Ask your Representative and Senators to sign on to HR 676 (https://www.congress.gov/bill/115th-congress/house-bill/676) and S 1804 (https://www.congress.gov/bill/115th-congress/senate-bill/180...), if they haven't already.

The balance sheets of public insuers would also benefit from denying care.

And if your government denies care, there is no higher authority to keep them in check.

Voters?

I'm not entirely sold on the idea of people voting in their self interest anymore.

idk about you but i have a zero premium plan with $2300 max out of pocket for in-network services. all i want is a foolproof way to ensure all my providers are in-network.

How much does that plan actually cost? Your W-2 should include the value of the employer's subsidy.

You're still paying for inflated healthcare costs either way; in a competitive labor market (not always the case but certainly is in SV), reduced benefit costs would be expected to increase cash compensation.

> How much does that plan actually cost? Your W-2 should include the value of the employer's subsidy.

idk honestly, but i would be interested to find out. this is my first year working at this particular form so i will need to wait for my first w-2.

> You're still paying for inflated healthcare costs either way; in a competitive labor market (not always the case but certainly is in SV), reduced benefit costs would be expected to increase cash compensation.

sure, but the employer doesn't pay any tax on this type of benefit, whereas we would both face additional taxes if they simply paid me more.

all i'm pushing back on is the original statement that "people should demand an end to private insurers". people who don't get insurance through their employer and/or can't afford it themselves should probably oppose private insurance. software engineers, who already tend to have company insurance and be in high tax brackets, are pretty unlikely to benefit from any efficiency gains from a national health service. people like this can be wiped out by surprise out-of-network fees quite easily, so it is rational to focus on that aspect.

> sure, but the employer doesn't pay any tax on this type of benefit, whereas we would both face additional taxes if they simply paid me more.

That argument seems like the equivalent of wasting money just for a tax deduction. You are right in a way though: if a single-payer plan is financed through progressive taxation or a payroll tax with no or a sufficiently high cap, higher earners will end up paying more than under the current system while lower earners will pay less.

> all i'm pushing back on is the original statement that "people should demand an end to private insurers". people who don't get insurance through their employer and/or can't afford it themselves should probably oppose private insurance.

Unless you get sick, are unable to work as a result, exhaust FMLA (if available), and can't get coverage through a spouse or parent (if under 26). Then hopefully you've got the savings or disability insurance to pay for COBRA (under which you have to pay the full premium your employer is currently paying) and/or Marketplace insurance in the interim, or you're stuck with Medicaid. Even worse, most Marketplace plans have narrow networks, so you may find that you're not able to keep some of your doctors -- particularly the specialists you're likely to need for an extended illness. Medicaid is even worse, because the reimbursement rates are so low.

And hopefully none of that happens to a loved one, who may not be in the relatively good position you are.

And that's ignoring the moral argument in favor of, well, not allowing people to die in a supposedly first-world country because they can't afford healthcare.

Yeah me too with no such thing as out of pocket maximum for all services, because they’re all in network, because I live in Canada.

How can such a plan exist? Or am I missing something?

You are missing the fact that its basically his employer self insuring, as a form of unpaid compensation. The only thing the insurer is doing is acting as a billing agent.

It’s not self-insurance, necessarily. When OP says “zero premium” they mean (even if they don’t know it) that their employer is paying 100% of their premium.

What they said, I worked for an outfit with a similar plan (lower max. out of pocket, though). They were self-insured, though, and the latest year I have data for, it was about $20K/year for health coverage.

Also worth noting that self-funded plans will have their premiums set based on the plan's actual claims experience, which means employers with a sicker risk pool will pay more. This also encourages discrimination against older or unhealthy/disabled workers, since they statistically cost more. (This is illegal, but it happens all the time and is hard to prove.)

Well, when I was working there, employee premiums where exactly 0, company picking up the entire tab, but I am quite sure that this stuff does happen.

The employer picking up 100% of the premiums (which, in a self-funded plan like this, are paid into the plan trust) just makes this kind of stuff even more likely. If an employee or employee's covered spouse or dependent has health issues requiring $XXX,XXX/year of treatment, getting rid of the employee will directly save the company $XXX,XXX/year. Quite a powerful incentive for scumbags, even if it's completely immoral and illegal (ERISA 510).

Of course. Since the company actually does have some decency (being privately held helps, too) eventually they just decided, as I hear, to simply convert to a (still generous) regular insurance plan.

Granted, the other reason was that because of Pajamacare, health plans that are "too good" get taxed excessively.