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Show HN: Healthcare Is Dumb

441 points by antcas 6y ago

jimbokun 6y ago
That...is actually kind of clever. Wonder how long before these loopholes get shut down.
- antcas 6y ago
  In the ideal world this loophole would be made irrelevant by universal healthcare. Realistically the minimum credit hour requirements might be increased at some schools, but otherwise if you take advantage of this system you're pretty much using the system as designed. Insurers already account for the fact that healthy and insured students are less likely to opt-in for their student health plans.
  - lotsofpulp 6y ago
    That was the ideal with ACA (since taxpayer funded healthcare is such a bad word for many US voters), but the voters got up in arms about having to pay for others’ healthcare so they got to keep their silo’d school/church/employer health insurance pools.
    - newen 6y ago
      It probably was insurance companies that got up in arms about it rather than voters since insurance companies are incentivized to silo their clients as much as they can. Also insurance companies are the ones who have actual say in the matter of writing the law compared to the voters.
      - lotsofpulp 6y ago
        I remember people being pissed off their premiums went up because people with pre existing conditions and pregnancy and whatnot had to be covered now. People are still pissed off about having to pay increased premiums so more people can get more healthcare. Insurance companies, by statute, can earn up to 15% to 20% of healthcare expenses they pay for, so increasing the population they cover is in their interest.
- kyuudou 6y ago
  Sadly it shouldn't be considered a "loophole" as society gets an individual looking to educate themselves (since realistically you'd have to try hard enough to not get kicked out so you're bound to learn useful things) that is also health-insured. Right? That's what I think, anyway.
finaliteration 6y ago
While I think this project and the data are interesting, one thing that becomes problematic is that you actually DO have to invest time in whatever courses you register for at most colleges and universities (or at least the ones that I've seen). Generally, if you aren't making adequate progress in a course, you can be dropped by the instructor mid-semester/quarter or placed on academic probation, both of which can cause you to fall below the minimum number of credits needed to be eligible for healthcare coverage. So while you may save some money on health insurance, you lose a potentially large amount of time due to having to keep up with coursework to maintain eligibility. That being said, this may not be a problem if they are courses you are actually interested in and can dedicate time to completing.
- antcas 6y ago
  100% This works out best if you're taking classes that are relevant to you so that you're getting value from the time spent as well. Otherwise your goal should be to find the easiest most phone-in-able class possible.
  - ethbro 6y ago
    > Otherwise your goal should be to find the easiest most phone-in-able class possible. Thanks, COVID!
- alanbernstein 6y ago
  Take big engineering classes at a state school, nobody will pay any attention to you.
- nip180 6y ago
  Funny, I was thinking that the opportunity to spend time in classes sounds like a win. I’d love to brush up on discrete math and take a bowling credit for the next five months.
- rossdavidh 6y ago
  True that, but in many cases, if you just need to stay enrolled and don't have the stress of needing a good grade or to juggle a full load, it could be just eating into your TV couch potato time, be way more interesting and rewarding, and be a win as well. Depends on how much you have to take to get the insurance, though.
antcas 6y ago
I built a spreadsheet showing how many credits you have to take at a school to qualify for their health insurance plan. In many states, the cost of taking the class + health insurance costs is actually lower than monthly premiums for a plan within the state.
- deegles 6y ago
  What would this do to the university or state’s finances if a ton of people did it? Would it make budget shortfalls? Or do insurance companies just make less from those plans?
  - antcas 6y ago
    Both the school and the insurer would make a bunch more money in the short-term. Might bite the insurer's in the long term if a bunch of sick people sign up, but very sick people don't tend to stay in school.
  - alanbernstein 6y ago
    Perhaps college plans are inexpensive in part because those insured are generally younger and healthier than the overall population? If a representative sample of the general population did this, presumably the prices would adjust upward.
    - antcas 6y ago
      This is part of it, however there's positive price pressure from "anti-selection". Basically healthy young students are more likely to already be insured or be on their parents plans so they opt-out more frequently. Wrote a thread with more deets the other day: https://twitter.com/AnthonyCastrio/status/1298702771986857989 https://twitter.com/AnthonyCastrio/status/129870277198685798...
    - IshKebab 6y ago
      Perhaps, but I think it's more likely just price differentiation the same as any other student discount. Plus universities have better negotiating power than individuals.
jamestimmins 6y ago
It's wild that less than $500/month for health insurance is a win in the United States
- nostromo 6y ago
  It really depends. If you're single and under 40 it's not so bad. But if you have a partner, kids, and are a bit older then suddenly it can be quite expensive.
  - bfrog 6y ago
    I mean, even if your young its ridiculous. I'm mid thirties now with a wife and kid, healthcare costs are double my mortgage. For the highest deductible I can get. None of us have any illnesses or do anything other than see the physician on the usual prescribed basis. It's insane.
    - treis 6y ago
      You've got much cheaper housing or much more expensive insurance than the average person.
      - garmaine 6y ago
        His numbers seem correct if you assume national-average housing costs, not Bay Area figures. Which is fair because the insurance cost does not vary much between locales.
    - lotsofpulp 6y ago
      It’s because you’re not paying for your healthcare when you’re young. Health insurance is just a tax, with the premiums going towards paying for healthcare for the sick and elderly (in the US, people 55+). ACA specifically capped health insurance premiums for the elderly as a multiple of a 21 year old’s premiums. Otherwise health insurance premiums for 20 year olds would be $30 a month and $3000 a month for 60 year olds.
peter_1233 6y ago
I think this math is off, as it assumes a single semester lasts a full year. For a full year you would need to pay for multiple semesters of tuition, probably 3 at most universities to cover the summer.
- antcas 6y ago
  Let me double check, should be multiplying semester by 2 when necessary. Annual insurance fee is already calculated annually.
  - finaliteration 6y ago
    Portland State is actually on a quarter system, so you'd need to multiple those values by 3 or 4 (depending on if you include the Summer quarter or not). Source: I'm a Portland State alumnus.
    - antcas 6y ago
      Thanks for this note! I'll include this when I build out v2.
    - adrianmonk 6y ago
      I thought about summer as well. I checked my alma mater's web site. Seems you can get year-round health insurance without registering for summer classes. The exception is when summer is the first time you attend and you want to start insurance before fall. Then you need to meet minimum hour requirements. I'd guess most schools are similar because otherwise they'd practically force every student to take summer classes. But it's good to verify.
