Does your employer pay for your health insurance in the US? 🏥

Nick Karnik on October 14, 2018

Most of us in the US who are in the software profession are lucky because employers provide health insurance plans and other benefits. On the ot... [Read Full]
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I worked in the health insurance billing industry as a software developer for about 6 years before leaving that industry. I found the amount of regulation, waste, abuse, fraud, you name it, staggering. It only heightened my dislike of government run one-size-fits-all solutions to the situation. It also made me strongly distrust the big insurance companies who engage in rent seeking on a massive scale.

If there is a good solution(s) it has to be small and local. The US is too big and too diverse for the same solution to work well nationwide.

 

The problem with "small and local" is that the smaller your coverage-pool is, the less leverage you have in negotiating payments.

I read an interesting article, recently. My first thought, at the end of reading it was, "when you represent 10% of the households in a given jurisdiction — 20% when you consider the typical percentage of people covered by insurance — you're going to have leverage to work against the extortionate practices of for-profit hospitals, pharmaceuticals, etc."

Bargaining-leverage is directly proportionate to how much money you control. It's why Centers for Medicare & Medicaid Services can pretty much dictate pricing. It's also why (prior to ACA), so many employers reduced or dissolved their coverage for employees with each passing year. Arguing for "small and local" really only makes sense if all of the bargaining players are "small and local". Pharmaceutical companies are neither small nor local. Fewer and fewer hospitals are "small and local".

While, like most people that have grown up in post WWII America I have a near-reflexive aversion to things labeled "socialism", I'm also pragmatic. As such, I'm able to recongnize that single-payer style systems at least create a degree of peerage among the negotiating parties (service-providers, pharmaceuticals, and representatives of the medical consumers). You can see this illustrated in many places:

  • Compare a given medication's price in the US versus Canada
  • Compare a given medical procedure's price in the US versus other countries
  • Even containing your comparisons to within the US - or even just a "local" area - you can see it in a given medication's or procedure's price for an uninsured person, a commercially-insured person or a government-insured person (if you're insured, you can see some of this just by looking at any given EoB you receive by looking at the physician/hospital's billed-price and the negotiated-price)
 

Would you mind to somehow mark this sort of questions with #defaultcountry or like tag?

FYI: there is the world outside of US where these problems are either nearly solved (Europe) or far worse than you could even imagine.

 

Thanks for pointing that out. I was thinking about somehow highlighting that and was playing with the content/tags and got trigger happy and published! I'll make a change to reflect that.

 

Have European companies managed to solve this issue for remote workers?

 

Oh, that's right, it works similarly within the EU. I suppose most of them set up shop in the US to be able to provide health insurance for US employees.

I honestly think that’s none of companies’ business. Social protection for the citizens is the first and main duty of the government.

It should not matter whether one works for the Giant or is homeless. Luxury services—well, yes, maybe. But not the base healthcare.

AFAICT, the vast majority of those willing to work for Europe employers in CS/IT do indeed move across the ocean. I had never heard of anyone living in US and remotely working for Europe.

I agree that the government should provide that protection. That's something I'm hoping will change in the US in my lifetime. In the meanwhile, I'm exploring relocating to Canada.

I've run into several people who work for companies in the EU and live the US, but I never bothered to ask them about this. I'll have to do that next time.

Often, the expense of covering health insurance in the US is similar to the cost of hiring an additional employee in the EU. That makes no economic sense for them!

 

My employer in the United States supplements my health insurance costs. First, they do this through the group plan. Second, they pay about 50% of the price. For my family of 4, I pay around $1200/month. We have Blue Cross and Blue Shield as our provider, but there are so many issues with them dropping coverage for what we need it's very frustrating.

I have been seriously considering moving to a different country where these problems are being taken care of. That is a different discussion I want to have, being able to find people who did relocate countries. The thought is exciting and terrifying.

 

My employer pay's a portion of health insurance coverage, it may even be full coverage if only for covering yourself - but I have a family so :3

All that being said... single payer FTW gogogo fite me!

 

I'm in California, and my experience has been an employer will pay for most of your insurance. Typically I end up paying an extra $200 each month for insurance.

Adding on a family is a different story. Employers cover a lot less for family members. So I end up paying an extra $400 to cover the wife. If you have kids, add on more. It can add up quickly.

Every employer is different, but ^ this is pretty typical.

 

Most companies I have worked for as an IT person or dev have paid the majority share of health coverage, but I usually paid some. Despite having a family, I have mostly had single coverage for various reasons. So it has not been that expensive.

What I paid was certainly not a debilitating amount like you have to pay. At that point, it seems like it would be cheaper to pay the hospital directly. Except, hospital rates tend to be insanely over-inflated because they are expecting to get negotiated down by insurance companies, and doubly so by medicare/medicaid. I wonder if an insurance negotiating service exists that could fill that gap for you?

There is one other kind of "insurance" that I'm aware of, but it seems only available on a religious basis. I'm referring to medical-bill-sharing services (not technically insurance), such as MediShare. They are considered a stand-in for insurance, probably through the same legislative exemptions for Amish communities, who generally provide for their own health care as part of their way of life. Anyway, if eligible for one of those organizations, that is probably a cheaper option to get medical bills paid.

 

Having moved from Canada to Europe, this confuses me.

Apparently software engineers make more in the states though, so I would say on this topic alone it slightly balances out. Slightly.

 

Perhaps you're right about this for full-time employees.

In my case, I have to work $4k worth of extra hours just so that I can afford to buy insurance each month. If I moved to Canada, I'm assuming I wouldn't have to bother with that extra work because my taxes would cover that benefit. Does that sound right?

 

Not sure on the numbers, but that sounds aboot right, and the wage difference is easily 4k (from what little knowledge & research I have and have done).

Basic health care is covered so you wouldn't have to worry aboot it, full or part time, and the only expenses are for elective surgery and probably a few other things (again, someone else probably knows more). I don't really know the ins and oots because the few times I needed a doc it was just in and oot without thinking aboot it.

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