Americans Face Biggest Increase in Health Insurance Costs in 15 Years

So the solution to healthcare for the self-employed is pansexual polygamy without the sex. Benefits without "benefits", if you will

HSA limit is $4,300 annual, how does that protect against total ruin? That's a hospital trip in a Uber and a few tylenol.

I was going to say. This is probably one of those few things that Bush got somewhat right.

The maximum you can make and receive any subsidy is absurdly low. I don't qualify for any government subsidies yet I'm the one actually paying real income tax.

When I was on the marketplace, I couldn't tell much difference between the metals. I'd pick a network, all the tiers covered only the mandatory stuff as best as I could see; really same deal with all the networks, but different providers. Higher tiers had higher premiums and lower deductables... for me, I just went with bronze because premiums + out of pocket max was lowest; I'm sure there's portions of the curve where care would cost less with a higher tier, but I figured lower cost with minimal use and lower cost with maximal use is pretty good.

IMHO, health insurance makes it hard to do cost control of healthcare. Patients can't do it, because they won't know how much stuff costs until 6 months after service, so they can't really make decisions on cost. Providers can't do it either, they have even less idea of what things cost for patients, and they have an interest in providing more billable care. Insurance companies could do it, but denying care for economic reasons is hard, so they just go with denying care for beuracratic reasons; also, ACA insurers have revenue limits based on ratios to covered care, so covering more things allows them to get more revenue. Even government paid healthcare has trouble because everyone gets grumpy when they can't get all the care available.

In what way were insurance companies limited before the ACA that “Obama” removed? Please be specific. I’ve never heard this take before.

ACA is largely based on Heritage Foundation policy papers. Project 2010, if you will.

The ACA bill was originally a republican bill that Obama agreed and pushed. And then the republicans flipped around and started blaming Obama on their own bill.

That might be more efficient.

But to be clear, you are socializing risk though. You're just doing it a different way, by genetics and age.

Your monthly payment (and what your employer kicks in) are for all those day to day costs. And of course there's the deductible. But people in their 40s to 50s often don't have young kids. Meanwhile, people in their 80s to 60s have more health risks.

So what happens elsewhere is that everyone throws money into the same pot for their entire lives, and your costs are averaged as per above. It's why a single insurer, the government, is perfect for this. And it works for rare conditions that might happen to some during their lives, and not all too.

And typically, for thousands of years, we've had more young than old. So while elderly people do have more issues late in life, they've paid into the system the whole time. And, now there are young people to pay just as they did.

The only downside is when you end up with an age skewed population, such as is happening with the entire planet. It's affecting all health care systems, private or public. The US has this problem too, as medicare is being hit by spiraling costs.

One thing I find really weird, is the need for-profit in the US system. Other systems have that too, sure, but not like the US. An example, the fire department isn't for profit. It'd be insane if so! Why would it be?! Yet, there is private sector work in the fire department, such as all the equipment bought from the private sector, chemical analysis done on debris post-suspicious-fire, and even training in some cases.

Most health care systems around the world are like that. The insurance is public, not for profit. The hospitals too. Many parts of the system as well.

But then some aspects are private.

> So a more efficient system would be one where you selfpay for regular procedures and have insurance for rare, life altering conditions.

This is sort of what a high deductible plan is, which were encouraged by the ACA. After premiums, my first ~$4,000 in medical expenses each year come out of my pocket. Then the next ~4,000 in medical expenses are shared between me and my insurance. Then the remainder is covered by my insurance. The difference is perhaps just what "rare, life altering conditions" means. For a lot of people the cost of medical care becomes untenable not at "oh god I need seven figures in surgeries" but instead "oh god that appendectomy is $50,000 before insurance" or even "oh god I don't have $10,000 to pay for that hospital visit."

What we call insurance is more like a Costco club membership where members get better rates

Usually you tax the ultra wealthy to reign in their influence and limit corruption/lobbying/political spending. That’s how it’s been done non-violently in the past.

But, voters indeed punished politicians that wanted reforms like price transparency or single payer.

Voters consider it bad socialism.

Like Mexico after us, we didn't send our finest.

Yes, the internet advertising machine has been affected negatively when it spams me (and everyone else) thanks to the privacy invading adult verification requirements.

I don't feel sorry for them either, they were always parasites, but I am not sure what your point is or what it has to do with this conversation.