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Comment by yesco

2 days ago

To throw in a data point on this for reference, as an American I pay around ~$220 a month (~$2,640 per year) on health insurance through my job, this comes out of my pre-taxed income. While I won't get into specifics on the details of the terms, I am quite happy with it.

I work in Massachusetts, but I live in New Hampshire. I pay more than double this on both Social Security fees & Massachusetts income taxes, which are non-deductible since New Hampshire has no income tax and makes up for that with higher property taxes (housing is cheaper though). Filtered to just health related services I can easily identify, in total I pay for Social Security, Medicare, and indirectly Massachusett's state healthcare (which I can only gain access to under limited conditions). Of these, only the private insurance fee directly benefits me, and I have little faith social security will actually pay out when I reach the qualifying age.

In terms of investment my HSA, and 401k are a much better dollar for dollar investment for my future finances than any government service, so I find it extremely unlikely I would ever truly benefit from public healthcare.

Despite my tone here, I'm more annoyed than upset about this. Due to the overall societal benefit, I'm not entirely against public healthcare depending on the details, I'm just under no illusion that it would be to my benefit, and I'm not much of an outlier. I'm also mostly convinced the root issue here is the inflated cost of healthcare rather than just the insurance aspect, public healthcare naively implemented would likely turn into yet another government subsidy for hospitals to devour imo.

> To throw in a data point on this for reference, as an American I pay around ~$220 a month (~$2,640 per year) on health insurance

Having just filled my annual benefits selections tonight, here's my data point: health insurance is $3000/month on the company plan (36K/year).

Yes, the company "pays" for a percentage of that. But of course the entire $3K/month is part of my total compensation cost to the company. If healthcare wasn't so ludicrously expensive in the US, they could afford to pay me more, instead of funneling all this money to insurance company profits.

  • Insurance companies don’t actually make very much profit. I don’t recall the exact number, but something like 80-90% of premiums taken in are paid out in claims. Insurance companies are an easy target though, since no one wants to go after the doctors and hospitals for charging too much.

    • > Insurance companies don’t actually make very much profit.

      Insurance companies usually (maybe it's always, not certain) are regulated to a percentage cap spent on categories. What is the result? They are incentivized to push prices ever higher as much and as fast as possible because a % of higher price is more profit for them.

      > Insurance companies are an easy target though, since no one wants to go after the doctors and hospitals for charging too much.

      Doctors and hospitals actually provide a valuable service, they provide health care. They deserve to be paid.

      Insurance companies provide no value whatsoever, they are just a middleman siphoning off profits off the work of doctors (and nurses and everyone else doing the actual work).

      Also, doctors don't actually charge that much. When I get billed $980 for a 15 minute doctor visit (as I just was last month), it is most certainly not because the doctor is earning ~$4000/hr. That doctor isn't paid more than your average senior software engineer (in Silicon Valley anyway), all the rest of the money is lost to middlemen who didn't contribute anything.