9 ms·

Yes. It's a hindrance to most life paths that don't involve full-time employment. As someone with a chronic auto-immune condition I'm effectively tethered to an

by brm 13y ago

Yes. It's a hindrance to most life paths that don't involve full-time employment. As someone with a chronic auto-immune condition I'm effectively tethered to an employer or a spouse if I want health coverage. Should I choose pursue an art as my vocation or start a company I'd have to be willing to endure a lag in my insurance until whatever I was pursuing became successful enough that I was eligible to be covered by a trade group or had enough revenue to buy health insurance. Guaranteed, affordable health coverage not tied to an employer or a spouse would remove a incredible burden from my life.

mjn 13y ago
Once the PPACA exchanges phase in next year, will that ameliorate the problems in your case? They seem like they target this case specifically, essentially trying to turn each state's population into a large risk pool that anyone can buy into, rather than having risk pools be employer-tied.
- jjoonathan 13y ago
  You beat me to it! (For those who don't know, the PPACA is sometimes called "Obamacare" although it should be noted that the name is more a result of political maneuvering than the result of particularly close affiliation with Obama.) I still think we should go all the way to single-payer. Other countries have had such success with this model that it's becoming very difficult to argue that it's inherently flawed (rather than the other way around). If the US health industry had to compete directly with any of these systems, it would go out of business tomorrow, since they offer similar care (in terms of outcome rates) at half the price per person. That doesn't even include the effects on entrepreneurship and employment! While the ACA did little to fix the "US health care costs twice as much and doesn't deliver better outcomes" problem, it does have a good shot at fixing the preexisting condition and individual insurance debacles.
  - mjn 13y ago
    I agree it's not really a proper solution. My move from the U.S. to Denmark has been smooth when it comes to healthcare; I've been very impressed at the lack of paperwork and lack of stress over my coverage. But nonetheless I grudgingly supported PPACA, despite it seeming like a mess, because I can't see another way to solve the tied-to-employers issue that's politically feasible, at least for now.
    - jaibot 13y ago
      It may become easier to reform healthcare if/when people see that PPACA doesn't Ruin Everything Forever.
      - zanny 13y ago
        The kind of sentiment that breeds that ignorant opinion is propegated by those that don't want to see single payer because it hurts their profits. The health insurance / for profit hospital / big pharma lobbies are aburdly massive, and like many (most nowadays) industries, they abuse their wealth to exploit faulty political process to see what they want instituted brought into law and to keep advances that invalidate their profit centers from being legal.
        jaibot 13y ago
        If you have a plan to fix the entire American political system, I will happily listen. I just spent 2.5 years working tech in US politics and it did not fill me with optimism. When you have eliminated the implausible, whatever remains, however distasteful, must be endorsed.
        mjn 13y ago
        I recall even Ted Kennedy somewhat later in life commenting that not reaching a compromise with Nixon's health-care proposals in the '70s, flawed as they were, was one of his major regrets, because the end result of holding out for proper reform was that here we were decades later, and nothing had gotten passed at all. The Nixon proposal is an interesting one in retrospect. In some ways it's "left" of PPACA, despite at the time being opposed by Democrats, who preferred a real public plan and criticized Nixon's as a sellout to insurance companies. Although it wasn't single-payer, one of Nixon's proposed compromises would've actually included a public plan as an opt-in possibility (but not the default), reminiscent of the "public option" that more liberal Democrats unsuccessfully tried to include in PPACA.
  - Daniel_Newby 13y ago
    > Other countries have had such success with this model that it's becoming very difficult to argue that it's inherently flawed ... The British NHS discovered that by not feeding hospitalized patients they could realize tremendous savings in food, shortened length of hospital stay, followup costs, etc. > half the price per person Health care spending will dramatically increase under Obamacare. Americans spend a lot on health care as a lifestyle choice. Obamacare is nothing more than an attempt to recreate the housing bubble using health care.
    - tocomment 13y ago
      That sounds interesting. Can you explain more about the bubble angle?
      - Daniel_Newby 13y ago
