6 ms·

Cost of employer-sponsored health insurance is flattening worker wages

40 points by clumsysmurf 3y ago

paulpauper 3y ago
obesity is probably to blame here. So many chronic health problems are probably downstream from obesity.
- dchung333 3y ago
  Uhh... Researchers also found that Black and Hispanic families lost a higher percentage of their wages than white families. By 2019, health care premiums as percentage of compensation were 18.5% for Asian families, 19.2% for Black families, and 19.8% for Hispanic families, compared to 13.8% for white families. Lower-wage workers are also hit hard by this disparity. In 2019, health care premiums as percentage of compensation represented 28.5% of compensation for families in the 20th percentile of earnings, compared with only 3.9% for families in the 95th percentile. Maybe not the one you want to skip the article for. On another note Asian Americans are skinnier than White Americans even adjusted for on BMI so obesity is ruled out.
  - SuperNinKenDo 3y ago
    What those other races do have over whites is probably their propensity for Type 2 diabetes though. Blacks and Asians definitely, possibly for different reasons. Not completely certain about hispanics tbf.
- ttt3ts 3y ago
  The rising costs of healthcare should not be simplified to this extreme. Other huge factors: we are getting older on average, fewer doctors, bureaucracy, transparency, etc. Further, these are heavily entertwined. Been working on costs of healthcare for a while and the laymens simplified explanation of the problem makes it tough at times.
  - nxm 3y ago
    + malpractice insurance
- iancmceachern 3y ago
  Obesity is the symptom. The disease is a bigger, more interconnected subject.
  - PaulHoule 3y ago
    It could well be the effect of PFAS, glyphosate, bisphenol A or some other industrial chemical that exploded in prevalence in the last quarter of the 20th Century.
    - teslabox 3y ago
      Good candidates for contributing factors for the obesity epidemic. There seems to have been a spark that set off the obesity conflagration sometime around 1978-1981. The kindling that nurtures this spark had been accumulating since the early 20th century… The chemicals you mention were certainly contributory. https://news.ycombinator.com/item?id=38812171 https://news.ycombinator.com/item?id=38812171
- dublin 3y ago
  Obesity may be a factor, but it's stupid to think that it has anything like the impact that boneheaded government policy has on healthcare costs. Obamacare was, and is, a disaster, driving up costs while producing worse outcomes. (I've worked as a CEO in a healthcare tech startup since then, so I've got better insight than the average bear.) The vast majority of people actually need those "junk plans" Obama eliminated: Catastrophic coverage plans with fairly high deductibles (which HSAs would handle after a few years...)
  - Sohcahtoa82 3y ago
    > Obamacare was, and is, a disaster, driving up costs while producing worse outcomes. I'm not sure I'd call it a disaster, but I will agree that ACA did absolutely nothing to address the core issue: Health care is just too expensive. I crashed my mountain bike in the summer of 2022, broke my arm and scraped up my knee real bad, though managed to put my bike back on the rack on my car and drive to the ER one-handed. They did an X-Ray, confirmed the breakage, gave me an arm sling and a prescription for painkillers, and cleaned up my knee. Total visit was 20 minutes. Without insurance, it would have cost me nearly $3,000. $3,000 for 20 minutes of work between an X-Ray tech, 1 doc, 1 nurse, and 1 person at the front desk. I understand that there's overhead, but I still think that cost was 5x what it should have been.
  - jmye 3y ago
    The ACA was a fantastic tool, enabling millions more people to access insurance that will actually pay things. If this is your analysis, my assumption is that you work in a healthcare adjacent world like BNPL and don’t actually have even the vaguest understanding of what the ACA is, does, or includes. We can start with the simple fact that catastrophic plans still exist and that they actually cover things, now. That you think they both don’t exist and we’re somehow better before defies belief.
    - gausswho 3y ago
      Catastrophic plans are only available for those age 30 or below.
gumballindie 3y ago
In the UK you get to pay both public and private healthcare. Both of low quality. Private health care relies on “virtual appointments” and usually leads to mis diagnostics. It will get worse with ai.
- lurking15 3y ago
