I had a friend try to adopt a baby from china many years ago (1990s). He was rejected. The Chinese thought he didn't earn enough to safely raise a kid. They were using a means test designed for US applicants. My friend lobbied to explain all the things he gets in Canada for free, health care being the big ticket item. The Chinese authorities relented and he was allowed to adopt.
My company would happily hand our insurance premiums over to California in return for not having to deal with sleazy insurance dickwads.
So where would the discrepancy in accounting between that and Canada come from? It seems unlikely that the Chinese government would assume that even Americans buy health insurance retail.
They aren't assuming anything. They know that healthcare in the US is hit-or-miss, that it is normally for people to move between having and not having healthcare throughout a lifetime.
>> The new report highlights that 5.5% of children under the age of 19 were uninsured, largely because of a decline in public coverage.
https://www.census.gov/library/stories/2019/09/uninsured-rat...
1 in 20 American kids are uninsured, not counting the undocumented who don't answer the census. That's ridiculous today but it was even worse in the 90s. That's why the Chinese didn't want to give kids to non-wealthy Americans. Uninsured children are almost unheard of in Canada. Only some illegal immigrant children, but even there they have systems in place.
That's a general complaint that has nothing to do with insurance being a cost you pay out of your take-home salary in the US.
Your anecdote seemed to be predicated on an accounting difference between the US and Canada, that the Chinese supposedly didn't know about. I'm saying that doesn't really exist. The sort of people who adopt would have a job with insurance, but the price of the insurance would not be included in their salary.
In my lifetime, I have been uninsured, insured by my employer, on an ACA (Obamacare) plan, etc. But never been in the situation where I was making a good salary and paying full price out of it for a health insurance policy, like people do with car insurance. Nor have I ever known anyone who did. Of course, somebody probably has, somehow, but it's not common, let alone a norm that some government would assume.
The second group may be unprofitable with lower payments, but the insurer doesn't even want the second group, the profits are from decreased expenditures on the first group.
I’m not arguing those other conditions shouldn’t exist, but rather making the weaker, more limited argument considering “given the arrangement of the insurance market as it exists today, what should the price for that insurance offer be?” In other words, “What should a for-profit insurance company do, acting on their own and immediately?” because I think that’s pretty close to the question they’re facing when setting pricing for individual plans.
I think you’re arguing that perhaps health outcomes should not be funded by private for-profit insurance companies and I’d agree, but while it is, this outcome seems grounded in actuarially sound math.
Is Y’s behavior being on average healthier and therefore less costly to insure?
5.5% of children under the age of 19 were uninsured
Most employers in the US subsidize healthcare, but employees still pay. You usually pay X if you are single, a bit more if you are married, and ~2.5X if you are married with children. Each company has negotiated it slightly differently and it also depends on the specific plan and the state you are in.
but that is not all.
You also pay a co-pay ($15-$50) per visit to a doctor and a co-pay for many prescription drugs. In NYC, a pregnancy with my diamond healthplan cost ~$10k
You also pay a deductible (can be $0 to $5000 or more) where you cover the first $X of the annual payments.
Finally, depending on the state you are in (some allow it, some do not) you also pay balance billing. Basically, the hospital/doctor comes up with some surprise figure of how much you owe, they subtract what insurance paid, and you owe the rest. Usually it is nothing. In the case of more complicated things like surgery, it can be thousands.
I only heard of startups doing this. Outside of that you pay x % for healthcare per paycheck the employer covers some other amount. Healthcare might not be socialized but at least I can always find a new provider if I absolutely wanted one just pay out of my own pocket is the only downside. The subsidizing happens for bigger corps usually and negotations between healthcare providers vs insurance companies. The more clients you have the more effective the negotiations.