The point of health insurance is to pay into a risk pool as a collective so that the small percentage of people who end up needing the largest percentage of health care, nobody dies or goes into monumental debt. This can be done via taxes but insurance is a private market solution which should in theory make it more efficient for the sake of maximizing profit.<p>So then if it's supposedly more efficient, why do I waste multiple hours dealing with insurance bullshit literally every few months?<p>Start a new job at a startup, need to go to trainings to understand the health care options and choose one, get new cards and website logins, update my info at every provider<p>New dentist is having difficulty getting my routine care billed to insurance and calls me every week asking for my insurance information again.<p>Wifes doctor didn't do something correctly when I updated insurance so now I need to call and deal with this big medical bill that I shouldn't have gotten.<p>Startup got acquired so I get another training for the new insurance options. And get new cards and logins and update with all providers again<p>Planning to get a surgical operation but nobody can tell me how much it will cost, doctor says "probably whatever your deductible is" except I have a high deductible plan so is it really going to cost me $2500?<p>Etc cetera. There's no end to the nuisance. If I could choose to just pay more in taxes (hell I'll pay way more than my current premiums) and never deal with insurance again, I would do it in a heartbeat.
When I quit my job in SF in November 2017, I had $1200 on my FSA. When I switched to COBRA, my FSA account kept its balance, but my VISA card associated with it immediately and unexpectedly stopped working. I was seeing a psychologist at the time and it was awkward when I didn’t pay him right away because I thought it would be fine to try and fix my card and pay him the next day (which I did). It felt awkward enough to me that I stopped my therapy sessions with him, because I felt like it had become strained. Anyway, the company stopping my card from working was intentional. It was the same company and the same account but my card didn’t work anymore and I had to go through the trouble to submit a claim, and they acted like this was by design that my FSA card would stop working when I quit and switched to COBRA.<p>Now I’m working remotely and am in a new state (Florida) and not sure I’ll stay here long enough to switch everything to this state. I needed to get a fever checked out and ended up paying out of pocket because I was told over the phone that they accepted my out of state insurance, but when I got there in person, they didn’t.<p>What a mess.
Health insurance in the United States is a shit show. The Medicare for all that Bernie is proposing is a reaction to the inability of Congress to meaningfully fix the issue.<p>I personally would prefer a market based approach to fixing the issues with obtaining medical care, but Congress can't do anything because there's just too much money and influence involved.
One of the fundamental reasons why I haven't really bothered doing startups or running a small business myself is the radical uncertainty over health insurance for myself and my family. It's not just plain $$$ and career risk, it's the "suppose you will go bankrupt and your family has permanent medical issues now" risk. That game is for the wealthy or healthy single people<p>In addition, each insurance plan has slightly different doctors that sign on, so when there are changes, you might wind up needing to use different doctors or worse, health systems.<p>It'd be much better for me, personally, to require providers to all accept some US Public Single Payer plan (or whatever you call it) as part of opening a practice and seeing patients.<p>(I don't speak in any sense for my employer, who is in the health care space: this is just an engineer's personal musings)
The fundamental problem is no body knows the cost of anything beforehand. Neither insurance company not doctors tell the cost of the care. Its really frustrating ! The first step to fix the problem is getting the cost of the care transparently. Without this i am not sure how any of the scheme works whether it is done by govt or private insurance companies !
it's a shit show. I had "great benefits" at my last job accept when i needed them<p>1. when something happened and i needed physical therapy it turned out my copay was like 6k so i just DIY my own therapy..<p>2. when changing jobs i had a month gap, so i bought COBRA and 3 things went wrong.<p><pre><code> a. it cost $1300 for a month of coverage (even with a 2k deductible)
b. since my last day was before a weekend, they actually covered my only until that same day next month, so i still had a gap of coverage (might be my employer but still sucks people have to be faced with this bs)
c. when i did go to a routine physical healthcare provider still denied the claim and i was sent a full bill. after hours of calling it turned out they initially rejected it, but then accepted months later and i was left with _*some*_ expenses ?!
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all this BS while dealing with expensive benefit package.. i can only image what self employed people must go through..
