[EGreg]

My grandfather used to tell me about a Chinese king who paid his doctors only when he was well, not the other way around.

I used to really dislike private insurance companies but after teaching about Charles Babbage using math for "Comparative View of the Various Institutions for the Assurance of Lives" I realized something:

Insurance companies are the most aligned with your wellness financially. They want as many healthy people to pay in as possible.

And thus a government health insurance system with universal coverage would be even more financially aligned with increasing health.

I think one of the greatest things you can do as a startup is to improve health for people, through diet and exercise apps and preventative checkups etc. and the insurance companies will PAY YOU to do it!

[fictioncircle]

> Insurance companies are the most aligned with your wellness financially. They want as many healthy people to pay in as possible.

That is only true if they are forced to accept people blindly and without screening.

Otherwise, they simply create a screening process centered around removing unhealthy people and preventing unhealthy people from enrolling.

[theseatoms]

If an insurance company can "remove" you when you become unhealthy, then they weren't providing insurance in the first place.

[dzdt]

What do you think happens when insurance is provided through your employer and you develop a health problem that interferes with your ability to do that job?

[openasocket]

In that case, assuming you are fired from your work, you can get a continuation of your insurance under COBRA. See https://en.wikipedia.org/wiki/Consolidated_Omnibus_Budget_Re...

The short answer is you can get a continuation of your same health plan for a certain period of time, but you have to pay more because your employer isn't subsidizing your premiums. Generally this extension lasts for 18 months, though if you qualify for disability it can go for 29 months. And you do have to pay the full price for the plan because your employer is no longer providing it for you, though you may get government assistance.

Also relevant is the Family and Medical Leave Act. Also, if you're unable to do your job due to a medical issue you may qualify for https://en.wikipedia.org/wiki/Social_Security_Disability_Ins... , along with Medicare. And there's regular disability insurance: https://en.wikipedia.org/wiki/Disability_insurance

[DougWebb]

I've gone through this; you should be aware that COBRA is a retroactive continuation of your coverage, from the day you leave your job, but it's not actually continuous. It can take weeks for the paperwork to go through, and during that time you effectively have no coverage. I found this out because I was scheduled for a surgery the week after leaving my job, and while checking in the hospital told me they couldn't verify my insurance. I was delayed about an hour while trying to convince them that I'd applied for (and paid for) COBRA already, and that I was, or would be, covered for the surgery that day. Eventually the department head allowed me to be checked in, but I'd gotten lucky.

[fictioncircle]

Probably worth keeping in mind that many SSDI requests are denied and the process can take 18 months.

So pretty much everyone needs an 18 months of savings + COBRA costs. Even then its quite likely not enough unfortunately.

[theseatoms]

You likely lose your job and your healthcare insurance, at least after some period of time, I'm assuming. (Fortunately I can't speak from experience.)

So you did not, in fact, have insurance against a very bad situation. All the more reason to eliminate employer-based health insurance tax incentives. I don't buy anything else through my employer. Why should I be insuring against my future medical bills through them?

It obscures my effective insurance premia (via a lower salary), on top of the already obscured price of healthcare, since most insurance policies cover so many incidental, non-catastrophic medical costs.

[EGreg]

Single Payer. Medicare for all.

[fictioncircle]

> If an insurance company can "remove" you when you become unhealthy, then they weren't providing insurance in the first place.

Yup, hence Obamacare with mandatory enrollment and the removal of all the tools they used to it. Then people complain about prices going up. :/

[DougWebb]

Therein lies the difference of opinion between the Democratic and Republican points of view on US healthcare. Democrats want a system where insurance companies have to cover everyone regardless of their health, and (most) Republicans want (or have voted for) a system where the unhealthy are off in one pool with insurance they can't afford, while the healthy are in another pool with insurance that's cheap but doesn't cover any actual healthcare.