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Comment by bluGill | Hacker News Reader

Your [large] employer benefits from the system and wants it to stay.

You cannot get a better deal on health insurance on your own than through your employer. If you want to take a summer off the amount of money you would have to save up to pay for that is much higher. If you are thinking about changing jobs for more money you have to not only compare salaries, but also a complex benefit system that isn't really explained in the job offer.

If you want to see transparent pricing get the employer out. Buy your insurance directly from whoever you want (or maybe from the agent you like). Of course it will take years for things to change after this, don't expect things overnight.

Edit: as others have pointed out, it is the large companies who benefit at the expense of small companies and employees.

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This was one of the many things misrepresented in the ACA debate. ACA, as intended, (and Medicare for all) put small business and startups on a more equal footing with the "big guys", but the "anti" campaign said "oh small business will suffer". Of course most small businesses can't afford to provide health insurance at all right now.

And of course some lobbyist was able to put a stumbling block into the ACA: companies can't reimburse your ACA premiums (they can give you a raise but it's taxed).

As a small employer (< 50 people), I can tell you I hate that it is on me to find and provide insurance to my employees.

It's only huge companies that want this system to remain.

Huge companies don't necessarily want this system to remain any more. Costs have increased to the point that it's now impacting their ability to compete internationally. Their competitors based in other countries can undercut their pricing due to lower employee healthcare costs.

Huge companies are the only ones that have a real voice. Small companies only get lip service.

One layer removed from this - stop giving employers tax breaks for providing insurance benefits, and you remove the infinite gov't money hose from the equation - only then will you get a pricing signal that means something to individuals.

Yes, it's a f...ed up system that pretty much benefits everyone but the patient. Employers have control and providers and middlemen make boatloads of money.

An employer benefits only if you are a big employer with an HR department that can afford to spend time on the BS paperwork. If you're a smaller employer, the overhead and costs are crushing.

For smaller employers, it's better to just tell the employees to go to healthcare.gov and reimburse them for premiums they pay. Less paperwork, and employee gets to pay for health insurance with tax exemption.

Pricing Transparency isn't about insurance. It's about people knowing the total out of pocket expense before they ever agree to a procedure. Emergency medical services only account for 2-7% of medical spending in the US so there's a lot of room for people to shop around for the best price.

> Your [large] employer benefits from the system and wants it to stay. > > Edit: as others have pointed out, it is the large companies who benefit at the expense of small companies and employees.

This is completely wrong. The amount of money that employers have to pay in order to subsidize public insurance (which is the literal reason that prices are not transparent) is orders of magnitude more than what they can quantifiably get from you working that extra summer, or what have you.

Unfortunately, as long as getting health insurance through your employer remains tax-advantaged, people will be unlikely to demand the decoupling of work and health coverage...

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