  - peter_1233 6y ago
    Thanks. I didn't realize most schools allow only 2 semesters for insurance coverage but that makes sense. I did the math with Auburn University and it's definitely off. Unless that school allows an entire semester to last a year? (1 credit hours * $430 per credit) + $2028 insurance cost / 12 = $204. I think it would be 2 credit hours, so: (2 credit hours * $430 per credit) + $2028 insurance cost / 12 = $240
nostromo 6y ago
I wonder how many of those schools would kick you out for never showing up and failing all your courses every quarter. Maybe you could filter this list for those schools. Or perhaps you could subcontract our your schooling online and just pay people to do the minimum required to get a passing grade. :-)
- antcas 6y ago
  If you don't show up to class then technically you won't qualify for a lot of these plans. In the policy they require in-person classes. How that's going to work this year with online-only classes is an open question.
sharps_xp 6y ago
Where can I find more stories like this where someone who has a familiarity with a system finds some form of leverage that is often overlooked? stuff like this excites me
- antcas 6y ago
  For healthcare specifically I'd check out https://twitter.com/nikillinit https://twitter.com/nikillinit More generally HN is a good place ;)
- VikingCoder 6y ago
  http://reddit.com/r/lifeprotips http://reddit.com/r/lifeprotips
- quickthrower2 6y ago
  In the UK there is moneysavingexpert.co.uk that sometimes goes to ludicrous lengths to save a quid (a British pound)! Think sign up for a credit card using a cash back site to buy an easy jet plane ticket using a promo code to fly for free kind of thing!
adrianmonk 6y ago
I guess you have to actually try to pass the class as well, right? Otherwise you trash your academic record and/or jeopardize your ability to do this again next year. That not only requires your time, it might also require you to spend money on textbooks, etc. Although maybe not if there are schools that let you drop all your classes but stay eligible for health insurance for the rest of the term.
- antcas 6y ago
  You don't have to pass the class you just can't get kicked out of the school. One BIG caveat with these plans is that coverage ends if you leave school. That's how the insurers cover their asses. They're able to provide cheaper plans because many of the sickest will drop out. It's dumb. Read this article by Charles Gaba for deeper insights than I can muster: http://acasignups.net/20/08/26/updated-how-much-can-risk-pools-vary-heres-stunning-real-world-example http://acasignups.net/20/08/26/updated-how-much-can-risk-poo...
  - jjoonathan 6y ago
    That's not dumb, that's evil.
    - antcas 6y ago
      Why not both?
      - Skunkleton 6y ago
        Because it isn't dumb.
    - kube-system 6y ago
      Or neither dumb or evil, but just an expected result of the way group insurance works. 1. University: Has group of people they want to insure 2. Insurer: Measures risk of that group You're either in the group or your not. Sick people drop out of school not because insurance is making them drop out, but because academics is hard to do when your health issue prevents you from doing so. The people at fault are your representatives, who forgot about university group plans when drafting COBRA.
psim1 6y ago
I might be misunderstanding this chart, but it appears the author is saying that by enrolling for the minimum number of credits, you will receive the associated insurance for free. For at least one university listed -- Penn State -- that is not true. You must also purchase the insurance plan.
- antcas 6y ago
  No, you also have to opt-in and pay the annual premium. This is included in the cost calculation (see notes section at the bottom for details).
  - psim1 6y ago
    OK, I did misunderstand. The numbers make more sense now. I believe step 3 "enroll, get that cheap insurance" should make this a little more clear. (It's not just the act of enrollment that gets you the insurance.)
    - antcas 6y ago
      This is a good point, and also kind of an unintentional pun since enroll could refer to either enrolling in school or enrolling in the healthplan. Some (many?) schools you are enrolled automatically to the healthcare plan unless you opt-out.
xenonite 6y ago
Won’t this drive up the costs for students in the long run?
- antcas 6y ago
  Mentioned in another reply, but insurers already take into consideration the fact that sicker students are more likely to need their insurance. This is mitigated by lower maximums than normal and the fact that the sickest students will tend to drop out.
marvinblum 6y ago
I just checked, and I paid 189,60 € for my health insurance last month, in Germany.
- antcas 6y ago
  Germany doesn't let us Americans in anymore unfortunately.
  - davidw 6y ago
    Even before COVID-19, you'd have to get a work visa, which probably isn't too tough for most software people, but can be a hassle.
- CincinnatiMan 6y ago
  Does that include the healthcare-related taxes you paid? Not being snarky, genuinely wondering.
  - oneplane 6y ago
    There are no extra healthcare taxes.
    - deleted 6y ago
      [deleted]
  - est31 6y ago
    https://www.krankenkassen-direkt.de/themen/thema.pl?id=474948 https://www.krankenkassen-direkt.de/themen/thema.pl?id=47494... The public insurance which covers 88% of the population gets 15 billion tax EUR annually, with total revenue of public insurances being 250 billion. https://de.statista.com/statistik/daten/studie/192409/umfrage/einnahmen-und-ausgaben-der-gesetzlichen-krankenversicherungen-in-deutschland/ https://de.statista.com/statistik/daten/studie/192409/umfrag... So most money comes from the insured people. The maximum you pay for the public insurance is 703€ per month, and it covers your children and non working spouse.
didip 6y ago
OP actually confirms my long term suspicion. Thanks! For the longest time, one of my early retirement plan is to simply go back to school, learn everything that excites me and enjoy the health insurance offered by the school.
vonmoltke 6y ago
Any idea what level of coverage you get for these rates? It's hard to compare these options to exchange plans, some of which are significantly cheaper. I tried doing it for Rutgers, but the site they use won't let me see plans without a student ID number.
- antcas 6y ago
  Most of the plans you can find on the school website's with some digging. Some common gotcha's are low lifetime maximums and exceptions. Also, the the sickest students are most likely to drop out of school and lose their coverage.
rajangdavis 6y ago
The monthly cost for health insurance through using Cal Maritime ($627) is more than what I spent for health insurance for a single person via COBRA ($494.36) in California from 2018 - Spring 2019.
- antcas 6y ago
  If you qualify for COBRA or Medicaid that might be a better option. California is also an odd bird in general and a lot of their public schools didn't offer a student health plan for part time students that I could find.
pkaye 6y ago
Its this a big issue for most on HN? If even junior engineers are making $200k these days they should have pretty nice health plans.
- rossdavidh 6y ago
  Well, the key word here is "most". Not everyone on HN is in a tech job.
- Rebelgecko 6y ago
  I imagine it could be helpful for people who are self employed or semi-retired and make too much for maximum Obamacare subsidies while not being old enough for Medicare You can go take a ballroom dancing class with a bunch of 20 year olds while getting slightly cheaper insurance
- dmcginty 6y ago
