

The Health Insurance Marketplace is coming soon - shire
https://www.healthcare.gov/

======
mjn
This looks a lot nicer than the websites I had to deal with last time I bought
individual insurance on the open market (2010). Will be interested to see how
the presentation of plan information is when it becomes available, since that
was the second-worst part of the old experience [1]. Hopefully they'll get it
right and lay out the choices in some kind of understandable and transparent
way.

[1] The worst part was the scammy "comparison" websites, who presented
themselves as third-party information aggregators, but often turned out to be
stealth affiliate-marketing fronts for a small subset of companies.

~~~
300bps
It looks nicer than my.company's website for open enrollment. Since Obamacare
was enacted, I've gone from a PPO that pays for just about everything to a
HDHP that only pays for catastrophic things. But at least the price of the
coverage only went up 28% for the vastly inferior coverage.

Two of the provisions that are in place already that really raised the cost of
the vast majority's health bills are having to cover pre-existing conditions
and cover students well into adulthood.

~~~
Weltan
That's one of the reasons why subsidising and regulating private health
insurance is not a good approach. If the government worked the way it was
supposed to (rationally), then they would have voted for a public insurance
option. They went half-way, and everyone will now pay the price.

~~~
yummyfajitas
300bps is complaining about the fact that as a person with a low actuarial
cost, he is being forced to subsidize others with a high actuarial cost. I too
share this complaint - I wake up and hit the gym from 8-9:30 every day - as a
reward for taking care of myself, I'm obligated to subsidize diabetes
treatment for people who wake up and eat donuts.

How would a public insurance option change this?

~~~
yequalsx
It wouldn't change that and this is a good thing.

Part of being in a society is shared responsibilities. I subsidize the
education of other peoples' children by paying taxes that fund k-12 education.
I have no children of my own. But I'm not being cheated because a society that
has universal, free k-12 education is better than one that doesn't. Similarly
a society that has free, universal healthcare is better than one that doesn't.

In the current system the U.S. spends around 40% more GDP per year on
healthcare than any universal healthcare system and has much lower outcomes
than many. The evidence is that it would be cheaper and better to have a
single payer system.

It's great that you workout and lead a healthy life. What are you doing to
counter genetic defects you may possess? Perhaps you have a predisposition to
cancer or some rare disease that is expensive to cover. The reward in a single
payer system is that everyone gets covered regardless of genetic or life
circumstances.

Every person for themself makes us all(almost all!) poorer.

~~~
ahallock
I agree with the shared responsibilities, but you make it sound as if you are
voluntarily subsidizing other peoples' children when in fact you are forced
to. If you would contribute to the education and the health costs of others,
why do you need to be forced to do it? And if people agree with you, they will
do so without a gang of people coercing them to. So cut out the middleman.

> Similarly a society that has free, universal healthcare is better than one
> that doesn't.

That's a pretty broad, unsubstantiated statement. And how is it free? Nothing
is free; that's just propaganda.

~~~
yequalsx
We all know that nothing, ultimately is free. However, the colloquial usage of
the term means free means that the person receiving a free service means they
don't fork over money specifically for that service. Free healthcare means, in
essence, a person receiving it is not in danger of going bankrupt or of having
significantly less money as a result of the care.

I did not make it seem like I pay for k-12 education voluntarily. the opposite
is true. It was an essential part of my point that it isn't done voluntarily.
It should be forced because some greedy self-centered person will refuse to
pay for it. It's called the free rider problem.

Societies that don't have free, universal healthcare overwhelmingly have worse
health outcomes, and are crappier places to live.

~~~
ahallock
I find it funny that the person using force is calling the other people greedy
and self-centered. You are being self-centered by acting like your ideas and
needs trump everyone else's to the point of being mandatory. I'm sorry, they
don't. If your ideas are good, you will get support. You can put down the
guns. If you have kids and think that education is important (I agree), then
work for it and get support from those around you. I know it's not easy as
pointing guns at people via the State, but I don't think k-12 education is a
hard sell.

