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I think I like her. https://www.willowfinch.com/ https://www.willowfinch.com/ seems to be the start-up that this article founded (or is the story of how she go

I think I like her. https://www.willowfinch.com/ https://www.willowfinch.com/ seems to be the start-up that this article founded (or is the story of how she got there) It seems to be a fairly sensible idea - cost-of-living is not just how much a house in Rural "Southern State" costs but varies based on house price + Other State laws and Taxes + mostly healthcare stuff non_US folks dont understand + othr variables based on your stage of life (young and single vs young family etc.) So her startup helps people find best part of the country to live in based on all those variables. Which sounds awesome, if only most people did not base their location on a job. Which after COVID means this is a really good time to start that start up.

EdwardDiego 5y ago
As a non-US folk I definitely don't understand that health insurance variance. Presumably, as she mentioned ACA, you're getting the same level of service, so how can it vary by state? I thought ACA was federal level?
- bufferoverflow 5y ago
  Different laws, different levels of health problems.
- machinerychorus 5y ago
  ACA is a federal level law that does several different things. As I understand it, the main points were increased insurance regulation, the individual mandate, and an option for states to expand medicaid [0]. I'm not sure why there is so much state-to-state variance, but afaik the aca wouldn't prevent that. [0]: https://en.wikipedia.org/wiki/Affordable_Care_Act https://en.wikipedia.org/wiki/Affordable_Care_Act
  - lotsofpulp 5y ago
    The main point of ACA was removing the ability for managed care organizations (MCOs, or health insurers) to refuse or price one’s premiums based on the probabilities of their future healthcare costs. This is why I prefer the term MCO, as they are no longer selling just insurance, so the term insurer does not seem apt. ACA introduced rules that effectively make health insurance premiums a tax, where the young and healthy pay for the old and sick (like taxpayer funded healthcare). It did so in a few ways: 1) force MCOs to provide insurance to everyone, by removing pre existing conditions as a criteria for pricing insurance (effectively causing healthy people to subsidize sick people) 2) force everyone to buy insurance (although this got neutered, both by removing individual penalty and allowing employer sponsored plans to continue to exist) 3) pricing is only based on age, location, smoking status 4) pricing is such that highest premium can only be 3x the premium of ages 21 to 24, effectively causing young people to subsidize old people 5) out of pocket maximums for in network providers - this leaves in the true insurance part of the business in that you will not have to pay over a certain amount in a calendar year. https://www.healthcare.gov/glossary/out-of-pocket-maximum-limit/ https://www.healthcare.gov/glossary/out-of-pocket-maximum-li... >I'm not sure why there is so much state-to-state variance, but afaik the aca wouldn't prevent that. Because insurance regulation is still at the state level, and MCOs were allowed to use location as a factor in calculating premiums, so different places in the US have different healthcare costs due to factors such as wages, land costs, liability costs. Although this mostly exists on the state level, I do not think it gets more granular than that.
  - sidlls 5y ago
    The main thing ACA does is help shift even more money from people to health insurance companies. Any other benefits are ancillary or completely accidental.
- lotsofpulp 5y ago