  I'm a mid-level engineer making half that. Please point me towards these entry-level jobs that are offering $200k.
  - pkaye 6y ago
    My comment was mostly a poke at the claim on HN and elsewhere that starting engineers make a vast amount of money.
supernova87a 6y ago
I find it sad, yet interesting, how many things/institutions/processes have built up in a way that you would never actively choose as an option. As in, if given the choice between building the current system and some alternative, there is no way you'd say, "for sure, build again what we have now, it's great". Yet that's what we kind of do every year implicitly by continuing through inertia. Healthcare, financial/banking, transportation, rocket launches, etc. I guess that's how a country gets old and slow -- too many legacy things that have to be supported or can't be changed without disruption to people's established habits or ways that they've come to rely on. (or make a profit from) And it's not until some outside actor shows you it's possible that you're shocked into knowing that it can be done differently. Or forced to do it differently out of necessity now.
- MattGaiser 6y ago
  I am currently in government. I would say that most processes are not really designed at all. They are the sum of a lot of other decisions kludged together. We are currently putting together a software system for managing parking contracts and in doing so are excruciatingly copying how those contracts are currently handled (often to an absurd level). Nobody thinks the current process makes sense, but here we are baking it into a mega project.
  - dutchmartin 6y ago
    It is sad indeed, but I guess no manager wants to change things not be responsible for changes that fail.
    - MattGaiser 6y ago
      Eh, one of the larger challenges is figuring out who is responsible for certain things. We genuinely are not sure who is responsible for various elements of projects.
  - pbronez 6y ago
    Here’s a whole article about that! “Kludgeocracy in America” (2013) https://www.nationalaffairs.com/publications/detail/kludgeocracy-in-america https://www.nationalaffairs.com/publications/detail/kludgeoc...
legitster 6y ago
Looking at the first plan on the list, Auburn: https://www.uhcsr.com/uhcsrbrochures/Public/BenefitSummaryFlyers/2020-38-1%20Summary%20Brochure.pdf https://www.uhcsr.com/uhcsrbrochures/Public/BenefitSummaryFl... On first blush, this looks like phenomenally good coverage for the cost. $1970 for the year. $7150 out of pocket maximum. 80% coinsurance after a $250(!) deductible. The ACA limited how much cost discrimination insurance companies can do by age, and I am wondering if college plans are a workaround - it's not age descrimination, per-say. But the risk associated with students is much, much lower than on the marketplaces.
- antcas 6y ago
  College plans are considered "special-risk" plans and therefore aren't obliged to follow ACA guidelines at all. So they can do tricky stuff ACA banned like have low lifetime maximums, exclusions, and kick you off the plan when you drop out of school because you're too sick.
- lotsofpulp 6y ago
  It is age discrimination. People who were silo’d in employer plans and other lower risk pools than the general public were incensed they would have to help pay for everyone’s healthcare, so they lobbied to be exempt from ACA. It’s a major hindrance to proper insurance mechanisms when your healthiest lives aren’t on healthcare.gov. Ideally everyone would be forced into the same marketplace subject to the same sick and healthy lives proportions so the costs are spread out evenly.
dusted 6y ago
$500/MONTH is considered cheap? gosh damn, I'm sorry USA but you really, deeply fucked yourself over on this one..
- antcas 6y ago
  yea, it's pretty dumb
- rossdavidh 6y ago
  While I am not one to subscribe to the "Europe does everything better"-style thinking of U.S. progressives, the reality is, in this particular field, there is absolutely no way to defend the U.S. system.
- RandallBrown 6y ago
  How much do you pay per month for health insurance where you live? (Or if you don't know, how much does your country spend per capita on healthcare?) My wife and I pay way less than $500/month, but her employer pays some of it so I'm not sure what the total cost is. When I was looking for it on my state's healthcare exchange it was also considerably cheaper than $500/month, but then since I was unemployed at the time, it ended up being free. Healthcare in the US is a real problem that needs to be resolved, but it's not a simple situation.
  - CogitoCogito 6y ago
    > How much do you pay per month for health insurance where you live? (Or if you don't know, how much does your country spend per capita on healthcare?) The cost per capita in the US is apparently 85% than in Sweden [0] while the gdp per capita in the US is only around 27% more than in Sweden [1]. I'm not sure how current/accurate those numbers are, but they do fit in with everything I've read over the years. > Healthcare in the US is a real problem that needs to be resolved, but it's not a simple situation. I don't really understand this sentiment. There are so many other systems to look to for comparison. If you mean that powerful entrenched interests that would stand to make less money and they are hard to fight, then sure that's hard, but it's not like we don't know better systems. They are everywhere if we choose to look. I think the main problem is that too many Americans seem incapable of recognizing that the system there really is worse than many high-tax socialist countries. They don't really have any reason to believe this, but they know this deeply in their heart. It only hurts the US and plays into the hands of the aforementioned entrenched interests (which to be fair certainly work hard to propagate the lies that Americans later believe). By the way, I'm both an American and Swedish citizen. I was born in Sweden, lived most of my life in the US, and am now back in Sweden. I definitely identify more as American than a Swede. In my experiences of the US and Swedish systems I'd take the Swedish one (i.e. the cheapest setup without any of the possible extra insurance which can be purchased extra here) over the US system any day of the week. I think the Americans who have knee-jerk reactions against "socialized medicine" are either totally ignorant or deluded. It's sad. Such self-defeating attitudes weaken American as a nation. [0] https://www.businessinsider.com/personal-finance/cost-of-healthcare-countries-ranked-2019-3 https://www.businessinsider.com/personal-finance/cost-of-hea... [1] https://en.wikipedia.org/wiki/List_of_countries_by_GDP_%28nominal%29_per_capita https://en.wikipedia.org/wiki/List_of_countries_by_GDP_%28no...
sacred_numbers 6y ago
The data here may not be totally accurate, but the sentiment is right. For my local school it's showing the marginal cost of the first credit hour, but the average cost per credit hour is substantially lower once you get to the minimum number of credit hours to qualify for insurance. After correcting for that mistake it cut the monthly cost for tuition+insurance for my local school in half. In addition, some schools offer insurance for spouses and children as well, which usually drives the cost per person down even further. For our situation, the total cost of tuition (9 credit hours per semester) plus insurance (2 people) is about $870 per month. A comparable ACA-compliant insurance plan would be about $1,000 per month. Even with a "gold level" insurance plan we ended up spending around $4,000 for an accident that occurred on campus that required an ambulance to the University hospital (1 mile away) and about 4 hours in the emergency room to get stitches and confirm that a head injury was not a concussion. It's hard to visualize how much money has been legally stolen from the American people over the last few decades due to the giant scam that is the health insurance industry. The combined salaries of every single doctor in America could be paid for with 8% of what we spend on healthcare every year. If you add in the salaries of nurses, pharmacists, drug researchers, etc. it's probably under 25% of what we pay. Unfortunately there are literally millions of middlemen and unnecessary administrators who soak up a very large percentage of healthcare spending without really doing anything. Canada and Australia spend less than half as much per capita as we do on healthcare despite having similar levels of GDP per capita and better average life expectancies. If the US could save 50% on healthcare we could probably solve climate change single-handedly. This is not even an exaggeration, it's an illustration of just how much we spend on healthcare.
