11 ms·
It's wild that less than $500/month for health insurance is a win in the United States
by jamestimmins 6y ago
It's wild that less than $500/month for health insurance is a win in the United States
- nostromo 6y agoIt 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 agoI 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 agoYou've got much cheaper housing or much more expensive insurance than the average person.
- garmaine 6y agoHis 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 agoIt’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.
- deleted 6y ago[deleted]
- antcas 6y agoAlso FYI to anyone reading this, these plans are all individual-rate plans but many also offer family or spouse plans for not that much more.
- antcas 6y agoIt's pretty dumb tbh
- war1025 6y agoAnd then think about how it shakes out for a family plan. Health insurance in the US is an untenable situation and I really just hope it explodes sooner rather than later. The biggest issue, in my opinion, is how much of the cost is shielded by employer contributions that no one ever thinks about. This makes it too easy for people with good employer-sponsored health insurance to scoff at and dismiss all the people who aren't in that situation. When your employer is shouldering $20k in health insurance premiums without really telling you, it's easy to feel like the costs aren't a problem.
- koolba 6y agoIt’s a double whammy because the employer gets to deduct 100% of their contribution but the little guy buying it on the open market has to use post tax dollars.
- zrail 6y agoWhich is _bullshit_. Everyone should be able to deduct their out of pocket premium costs.
- zbrozek 6y agoOr better yet, nobody.
- zrail 6y agoYeah either way. The playing field should be level.
- jermaustin1 6y agoThis is probably a better idea. No hidden costs to any one. Employers would either lower salaries in America, or stop covering insurance. When the cost of healthcare is visible, maybe then the majority who have employer provided insurance would then fight with the minority of us who use the marketplace, and shoulder the entire burden of the price.
- deleted 6y ago
- TuringNYC 6y agoIt is only a "win" in a very general sense if you just need catastrophic coverage. You cannot really judge a win w/o seeing what is/isnt covered, co-pays, deductibles, co-insurance, networks, and a variety of other factors.
- oneplane 6y agoAll of that just points out how bad it is, even with 'insurance'.
- TuringNYC 6y agoExactly. One of the really bad things about US health insurance is that you dont know how bad it is until you have a John-Q type event (https://en.wikipedia.org/wiki/John_Q. https://en.wikipedia.org/wiki/John_Q.) or a difficult pregnancy or a surgery. Healthy people go in for annual visits and think "wow, this is great" not knowing what exception scenarios are like. Then people vote for politicians who uphold the status quo thinking everything is fine.
- oneplane 6y agoNot sure where I read it, but a theory was that since there is some sort of extreme self-reliance doctrine at the base of many sociological and political concepts in the USA it's frowned upon to ask for help, or help each other, or create a system where everybody agrees that helping each other by default is a good thing. Keeps most things as-is, keeps people fighting over who gets to proxy-kill sick people and what the best way to screw each other for perceived personal gain is. Edit: here on HN there was a comment from someone along the lines of "from the outside looking in, the USA looks like people fighting over who gets to punch babies and you're not allowed to not want to be on either side because that's taking a side as well".
- nicoburns 6y agoFor comparison, in the UK we spent £197.4 billion in 2017, or approximately £2,989 spent per person [0]. Which works out as: ~£250/per person/per month. Which is $330. Or $350 adjusted for inflation since 2017. That covers everything: emergency room, ambulances, giving birth, cancer treatment. Everything: no copays (except very small ones (<£10) for prescription medicines). And it covers the entire population. * Except dentistry. For some reason that is separate. [0]: https://www.ons.gov.uk/peoplepopulationandcommunity/healthandsocialcare/healthcaresystem/bulletins/ukhealthaccounts/2017#:~:text=In%202017%2C%20spending%20on%20healthcare,equal%20to%209.7%25%20of%20GDP https://www.ons.gov.uk/peoplepopulationandcommunity/healthan....
- garmaine 6y agoTo compare apples to apples, note that the American number is just the premium. In my case for example, I need to spend an additional $6800 before the insurance kicks in and starts paying out.
- maxerickson 6y agoIt's more complex than that. Certain services are built into the premiums. An annual primary care visit, cancer screening, vaccinations, and so on. So for example if you have medical need for a colonoscopy, it will be covered before the deductible has been met.