~~~
showerst
The problem is, at some point it becomes the _individual's_ best interest not
to pay for education, but it's in _everyone's_ best interest to have more
education. This is a classic collective action/free rider problem.

So you if your ideas are good, you get support from your neighbors, and you
get your idea moving, so the benefits start to accrue. Then the situation
changes so that education 'exists' whether you individually pay for it or not,
so you need to put in some penalty for not-paying otherwise the system falls
apart when people start acting in their best interests... and next thing you
know you've ended up with governance.

------
joshmn
Nice government website? Impossible.

Nice government website with an API? Get out.

[https://www.healthcare.gov/developers/](https://www.healthcare.gov/developers/)

~~~
yummyfajitas
All the API does is return healthcare.gov advertisements in json format.

I'm a little less impressed.

~~~
jonknee
What else could it return other than the content of healthcare.gov (that you
apparently designate an advertisement)? That the government recognizes the
value of an interchange format like JSON is quite a good sign. They even have
CORS setup so that you can include stuff client-side.

------
dangrossman
This site's source is also on Github, and they've pledged to keep the
repository up-to-date with the site --
[https://github.com/CMSgov/healthcare.gov](https://github.com/CMSgov/healthcare.gov)

------
jerrya
That's actually a very nice website, and quadruply so for being a government
created website.

~~~
cheald
Of course, my question is how much we paid for it.

~~~
jerrya
Well, I was trying not to be negative, because often HN is accused of just
being 99% negativity, but yeah, I was thinking just that.

Philip Greenspun wrote a post about that sometime back.

[http://blogs.law.harvard.edu/philg/2012/09/15/californias-
st...](http://blogs.law.harvard.edu/philg/2012/09/15/californias-state-
government-builds-itself-a-327-million-web-site/)

~~~
bcoates
Kind of a cheap shot: This website created in compliance with a law designed
to increase insurance industry control over medicine is overpriced, therefore
we should remove one of the last remaining restrictions on that control.

~~~
yummyfajitas
How is prohibiting competition a restriction on insurance industry control
over medicine?

That's like saying medallion cabs have too much control on taxi service,
therefore we should not remove restrictions which keep Uber and other
competitors out of the market.

~~~
bcoates
The only "prohibiting competition" rule is that currently insurance companies
have to create plans for each state they want to operate in, and those plans
have to follow the laws in that state.

Since not every state insurance commissioner is captured by the insurance
industry, this is a big problem for them so they're heavily lobbying the feds
to create a situation where insurance policies are regulated by the state the
company is based out of.

This will let them set up an operation like corporate governance and consumer
lending have, where one of the most corrupt states like Delaware sets up rules
that let insurance companies do whatever they want.

------
joshuaheard
We have a health insurance marketplace already. The headline should read:
"Government run insurance coming soon".

~~~
jerrytsai
This is a common MISUNDERSTANDING, unfortunately. The insurance in the
exchanges is still "run" by HEALTH INSURANCE COMPANIES. Where government
enters is:

(1) To allow people to compare apples to apples by having, in the exchange,
groups of plans that offer the same coverage.

In the current individual insurance marketplace, it is basically impossible to
compare policies because they all differ on many different details, and
finding out those details is a laborious, unrewarding, and confusing slog.

(2) To make sure that the plans in the exchanges would be considered insurance
to a rational person. Right now, the individual market has a lot of low
premium plans (i.e., plans for which you don't have to pay very much per
month) which are next to useless when you actually NEED the insurance, because
they don't cover very much at all. The idea is to maintain minimum standards
of coverage so if you ever are in a situation when you really NEED insurance,
you actually will HAVE insurance.

------
elchief
The Health Insurance Marketplace is coming soon...as soon as Martin Fowler and
Uncle Bob figure out how to breed.