- Supermancho 6y ago
  Eastern/Western Washington State University is listed... https://cougarhealth.wsu.edu/studentinsurance/insurance-coverage-assistance/ https://cougarhealth.wsu.edu/studentinsurance/insurance-cove... https://inside.ewu.edu/bewell/optional-medical-insurance/ https://inside.ewu.edu/bewell/optional-medical-insurance/ This spreadsheet is inaccurate, at best. Also, what kind of insurance matters. I can get you 50$ a month insurance that wont cover anything. Without context, this spreadsheet is a big list of rumours for you go look up and be disappointed.
padseeker 6y ago
this is kinda brilliant.
rexelhoff 6y ago
> US Healthcare Is Dumb FTFY
burnte 6y ago
So many things in healthcare are screwed up. I was in IT for 20+ years and ready to move into law when a healthcare IT management job fell in my lap. 5 years later I still love healthcare IT because there is SO MUCH OPPORTUNITY to improve things, save money, make things better for users and patients. The entire system needs an overhaul, but the really odd thing is that as a nation (USA) we actually CAN do all the things we need to fix it. It's all payment and administrative stuff we need to fix.
- sk5t 6y ago
  It's unrolling the entire system of economic incentives that needs to be fixed. This is going to be monstrously difficult... there is lots of potential to improve healthcare but actually trying to achieve it is a bit Quixotic.
  - burnte 6y ago
    Nah, we can fix it chunk by chunk. It's actually doable. People IN healthcare WANT it, so that helps a lot.
LordHeini 6y ago
You can do something similar in Germany to get access to cheap public transport. Just enroll in an University which cost around 280€ for half a year. This will get you a ticket which you can use in busses and trains for quite some distance. Usually a whole Bundesland (County or whatever the US equivalent is). This is a fraction of the cost of a regular ticket and nobody checks if you pick an unpopular field like physics. I know people doing this for many years. And yes the US should totally get a proper public Healthcare system...
- TeMPOraL 6y ago
  Where I lived (Kraków, Poland; but arguably, similar schemes apply across the country), you'd get half-priced tickets if you're a student under 26. After finishing their 5 years at the uni, many people then sign up with whatever private school offers the cheapest nonsense course in underwater basket weaving or whatnot, and continue to use the public transport for half the price (as well as using many other discounts for things like trains, cinemas, etc., for which a student card makes you eligible).
  - Tade0 6y ago
    My friend did something similar - he started studying something at the University of Warsaw's Faculty of Education - really easy to get in and since this is UW, academic progress is judged on an annual basis. He even showed up there a few times.
- MH15 6y ago
  At my University (Ohio State) we get unlimited bus passes in the metro area for quite cheap. Sadly, we don't have any real public transport lines. Columbus is one of the largest US cities without light rail/subway.
- kiliantics 6y ago
  A Bundesland is technically a federal state, which is quite a large area in the US, though also large for some states in Germany too. I am mostly familiar with Bavaria, a big state where you can get a "Bayernticket", that lets you travel on any public transit in the entire state for a day, and even gets you to Salzburg in Austria. Seems the pricing has changed and is not quite as good anymore, though still a good deal. It used to be you could get one ticket that would cover up to 5 people for about 25 euro. Unbelievable value.
1f60c 6y ago
> Health insurance in the United States is expensive (duh). Healthcare through a university is less expensive. Using this website you can find insurance for less than ... > $500 per month. jaw drops to the floor The fact that "just" paying $500 per month (in premiums, I assume?) is considered an improvement...
fblp 6y ago
Are you eligible for health insurance with these universities if you live out of state?
godzillabrennus 6y ago
Before my father qualified for Medicare he figured out this hack. He has a severe chronic condition. Health insurance for him as a self employed person at the time was $4k/month Tuition at the local public college at the time came with a senior discount for folks in his age group and insurance for $10k/year. He loved the classes and saved a bundle on health insurance. He needed a life flight and weeks of hospitalization related to his chronic illness. The insurance had him covered. I think it was a non-trivial payout for the insurance company. The following year the insurance company changed the terms with the university to charge more if you didn’t live on campus. My father went to a different school with a different insurer after that. He’s finally on Medicare. We shouldn’t tie healthcare coverage to employment in our country. It’s stupidly expensive.
- thayne 6y ago
  Tying health insurance to your employer is incredibly dumb. It means insurarers compete for your employers business, not yours, which influences their incentives. It means if you don't like your insurance company, your only option is to change jobs. It disincitives people from being self employed, because then health insurance is prohibitively expensive.
  - sukilot 6y ago
    It's not dumb, it's smart for employers who want to trap employees.
    - tonyhb 6y ago
      So... it's dumb for 999/1000 people.
    - defnotashton2 6y ago
      This was by design. Didn't the dems do this in '96?
      - judge2020 6y ago
abeppu 6y ago
One of these is a medical school. Can you imagine? You apply, you get admitted, you go to your first class. You meet young bright-eyed students. "I want to be an oncologist! My aunt's battle with cancer really inspired me." "I want to be a neurologist. The brain is just so fascinating!" "I wanted health coverage."
- desdiv 6y ago
  A Soviet Russia joke goes: A toy factory worker wanted to get his son a nice toy for Christmas, but couldn't afford it. So he sneaks out a single component from the factory every day. When he assembled it, it turned out to be a machine gun. The topical American joke would be: At a medical school graduation party, the whole class started discussing their future career prospects. It turns out that none of them would become doctors; all of them joined for the healthcare coverage.
29athrowaway 6y ago
When I quit my job a couple of years ago, I bought my own insurance for about $400 a month. This was not done via COBRA. I don't fully understand the need for this. Can someone explain?
quickthrower2 6y ago
I’m sorry USA that this site needs to exist for you guys. Hope you get affordable healthcare soon :-( It should be $0 and no hack required, for all, ideally at point of care (so no invoice).