        Government officials find something popular, promise unlimited amounts of it to get votes, then create a program to deliver it with total disregard for economic consequences. Last decade they bought votes with easy mortgages. After all, even an idiot could see that home ownership was a sound investment. They won two or three rounds of elections with mortgage policy. This decade it is health care for all! Even an idiot can see that health care for everyone is a sound investment. Just look at these scary charts of runaway growth of medical costs. And the votes roll in. In reality, most health care consists of vaccines, blood pressure pills, diabetes pills, and the occassional antibiotics. That gives most of the benefits and costs almost nothing. Most of the costs come from ludicrous end-of-life procedures on old people, most of the rest comes from ludicrous $500k courses of treatments for this like multiple sclerosis and stage 29 recurrent cancer. These are lifestyle choices for well-off people who would rather pay a doctor than leave an inheritance. Trying to extend this lifestyle to every waitress will destroy the economy. It's no different than last decade's plan to put every hairdresser in a $700k mansion.
        deleted 13y ago
        [deleted]
        13y ago
  - MrFoof 13y ago
    Massachusetts already has much of what PPACA provides as "RomneyCare", a.k.a. the Massachusetts Health Connector and MassHealth. It's exactly what allowed me (as a Type II diabetic) to strike out on my own without much concern. I pay ~$430/mo (early 30s, single) for a high-deductible plan with low co-pays from a major carrier with no co-insurance. Do I wish my costs were less? Yes. Is it better than having to be someone's employee? Hells yes. Providing this to the entire country isn't the ideal solution for everyone, but it's a big step in the right direction.
- brm 13y ago
  It will, in theory. In the past I would have been ridered or surcharged into oblivion had I applied for individual coverage. Expanding the pool, implementing some checks on costs, and properly operating an exchange would enable coverage for my condition and prevent me from being surcharged more than 25%? when compared with typical healthy person coverage. That said, we're in an interesting part of the law's implementation. If you live in one of the 26-33(?) states who have currently declined to operate all or part of their own exchange (exchanges in these cases will be operated by the federal government) your state also lost some of the federal funding that was intended for use in spreading awareness and helping people to "navigate" the sign-up and purchasing process of the exchange. The worry thereafter is that if not enough people enroll through the exchanges they may not have enough leverage to keep costs down. Add to this the idea that some state governments are actively dragging their feet with the implementation of anything exchange related (enrollment starts in October and my state has next to no information out there on the process yet) and we get the potential for messiness. In my case, I still dream of single payer. Disclaimer: Typing off the cuff, not a health insurance administrator, etc... *For those interested in more about how the exchanges are progressing, I find the website of the Kaiser Family Foundation to be excellent: http://kff.org/health-reform/issue-brief/establishing-health-insurance-exchanges-an-overview-of/ http://kff.org/health-reform/issue-brief/establishing-health... http://kff.org/health-reform/state-indicator/health-insurance-exchanges/ http://kff.org/health-reform/state-indicator/health-insuranc...
j2d3 13y ago
I'm in pretty much the same situation, and it's absurd and also should be obvious.
- llamataboot 13y ago
  Ditto here. About to run out of COBRA, working fulltime as a freelancer, and unable to get coverage because of chronic conditions.
  - aestra 13y ago
    Hang on until Jan, that's when guaranteed issuance kicks in. http://www.consumerreports.org/cro/2012/06/update-on-health-care-reform/index.htm http://www.consumerreports.org/cro/2012/06/update-on-health-...
    - llamataboot 13y ago
      yeah that's my hope - unfortunately my insurance runs out in oct and I have expensive RXes to get every month, but hopefully I can figure something out
      - aestra 13y ago
        I wish you the best of luck. Check with the manufacturer of your medications to see if they have a coupon program, the other option is to ask your docs for a 3 month supply right before your insurance runs out.
lukifer 13y ago
Everyone who has a chronic condition has heard no shortage of "magic bullets" for treating their condition from strangers, so apologies for being that guy. I've read in /r/paleo that some have managed to improve auto-immune conditions through a modified paleo diet: http://paleospirit.com/2013/what-is-the-autoimmune-paleo-protocol/ http://paleospirit.com/2013/what-is-the-autoimmune-paleo-pro... Anyway, good luck. Hopefully someday our society views health care as infrastructure rather than entitlement, and persons in your situation can start a business without fear.
- deleted 13y ago
  [deleted]

by brm 13y ago

mjn 13y ago

Once the PPACA exchanges phase in next year, will that ameliorate the problems in your case? They seem like they target this case specifically, essentially trying to turn each state's population into a large risk pool that anyone can buy into, rather than having risk pools be employer-tied.

