4 ms·

also, can you really stop working in your 50s when the health problems come and you realize you now need your employer for the health insurance?

mgkimsal 6y ago
or you can buy it yourself. budget for it like any other expense. it's not necessarily cheap, but it's not something so astronomical that no one can afford it at all. Many people somehow find $700/month for their favorite SUV, but $700/month for health insurance is unattainable. I'm not saying the system is great - I'm in favor of single-payer system overall. But tying access to health insurance to employment as a default mindset really has to be stopped, somehow.
- electricviolet 6y ago
  Most of the people for whom $700/month for health insurance is unattainable are not spending $700/month on car payments. There's bound to be some overlap, sure, but let's keep the focus on the fact that expecting everyone to pay $700/month in order to not go bankrupt from health expenses is insane.
  - missedthecue 6y ago
    Isn't the average monthly payment in germany over $800?
    - ratww 6y ago
      National average is around 3800. Minimum is 1584, I think.
    - Xylakant 6y ago
      The maximum monthly payment you can have for german public health insurance is 14.6% of 4.687,50 EUR per month in 2020 - that's about 800USD. Mind you, maximum, not average. 14.6% of your wage is the health insurance deductible, 4.687,50 EUR is the so-called "Beitragsbemessungsgrenze", that is the cap from which on your wage is free - it's regularly adjusted (upwards usually). You can reach that maximum if you are self employed and voluntarily member of the public health insurance - meaning you have to pay both the employers and the employees share. If you're employed, your employer pays about half of it. Your chosen health insurance can optionally add an extra fee, usually less than a percent or two, most are free.
      - mgkimsal 6y ago
        How does this work if you're unemployed? Is there a separate public option? Or do you just keep on with whatever you may have had before, without paying? Also, that "maximum/wage" thing - is that per person, or for a household (spouse/kids/etc)?
        kaybe 6y ago
        If you're on unemployment or welfare payments the state pays for you. If you live off savings and don't have income you can pay a base rate (a little bit below 200€).
        Xylakant 6y ago
        The level of care is independent of your payment, if you're unemployed you're still covered without payment, students are covered for free until they're 27 (there are ways to loose coverage, but just being unemployed is not one). Like the sibling comment pointed out: if you're living of savings, there's a minimum payment. The cap is per wage, so every person earning a wage gets the same cap applied to their individual income. (one of the ways that households with a single high earner profit, while two people earning a moderate wage have less). No bonus for kids here, buy if you're member of the public health insurance, your kid is covered for free.
  - mgkimsal 6y ago
    "but let's keep the focus on the fact that expecting everyone to pay $700/month" Everyone's paying it, in one manner or another, either through subsidies, or employer contributions, or paying direct. These are the average costs (relative to location and age) for health insurance plans from for-profit health insurance companies. But the context was with respect to people planning to retire in their 50s. Plenty of people budget for car payments, and they can budget for health insurance costs too.
    - metabagel 6y ago
      Car payments only last for five years.
      - mgkimsal 6y ago
