5 ms·

I'm not in the US, this is a actual question. Is this different in some fundamental way from not being able to offer a high enough salary?

by netcan 16y ago

jonknee 16y ago
Health insurance for companies is sold on a group basis and it's often much more difficult (and expensive) to negotiate a smaller group. If you do get a policy, good luck if anyone in your small group has a serious claim...
- rombus 16y ago
  When my company was sold, it was done as an asset sale, rather than a stock sale, specifically so my business partner could keep the health insurance. He then paid for my policy in the post-sale "group" because it was cheaper for him to pay for him, his wife, me, and my wife, than it was for him to buy an individual policy for him and his wife. (His wife had serious medical claims, and is essentially uninsurable without a bit of a group.)
- kls 16y ago
  Right, US heath insurance is a form of collective bargaining. The more people you have the more you can negotiate. If you have a small group you cost are exponentially higher and the conditions covered significantly less. I once bought a policy for myself, we had just exited one of our startups and I was on my own and working freelance. So I had no insurance. I was a 25 year old male and the only health problem I had was high blood pressure. It is/was controlled by medication. Anyway, given that I was essentially a group of 1, the policies available to me where pretty expensive. If I recall correctly they where around $1000 a month for me. I did not have family at the time so it was just me. Further I had a $500 annual deductible (I had to spend $500 before they started paying anything) then the per visit co-pays where pretty steep too. They ruled almost every possible male related problem a preexisting condition, so if I had a major medical issue related to any of them, they would not cover it and probably the wost of all, self purchased insurance plans don't cover perscriptions, these are a huge medical expense. So not only where the policies expensive but they where essential useless for 2 years while you run down the clock on the preexisting conditions clauses. Given that many people are insured through a company policy or medicare many never deal directly with the reality of trying to get a decent policy on their own. I have to say, when I had that experience I realized how broke the insurance system is, it is totally stacked in the favor of the insurance company and the only way to claw some of that favor back is through collective bargaining.
  - mcculley 16y ago
    > The more people you have the more you can negotiate. If you have a small group you cost are exponentially higher and the conditions covered significantly less. I have not found this to be true. I run a small company in Florida. We have BlueCross BlueShield. Comparing notes with other employers, big and small, the size of the group does not appear to make a difference. What seems to matter more is the makeup of the group in terms of age, gender, and preexisting conditions. There is a huge difference between buying individual insurance and qualifying as an employer group of two or more.
mcculley 16y ago
Yes, individuals cannot buy health insurance for the same rates that employers pay. Some individuals cannot buy health insurance at all if they have preexisting conditions.
- anamax 16y ago
  > Some individuals cannot buy health insurance at all if they have preexisting conditions. That's true only if they let their insurance lapse. As long as they don't do that, they can stay with their current, switch, etc, all without waiting periods or a significant premium relative to "well people". (It's been that way for years.) That's why I wouldn't let insurance lapse if I had a pre-existing condition, so why do folks with pre-existing conditions let their insurance lapse? Or, are we assuming that they do without cause or that they don't know the rules? Or, are "we" ranting about the system without knowing rules that don't apply to us?
  - gte910h 16y ago
    >That's true only if they let their insurance lapse. As long as they don't do that, they can stay with their current, switch, etc, all without waiting periods or a significant premium relative to "well people". (It's been that way for years.) On individual and even small group (or medium size groups) they up your premiums, often by a lot of you have something big done, possibly beyond the point of payment. So yes, "if you lapse it goes" is true, often the COST of insurance goes up 10x if something happens to you and you don't happen to be able to be kicked out on another technicality.
  - mcculley 16y ago
    I have employees who were laid off from their previous jobs. They could not afford to pay the COBRA payment and let their insurance lapse. They are now disqualified from private insurance and have pre-existing conditions that are not covered under our group plan. It is easy to tell people not to let their insurance lapse. If they have no income, this is not feasible. The point of the article is that the current system inhibits entrepreneurship. Plenty of employees in the current system stay with their employer out of fear of losing their coverage instead of pursuing other opportunities.