- asdasfasdfasdf 6y agoI pay $1200 a month for my family and don't even really get to use it for anything but routine checkups (which I still pay $30/ea for) until I hit my $5k deductible (and to another extent, the $8k out-of-pocket max). A few times a year I spend an hour on the phone arguing about coverage or an incorrect billing code. This is all for peace of mind that if I get hit by a car or fall off my roof that I won't instantly be ruined by debt. In the event of one of those accidents I fully expect to have to fight the company I pay over $10k a year to actually provide that "I'm broke but at least I'm not bankrupt" coverage. Oh also, we need a separate plan to insure our teeth for some reason and most plans only cover $1500 a year. I needed to get my wisdom teeth out and ended up splitting it over two years so I didn't have to pay the full uninsured price. Our "liberal" presidential candidate is painted as "radical" by the current president, and said "radical liberal" has said on multiple occasions that "people love their insurance" I've considered trying to move to another country simply because of healthcare. I am immediately skeptical of anyone who thinks this is a reasonable system.
- sgerenser 6y agoI don’t think there are many people who think as a whole our system is “reasonable.” Just those that recognize the “be careful what you wish for” possibility. For example, for people who always point out how efficient European single payer health care is and how much money we’d all save if we switched to it: the U.S. government is already spending more per-capita on healthcare (Medicaid, Medicare, VA, etc.) than most European countries pay for single-payer healthcare systems that covers everyone [0]. So switching everyone on private plans (or uncovered) to a single-payer system is mathematically impossible to be even close to as cheap as other countries have it. (When I say per-capita, that means dividing the costs by all residents of a country, not just those enrolled in the plan). That doesn’t mean it wouldn’t be better than what we have now, but it’s disingenuous when people imply that all it takes is to change the “payer” and we’d magically fall in line with costs seen in Europe. The real issue is many-fold and in order to truly bring costs down its going to take a lot of sacrifices from the provider side as well. Most doctors, nurses, and others in the health care industry in Europe (and other places with single-payer systems) do not earn nearly as much as their counterparts in the U.S. [0] https://www.commonwealthfund.org/publications/issue-briefs/2015/oct/us-health-care-global-perspective https://www.commonwealthfund.org/publications/issue-briefs/2...
- MrFantastic 6y agoThat's just for insurance. You still going to be paying 20% of the actual medical bill. You can easily run up a $100k bill in a week.
- maxerickson 6y agoUnder the ACA, out of pocket maximums are ~$8000 or $16,000 (individual/family). That leaves care that doesn't get covered by insurance of course, but people aren't on the hook for 20% of the bill that insurance covers.
- mariojv 6y agoDon't out of pocket maximums only apply to in-network care most of the time? I think you're still on the hook for the full coinsurance amount if you're at a hospital and a doctor from out of your network happens to step in the room without telling you they're out of network.
- maxerickson 6y agoYeah. I'm certainly not trying to defend the US system, just trying to paint a clearer picture of how it works. Totally fair to always discuss the huge caveat of out of network providers getting involved without any opportunity to refuse their care alongside the out of pocket maximums for in-network services.
- notJim 6y agoWhat's even wilder is that in the recent primaries (both 2020 and 2016) of the "left" party a major argument was that this system is so awesome that it must be protected at all costs, even if moving to something like single-payer would be cheaper while covering more people [1]. [1]: https://www.peoplespolicyproject.org/2018/07/30/mercatus-study-finds-medicare-for-all-saves-2-trillion/ https://www.peoplespolicyproject.org/2018/07/30/mercatus-stu...
- SilasX 6y agoYes! Another indicator of how bad it is. Relatedly, I like to joke that you can get a huge discount on delivering a pregnancy if you make sure you're on a European vacation when the baby comes due. They'll come to you and super-apologetically explain that, well, you're not a citizen or permanent resident, so you haven't paid into the system and have to pay the full price of the medical services, which is sadly ... something like 500 USD. And then you laugh at how that's less than you'd pay with insurance in the US.
- deleted 6y ago[deleted]
- deleted 6y ago[deleted]
- deleted 6y ago[deleted]