jjoonathan 13y ago
You beat me to it! (For those who don't know, the PPACA is sometimes called "Obamacare" although it should be noted that the name is more a result of political maneuvering than the result of particularly close affiliation with Obama.) I still think we should go all the way to single-payer. Other countries have had such success with this model that it's becoming very difficult to argue that it's inherently flawed (rather than the other way around). If the US health industry had to compete directly with any of these systems, it would go out of business tomorrow, since they offer similar care (in terms of outcome rates) at half the price per person. That doesn't even include the effects on entrepreneurship and employment! While the ACA did little to fix the "US health care costs twice as much and doesn't deliver better outcomes" problem, it does have a good shot at fixing the preexisting condition and individual insurance debacles.
- mjn 13y ago
  I agree it's not really a proper solution. My move from the U.S. to Denmark has been smooth when it comes to healthcare; I've been very impressed at the lack of paperwork and lack of stress over my coverage. But nonetheless I grudgingly supported PPACA, despite it seeming like a mess, because I can't see another way to solve the tied-to-employers issue that's politically feasible, at least for now.
  - jaibot 13y ago
    It may become easier to reform healthcare if/when people see that PPACA doesn't Ruin Everything Forever.
    - zanny 13y ago
      The kind of sentiment that breeds that ignorant opinion is propegated by those that don't want to see single payer because it hurts their profits. The health insurance / for profit hospital / big pharma lobbies are aburdly massive, and like many (most nowadays) industries, they abuse their wealth to exploit faulty political process to see what they want instituted brought into law and to keep advances that invalidate their profit centers from being legal.
      - jaibot 13y ago
        If you have a plan to fix the entire American political system, I will happily listen. I just spent 2.5 years working tech in US politics and it did not fill me with optimism. When you have eliminated the implausible, whatever remains, however distasteful, must be endorsed.
        mjn 13y ago
        I recall even Ted Kennedy somewhat later in life commenting that not reaching a compromise with Nixon's health-care proposals in the '70s, flawed as they were, was one of his major regrets, because the end result of holding out for proper reform was that here we were decades later, and nothing had gotten passed at all. The Nixon proposal is an interesting one in retrospect. In some ways it's "left" of PPACA, despite at the time being opposed by Democrats, who preferred a real public plan and criticized Nixon's as a sellout to insurance companies. Although it wasn't single-payer, one of Nixon's proposed compromises would've actually included a public plan as an opt-in possibility (but not the default), reminiscent of the "public option" that more liberal Democrats unsuccessfully tried to include in PPACA.
- Daniel_Newby 13y ago
  > Other countries have had such success with this model that it's becoming very difficult to argue that it's inherently flawed ... The British NHS discovered that by not feeding hospitalized patients they could realize tremendous savings in food, shortened length of hospital stay, followup costs, etc. > half the price per person Health care spending will dramatically increase under Obamacare. Americans spend a lot on health care as a lifestyle choice. Obamacare is nothing more than an attempt to recreate the housing bubble using health care.
  - tocomment 13y ago
    That sounds interesting. Can you explain more about the bubble angle?
    - Daniel_Newby 13y ago
      Government officials find something popular, promise unlimited amounts of it to get votes, then create a program to deliver it with total disregard for economic consequences. Last decade they bought votes with easy mortgages. After all, even an idiot could see that home ownership was a sound investment. They won two or three rounds of elections with mortgage policy. This decade it is health care for all! Even an idiot can see that health care for everyone is a sound investment. Just look at these scary charts of runaway growth of medical costs. And the votes roll in. In reality, most health care consists of vaccines, blood pressure pills, diabetes pills, and the occassional antibiotics. That gives most of the benefits and costs almost nothing. Most of the costs come from ludicrous end-of-life procedures on old people, most of the rest comes from ludicrous $500k courses of treatments for this like multiple sclerosis and stage 29 recurrent cancer. These are lifestyle choices for well-off people who would rather pay a doctor than leave an inheritance. Trying to extend this lifestyle to every waitress will destroy the economy. It's no different than last decade's plan to put every hairdresser in a $700k mansion.
      - deleted 13y ago
        [deleted]
      - 13y ago
- MrFoof 13y ago
  Massachusetts already has much of what PPACA provides as "RomneyCare", a.k.a. the Massachusetts Health Connector and MassHealth. It's exactly what allowed me (as a Type II diabetic) to strike out on my own without much concern. I pay ~$430/mo (early 30s, single) for a high-deductible plan with low co-pays from a major carrier with no co-insurance. Do I wish my costs were less? Yes. Is it better than having to be someone's employee? Hells yes. Providing this to the entire country isn't the ideal solution for everyone, but it's a big step in the right direction.
brm 13y ago
It will, in theory. In the past I would have been ridered or surcharged into oblivion had I applied for individual coverage. Expanding the pool, implementing some checks on costs, and properly operating an exchange would enable coverage for my condition and prevent me from being surcharged more than 25%? when compared with typical healthy person coverage. That said, we're in an interesting part of the law's implementation. If you live in one of the 26-33(?) states who have currently declined to operate all or part of their own exchange (exchanges in these cases will be operated by the federal government) your state also lost some of the federal funding that was intended for use in spreading awareness and helping people to "navigate" the sign-up and purchasing process of the exchange. The worry thereafter is that if not enough people enroll through the exchanges they may not have enough leverage to keep costs down. Add to this the idea that some state governments are actively dragging their feet with the implementation of anything exchange related (enrollment starts in October and my state has next to no information out there on the process yet) and we get the potential for messiness. In my case, I still dream of single payer. Disclaimer: Typing off the cuff, not a health insurance administrator, etc... *For those interested in more about how the exchanges are progressing, I find the website of the Kaiser Family Foundation to be excellent: http://kff.org/health-reform/issue-brief/establishing-health-insurance-exchanges-an-overview-of/ http://kff.org/health-reform/issue-brief/establishing-health... http://kff.org/health-reform/state-indicator/health-insurance-exchanges/ http://kff.org/health-reform/state-indicator/health-insuranc...

