4 ms·

The sad truth is people only realize how fucked the US healthcare system is when they or their loved ones get sick. I was the same way until my son got sick (t

The sad truth is people only realize how fucked the US healthcare system is when they or their loved ones get sick. I was the same way until my son got sick (type 1 diabetes.) From then on (~2013) we've spent $20,000+/year to cover health insurance premiums/deductibles/copays. It's truly bonkers.

EvanAnderson 5y ago
US, OH here - Most people I know have employer-sponsored health insurance and have no idea what it actually costs. I was self-employed and paid for my own insurance for years (and paid roughly the same that my employer pays now). If people realized how much is getting paid for their health insurance that could be going to their income they might actually care. Except they won't. >sigh< (Yes, I'm aware that there'd still be cost for universal insurance coverage in the form of taxes-- that's not all lost income. Still, I bet we could do better than the current "system" with single-payer and a real, forthright effort to actually reign-in costs. Oh, and no for-profit insurers.)
- gruez 5y ago
  >Most people I know have employer-sponsored health insurance and have no idea what it actually costs. >Yes, I'm aware that there'd still be cost for universal insurance coverage in the form of taxes-- that's not all lost income Seems like the right way to approach this would be to promise to tax it on the employer side, replacing whatever premiums they had paid before? That way everyone's happy. The workers don't see any increased premiums, and companies pay equal or less taxes (assuming it actually works out cheaper, but that's another debate).
  - GiorgioG 5y ago
    The right way to approach this is to move to a single-payer healthcare system. The administrative overhead of all of these insurance companies is STAGGERING. I consulted for a franchisee of Blue Cross Blue Shield 15 years ago. They were a "non-profit" org...the CEO made 2.1m/year. That's in a rust-belt city with ~1m metro area population. edit: They had a 200 person IT department that could have easily been run with 100 competent folks. For illustration, they had 20 people working full time managing the source of truth of their healthcare plans (to feed their claims processing system.) The source of truth was Excel spreadsheets on a shared drive. You can't make this crap up.
  - toast0 5y ago
    You can't really make such a promise in good faith. You're going to need some form of uniform tax, but current premiums are not uniform. Even if we assume the system is less expensive in aggregate, there will be some (probably many) cases where it is more expensive in specific and promising otherwise sets wrong expectations.
  - cogman10 5y ago
    > Seems like the right way to approach this would be to promise to tax it on the employer side, replacing whatever premiums they had paid before? IDK why this couldn't simply be a part of regular income tax and perhaps a bump in the capital gains taxes. When you think about it, it's a bit silly that employees earning 2 or 3x the salaries of other employees are paying the same for healthcare. This would also have to happen because not all employers offer healthcare (small businesses or contracting), yet everyone would still (presumably) get healthcare. In any event, I'd honestly happily pay a bit more in taxes for the more progressive healthcare plans. No deductible and vision/dental? Impossible to break the bank for cancer? No coverage gaps between employment? I could start my own business and not worry about health coverage? Universal healthcare is a terrific idea that most other nations have. It's not bank breaking and there's no country I know of that's decided to ditch it after implementing it.
    - gruez 5y ago
      >IDK why this couldn't simply be a part of regular income tax and perhaps a bump in the capital gains taxes. psychological reasons, because you're already accustomed to it. You'll be shocked/outraged if the government randomly fined you $25k, but when the IRS wants $25k of your income you begrudgingly put up with it.
    - maccolgan 5y ago
      >When you think about it, it's a bit silly that employees earning 2 or 3x the salaries of other employees are paying the same for healthcare. You think it costs more to treat someone who makes more money?
      - cogman10 5y ago
        No, I think everyone needs healthcare regardless of income and expenses. However, I think someone making 200,000 is much more capable of paying $1200 monthly than someone earning $30,000 is capable of paying $600 monthly. And, if you are talking about treating people based on what it costs, then why have insurance in the first place? The entire point of insurance is sharing the cost with others.

EvanAnderson 5y ago

US, OH here - Most people I know have employer-sponsored health insurance and have no idea what it actually costs. I was self-employed and paid for my own insurance for years (and paid roughly the same that my employer pays now). If people realized how much is getting paid for their health insurance that could be going to their income they might actually care. Except they won't. >sigh< (Yes, I'm aware that there'd still be cost for universal insurance coverage in the form of taxes-- that's not all lost income. Still, I bet we could do better than the current "system" with single-payer and a real, forthright effort to actually reign-in costs. Oh, and no for-profit insurers.)

gruez 5y ago
>Most people I know have employer-sponsored health insurance and have no idea what it actually costs. >Yes, I'm aware that there'd still be cost for universal insurance coverage in the form of taxes-- that's not all lost income Seems like the right way to approach this would be to promise to tax it on the employer side, replacing whatever premiums they had paid before? That way everyone's happy. The workers don't see any increased premiums, and companies pay equal or less taxes (assuming it actually works out cheaper, but that's another debate).
- GiorgioG 5y ago
  The right way to approach this is to move to a single-payer healthcare system. The administrative overhead of all of these insurance companies is STAGGERING. I consulted for a franchisee of Blue Cross Blue Shield 15 years ago. They were a "non-profit" org...the CEO made 2.1m/year. That's in a rust-belt city with ~1m metro area population. edit: They had a 200 person IT department that could have easily been run with 100 competent folks. For illustration, they had 20 people working full time managing the source of truth of their healthcare plans (to feed their claims processing system.) The source of truth was Excel spreadsheets on a shared drive. You can't make this crap up.
- toast0 5y ago
  You can't really make such a promise in good faith. You're going to need some form of uniform tax, but current premiums are not uniform. Even if we assume the system is less expensive in aggregate, there will be some (probably many) cases where it is more expensive in specific and promising otherwise sets wrong expectations.
- cogman10 5y ago
  > Seems like the right way to approach this would be to promise to tax it on the employer side, replacing whatever premiums they had paid before? IDK why this couldn't simply be a part of regular income tax and perhaps a bump in the capital gains taxes. When you think about it, it's a bit silly that employees earning 2 or 3x the salaries of other employees are paying the same for healthcare. This would also have to happen because not all employers offer healthcare (small businesses or contracting), yet everyone would still (presumably) get healthcare. In any event, I'd honestly happily pay a bit more in taxes for the more progressive healthcare plans. No deductible and vision/dental? Impossible to break the bank for cancer? No coverage gaps between employment? I could start my own business and not worry about health coverage? Universal healthcare is a terrific idea that most other nations have. It's not bank breaking and there's no country I know of that's decided to ditch it after implementing it.
  - gruez 5y ago
    >IDK why this couldn't simply be a part of regular income tax and perhaps a bump in the capital gains taxes. psychological reasons, because you're already accustomed to it. You'll be shocked/outraged if the government randomly fined you $25k, but when the IRS wants $25k of your income you begrudgingly put up with it.
  - maccolgan 5y ago
    >When you think about it, it's a bit silly that employees earning 2 or 3x the salaries of other employees are paying the same for healthcare. You think it costs more to treat someone who makes more money?
    - cogman10 5y ago
      No, I think everyone needs healthcare regardless of income and expenses. However, I think someone making 200,000 is much more capable of paying $1200 monthly than someone earning $30,000 is capable of paying $600 monthly. And, if you are talking about treating people based on what it costs, then why have insurance in the first place? The entire point of insurance is sharing the cost with others.