. I am very curious about what affects single-payer in the US would have on global healthcare innovation. E.g. concepts like: > the high spending of health care consumers in the United States is arguably funding not only global pharmaceutical innovation but is also facilitating the availability of new medicines to other countries at much lower prices than domestic consumers pay. https://arcdigital.media/u-s-health-care-reality-check-1-pharmaceutical-innovation-574241fb80ba https://arcdigital.media/u-s-health-care-reality-check-1-pha...
- henrikschroder 7y ago
  Is there any serious research that shows this to be true? In America, the Big Lie that all Americans tell about themselves and their country, is that the US is #1 in everything. And, if statistics happen to show that the US isn't #1, there's always a reason, an excuse, as to why in this instance the US isn't #1, but it totally could be, it just doesn't want to, or it has to deal with some exceptional circumstance that lesser countries just don't have to deal with. To me, the idea that the US subsidizes global healthcare innovation feels just like such an excuse. It gives Americans an opportunity to martyr themselves. "We could have cheaper healthcare, but we bear this burden, for you." Come on. It's a load of horseshit. And even if it were true, why would you accept it? America hates altruism, deriding it as socialism, so much so that "socialized" healthcare is seen as a horrible thing. It's not ok for Americans to pay for each other's healthcare, but it's suddenly perfectly ok to pay for the development of healthcare for other countries?!? You're happily spending healthcare money for the benefit of other countries, but not your own population? This makes no sense. This can't be true. It's a bad excuse to cover up failed exceptionalism, because the truth is simply that a lot of people with money to pay for lobbyists are benefiting from the current system.
  - colinmhayes 7y ago
    1. American culture may be anti-altruism, but I can still argue that altruism is a good thing. Developing life saving drugs is a good thing. I'd like to think that on this forum everyone can agree that technological innovation is incredibly important. Of course I would prefer everyone contributes to drug research costs, but if others aren't willing to pick up the slack I am. 2. Drugs cost upwards of a billion dollars to develop. Plenty of failed drugs cost a billion dollars before they fail. If drug companies don't make money they will stop developing drugs.
purplezooey 7y ago
"Americans are already paying enough to fund a European-style welfare state." Why do we tolerate this. Vote next time.
- jouss 7y ago
  You dont fund european welfare state, on the contrary, the world fund your american-style of life when US enforces buy oil with dollars

35 points by TheAlchemist 7y ago

This is a useful way to discuss the cost of healthcare. Premiums are a silent tax we pay out of our paychecks. I actually think the most capitalist solution is to remove this burden from businesses entirely and create some public alternative to live alongside the private system. There should not be some magic number of employees where your startup suddenly has to put together a benefits package for everyone. That's not good for growth or competition.

jandrese 7y ago
If we really want to get politicians on board we should bring up how much our current healthcare system hurts small businesses. There is not a politician in the US that doesn't kiss up to the small business owner, yet we have what is probably the worst possible system for someone trying to start a home business. If you have a family it's borderline irresponsible to quit your job and leave behind that employer sponsored health plan. As an individual you're at the mercy of the insurance companies and they are merciless.
kgwxd 7y ago
I can't even image who would argue against it. What was the point of tying health insurance to work in the first place? I'm finally in a situation where I'm managing my own insurance and being compensated for the "lack of benefits" directly. I got a plan way better than my last one, for $5 more than what my side of the cost was. And I no longer feel chained to my employer. Even if you like where you work, that's not a good situation to be in. Companies get the worst options, and it still cost both parties a horrible amount, and now the employee is stuck with that crappy plan when they could have shopped around for a much better deal directly.
- cannonedhamster 7y ago
  The current system is because of wage fixing by the government during WW2. It was a way for employers to differentiate at a time when wages weren't available as an option. I agree that the free market is the place to do this.

thinkingkong 7y ago

Let's just say people could agree that a public system or option was actually the right course of action. I think the most interesting / challenging part would be the transition into that system from what we currently have. To me, that would be more interesting to read about than arguments about how to change peoples minds.