  > It will get worse with ai. I've had to self-diagnose and then just plainly guide several of my doctors, even specialists, on diagnostics (for evidence) and subsequent treatment. I've had some really lame infections and things going on, and most of my GPs over the years would just pin it down to anxiety or blindly prescribe antibiotics (made things much worse). I've lost all faith in the average doctor's expertise, so I expect AI must be better but at the same time realize the whole system gets inexplicably worse as a human being on the other end, despite advances in technology.
  - gumballindie 3y ago
    Ok, so you've received low quality health care and you think a hallucinating bot is the solution? What if we, you know, start hiring competent people? Or change the system to allow them to become competent?
    - lurking15 3y ago
      > What if we, you know, start hiring competent people? I've seen enough doctors at this point in completely different specialities and they're all reliably pretty bad. After so many years of education and experience. To me this backs-up another common sense fact: experts often suck and persist in their error because they've built an entire toolbox of sophisticated mental tools that are able to support their erroneous thinking. To me this is why experts of all sorts are often in the position of arguing "don't believe your lying eyes" to normal people.
  - LeafItAlone 3y ago
    > I've had to self-diagnose and then just plainly guide several of my doctors, even specialists, on diagnostics (for evidence) and subsequent treatment. Being involved in your own treatment is very important. In my opinion, it’s folly to expect your doctor to know everything. I can read descriptions of similar diseases and problems and be able to compare my symptoms. You generally know your body better than anyone.
PaulHoule 3y ago
... but it's not like they're just stealing the money from you, you are getting health insurance, which has a lot of value. There's another story going around that if you add benefits like health insurance not to mention programs like food stamps the gap between rich and poor hasn't increased as much as you'd think otherwise.
- dublin 3y ago
  No, it has little to no value at all until something really catastrophic happens to you. Paying thousands of dollars a year for a "free" annual checkup is NOT delivering "a lot of value". It's been much more of just a money pit. Over my career, I am upside-down on my healthcare costs to the tune of six figures - and that's after kidney stone surgery some years back...) I think I'll pass on succumbing to cancer to try to recover a bit more, though...
  - mikeyouse 3y ago
    It's tax time now so I get a wonderful breakdown of how much my company paid for my and my family's insurance (over $25k) and I also get to put together how much we spent out of pocket on health services (over $5k for a bog-standard pregnancy). If this is supposed to be some sort of bargain or good deal, I'm missing it. In the decade prior to this, my total premiums must have been over $200k for literally no usage.
    - LeafItAlone 3y ago
      > In the decade prior to this, my total premiums must have been over $200k for literally no usage. You’ve just described insurance. If everyone took more than they used, it wouldn’t work.
    - Sohcahtoa82 3y ago
      I think you're fundamentally misunderstanding what insurance is, or just refusing to acknowledge it. It's not pre-paid care. It's not a discount plan. Really, it's a gamble. Health insurance is ridiculously expensive because health care can become ridiculously expensive. Sure, you're healthy and accident-free, but the costs of a traumatic accident or long-term illness could easily reach 6, possibly even 7 figures in the long term. That's what your insurance is paying for. For any type of insurance to work, you need people that aren't making claims to fund the people that are making claims. If you take the attitude of "Why should my premiums pay for someone else's care?", then really there's no reason to even get insurance. Your insurance is costing $25K/year, because statistically, the average family has at least $20K in healthcare costs per year (Assuming the insurance company is satisfying the ACA requirement of 80% of premiums must go to paying for care). Your $25K/year in premiums is a bet that you won't need some $Y to pay for healthcare, where $Y >>> $25K. Most of the time, you're losing that bet, and the insurer is making $25K off of you. But if you ever find yourself in a world of hurt (quite literally), you'll be glad you made the bet.
jl2718 3y ago
1. No negotiated rates. 2. No employer mandate. 3. No special tax treatment. 4. No individual mandate. Crazy idea: Convert Medicare, Medicaid, and SSDI to universal medical loan insurance.