441 points by antcas 6y ago

jimbokun 6y ago

That...is actually kind of clever. Wonder how long before these loopholes get shut down.

antcas 6y ago
In the ideal world this loophole would be made irrelevant by universal healthcare. Realistically the minimum credit hour requirements might be increased at some schools, but otherwise if you take advantage of this system you're pretty much using the system as designed. Insurers already account for the fact that healthy and insured students are less likely to opt-in for their student health plans.
- lotsofpulp 6y ago
  That was the ideal with ACA (since taxpayer funded healthcare is such a bad word for many US voters), but the voters got up in arms about having to pay for others’ healthcare so they got to keep their silo’d school/church/employer health insurance pools.
  - newen 6y ago
    It probably was insurance companies that got up in arms about it rather than voters since insurance companies are incentivized to silo their clients as much as they can. Also insurance companies are the ones who have actual say in the matter of writing the law compared to the voters.
    - lotsofpulp 6y ago
      I remember people being pissed off their premiums went up because people with pre existing conditions and pregnancy and whatnot had to be covered now. People are still pissed off about having to pay increased premiums so more people can get more healthcare. Insurance companies, by statute, can earn up to 15% to 20% of healthcare expenses they pay for, so increasing the population they cover is in their interest.
kyuudou 6y ago
Sadly it shouldn't be considered a "loophole" as society gets an individual looking to educate themselves (since realistically you'd have to try hard enough to not get kicked out so you're bound to learn useful things) that is also health-insured. Right? That's what I think, anyway.

finaliteration 6y ago

While I think this project and the data are interesting, one thing that becomes problematic is that you actually DO have to invest time in whatever courses you register for at most colleges and universities (or at least the ones that I've seen). Generally, if you aren't making adequate progress in a course, you can be dropped by the instructor mid-semester/quarter or placed on academic probation, both of which can cause you to fall below the minimum number of credits needed to be eligible for healthcare coverage. So while you may save some money on health insurance, you lose a potentially large amount of time due to having to keep up with coursework to maintain eligibility. That being said, this may not be a problem if they are courses you are actually interested in and can dedicate time to completing.

antcas 6y ago
100% This works out best if you're taking classes that are relevant to you so that you're getting value from the time spent as well. Otherwise your goal should be to find the easiest most phone-in-able class possible.
- ethbro 6y ago
  > Otherwise your goal should be to find the easiest most phone-in-able class possible. Thanks, COVID!
alanbernstein 6y ago
Take big engineering classes at a state school, nobody will pay any attention to you.
nip180 6y ago
Funny, I was thinking that the opportunity to spend time in classes sounds like a win. I’d love to brush up on discrete math and take a bowling credit for the next five months.
rossdavidh 6y ago
True that, but in many cases, if you just need to stay enrolled and don't have the stress of needing a good grade or to juggle a full load, it could be just eating into your TV couch potato time, be way more interesting and rewarding, and be a win as well. Depends on how much you have to take to get the insurance, though.

antcas 6y ago

I built a spreadsheet showing how many credits you have to take at a school to qualify for their health insurance plan. In many states, the cost of taking the class + health insurance costs is actually lower than monthly premiums for a plan within the state.

deegles 6y ago
What would this do to the university or state’s finances if a ton of people did it? Would it make budget shortfalls? Or do insurance companies just make less from those plans?
- antcas 6y ago
  Both the school and the insurer would make a bunch more money in the short-term. Might bite the insurer's in the long term if a bunch of sick people sign up, but very sick people don't tend to stay in school.
- alanbernstein 6y ago
  Perhaps college plans are inexpensive in part because those insured are generally younger and healthier than the overall population? If a representative sample of the general population did this, presumably the prices would adjust upward.
  - antcas 6y ago
    This is part of it, however there's positive price pressure from "anti-selection". Basically healthy young students are more likely to already be insured or be on their parents plans so they opt-out more frequently. Wrote a thread with more deets the other day: https://twitter.com/AnthonyCastrio/status/1298702771986857989 https://twitter.com/AnthonyCastrio/status/129870277198685798...
  - IshKebab 6y ago
    Perhaps, but I think it's more likely just price differentiation the same as any other student discount. Plus universities have better negotiating power than individuals.

jamestimmins 6y ago

It's wild that less than $500/month for health insurance is a win in the United States

nostromo 6y ago
It really depends. If you're single and under 40 it's not so bad. But if you have a partner, kids, and are a bit older then suddenly it can be quite expensive.
- bfrog 6y ago
  I mean, even if your young its ridiculous. I'm mid thirties now with a wife and kid, healthcare costs are double my mortgage. For the highest deductible I can get. None of us have any illnesses or do anything other than see the physician on the usual prescribed basis. It's insane.
  - treis 6y ago
    You've got much cheaper housing or much more expensive insurance than the average person.
    - garmaine 6y ago
      His numbers seem correct if you assume national-average housing costs, not Bay Area figures. Which is fair because the insurance cost does not vary much between locales.
  - lotsofpulp 6y ago
    It’s because you’re not paying for your healthcare when you’re young. Health insurance is just a tax, with the premiums going towards paying for healthcare for the sick and elderly (in the US, people 55+). ACA specifically capped health insurance premiums for the elderly as a multiple of a 21 year old’s premiums. Otherwise health insurance premiums for 20 year olds would be $30 a month and $3000 a month for 60 year olds.

peter_1233 6y ago

I think this math is off, as it assumes a single semester lasts a full year. For a full year you would need to pay for multiple semesters of tuition, probably 3 at most universities to cover the summer.

antcas 6y ago
Let me double check, should be multiplying semester by 2 when necessary. Annual insurance fee is already calculated annually.
- finaliteration 6y ago
  Portland State is actually on a quarter system, so you'd need to multiple those values by 3 or 4 (depending on if you include the Summer quarter or not). Source: I'm a Portland State alumnus.
  - antcas 6y ago
    Thanks for this note! I'll include this when I build out v2.
  - adrianmonk 6y ago
    I thought about summer as well. I checked my alma mater's web site. Seems you can get year-round health insurance without registering for summer classes. The exception is when summer is the first time you attend and you want to start insurance before fall. Then you need to meet minimum hour requirements. I'd guess most schools are similar because otherwise they'd practically force every student to take summer classes. But it's good to verify.
- peter_1233 6y ago
  Thanks. I didn't realize most schools allow only 2 semesters for insurance coverage but that makes sense. I did the math with Auburn University and it's definitely off. Unless that school allows an entire semester to last a year? (1 credit hours * $430 per credit) + $2028 insurance cost / 12 = $204. I think it would be 2 credit hours, so: (2 credit hours * $430 per credit) + $2028 insurance cost / 12 = $240

nostromo 6y ago

I wonder how many of those schools would kick you out for never showing up and failing all your courses every quarter. Maybe you could filter this list for those schools. Or perhaps you could subcontract our your schooling online and just pay people to do the minimum required to get a passing grade. :-)

antcas 6y ago
If you don't show up to class then technically you won't qualify for a lot of these plans. In the policy they require in-person classes. How that's going to work this year with online-only classes is an open question.

