Comment by leetcrew | Hacker News Reader

Comment by leetcrew | Hacker News Reader

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the uncertainty around the cost of healthcare makes universal healthcare a hard sell for a rational, mostly self-interested voter with a decent job. to get to "yes", you need to convince this voter that their additional tax burden would be less than their current healthcare costs. comparing US insurance premiums with european per-capita costs doesn't do much unless you can explain why this would be different than all the other public services that are way less efficient here than overseas.

take me for example. I have no idea how much my employer contributes to my premiums. the only way I can think of to estimate the cost is to look up typical pricing for comparable ACA plans. if we switched to universal healthcare, I have no way of knowing what fraction of those premiums would be tacked back onto my salary versus simply pocketed by my employer. all I know is that things are currently okay for me, and as long as I do the in/out-of-network dance correctly, my exposure is limited to my out-of-pocket max. outside of ideological/moral concerns, there's really no incentive for me to rock the boat.

That gives me an interesting idea. What if employer provided health insurance was outlawed? Once people see the real costs of their coverage, I feel they'll all be all in on reform of some kind.

interesting idea, but probably even less viable than full universal healthcare politically. individual rates are not really the true cost of insurance. they're just the rates you get when you can't negotiate as a group. you would lower the standard of living for pretty much everyone with a full-time job and give them nothing in exchange.

Employers don’t get lower health insurance premiums because they are big enough to negotiate. They might get them if they happen to employ healthier people than average and if the employees are on the younger side, hence experience lower healthcare costs.

Employer provided insurance should be outlawed, and everyone should be forced to go to healthcare.gov. Then there would be enough lived on the marketplace for competing insurance to stay in business and the more competing insurers there are, the more pressure there will be to keep premiums lower.

> I have no idea how much my employer contributes to my premiums. the only way I can think of to estimate the cost is to look up typical pricing for comparable ACA plans.

Code DD in box 12 of your W2 shows the cost of the health benefits from your employer.

it does not on my W2. for whatever reason, my employer is not required to provide this information.

They are only a few unlikely scenarios where they don’t have to:

https://www.irs.gov/affordable-care-act/form-w-2-reporting-o...

> The Affordable Care Act requires employers to report the cost of coverage under an employer-sponsored group health plan. Reporting the cost of health care coverage on the Form W-2 does not mean that the coverage is taxable. The value of the employer’s excludable contribution to health coverage continues to be excludable from an employee's income, and it is not taxable. This reporting is for informational purposes only and will provide employees useful and comparable consumer information on the cost of their health care coverage.

there's something about it being optional for:

> Employers required to file fewer than 250 Forms W-2 for the preceding calendar year (determined without application of any entity aggregation rules for related employers)

I'm guessing it's that; pretty sure we have less than 250 employees in the US.

Doesn’t the US government already spend more per capita on healthcare than any other developed nation? Surely it would just be cheaper by cutting out the parasites.

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