I'm not in the US, this is a actual question. Is this different in some fundamental way from not being able to offer a high enough salary?

by netcan 16y ago

I'm not in the US, this is a actual question. Is this different in some fundamental way from not being able to offer a high enough salary?

jonknee 16y ago

Health insurance for companies is sold on a group basis and it's often much more difficult (and expensive) to negotiate a smaller group. If you do get a policy, good luck if anyone in your small group has a serious claim...

rombus 16y ago
When my company was sold, it was done as an asset sale, rather than a stock sale, specifically so my business partner could keep the health insurance. He then paid for my policy in the post-sale "group" because it was cheaper for him to pay for him, his wife, me, and my wife, than it was for him to buy an individual policy for him and his wife. (His wife had serious medical claims, and is essentially uninsurable without a bit of a group.)
kls 16y ago
Right, US heath insurance is a form of collective bargaining. The more people you have the more you can negotiate. If you have a small group you cost are exponentially higher and the conditions covered significantly less. I once bought a policy for myself, we had just exited one of our startups and I was on my own and working freelance. So I had no insurance. I was a 25 year old male and the only health problem I had was high blood pressure. It is/was controlled by medication. Anyway, given that I was essentially a group of 1, the policies available to me where pretty expensive. If I recall correctly they where around $1000 a month for me. I did not have family at the time so it was just me. Further I had a $500 annual deductible (I had to spend $500 before they started paying anything) then the per visit co-pays where pretty steep too. They ruled almost every possible male related problem a preexisting condition, so if I had a major medical issue related to any of them, they would not cover it and probably the wost of all, self purchased insurance plans don't cover perscriptions, these are a huge medical expense. So not only where the policies expensive but they where essential useless for 2 years while you run down the clock on the preexisting conditions clauses. Given that many people are insured through a company policy or medicare many never deal directly with the reality of trying to get a decent policy on their own. I have to say, when I had that experience I realized how broke the insurance system is, it is totally stacked in the favor of the insurance company and the only way to claw some of that favor back is through collective bargaining.
- mcculley 16y ago
  > The more people you have the more you can negotiate. If you have a small group you cost are exponentially higher and the conditions covered significantly less. I have not found this to be true. I run a small company in Florida. We have BlueCross BlueShield. Comparing notes with other employers, big and small, the size of the group does not appear to make a difference. What seems to matter more is the makeup of the group in terms of age, gender, and preexisting conditions. There is a huge difference between buying individual insurance and qualifying as an employer group of two or more.

mcculley 16y ago

Yes, individuals cannot buy health insurance for the same rates that employers pay. Some individuals cannot buy health insurance at all if they have preexisting conditions.

anamax 16y ago
> Some individuals cannot buy health insurance at all if they have preexisting conditions. That's true only if they let their insurance lapse. As long as they don't do that, they can stay with their current, switch, etc, all without waiting periods or a significant premium relative to "well people". (It's been that way for years.) That's why I wouldn't let insurance lapse if I had a pre-existing condition, so why do folks with pre-existing conditions let their insurance lapse? Or, are we assuming that they do without cause or that they don't know the rules? Or, are "we" ranting about the system without knowing rules that don't apply to us?
- gte910h 16y ago
  >That's true only if they let their insurance lapse. As long as they don't do that, they can stay with their current, switch, etc, all without waiting periods or a significant premium relative to "well people". (It's been that way for years.) On individual and even small group (or medium size groups) they up your premiums, often by a lot of you have something big done, possibly beyond the point of payment. So yes, "if you lapse it goes" is true, often the COST of insurance goes up 10x if something happens to you and you don't happen to be able to be kicked out on another technicality.
- mcculley 16y ago
  I have employees who were laid off from their previous jobs. They could not afford to pay the COBRA payment and let their insurance lapse. They are now disqualified from private insurance and have pre-existing conditions that are not covered under our group plan. It is easy to tell people not to let their insurance lapse. If they have no income, this is not feasible. The point of the article is that the current system inhibits entrepreneurship. Plenty of employees in the current system stay with their employer out of fear of losing their coverage instead of pursuing other opportunities.