sharps_xp 6y ago

Where can I find more stories like this where someone who has a familiarity with a system finds some form of leverage that is often overlooked? stuff like this excites me

antcas 6y ago
For healthcare specifically I'd check out https://twitter.com/nikillinit https://twitter.com/nikillinit More generally HN is a good place ;)
VikingCoder 6y ago
http://reddit.com/r/lifeprotips http://reddit.com/r/lifeprotips
quickthrower2 6y ago
In the UK there is moneysavingexpert.co.uk that sometimes goes to ludicrous lengths to save a quid (a British pound)! Think sign up for a credit card using a cash back site to buy an easy jet plane ticket using a promo code to fly for free kind of thing!

adrianmonk 6y ago

I guess you have to actually try to pass the class as well, right? Otherwise you trash your academic record and/or jeopardize your ability to do this again next year. That not only requires your time, it might also require you to spend money on textbooks, etc. Although maybe not if there are schools that let you drop all your classes but stay eligible for health insurance for the rest of the term.

antcas 6y ago
You don't have to pass the class you just can't get kicked out of the school. One BIG caveat with these plans is that coverage ends if you leave school. That's how the insurers cover their asses. They're able to provide cheaper plans because many of the sickest will drop out. It's dumb. Read this article by Charles Gaba for deeper insights than I can muster: http://acasignups.net/20/08/26/updated-how-much-can-risk-pools-vary-heres-stunning-real-world-example http://acasignups.net/20/08/26/updated-how-much-can-risk-poo...
- jjoonathan 6y ago
  That's not dumb, that's evil.
  - antcas 6y ago
    Why not both?
    - Skunkleton 6y ago
      Because it isn't dumb.
  - kube-system 6y ago
    Or neither dumb or evil, but just an expected result of the way group insurance works. 1. University: Has group of people they want to insure 2. Insurer: Measures risk of that group You're either in the group or your not. Sick people drop out of school not because insurance is making them drop out, but because academics is hard to do when your health issue prevents you from doing so. The people at fault are your representatives, who forgot about university group plans when drafting COBRA.

psim1 6y ago

I might be misunderstanding this chart, but it appears the author is saying that by enrolling for the minimum number of credits, you will receive the associated insurance for free. For at least one university listed -- Penn State -- that is not true. You must also purchase the insurance plan.

antcas 6y ago
No, you also have to opt-in and pay the annual premium. This is included in the cost calculation (see notes section at the bottom for details).
- psim1 6y ago
  OK, I did misunderstand. The numbers make more sense now. I believe step 3 "enroll, get that cheap insurance" should make this a little more clear. (It's not just the act of enrollment that gets you the insurance.)
  - antcas 6y ago
    This is a good point, and also kind of an unintentional pun since enroll could refer to either enrolling in school or enrolling in the healthplan. Some (many?) schools you are enrolled automatically to the healthcare plan unless you opt-out.

xenonite 6y ago

Won’t this drive up the costs for students in the long run?

antcas 6y ago
Mentioned in another reply, but insurers already take into consideration the fact that sicker students are more likely to need their insurance. This is mitigated by lower maximums than normal and the fact that the sickest students will tend to drop out.

marvinblum 6y ago

I just checked, and I paid 189,60 € for my health insurance last month, in Germany.

antcas 6y ago
Germany doesn't let us Americans in anymore unfortunately.
- davidw 6y ago
  Even before COVID-19, you'd have to get a work visa, which probably isn't too tough for most software people, but can be a hassle.
CincinnatiMan 6y ago
Does that include the healthcare-related taxes you paid? Not being snarky, genuinely wondering.
- oneplane 6y ago
  There are no extra healthcare taxes.
  - deleted 6y ago
    [deleted]
- est31 6y ago
  https://www.krankenkassen-direkt.de/themen/thema.pl?id=474948 https://www.krankenkassen-direkt.de/themen/thema.pl?id=47494... The public insurance which covers 88% of the population gets 15 billion tax EUR annually, with total revenue of public insurances being 250 billion. https://de.statista.com/statistik/daten/studie/192409/umfrage/einnahmen-und-ausgaben-der-gesetzlichen-krankenversicherungen-in-deutschland/ https://de.statista.com/statistik/daten/studie/192409/umfrag... So most money comes from the insured people. The maximum you pay for the public insurance is 703€ per month, and it covers your children and non working spouse.

didip 6y ago

OP actually confirms my long term suspicion. Thanks! For the longest time, one of my early retirement plan is to simply go back to school, learn everything that excites me and enjoy the health insurance offered by the school.

vonmoltke 6y ago

Any idea what level of coverage you get for these rates? It's hard to compare these options to exchange plans, some of which are significantly cheaper. I tried doing it for Rutgers, but the site they use won't let me see plans without a student ID number.

antcas 6y ago
Most of the plans you can find on the school website's with some digging. Some common gotcha's are low lifetime maximums and exceptions. Also, the the sickest students are most likely to drop out of school and lose their coverage.

rajangdavis 6y ago

The monthly cost for health insurance through using Cal Maritime ($627) is more than what I spent for health insurance for a single person via COBRA ($494.36) in California from 2018 - Spring 2019.

antcas 6y ago
If you qualify for COBRA or Medicaid that might be a better option. California is also an odd bird in general and a lot of their public schools didn't offer a student health plan for part time students that I could find.

pkaye 6y ago

Its this a big issue for most on HN? If even junior engineers are making $200k these days they should have pretty nice health plans.

rossdavidh 6y ago
Well, the key word here is "most". Not everyone on HN is in a tech job.
Rebelgecko 6y ago
I imagine it could be helpful for people who are self employed or semi-retired and make too much for maximum Obamacare subsidies while not being old enough for Medicare You can go take a ballroom dancing class with a bunch of 20 year olds while getting slightly cheaper insurance
dmcginty 6y ago
I'm a mid-level engineer making half that. Please point me towards these entry-level jobs that are offering $200k.
- pkaye 6y ago
  My comment was mostly a poke at the claim on HN and elsewhere that starting engineers make a vast amount of money.

supernova87a 6y ago

I find it sad, yet interesting, how many things/institutions/processes have built up in a way that you would never actively choose as an option. As in, if given the choice between building the current system and some alternative, there is no way you'd say, "for sure, build again what we have now, it's great". Yet that's what we kind of do every year implicitly by continuing through inertia. Healthcare, financial/banking, transportation, rocket launches, etc. I guess that's how a country gets old and slow -- too many legacy things that have to be supported or can't be changed without disruption to people's established habits or ways that they've come to rely on. (or make a profit from) And it's not until some outside actor shows you it's possible that you're shocked into knowing that it can be done differently. Or forced to do it differently out of necessity now.

