Re: [LibreQoS] [Bloat] [Starlink] On fiber as critical infrastructure w/Comcast chat

[David Lang <david@lang.hm>]

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On Sat, 25 Mar 2023, Bruce Perens via Bloat wrote:

> On Sat, Mar 25, 2023 at 3:04 PM Robert McMahon <rjmcmahon@rjmcmahon.com>
> wrote:
>
>> My opinion is poor people shouldn't have to pay for insurance to insurance
>> companies, companies that figure figures for a living.
>>
>
> Be sure to be out there campaigning at every election. Really off-topic,
> but IMO the current scheme of health insurance keeps many people from going
> into their own business, and keeps them working for large companies. I'm
> sure that's deliberate. Valerie works for the University, which is the only
> thing that kept me under health insurance - I'm just a consultant.
> California would give me a plan today, but most states would not.
> November's heart attack cost $359K, the insurance company negotiated 60K
> away and paid the rest, charging me $125. Prices aren't going to fall
> unless we get single-payer like most civilized countries. Somebody *does *have
> to pay for health care, though, and the choices are out of your pocket, or
> in your taxes, or through inflation.

History, employer provided health insurance started in WWII as a way for 
companies to get around government wage controls to attract employees.

I've been saying for a long time that if I could pay what the insurance 
companies pay, I wouldn't need health insurance (other than a catesrophic policy 
that didn't kick in until $10k or something like that)

my suggestion (which I spout off when the topic comes up to get more people to 
think about in the hope that the idea spreads) is that if you are willing to pay 
at the time of service (including by CC) you should not have to pay more than x% 
(50-100% could even be reasonable) more than the lowest negotiated price that 
they have with any insurance company (not counting government run 
medicade/medicare, those aren't negotiations)

rationale
1. bill collection is expensive (including the cost of people who never 
pay), so the price that they have to charge needs to account for these losses.

2. the 'list price' is getting inflated so that they can claim that they are 
getting a huge discount (so if the actual cost of the service to the provider 
goes up 10%, and the insurance company price negotiator wants an extra 10% 
discount this year, the service provider just increases the list price by 20% 
and everyone is happy, except the person paying list price out of pocket)

3. the reason for allowing > lowest negotiated prices is that there are some 
legtimate reasons for discounts (volume, directing people to you) that don't 
come into play for individuals. Given that I've seen negotiated prices around 
10% of list price, being able to pay 15-20% of list price is still such a huge 
win that it's acceptable to still be up to double the insurance negotiated 
minimum.

David Lang

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