  ACA is at the federal level, but it allows pricing healthcare based on 3 things: location, age, and smoking status. And up until ACA, all health "insurance" was administered state by state, with various additional state laws and compliance with state insurance regulators, so instead of dismantling all that, it was mostly left alone as long as it complied with the ACA minimums. Healthcare providers charge very different amounts in very different places, due to reasons such as doctors wanting more money for having to live in less desirable areas, so it makes sense that it would cost more or less in different places. Also, the "risk pool" is restricted to each state due to aforementioned system of regulating insurance state by state, so states with smaller populations have less lives to spread the healthcare costs around. This means that healthcare costs in smaller states could be lower, if everyone is healthier, but more likely is something like the case of Iowa where a single anemic patient caused an insurer to back out of the state since their healthcare costs were so high it was not profitable to operate in the state (until the Iowa government, i.e. rest of Iowa taxpayers, stepped in to help.) Some of this is also due to political compromises during ACA passage that continued to allow employers to silo their employees' into their own risk pools via employer sponsored health insurance, and a lot of these are the healthier lives that would help shoulder the healthcare costs of the "general public".
  - senortumnus 5y ago
    Look up the share of health care spending that goes to doctors. It’s maybe 6-10% of overall costs. (Often reported as share that goes to “doctors and clinics” ~20% which includes salaries of nurses & other workers, etc) Biggest share goes to hospitals.
    - lotsofpulp 5y ago
      That was just one easy example that came to mind, since there is specifically a federal program that exists to get doctors to go where they do not want to be. Obviously, nurses/janitors/hospital management will want more/less to live in certain areas, and maybe that is offset by lower land costs, utility costs, legal costs depending on state's laws and courts, and there is a whole host of factors that can cause differences between two places.
- EricE 5y ago
  1. The US is huge. Good example that blew my mind: https://www.txmemes.com/post/texas-is-larger-than-any-european-country https://www.txmemes.com/post/texas-is-larger-than-any-europe... 2. Economic variables can vary significantly between regions 3. There are artificial barriers that significantly distort the market for health care - the most egregious being prohibitions on insurance across state lines that create artificial silos. The overhead of insurance companies and people using insurance for all health care instead of just providing coverage for catastrophic needs inflicts bloat and overhead on even the most mundane of transactions. I've switched to a high deductible plan with a health savings account that lets me pay for my health care tax free so I negotiate with cash for the vast majority of my health care needs and let me tell you - the difference vs. going through insurance is eye opening. On top of that I no longer have to look for providers who are in network - I can pick whoever I want for whatever reason I want. Yup, it takes a bit more effort - but it's my freaking health. There are few things more important or worth dedicating effort to.
PragmaticPulp 5y ago
A tool that compares cost of living in high resolution could be useful for comparing relocation options. However, I have my doubts that many retirees are interested in evaluating retirement destinations solely on cost of living requirements. Nearly everyone wants to retire to some place they enjoy which is close to their friends and family. Moving across the country to save a few hundred dollars per month isn’t helpful if you spend thousands of dollars more every year on plane tickets to travel back to see friends and family.
- aidenn0 5y ago
  Look at the costs at borders between states. If you have family in Danville, IL, you might want to retire in Attica, IN
- burnished 5y ago
  Could be useful for a group of people, say a family, to help decide where they should settle down.
lotsofpulp 5y ago
>Which sounds awesome, if only most people did not base their location on a job. I would say family/friends even takes priority, as many people give up economic/political benefits of moving elsewhere to stay closer to their network.
dominotw 5y ago
how do i use this website. Don't see any signup button.
- jonnydubowsky 5y ago
  I couldn't figure it out either. If anyone has successfully used the Willowfinch.com site, how do you get started?
ryandrake 5y ago
It looks interesting, but how do you actually get into and use the tool? The home page has lots of words describing it and a video, but I could find no links to the actual tool.