MattGaiser 6y ago
I am currently in government. I would say that most processes are not really designed at all. They are the sum of a lot of other decisions kludged together. We are currently putting together a software system for managing parking contracts and in doing so are excruciatingly copying how those contracts are currently handled (often to an absurd level). Nobody thinks the current process makes sense, but here we are baking it into a mega project.
- dutchmartin 6y ago
  It is sad indeed, but I guess no manager wants to change things not be responsible for changes that fail.
  - MattGaiser 6y ago
    Eh, one of the larger challenges is figuring out who is responsible for certain things. We genuinely are not sure who is responsible for various elements of projects.
- pbronez 6y ago
  Here’s a whole article about that! “Kludgeocracy in America” (2013) https://www.nationalaffairs.com/publications/detail/kludgeocracy-in-america https://www.nationalaffairs.com/publications/detail/kludgeoc...

legitster 6y ago

Looking at the first plan on the list, Auburn: https://www.uhcsr.com/uhcsrbrochures/Public/BenefitSummaryFlyers/2020-38-1%20Summary%20Brochure.pdf https://www.uhcsr.com/uhcsrbrochures/Public/BenefitSummaryFl... On first blush, this looks like phenomenally good coverage for the cost. $1970 for the year. $7150 out of pocket maximum. 80% coinsurance after a $250(!) deductible. The ACA limited how much cost discrimination insurance companies can do by age, and I am wondering if college plans are a workaround - it's not age descrimination, per-say. But the risk associated with students is much, much lower than on the marketplaces.

antcas 6y ago
College plans are considered "special-risk" plans and therefore aren't obliged to follow ACA guidelines at all. So they can do tricky stuff ACA banned like have low lifetime maximums, exclusions, and kick you off the plan when you drop out of school because you're too sick.
lotsofpulp 6y ago
It is age discrimination. People who were silo’d in employer plans and other lower risk pools than the general public were incensed they would have to help pay for everyone’s healthcare, so they lobbied to be exempt from ACA. It’s a major hindrance to proper insurance mechanisms when your healthiest lives aren’t on healthcare.gov. Ideally everyone would be forced into the same marketplace subject to the same sick and healthy lives proportions so the costs are spread out evenly.

dusted 6y ago

$500/MONTH is considered cheap? gosh damn, I'm sorry USA but you really, deeply fucked yourself over on this one..

antcas 6y ago
yea, it's pretty dumb
rossdavidh 6y ago
While I am not one to subscribe to the "Europe does everything better"-style thinking of U.S. progressives, the reality is, in this particular field, there is absolutely no way to defend the U.S. system.
RandallBrown 6y ago
How much do you pay per month for health insurance where you live? (Or if you don't know, how much does your country spend per capita on healthcare?) My wife and I pay way less than $500/month, but her employer pays some of it so I'm not sure what the total cost is. When I was looking for it on my state's healthcare exchange it was also considerably cheaper than $500/month, but then since I was unemployed at the time, it ended up being free. Healthcare in the US is a real problem that needs to be resolved, but it's not a simple situation.
- CogitoCogito 6y ago
  > How much do you pay per month for health insurance where you live? (Or if you don't know, how much does your country spend per capita on healthcare?) The cost per capita in the US is apparently 85% than in Sweden [0] while the gdp per capita in the US is only around 27% more than in Sweden [1]. I'm not sure how current/accurate those numbers are, but they do fit in with everything I've read over the years. > Healthcare in the US is a real problem that needs to be resolved, but it's not a simple situation. I don't really understand this sentiment. There are so many other systems to look to for comparison. If you mean that powerful entrenched interests that would stand to make less money and they are hard to fight, then sure that's hard, but it's not like we don't know better systems. They are everywhere if we choose to look. I think the main problem is that too many Americans seem incapable of recognizing that the system there really is worse than many high-tax socialist countries. They don't really have any reason to believe this, but they know this deeply in their heart. It only hurts the US and plays into the hands of the aforementioned entrenched interests (which to be fair certainly work hard to propagate the lies that Americans later believe). By the way, I'm both an American and Swedish citizen. I was born in Sweden, lived most of my life in the US, and am now back in Sweden. I definitely identify more as American than a Swede. In my experiences of the US and Swedish systems I'd take the Swedish one (i.e. the cheapest setup without any of the possible extra insurance which can be purchased extra here) over the US system any day of the week. I think the Americans who have knee-jerk reactions against "socialized medicine" are either totally ignorant or deluded. It's sad. Such self-defeating attitudes weaken American as a nation. [0] https://www.businessinsider.com/personal-finance/cost-of-healthcare-countries-ranked-2019-3 https://www.businessinsider.com/personal-finance/cost-of-hea... [1] https://en.wikipedia.org/wiki/List_of_countries_by_GDP_%28nominal%29_per_capita https://en.wikipedia.org/wiki/List_of_countries_by_GDP_%28no...

sacred_numbers 6y ago

The data here may not be totally accurate, but the sentiment is right. For my local school it's showing the marginal cost of the first credit hour, but the average cost per credit hour is substantially lower once you get to the minimum number of credit hours to qualify for insurance. After correcting for that mistake it cut the monthly cost for tuition+insurance for my local school in half. In addition, some schools offer insurance for spouses and children as well, which usually drives the cost per person down even further. For our situation, the total cost of tuition (9 credit hours per semester) plus insurance (2 people) is about $870 per month. A comparable ACA-compliant insurance plan would be about $1,000 per month. Even with a "gold level" insurance plan we ended up spending around $4,000 for an accident that occurred on campus that required an ambulance to the University hospital (1 mile away) and about 4 hours in the emergency room to get stitches and confirm that a head injury was not a concussion. It's hard to visualize how much money has been legally stolen from the American people over the last few decades due to the giant scam that is the health insurance industry. The combined salaries of every single doctor in America could be paid for with 8% of what we spend on healthcare every year. If you add in the salaries of nurses, pharmacists, drug researchers, etc. it's probably under 25% of what we pay. Unfortunately there are literally millions of middlemen and unnecessary administrators who soak up a very large percentage of healthcare spending without really doing anything. Canada and Australia spend less than half as much per capita as we do on healthcare despite having similar levels of GDP per capita and better average life expectancies. If the US could save 50% on healthcare we could probably solve climate change single-handedly. This is not even an exaggeration, it's an illustration of just how much we spend on healthcare.