40 points by clumsysmurf 3y ago

paulpauper 3y ago

obesity is probably to blame here. So many chronic health problems are probably downstream from obesity.

dchung333 3y ago
Uhh... Researchers also found that Black and Hispanic families lost a higher percentage of their wages than white families. By 2019, health care premiums as percentage of compensation were 18.5% for Asian families, 19.2% for Black families, and 19.8% for Hispanic families, compared to 13.8% for white families. Lower-wage workers are also hit hard by this disparity. In 2019, health care premiums as percentage of compensation represented 28.5% of compensation for families in the 20th percentile of earnings, compared with only 3.9% for families in the 95th percentile. Maybe not the one you want to skip the article for. On another note Asian Americans are skinnier than White Americans even adjusted for on BMI so obesity is ruled out.
- SuperNinKenDo 3y ago
  What those other races do have over whites is probably their propensity for Type 2 diabetes though. Blacks and Asians definitely, possibly for different reasons. Not completely certain about hispanics tbf.
ttt3ts 3y ago
The rising costs of healthcare should not be simplified to this extreme. Other huge factors: we are getting older on average, fewer doctors, bureaucracy, transparency, etc. Further, these are heavily entertwined. Been working on costs of healthcare for a while and the laymens simplified explanation of the problem makes it tough at times.
- nxm 3y ago
  + malpractice insurance
iancmceachern 3y ago
Obesity is the symptom. The disease is a bigger, more interconnected subject.
- PaulHoule 3y ago
  It could well be the effect of PFAS, glyphosate, bisphenol A or some other industrial chemical that exploded in prevalence in the last quarter of the 20th Century.
  - teslabox 3y ago
    Good candidates for contributing factors for the obesity epidemic. There seems to have been a spark that set off the obesity conflagration sometime around 1978-1981. The kindling that nurtures this spark had been accumulating since the early 20th century… The chemicals you mention were certainly contributory. https://news.ycombinator.com/item?id=38812171 https://news.ycombinator.com/item?id=38812171
dublin 3y ago
Obesity may be a factor, but it's stupid to think that it has anything like the impact that boneheaded government policy has on healthcare costs. Obamacare was, and is, a disaster, driving up costs while producing worse outcomes. (I've worked as a CEO in a healthcare tech startup since then, so I've got better insight than the average bear.) The vast majority of people actually need those "junk plans" Obama eliminated: Catastrophic coverage plans with fairly high deductibles (which HSAs would handle after a few years...)
- Sohcahtoa82 3y ago
  > Obamacare was, and is, a disaster, driving up costs while producing worse outcomes. I'm not sure I'd call it a disaster, but I will agree that ACA did absolutely nothing to address the core issue: Health care is just too expensive. I crashed my mountain bike in the summer of 2022, broke my arm and scraped up my knee real bad, though managed to put my bike back on the rack on my car and drive to the ER one-handed. They did an X-Ray, confirmed the breakage, gave me an arm sling and a prescription for painkillers, and cleaned up my knee. Total visit was 20 minutes. Without insurance, it would have cost me nearly $3,000. $3,000 for 20 minutes of work between an X-Ray tech, 1 doc, 1 nurse, and 1 person at the front desk. I understand that there's overhead, but I still think that cost was 5x what it should have been.
- jmye 3y ago
  The ACA was a fantastic tool, enabling millions more people to access insurance that will actually pay things. If this is your analysis, my assumption is that you work in a healthcare adjacent world like BNPL and don’t actually have even the vaguest understanding of what the ACA is, does, or includes. We can start with the simple fact that catastrophic plans still exist and that they actually cover things, now. That you think they both don’t exist and we’re somehow better before defies belief.
  - gausswho 3y ago
    Catastrophic plans are only available for those age 30 or below.

gumballindie 3y ago

In the UK you get to pay both public and private healthcare. Both of low quality. Private health care relies on “virtual appointments” and usually leads to mis diagnostics. It will get worse with ai.

