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In theory shouldn't there be health insurers who are willing to ensure you just as long as you pay your rates?

There are, in actual fact, insurance companies in the US that will do this. Some make it a business to cater to self-employed folks who don't have company insurance.

It's been a while since I thought about this, but (IIRC) the 'private companies pay for insurance' deal got started in World War II, as a perk. Companies could not compete for scarce labor (salary freeze) so they offered basic health insurance to attract workers. From there it just grew.

So why do so many of us accept it, when there are free-market alternatives? I think it's the convenience.

Take my dental plan at work. For about $10 a month I'm covered for all routine stuff at the dentist. Extraordinary work will cost me a bit off the top, but not _that_ much, for the care I'm getting.

Which is pretty much the plan I'd get if I eschewed the work plan and bought one on my own.

The convenience is that work has a team of guys who deal with the insurance companies, getting deals, selecting plans, negotiating rates, basically dealing with a lot of hassle so I don't have to.

Now, I could get a better rate on my own, and I probably _should_ if I were really worried about being laid-off but .. it's just easier this way. A trade-off.

For a lot of us, this is okay: the plans our employers offer are pretty good. For some people, who have sucky employers and rotten plans ... it's sub-optimal.

Having been a contractor previously, I can tell you that the main reason I moved over to being a full time developer for a company (complete with 1.5 hour commute) was that no private plan would cover both myself and my wife, mostly due to various medical reasons associated with my wife that I won't get into here. Suffice it to say that the only way we could get her covered without a ridiculous deductible and per-month cost was for me to get a full time job. She works as the director of a local teen drop-in center and as an HR secretary as a sheet-metal plant, and of course, since those are part time jobs, neither offers any benefits whatsoever. We were previously paying over $500 a month to cover myself and her on two private plans.

There are a lot of holes in the US healthcare system when you're doing something that's not what the majority is doing. I'd say this creates an argument for single-payer healthcare, but that's a debate for another thread. (Plus, I'm a little biased as a Canadian immigrant.)

This comes recommended to me from an email thread a few weeks ago on this topic ...


Not a customer, but the fellow who sent it along is.

Not every system will catch every person. I didn't have a problem obtaining coverage for my family a dozen years ago, but a) it was a dozen years ago and b) perhaps our pre-exisitings were not so bad.

I think it's the convenience.

I think its because employers for large companies get the only reasonable health care rates in the country. If you work for a large employer and you have a way as an individual to get comparative coverage for the same cost ignoring any pre-existing conditions, I'd love to hear it.

If you work for a large employer and you have a way as an individual to get comparative coverage for the same cost ignoring any pre-existing conditions,

Twelve or thirteen years ago I looked into this hard - had a family, had a kid and a wife with a pre-existing condition or two.

It was available and comparable in costs. The biz failed before it left the ground, so I didn't need to go that route.

A few weeks ago this link came into my mailbox, from a mailing list.


Recommended by the originator, who is a customer.

I also see that USAA offers health insurance. I'm a member, I should look into that.

Hm, let me guess: does it work because the employer pools all of his employees, and the insurance can account for that? Like one employee gets seriously ill, but 10 stay healthy, so the costs average out? I think private insurance here in Germany just forms arbitrary pools of people, but the don't just insure anybody. If you have some risk indicators, they won't insure you. Maybe the employers in the US simply have a good bargaining chip, they can say "if you insure our one risky employee, you'll also get to insure our other ten non-risky employees".

That is exactly what happens. There are so many tiers of issues its hard to dissect.

1. Big corporations get much better rates by pooling all their employees together and then negotiating for coverage. 2. The insurance companies pool all their subscribers and use that as leverage to negotiate better rates with the hospitals.

As an individual, you don't get the diversification effect of #1, so you end up paying a premium rate. If you are an individual the system is basically setup to vet you biasing toward no coverage.

Its hard to keep up with the state of the laws in my own country. (US) There are talks of market exchanges to basically give individuals back bargaining power, but I've heard that the insurance industry has managed to hobbel them pretty badly. I'm not sure where we are headed on this issue.

As an individual, you don't get the diversification effect of #1, so you end up paying a premium rate.


USAA quoted me $350.81 per month (same plan provider!) for two adults, two children, one adult 'healthy as a horse', one adult with preexisting conditions.

Just one pass, without shopping around.

That sounds pretty steep - it is - but it's only twice what you could expect to pay for car insurance.

I'll bet if I shop around I could find a deal. Wonder what would happen if more of us did so?

it doesn't seem steep to me, but where you live and your ages are two factors you didn't mention (deductible amount is another factor).

I live in fly-over country, in a drive-past town. Cost of living here is pretty low, all things considered. So I've gotten used to stuff being far less than it cost when I lived in the city.

I wonder if I could negotiate a salary increase from my employer in return for opting out of the plan.

USAA is an exceptionally good company.

I love USAA to pieces.

For years my time in the Marines was good only for memories (good and bad), cynicism, and a career in IT.

Which isn't bad. But then they let me in the club and my insurance cost dropped like a rock.

Plus they're super easy to deal with. Had some hail damage and where my neighbors were fighting _their_ insurance provider months later USAA couldn't get me the money fast enough.

"Overnight .. is that soon enough? We can borrow an F-18 and air drop in about 90 minutes it if that would be more convenient."

Well not that good. But pretty close.

Anything analogous, at least qualitatively, to USAA for folks with no military connections, in California?

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