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It's interesting that my ACA (Obamacare) premiums are lower than the premiums were at my last employer for similar coverage (using COBRA numbers for comparison)

It's interesting that my ACA (Obamacare) premiums are lower than the premiums were at my last employer for similar coverage (using COBRA numbers for comparison). This might be because my last employer was bad at negotiating but I think it's mostly because they had an aging Rustbelt workforce and lots of people in roles that were unhealthy long term (linesmen and call centers). Because rates are set based on the pool's group risk, the risk in the public ACA pool is lower than the employer's pool of employees. So even though my job was white collar work at a desk, my premiums were based on an unhealthy pool of workers. If I went to work for a startup made up mostly of 20 somethings, I (and my employer) would likely be paying less than my old employer and less than ACA. So this is another way that tying health insurance to employment creates pockets of unfairness and undesirable outcomes. While I'm not sold on having a government run healthcare system (the pandemic only reinforces this), there are plenty of hybrid systems out there in other industrialized nations that might (must recognize each country's situation is unique) have better outcomes.

bluejekyll 5y ago
> While I'm not sold on having a government run healthcare system (the pandemic only reinforces this) Would you mind elaborating on that? From my own perspective the federal government’s ability to help fund and drive the vaccine development and then to purchase in quantities to get the entire population vaccinated is actually proof of how powerful a single payer system could be. I’m curious as to what I might be missing.
- supportlocal4h 5y ago
  You offer two examples of value: 1. Fund and drive vaccine development 2. Purchase large quantities Neither of those is what I want from my insurance company. How much are those two things costing me? If my taxes just went up $100/year for the next 3 years to pay for that vaccine, that maybe wasn't ideal. If my taxes went up $10 total, that was an awesome deal. If I have no idea how much that vaccine cost me, and nobody else seems to have a way to figure it out, that's really bad. One of my biggest complaints about health insurance in general is the lack of transparency. If government control reduces transparency, that would be bad.
  - bluejekyll 5y ago
    It seems that you believe government is less transparent than private companies. There are laws which require transparency in government, and your elected officials can make those stronger. Private companies don’t have this inherent obligation and in fact desire to keep as much private as possible in order to compete better. Are governments or private companies more transparent?
    - supportlocal4h 5y ago
      Did you see the sentence about current lack of transparency with insurance companies?
gurleen_s 5y ago
> While I'm not sold on having a government run healthcare system (the pandemic only reinforces this) A reminder that government services suck on purpose. There is no reason for government healthcare to be ineffective other than the malicious intent of those who run our government (D or R).
- Jtsummers 5y ago
  > A reminder that government services suck on purpose. There is no reason for government healthcare to be ineffective other than the malicious intent of those who run our government (D or R). Yes. Government employees and elected officials have weekly meetings with a standing question: Where are we doing things well? And then they coordinate to fuck it up and make it suck. /s
  - chefkoch 5y ago
    Some republicans, yes.
    - VelkaMorava 5y ago
      I have been reading comments like yours on the internet for quite a while now. I am from Europe, so I have no horse in this race. I have these 2 questions/thoughts: 1) Do you think it's a good idea to have all the branches of the government controlled by 1 party? We actually had this a few decades ago in the Czech republic and we refer to that period as "totalita" or dictatorship. Let's say the wet dream (based on comments like yourself) of all Democrats becomes real and they control everything from communal level to presidency. How is it different than China, USSR or Czechoslovak Socialist Republic? 2) What has changed in the past half a year? If I am not mistaken, Democrats have had control of the presidency and house for over half a year now. I admit HN is my only source of news, but it seems like there are still ICE camps. There is still half-built wall between US and Mexico. The US still drones countries on the other side of the world. From the statistics people are still living paycheck to paycheck and can't afford healthcare (I understand the plague has its fair share here too). The US still helps Israel, which is IMO a rogue state at this point, as per the Pegasus scandal.
1123581321 5y ago
That is an interesting situation. I’m surprised your employer didn’t seek out a consortium to improve the group; it would’ve been a huge financial benefit to them, assuming they were paying a share of premiums.
ecommerceguy 5y ago
Sounds like you are young and because you are young you are receiving the privilege of paying less premium for health care. Health Insurance for better or worse heavily discriminates against the older folks. >> the risk in the public ACA pool is lower than the employer's pool of employees as a general rule, the public pool is substandard rating.
- PEJOE 5y ago
  > worse heavily discriminates against the older folks The ACA is actually a wealth transfer from the young to the old, like social security, because the young pay much more than their portion of healthcare costs, while the old have a ceiling on their healthcare costs. Whether this is good policy is for the think tanks and politicians, but after the ACA it is not true that health insurance discriminates against older Americans.
- paxys 5y ago
  > because you are young you are receiving the privilege of paying less premium for health care That's a weird way of putting it. Young people are getting far less value from their healthcare premiums than the old. That's how the entire system is able to work. Health insurance, social security, medicare etc. all discriminate against the young in favor of the old. And I'm not passing judgement for or against such a system. That's just how it is.
- tolbish 5y ago
  > Health Insurance for better or worse heavily discriminates against the older folks. Medicare exists only for the elderly.
- throwaway6734 5y ago
  As it should. It's incredibly unfair that as a young person I'm forced to subsidize the healthcare costs of older colleagues
  - sudosysgen 5y ago
    Well, not really. Unless you die young very rapidly in a way that won't incur major medical costs, you're going to get your money's worth eventually, with the added benefit of stability.
hackeraccount 5y ago
Premiums are part of the cost of insurance not the entire cost. Sometimes there are co-pays that can be large. I know that the ACA comes in bronze/silver/gold varieties and I seem to remember reading somewhere that the premiums were the same and what was covered was the same among all the "metal" categories but the deductable/co-pay amounts were different. If you had bronze you had a bigger deductable or co-pay then silver or gold.
- SanFranManDan 5y ago
  From personal experience I had the same carrier (blue cross) with the same deductible and same copay (the “gold” level PPO) but I currently pay $800 to buy it independently for my wife and I while at my old job the premiums were $1200 a month.
lsllc 5y ago
COBRA numbers are and have always been absolutely nuts, in fact I've come to the conclusion that they exist simply as a disincentive for employees to leave (along with non-competes).