j2d3 13y ago

I'm in pretty much the same situation, and it's absurd and also should be obvious.

llamataboot 13y ago
Ditto here. About to run out of COBRA, working fulltime as a freelancer, and unable to get coverage because of chronic conditions.
- aestra 13y ago
  Hang on until Jan, that's when guaranteed issuance kicks in. http://www.consumerreports.org/cro/2012/06/update-on-health-care-reform/index.htm http://www.consumerreports.org/cro/2012/06/update-on-health-...
  - llamataboot 13y ago
    yeah that's my hope - unfortunately my insurance runs out in oct and I have expensive RXes to get every month, but hopefully I can figure something out
    - aestra 13y ago
      I wish you the best of luck. Check with the manufacturer of your medications to see if they have a coupon program, the other option is to ask your docs for a 3 month supply right before your insurance runs out.

lukifer 13y ago

Everyone who has a chronic condition has heard no shortage of "magic bullets" for treating their condition from strangers, so apologies for being that guy. I've read in /r/paleo that some have managed to improve auto-immune conditions through a modified paleo diet: http://paleospirit.com/2013/what-is-the-autoimmune-paleo-protocol/ http://paleospirit.com/2013/what-is-the-autoimmune-paleo-pro... Anyway, good luck. Hopefully someday our society views health care as infrastructure rather than entitlement, and persons in your situation can start a business without fear.

deleted 13y ago
[deleted]