I don’t understand why the article uses labor turnover or health plan churn. Why would that be relevant to the original bolded premise that people like their better coverage sponsored by employers?<p>If I leave a job or get laid off, usually I’ll get a similar job that has similar insurance. Now maybe you could argue that there’s a big risk of an insurance gap or that something like COBRA is unfairly priced, etc., but that would have more to do with unemployment insurance and virtually nothing to do with the basic structure of health insurance.<p>When I “churn” in the insurance market, it is almost always going to be a super short-term switch from Insurance A to Insurance B (both via employers) where A and B are incredibly similar.<p>That seems perfectly consistent with saying that people love employer-provided insurance quality. The employers have to offer the same high quality insurance everywhere, or else people won’t switch. As a result, they <i>do</i> provide the same high quality insurance everywhere, to ensure insurance is not a sticking point that creates job movement friction.<p>Of course there are outliers offering bad insurance and classes of labor like Wal-Mart retail staff that get screwed by deliberately bad corporate actors, and I’m sure anybody reading this with a personalized anecdote will angrily try to refute me.<p>But in the aggregate, these are exceptions, and most people like their insurance for the most part and find that almost all possible employers (for them) offer such a nearly fungible set of insurance plans that they can churn jobs without significantly worrying that the insurance they like will be very different at company A vs company B.<p>There could be many arguments for nationalized healthcare, but this article seems pretty much wrong from its main thesis. People “keep” the private insurance they like all the time, because “churning” the coverage is not at all similar to giving up the coverage or making concessions or compromises for the next plan of insurance you accept from an employer.
These numbers are super misleading. 72% were continuously enrolled, but 16% switched to a different employer plan! We don't know how many of those were the same employer or if the spouse just had access a better deal that year or what. Either way, 88% were covered by their employer plan. 12% is entirely different from 28%. We all have to do open enrollment, but that's entirely different from losing coverage and finding something new!<p>I'm totally on board with Medicare-for-All but we don't need smoke and mirrors and misleading statistics.
Pelosi is a moron who doesn't even know how the current insurance system works. Of course people lose their insurance. And ACA insurance often doesn't cover the same things as the employer-based insurance. If people need to get on Medicaid, they need to wait months before it starts, months without coverage. Everyone needs healthcare and few people can afford to pay the exorbitant costs of it in this country. And of course, if you get injured on the job, you have to fight a whole different system that shouldn't exist either. Of course Pelosi has her own insurance and plenty of money so like so many rich assholes in congress and elsewhere doesn't care and doesn't want to improve healthcare coverage for the rest of us. Let us get sick and die. Even with insurance this is often the case. Pelosi's a moron on this issue and many others. She's almost as clueless as the Republicans who get off on kicking people off of Medicaid and watching them get sick and die. How can the US even be considered a developed country anymore when we let our own people get sick and die so a few rich assholes can get richer?
Am I correct in understanding that Medicare for All plans to abolish private insurance? I prefer there be a system where you can get private insurance if you want, but if you go without you are automatically on Medicare.
One thing this article doesn't discuss: at least some of the times where I "lost" my employer-sponsored insurance (either because I switched jobs or because my start-up decided to switch providers), it went to something better than what I had before, and most of the time it was a change that was a matter of indifference (from one major plan provider to another where everything was pretty similar). In most universal health care proposals I've seen, "leaving," isn't really an option, you're just stuck with The Healthcare Option.<p>Whatever the merits of the more general arguments for or against, it seems like we should at least not put a finger on the scale.
If you want a good example of government supplied health insurance, go to your local VA hospital, and see if that is the kind of health care you really want.
Medicare-for-All is some sort of "far left" fantasy in the United States, but single-payer healthcare is center-right dogma in every other developed country. I have no idea why this is so hard for the American right to grasp: single-payer healthcare is a social program, but it's not the same as socialism. We aren't trying to steal the means of production from you in some sort of revolution, we just don't want people to die from preventable things. It is entirely possible to have a single-payer healthcare system alongside a thriving capitalist economy. This sort of foundational public service actually makes economies better, not worse. It's not a burden on the market to have healthy workers.
Yes, people do lose their insurance constantly when they switch jobs...and then immediately sign onto their new plan. Is the argument that switching insurance plans is stressful? What's stressful is remaining uncovered. Switching plans is hardly comparable to the transition to a Medicare-for-all program.