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Buying healthcare as an individual is very expensive, since you're not buying in bulk. Some larger unions do have healthcare for members, but it's more of a bar

Buying healthcare as an individual is very expensive, since you're not buying in bulk. Some larger unions do have healthcare for members, but it's more of a bargaining chip to keep workers paying dues.

bhupy 7y ago
> Buying healthcare as an individual is very expensive, since you're not buying in bulk This is a common refrain, but it's actually not true. Individual plans operate as a giant "group" with other individuals, and the size of that group is often larger than most employer groups. There are a host of reasons why healthcare is expensive in the US, and the "bulk purchasing" is not really one of them. Source: I work in health insurance.
- hkmurakami 7y ago
  What we really need now to level is to make individual health insurance effectively a pre-income-tax item like it is when you get it via employment.
  - bhupy 7y ago
    > What we really need now to level is to make individual health insurance effectively a pre-income-tax item like it is when you get it via employment. The ICHRA[1], which came into effect on January 2020 is an interesting step in this direction. It allows employers to provide a pre-tax cash monthly allowance to buy health insurance on the individual market in lieu of the monthly premiums they would pay anyway as part of the employer mandate to provide group health insurance directly. There's even a YC company that offers ICHRA functionality for employers[2]. [1] https://ichra.com/ https://ichra.com/ [2] https://news.ycombinator.com/item?id=22527102 https://news.ycombinator.com/item?id=22527102
- pasttense01 7y ago
  Nonsense. It's cheaper to sell and administer one group policy that covers 10,000 individuals than do this for 10,000 individual policies.
  - bhupy 7y ago
    Those 10,000 individual policies are paid for out of a shared pool of risk. The payer administers it the same way they administer a group plan. It is literally identical to a group of 10,000 individuals. I work in health insurance.
scarface74 7y ago
Have you looked at the total cost of your insurance -- including what your employer pays? They have to report it to you as part of the ACA. Mine is $25000 a year for family coverage including employer subsidies. Luckily we pay less than $100/month though

bhupy 7y ago

> Buying healthcare as an individual is very expensive, since you're not buying in bulk This is a common refrain, but it's actually not true. Individual plans operate as a giant "group" with other individuals, and the size of that group is often larger than most employer groups. There are a host of reasons why healthcare is expensive in the US, and the "bulk purchasing" is not really one of them. Source: I work in health insurance.

hkmurakami 7y ago
What we really need now to level is to make individual health insurance effectively a pre-income-tax item like it is when you get it via employment.
- bhupy 7y ago
  > What we really need now to level is to make individual health insurance effectively a pre-income-tax item like it is when you get it via employment. The ICHRA[1], which came into effect on January 2020 is an interesting step in this direction. It allows employers to provide a pre-tax cash monthly allowance to buy health insurance on the individual market in lieu of the monthly premiums they would pay anyway as part of the employer mandate to provide group health insurance directly. There's even a YC company that offers ICHRA functionality for employers[2]. [1] https://ichra.com/ https://ichra.com/ [2] https://news.ycombinator.com/item?id=22527102 https://news.ycombinator.com/item?id=22527102
pasttense01 7y ago
Nonsense. It's cheaper to sell and administer one group policy that covers 10,000 individuals than do this for 10,000 individual policies.
- bhupy 7y ago
  Those 10,000 individual policies are paid for out of a shared pool of risk. The payer administers it the same way they administer a group plan. It is literally identical to a group of 10,000 individuals. I work in health insurance.

scarface74 7y ago

Have you looked at the total cost of your insurance -- including what your employer pays? They have to report it to you as part of the ACA. Mine is $25000 a year for family coverage including employer subsidies. Luckily we pay less than $100/month though