        I was going to point that out myself. yes. many people do end up continuing that cycle, although there is some ability to stop which is different than other more pressing things (like insurance).
- VRay 6y ago
  Keep in mind that $700 a month private personal health insurance isn't going to cover any of your week to week/month to month expenses. You'll end up with a $10k deductible or higher
  - apocalypstyx 6y ago
    And then there are denied claims and out of network costs. People often think of their insurance as good (or will respond so on surveys), until they actually call upon it and it evaporates, leaving them with multiple hundred-thousand-dollar bills related to the treatment of cancer.
  - mgkimsal 6y ago
    Neither is most "employer-provided" insurance. A few folks have 'gold-plated' plans where they are hardly out of pocket for anything, but most people with health insurance plans, of any stripe, still have moderately sized deductibles, on top of paying a portion towards the monthly premium anyway.
    - VRay 6y ago
      Best system in the world Well, in all fairness, my and my wife's health care in the USA has been WAY better than it was in Japan. It costs like 20x as much, though. That's my theory as to why nobody in power wants to actually fix the US system. Maybe the system really is the best if you have unlimited money and unlimited tolerance for bureaucracy
- war1025 6y ago
  I pay $800/month on top of what my employer covers for our health insurance. And it's still worse insurance than what most of my friends and family have. If you work for a small company or are trying to buy off the marketplace, health insurance is insanely expensive.
  - mgkimsal 6y ago
    If you're working for a megacorp, they might be self-funding their own insurance plan. Otherwise, it is just 'insanely expensive', we just have a system where some portion of that insanity is 'hidden' by employers participating in the transaction (much like FICA tax 50/50 split). I did some work for a small insurance broker - about 15 employees. They provided health insurance for all employees. They invited me to a few company meetings, and the owners asked what people thought the cost of the insurance was, per month, per person. Lots of $100 and $150/month guesses. I said '$600'. Someone laughed, and the owner said "you're close - it's $586". The room went silent. It was going to be going up to, IIRC, something like $630/month, and he was preparing people for "hey, we're going to cover this, but we're probably not going to be able to do much else, or may have to cut back some minor reimbursement stuff."
- jwilber 6y ago
  Very out of touch comment. People worried about Health insurance are not paying $700/month for a monthly car payment. Maybe instead of trying to paint the problem of american healthcare access as a mindset issue, you can recognize that there are many legitimate problems with linking healthcare to employment. Why should anyone go broke over a medical expense? Why in a developed country? Why is that only a common fear in the US?
  - putnambr 6y ago
    In the context of retiring early and planning for expenses, it's not out of touch. If someone is planning on retiring by their 50s, they surely have thought of health insurance and put it in their budget.
    - mgkimsal 6y ago
      thank you. that was the context - someone retiring in their 50s. "can you really stop working in your 50s when the health problems come and you realize you now need your employer for the health insurance?" If you get to your 50s, think you can retire, and don't have a plan for this stuff, you're out of touch.