bluejekyll 5y ago

> While I'm not sold on having a government run healthcare system (the pandemic only reinforces this) Would you mind elaborating on that? From my own perspective the federal government’s ability to help fund and drive the vaccine development and then to purchase in quantities to get the entire population vaccinated is actually proof of how powerful a single payer system could be. I’m curious as to what I might be missing.

supportlocal4h 5y ago
You offer two examples of value: 1. Fund and drive vaccine development 2. Purchase large quantities Neither of those is what I want from my insurance company. How much are those two things costing me? If my taxes just went up $100/year for the next 3 years to pay for that vaccine, that maybe wasn't ideal. If my taxes went up $10 total, that was an awesome deal. If I have no idea how much that vaccine cost me, and nobody else seems to have a way to figure it out, that's really bad. One of my biggest complaints about health insurance in general is the lack of transparency. If government control reduces transparency, that would be bad.
- bluejekyll 5y ago
  It seems that you believe government is less transparent than private companies. There are laws which require transparency in government, and your elected officials can make those stronger. Private companies don’t have this inherent obligation and in fact desire to keep as much private as possible in order to compete better. Are governments or private companies more transparent?
  - supportlocal4h 5y ago
    Did you see the sentence about current lack of transparency with insurance companies?

gurleen_s 5y ago

> While I'm not sold on having a government run healthcare system (the pandemic only reinforces this) A reminder that government services suck on purpose. There is no reason for government healthcare to be ineffective other than the malicious intent of those who run our government (D or R).

Jtsummers 5y ago
> A reminder that government services suck on purpose. There is no reason for government healthcare to be ineffective other than the malicious intent of those who run our government (D or R). Yes. Government employees and elected officials have weekly meetings with a standing question: Where are we doing things well? And then they coordinate to fuck it up and make it suck. /s
- chefkoch 5y ago
  Some republicans, yes.
  - VelkaMorava 5y ago
    I have been reading comments like yours on the internet for quite a while now. I am from Europe, so I have no horse in this race. I have these 2 questions/thoughts: 1) Do you think it's a good idea to have all the branches of the government controlled by 1 party? We actually had this a few decades ago in the Czech republic and we refer to that period as "totalita" or dictatorship. Let's say the wet dream (based on comments like yourself) of all Democrats becomes real and they control everything from communal level to presidency. How is it different than China, USSR or Czechoslovak Socialist Republic? 2) What has changed in the past half a year? If I am not mistaken, Democrats have had control of the presidency and house for over half a year now. I admit HN is my only source of news, but it seems like there are still ICE camps. There is still half-built wall between US and Mexico. The US still drones countries on the other side of the world. From the statistics people are still living paycheck to paycheck and can't afford healthcare (I understand the plague has its fair share here too). The US still helps Israel, which is IMO a rogue state at this point, as per the Pegasus scandal.

1123581321 5y ago

That is an interesting situation. I’m surprised your employer didn’t seek out a consortium to improve the group; it would’ve been a huge financial benefit to them, assuming they were paying a share of premiums.

ecommerceguy 5y ago

Sounds like you are young and because you are young you are receiving the privilege of paying less premium for health care. Health Insurance for better or worse heavily discriminates against the older folks. >> the risk in the public ACA pool is lower than the employer's pool of employees as a general rule, the public pool is substandard rating.

PEJOE 5y ago
> worse heavily discriminates against the older folks The ACA is actually a wealth transfer from the young to the old, like social security, because the young pay much more than their portion of healthcare costs, while the old have a ceiling on their healthcare costs. Whether this is good policy is for the think tanks and politicians, but after the ACA it is not true that health insurance discriminates against older Americans.
paxys 5y ago
> because you are young you are receiving the privilege of paying less premium for health care That's a weird way of putting it. Young people are getting far less value from their healthcare premiums than the old. That's how the entire system is able to work. Health insurance, social security, medicare etc. all discriminate against the young in favor of the old. And I'm not passing judgement for or against such a system. That's just how it is.
tolbish 5y ago
> Health Insurance for better or worse heavily discriminates against the older folks. Medicare exists only for the elderly.
throwaway6734 5y ago
As it should. It's incredibly unfair that as a young person I'm forced to subsidize the healthcare costs of older colleagues
- sudosysgen 5y ago
  Well, not really. Unless you die young very rapidly in a way that won't incur major medical costs, you're going to get your money's worth eventually, with the added benefit of stability.

hackeraccount 5y ago

Premiums are part of the cost of insurance not the entire cost. Sometimes there are co-pays that can be large. I know that the ACA comes in bronze/silver/gold varieties and I seem to remember reading somewhere that the premiums were the same and what was covered was the same among all the "metal" categories but the deductable/co-pay amounts were different. If you had bronze you had a bigger deductable or co-pay then silver or gold.

SanFranManDan 5y ago
From personal experience I had the same carrier (blue cross) with the same deductible and same copay (the “gold” level PPO) but I currently pay $800 to buy it independently for my wife and I while at my old job the premiums were $1200 a month.

lsllc 5y ago

COBRA numbers are and have always been absolutely nuts, in fact I've come to the conclusion that they exist simply as a disincentive for employees to leave (along with non-competes).