Supermancho 6y ago
Eastern/Western Washington State University is listed... https://cougarhealth.wsu.edu/studentinsurance/insurance-coverage-assistance/ https://cougarhealth.wsu.edu/studentinsurance/insurance-cove... https://inside.ewu.edu/bewell/optional-medical-insurance/ https://inside.ewu.edu/bewell/optional-medical-insurance/ This spreadsheet is inaccurate, at best. Also, what kind of insurance matters. I can get you 50$ a month insurance that wont cover anything. Without context, this spreadsheet is a big list of rumours for you go look up and be disappointed.

padseeker 6y ago

this is kinda brilliant.

rexelhoff 6y ago

> US Healthcare Is Dumb FTFY

burnte 6y ago

So many things in healthcare are screwed up. I was in IT for 20+ years and ready to move into law when a healthcare IT management job fell in my lap. 5 years later I still love healthcare IT because there is SO MUCH OPPORTUNITY to improve things, save money, make things better for users and patients. The entire system needs an overhaul, but the really odd thing is that as a nation (USA) we actually CAN do all the things we need to fix it. It's all payment and administrative stuff we need to fix.

sk5t 6y ago
It's unrolling the entire system of economic incentives that needs to be fixed. This is going to be monstrously difficult... there is lots of potential to improve healthcare but actually trying to achieve it is a bit Quixotic.
- burnte 6y ago
  Nah, we can fix it chunk by chunk. It's actually doable. People IN healthcare WANT it, so that helps a lot.

LordHeini 6y ago

You can do something similar in Germany to get access to cheap public transport. Just enroll in an University which cost around 280€ for half a year. This will get you a ticket which you can use in busses and trains for quite some distance. Usually a whole Bundesland (County or whatever the US equivalent is). This is a fraction of the cost of a regular ticket and nobody checks if you pick an unpopular field like physics. I know people doing this for many years. And yes the US should totally get a proper public Healthcare system...

TeMPOraL 6y ago
Where I lived (Kraków, Poland; but arguably, similar schemes apply across the country), you'd get half-priced tickets if you're a student under 26. After finishing their 5 years at the uni, many people then sign up with whatever private school offers the cheapest nonsense course in underwater basket weaving or whatnot, and continue to use the public transport for half the price (as well as using many other discounts for things like trains, cinemas, etc., for which a student card makes you eligible).
- Tade0 6y ago
  My friend did something similar - he started studying something at the University of Warsaw's Faculty of Education - really easy to get in and since this is UW, academic progress is judged on an annual basis. He even showed up there a few times.
MH15 6y ago
At my University (Ohio State) we get unlimited bus passes in the metro area for quite cheap. Sadly, we don't have any real public transport lines. Columbus is one of the largest US cities without light rail/subway.
kiliantics 6y ago
A Bundesland is technically a federal state, which is quite a large area in the US, though also large for some states in Germany too. I am mostly familiar with Bavaria, a big state where you can get a "Bayernticket", that lets you travel on any public transit in the entire state for a day, and even gets you to Salzburg in Austria. Seems the pricing has changed and is not quite as good anymore, though still a good deal. It used to be you could get one ticket that would cover up to 5 people for about 25 euro. Unbelievable value.

1f60c 6y ago

> Health insurance in the United States is expensive (duh). Healthcare through a university is less expensive. Using this website you can find insurance for less than ... > $500 per month. jaw drops to the floor The fact that "just" paying $500 per month (in premiums, I assume?) is considered an improvement...

fblp 6y ago

Are you eligible for health insurance with these universities if you live out of state?

godzillabrennus 6y ago

Before my father qualified for Medicare he figured out this hack. He has a severe chronic condition. Health insurance for him as a self employed person at the time was $4k/month Tuition at the local public college at the time came with a senior discount for folks in his age group and insurance for $10k/year. He loved the classes and saved a bundle on health insurance. He needed a life flight and weeks of hospitalization related to his chronic illness. The insurance had him covered. I think it was a non-trivial payout for the insurance company. The following year the insurance company changed the terms with the university to charge more if you didn’t live on campus. My father went to a different school with a different insurer after that. He’s finally on Medicare. We shouldn’t tie healthcare coverage to employment in our country. It’s stupidly expensive.

thayne 6y ago
Tying health insurance to your employer is incredibly dumb. It means insurarers compete for your employers business, not yours, which influences their incentives. It means if you don't like your insurance company, your only option is to change jobs. It disincitives people from being self employed, because then health insurance is prohibitively expensive.
- sukilot 6y ago
  It's not dumb, it's smart for employers who want to trap employees.
  - tonyhb 6y ago
    So... it's dumb for 999/1000 people.
  - defnotashton2 6y ago
    This was by design. Didn't the dems do this in '96?
    - judge2020 6y ago

abeppu 6y ago

One of these is a medical school. Can you imagine? You apply, you get admitted, you go to your first class. You meet young bright-eyed students. "I want to be an oncologist! My aunt's battle with cancer really inspired me." "I want to be a neurologist. The brain is just so fascinating!" "I wanted health coverage."

desdiv 6y ago
A Soviet Russia joke goes: A toy factory worker wanted to get his son a nice toy for Christmas, but couldn't afford it. So he sneaks out a single component from the factory every day. When he assembled it, it turned out to be a machine gun. The topical American joke would be: At a medical school graduation party, the whole class started discussing their future career prospects. It turns out that none of them would become doctors; all of them joined for the healthcare coverage.

29athrowaway 6y ago

When I quit my job a couple of years ago, I bought my own insurance for about $400 a month. This was not done via COBRA. I don't fully understand the need for this. Can someone explain?

quickthrower2 6y ago

I’m sorry USA that this site needs to exist for you guys. Hope you get affordable healthcare soon :-( It should be $0 and no hack required, for all, ideally at point of care (so no invoice).