lurking15 3y ago
> It will get worse with ai. I've had to self-diagnose and then just plainly guide several of my doctors, even specialists, on diagnostics (for evidence) and subsequent treatment. I've had some really lame infections and things going on, and most of my GPs over the years would just pin it down to anxiety or blindly prescribe antibiotics (made things much worse). I've lost all faith in the average doctor's expertise, so I expect AI must be better but at the same time realize the whole system gets inexplicably worse as a human being on the other end, despite advances in technology.
- gumballindie 3y ago
  Ok, so you've received low quality health care and you think a hallucinating bot is the solution? What if we, you know, start hiring competent people? Or change the system to allow them to become competent?
  - lurking15 3y ago
    > What if we, you know, start hiring competent people? I've seen enough doctors at this point in completely different specialities and they're all reliably pretty bad. After so many years of education and experience. To me this backs-up another common sense fact: experts often suck and persist in their error because they've built an entire toolbox of sophisticated mental tools that are able to support their erroneous thinking. To me this is why experts of all sorts are often in the position of arguing "don't believe your lying eyes" to normal people.
- LeafItAlone 3y ago
  > I've had to self-diagnose and then just plainly guide several of my doctors, even specialists, on diagnostics (for evidence) and subsequent treatment. Being involved in your own treatment is very important. In my opinion, it’s folly to expect your doctor to know everything. I can read descriptions of similar diseases and problems and be able to compare my symptoms. You generally know your body better than anyone.

PaulHoule 3y ago

... but it's not like they're just stealing the money from you, you are getting health insurance, which has a lot of value. There's another story going around that if you add benefits like health insurance not to mention programs like food stamps the gap between rich and poor hasn't increased as much as you'd think otherwise.

dublin 3y ago
No, it has little to no value at all until something really catastrophic happens to you. Paying thousands of dollars a year for a "free" annual checkup is NOT delivering "a lot of value". It's been much more of just a money pit. Over my career, I am upside-down on my healthcare costs to the tune of six figures - and that's after kidney stone surgery some years back...) I think I'll pass on succumbing to cancer to try to recover a bit more, though...
- mikeyouse 3y ago
  It's tax time now so I get a wonderful breakdown of how much my company paid for my and my family's insurance (over $25k) and I also get to put together how much we spent out of pocket on health services (over $5k for a bog-standard pregnancy). If this is supposed to be some sort of bargain or good deal, I'm missing it. In the decade prior to this, my total premiums must have been over $200k for literally no usage.
  - LeafItAlone 3y ago
    > In the decade prior to this, my total premiums must have been over $200k for literally no usage. You’ve just described insurance. If everyone took more than they used, it wouldn’t work.
  - Sohcahtoa82 3y ago
    I think you're fundamentally misunderstanding what insurance is, or just refusing to acknowledge it. It's not pre-paid care. It's not a discount plan. Really, it's a gamble. Health insurance is ridiculously expensive because health care can become ridiculously expensive. Sure, you're healthy and accident-free, but the costs of a traumatic accident or long-term illness could easily reach 6, possibly even 7 figures in the long term. That's what your insurance is paying for. For any type of insurance to work, you need people that aren't making claims to fund the people that are making claims. If you take the attitude of "Why should my premiums pay for someone else's care?", then really there's no reason to even get insurance. Your insurance is costing $25K/year, because statistically, the average family has at least $20K in healthcare costs per year (Assuming the insurance company is satisfying the ACA requirement of 80% of premiums must go to paying for care). Your $25K/year in premiums is a bet that you won't need some $Y to pay for healthcare, where $Y >>> $25K. Most of the time, you're losing that bet, and the insurer is making $25K off of you. But if you ever find yourself in a world of hurt (quite literally), you'll be glad you made the bet.

jl2718 3y ago

1. No negotiated rates. 2. No employer mandate. 3. No special tax treatment. 4. No individual mandate. Crazy idea: Convert Medicare, Medicaid, and SSDI to universal medical loan insurance.