EdwardDiego 5y ago

As a non-US folk I definitely don't understand that health insurance variance. Presumably, as she mentioned ACA, you're getting the same level of service, so how can it vary by state? I thought ACA was federal level?

bufferoverflow 5y ago
Different laws, different levels of health problems.
machinerychorus 5y ago
ACA is a federal level law that does several different things. As I understand it, the main points were increased insurance regulation, the individual mandate, and an option for states to expand medicaid [0]. I'm not sure why there is so much state-to-state variance, but afaik the aca wouldn't prevent that. [0]: https://en.wikipedia.org/wiki/Affordable_Care_Act https://en.wikipedia.org/wiki/Affordable_Care_Act
- lotsofpulp 5y ago
  The main point of ACA was removing the ability for managed care organizations (MCOs, or health insurers) to refuse or price one’s premiums based on the probabilities of their future healthcare costs. This is why I prefer the term MCO, as they are no longer selling just insurance, so the term insurer does not seem apt. ACA introduced rules that effectively make health insurance premiums a tax, where the young and healthy pay for the old and sick (like taxpayer funded healthcare). It did so in a few ways: 1) force MCOs to provide insurance to everyone, by removing pre existing conditions as a criteria for pricing insurance (effectively causing healthy people to subsidize sick people) 2) force everyone to buy insurance (although this got neutered, both by removing individual penalty and allowing employer sponsored plans to continue to exist) 3) pricing is only based on age, location, smoking status 4) pricing is such that highest premium can only be 3x the premium of ages 21 to 24, effectively causing young people to subsidize old people 5) out of pocket maximums for in network providers - this leaves in the true insurance part of the business in that you will not have to pay over a certain amount in a calendar year. https://www.healthcare.gov/glossary/out-of-pocket-maximum-limit/ https://www.healthcare.gov/glossary/out-of-pocket-maximum-li... >I'm not sure why there is so much state-to-state variance, but afaik the aca wouldn't prevent that. Because insurance regulation is still at the state level, and MCOs were allowed to use location as a factor in calculating premiums, so different places in the US have different healthcare costs due to factors such as wages, land costs, liability costs. Although this mostly exists on the state level, I do not think it gets more granular than that.
- sidlls 5y ago
  The main thing ACA does is help shift even more money from people to health insurance companies. Any other benefits are ancillary or completely accidental.
lotsofpulp 5y ago
ACA is at the federal level, but it allows pricing healthcare based on 3 things: location, age, and smoking status. And up until ACA, all health "insurance" was administered state by state, with various additional state laws and compliance with state insurance regulators, so instead of dismantling all that, it was mostly left alone as long as it complied with the ACA minimums. Healthcare providers charge very different amounts in very different places, due to reasons such as doctors wanting more money for having to live in less desirable areas, so it makes sense that it would cost more or less in different places. Also, the "risk pool" is restricted to each state due to aforementioned system of regulating insurance state by state, so states with smaller populations have less lives to spread the healthcare costs around. This means that healthcare costs in smaller states could be lower, if everyone is healthier, but more likely is something like the case of Iowa where a single anemic patient caused an insurer to back out of the state since their healthcare costs were so high it was not profitable to operate in the state (until the Iowa government, i.e. rest of Iowa taxpayers, stepped in to help.) Some of this is also due to political compromises during ACA passage that continued to allow employers to silo their employees' into their own risk pools via employer sponsored health insurance, and a lot of these are the healthier lives that would help shoulder the healthcare costs of the "general public".
- senortumnus 5y ago
  Look up the share of health care spending that goes to doctors. It’s maybe 6-10% of overall costs. (Often reported as share that goes to “doctors and clinics” ~20% which includes salaries of nurses & other workers, etc) Biggest share goes to hospitals.
  - lotsofpulp 5y ago
    That was just one easy example that came to mind, since there is specifically a federal program that exists to get doctors to go where they do not want to be. Obviously, nurses/janitors/hospital management will want more/less to live in certain areas, and maybe that is offset by lower land costs, utility costs, legal costs depending on state's laws and courts, and there is a whole host of factors that can cause differences between two places.
EricE 5y ago
1. The US is huge. Good example that blew my mind: https://www.txmemes.com/post/texas-is-larger-than-any-european-country https://www.txmemes.com/post/texas-is-larger-than-any-europe... 2. Economic variables can vary significantly between regions 3. There are artificial barriers that significantly distort the market for health care - the most egregious being prohibitions on insurance across state lines that create artificial silos. The overhead of insurance companies and people using insurance for all health care instead of just providing coverage for catastrophic needs inflicts bloat and overhead on even the most mundane of transactions. I've switched to a high deductible plan with a health savings account that lets me pay for my health care tax free so I negotiate with cash for the vast majority of my health care needs and let me tell you - the difference vs. going through insurance is eye opening. On top of that I no longer have to look for providers who are in network - I can pick whoever I want for whatever reason I want. Yup, it takes a bit more effort - but it's my freaking health. There are few things more important or worth dedicating effort to.

PragmaticPulp 5y ago

A tool that compares cost of living in high resolution could be useful for comparing relocation options. However, I have my doubts that many retirees are interested in evaluating retirement destinations solely on cost of living requirements. Nearly everyone wants to retire to some place they enjoy which is close to their friends and family. Moving across the country to save a few hundred dollars per month isn’t helpful if you spend thousands of dollars more every year on plane tickets to travel back to see friends and family.

aidenn0 5y ago
Look at the costs at borders between states. If you have family in Danville, IL, you might want to retire in Attica, IN
burnished 5y ago
Could be useful for a group of people, say a family, to help decide where they should settle down.

lotsofpulp 5y ago

>Which sounds awesome, if only most people did not base their location on a job. I would say family/friends even takes priority, as many people give up economic/political benefits of moving elsewhere to stay closer to their network.

dominotw 5y ago

how do i use this website. Don't see any signup button.

jonnydubowsky 5y ago
I couldn't figure it out either. If anyone has successfully used the Willowfinch.com site, how do you get started?

ryandrake 5y ago

It looks interesting, but how do you actually get into and use the tool? The home page has lots of words describing it and a video, but I could find no links to the actual tool.