mgkimsal 6y ago

or you can buy it yourself. budget for it like any other expense. it's not necessarily cheap, but it's not something so astronomical that no one can afford it at all. Many people somehow find $700/month for their favorite SUV, but $700/month for health insurance is unattainable. I'm not saying the system is great - I'm in favor of single-payer system overall. But tying access to health insurance to employment as a default mindset really has to be stopped, somehow.

electricviolet 6y ago
Most of the people for whom $700/month for health insurance is unattainable are not spending $700/month on car payments. There's bound to be some overlap, sure, but let's keep the focus on the fact that expecting everyone to pay $700/month in order to not go bankrupt from health expenses is insane.
- missedthecue 6y ago
  Isn't the average monthly payment in germany over $800?
  - ratww 6y ago
    National average is around 3800. Minimum is 1584, I think.
  - Xylakant 6y ago
    The maximum monthly payment you can have for german public health insurance is 14.6% of 4.687,50 EUR per month in 2020 - that's about 800USD. Mind you, maximum, not average. 14.6% of your wage is the health insurance deductible, 4.687,50 EUR is the so-called "Beitragsbemessungsgrenze", that is the cap from which on your wage is free - it's regularly adjusted (upwards usually). You can reach that maximum if you are self employed and voluntarily member of the public health insurance - meaning you have to pay both the employers and the employees share. If you're employed, your employer pays about half of it. Your chosen health insurance can optionally add an extra fee, usually less than a percent or two, most are free.
    - mgkimsal 6y ago
      How does this work if you're unemployed? Is there a separate public option? Or do you just keep on with whatever you may have had before, without paying? Also, that "maximum/wage" thing - is that per person, or for a household (spouse/kids/etc)?
      - kaybe 6y ago
        If you're on unemployment or welfare payments the state pays for you. If you live off savings and don't have income you can pay a base rate (a little bit below 200€).
      - Xylakant 6y ago
        The level of care is independent of your payment, if you're unemployed you're still covered without payment, students are covered for free until they're 27 (there are ways to loose coverage, but just being unemployed is not one). Like the sibling comment pointed out: if you're living of savings, there's a minimum payment. The cap is per wage, so every person earning a wage gets the same cap applied to their individual income. (one of the ways that households with a single high earner profit, while two people earning a moderate wage have less). No bonus for kids here, buy if you're member of the public health insurance, your kid is covered for free.
- mgkimsal 6y ago
  "but let's keep the focus on the fact that expecting everyone to pay $700/month" Everyone's paying it, in one manner or another, either through subsidies, or employer contributions, or paying direct. These are the average costs (relative to location and age) for health insurance plans from for-profit health insurance companies. But the context was with respect to people planning to retire in their 50s. Plenty of people budget for car payments, and they can budget for health insurance costs too.
  - metabagel 6y ago
    Car payments only last for five years.
    - mgkimsal 6y ago
      I was going to point that out myself. yes. many people do end up continuing that cycle, although there is some ability to stop which is different than other more pressing things (like insurance).
VRay 6y ago
Keep in mind that $700 a month private personal health insurance isn't going to cover any of your week to week/month to month expenses. You'll end up with a $10k deductible or higher
- apocalypstyx 6y ago
  And then there are denied claims and out of network costs. People often think of their insurance as good (or will respond so on surveys), until they actually call upon it and it evaporates, leaving them with multiple hundred-thousand-dollar bills related to the treatment of cancer.
- mgkimsal 6y ago
  Neither is most "employer-provided" insurance. A few folks have 'gold-plated' plans where they are hardly out of pocket for anything, but most people with health insurance plans, of any stripe, still have moderately sized deductibles, on top of paying a portion towards the monthly premium anyway.
  - VRay 6y ago
    Best system in the world Well, in all fairness, my and my wife's health care in the USA has been WAY better than it was in Japan. It costs like 20x as much, though. That's my theory as to why nobody in power wants to actually fix the US system. Maybe the system really is the best if you have unlimited money and unlimited tolerance for bureaucracy
war1025 6y ago
I pay $800/month on top of what my employer covers for our health insurance. And it's still worse insurance than what most of my friends and family have. If you work for a small company or are trying to buy off the marketplace, health insurance is insanely expensive.
- mgkimsal 6y ago
  If you're working for a megacorp, they might be self-funding their own insurance plan. Otherwise, it is just 'insanely expensive', we just have a system where some portion of that insanity is 'hidden' by employers participating in the transaction (much like FICA tax 50/50 split). I did some work for a small insurance broker - about 15 employees. They provided health insurance for all employees. They invited me to a few company meetings, and the owners asked what people thought the cost of the insurance was, per month, per person. Lots of $100 and $150/month guesses. I said '$600'. Someone laughed, and the owner said "you're close - it's $586". The room went silent. It was going to be going up to, IIRC, something like $630/month, and he was preparing people for "hey, we're going to cover this, but we're probably not going to be able to do much else, or may have to cut back some minor reimbursement stuff."
jwilber 6y ago
Very out of touch comment. People worried about Health insurance are not paying $700/month for a monthly car payment. Maybe instead of trying to paint the problem of american healthcare access as a mindset issue, you can recognize that there are many legitimate problems with linking healthcare to employment. Why should anyone go broke over a medical expense? Why in a developed country? Why is that only a common fear in the US?
- putnambr 6y ago
  In the context of retiring early and planning for expenses, it's not out of touch. If someone is planning on retiring by their 50s, they surely have thought of health insurance and put it in their budget.
  - mgkimsal 6y ago
    thank you. that was the context - someone retiring in their 50s. "can you really stop working in your 50s when the health problems come and you realize you now need your employer for the health insurance?" If you get to your 50s, think you can retire, and don't have a plan for this stuff, you're out of touch.