nugget 7y ago
I support Medicare for all but I’m also realistic that it will result in a two-tiered public/private system, similar to what the UK has with the NHS and separate cash pay services and private insurance. The key is to disconnect the private system from employment where the costs and purchase decisions are obfuscated from the end consumer. When a critical mass of consumers pay out of pocket for services, the market will drive down prices and increase transparency. At least that’s the best shot at it, based on what I’ve seen.
- sharemywin 7y ago
  Here's a couple list of top healthcare systems in the world: https://fr.april-international.com/en/healthcare-expatriates/which-countries-have-best-healthcare-systems https://fr.april-international.com/en/healthcare-expatriates...
- ameister14 7y ago
  I would be careful likening that system to the NHS - the NHS is much more fully nationalized than a medicare for all system would be
  - nugget 7y ago
    It would be at first. But if almost all of a hospital’s revenue comes from CMS, why wouldn’t CMS simply run the hospital? If it can run provider networks more efficiently, why not hospitals? At least that’s how I predict the political discussion will evolve.
    - 7y ago

sharemywin 7y ago

Another thing to point out. We pay for the un/under-insured through high medical prices. And as for high deductible plans. People tend to put off routine procedures and tests which then compound into more expensive procedures and care.

ASalazarMX 7y ago
I can't force myself to understand this Ferengi-like mindset. Paying for the un/under-insured through for-profit intermediaries is what lead to high medical prices. If it's a social service, if should be funded through taxes. And people putting off routine procedures and tests, which then compound into more expensive procedures and care, can be explained not just by apathy, but by the high cost of doing routine medical care. My dad slightly burned his forearm opening the radiator cap of his car. He drove to the hospital, where they washed his arm, put gauze, tape and sent him home with a non-negotiable $600 USD bill. He's Mexican, but they can collect in Mexico too. As a side note, this would have cost him $0 in Mexico, because taxes.

dang 7y ago

https://news.ycombinator.com/item?id=21073443 https://news.ycombinator.com/item?id=21073443

theandrewbailey 7y ago
Is this a repost? Because that one doesn't look like this one.
- TheAlchemist 7y ago
  Not a repost, but indeed the same topic and data

d--b 7y ago

I just moved from the US to France, and thought that I would get ripped off by the taxes here. But I did the exact same calculation. If you factor in Health insurance I'm much better off here (even without factoring the $4000 deductible I had in the US). If you add free school and free university, there is no comparison, France is way cheaper.

Sam_Odio 7y ago

I wish conversations about public healthcare in the US included discussions about innovation in the healthcare industry. We don't need to argue that consolidating buyers (e.g. single payer) has more market power and can negotiate prices down. This is an accepted principle among economists. I am very curious about what affects single-payer in the US would have on global healthcare innovation. E.g. concepts like: > the high spending of health care consumers in the United States is arguably funding not only global pharmaceutical innovation but is also facilitating the availability of new medicines to other countries at much lower prices than domestic consumers pay. https://arcdigital.media/u-s-health-care-reality-check-1-pharmaceutical-innovation-574241fb80ba https://arcdigital.media/u-s-health-care-reality-check-1-pha...

henrikschroder 7y ago
Is there any serious research that shows this to be true? In America, the Big Lie that all Americans tell about themselves and their country, is that the US is #1 in everything. And, if statistics happen to show that the US isn't #1, there's always a reason, an excuse, as to why in this instance the US isn't #1, but it totally could be, it just doesn't want to, or it has to deal with some exceptional circumstance that lesser countries just don't have to deal with. To me, the idea that the US subsidizes global healthcare innovation feels just like such an excuse. It gives Americans an opportunity to martyr themselves. "We could have cheaper healthcare, but we bear this burden, for you." Come on. It's a load of horseshit. And even if it were true, why would you accept it? America hates altruism, deriding it as socialism, so much so that "socialized" healthcare is seen as a horrible thing. It's not ok for Americans to pay for each other's healthcare, but it's suddenly perfectly ok to pay for the development of healthcare for other countries?!? You're happily spending healthcare money for the benefit of other countries, but not your own population? This makes no sense. This can't be true. It's a bad excuse to cover up failed exceptionalism, because the truth is simply that a lot of people with money to pay for lobbyists are benefiting from the current system.
- colinmhayes 7y ago
  1. American culture may be anti-altruism, but I can still argue that altruism is a good thing. Developing life saving drugs is a good thing. I'd like to think that on this forum everyone can agree that technological innovation is incredibly important. Of course I would prefer everyone contributes to drug research costs, but if others aren't willing to pick up the slack I am. 2. Drugs cost upwards of a billion dollars to develop. Plenty of failed drugs cost a billion dollars before they fail. If drug companies don't make money they will stop developing drugs.

purplezooey 7y ago

"Americans are already paying enough to fund a European-style welfare state." Why do we tolerate this. Vote next time.

jouss 7y ago
You dont fund european welfare state, on the contrary, the world fund your american-style of life when US enforces buy oil with dollars