Hmm, counting the insurance premiums 100% towards the birth of the child is a bit misleading. Presumably, you'd be paying those even if you didn't have the child. That said, the cost of health insurance for a family is pretty outrageous. My premiums are along the same lines as the ones here (although less noticeable since they're paid by my employer).
> Hmm, counting the insurance premiums 100% towards the birth of the child is a bit misleading.
I see your point, but do you not think that if you're a family of 4, having to pay $40K before insurance kicks in is ridiculously expensive, and out of reach for most Americans?
I'd wager that most self employed folks in the US almost never benefit from insurance (except for things covered by Obamacare which come nowhere near justifying the premiums). The deductibles can be so high that you're pretty much always paying out of pocket.
> I'd wager that most self employed folks in the US almost never benefit from insurance (except for things covered by Obamacare which come nowhere near justifying the premiums).
Self-employed here. My wife and I paid $470/month last year, $618/month next year, for a gold insurance plan than has a $3400 deductible with typically a $20 co-pay. It covers 3 prescriptions, therapy sessions for each of us, various older age diagnostic checks, and almost all office visits. In addition, if either of us develops cancer or is hit by a truck, we will not be rendered bankrupt.
i'm 36, self-employed. silver plans in my state are ~800/month next year, with 8k deductible, no out of network coverage at all, with no in-network providers out of my state, so god forbid I get injured while traveling to visit my in-laws. the marketplace is a joke and health insurance in this country is pointless.
> In a controversial decision, health insurance giant Anthem Blue Cross Blue Shield is warning policy holders—in Georgia, Kentucky and Missouri—that they may have to pay for their trips to the ER. The company has developed a secret list of diagnoses that they will not pay for, such as "chest pain on breathing" and blood in the urine, even if the patient thought it was a medical emergency.
> My wife and I paid $470/month last year, $618/month next year, for a gold insurance plan than has a $3400 deductible
That's really nice - are there state/government subsidies involved?
I work for a top tier company and my premiums are not that much lower than yours.
When I checked the public market's insurance options, getting a $3000 or so deductible was a lot more expensive than yours if one is not low income (i.e. not subsidized).
(a) for 2025, federal premium subsidies in effect ($19k/year of subsidy) !
(b) for 2026, NM temporary subsidies
A reminder that until the end of this year almost everyone gets subsidies. Nobody in the US, no matter their income level, should be paying more than 8.3% of their AGI for health insurance. That all changes come Jan 1st 2026, thanks to the current Congress. Our premiums would be $2531/month had NM not stepped in to use some of those sweet, sweet fossil fuel extraction taxes to help us out.
Oh yeah, deductible in 2025 was actually $2800. At our age (early 60s) and general health (good), gold plans make much more sense (if you can afford them).
The problem is the healthcare cost is insane. You will go through $40k after a good injury that may need a major surgery or few smaller surgeries. Average cost for hip replacement is $40k.
I've had a sports hernia and the bill was about $30k.
That's crazy, I looked it up and the average cost for a hip replacement here in the private system in Australia is about $24k (US$16k).
You can get it for basically nothing in the public system but you might have to wait a year or so if it's considered elective (emergency surgery is immediate of course), but most people with private health insurance can get the procedure done within in a few weeks and would only have to pay about $1000 (US$650) out of pocket with a $500 excess (which is pretty common), because the anaesthetist and surgery are usually invoiced separately. Some plans do have lower excesses (like $350) though if you pay higher premiums.
> And what the OP is pointing out is that if your injury is $30K, insurance covers nothing, because the premium + deductible is $40K.
The point of insurance is to mitigate risk. If you think you have enough money to cover your risk, there's no reason to buy insurance.
The sleight of hand here is first complaining that you did not incur enough hazards to offset the risk premium and then citing this as a reason the risk premiums should not exist. Where is the story of the family being weighed down by bills? Or of not getting physical therapy after an injury and having permanent, income-reducing disabilities?
What's under debate is "how much risk." For most people in the US, they'll need help before they hit $40K. They can't afford paying $40K every year for medical and medical related expenses.
Risk is not the only factor. Premium cost is probably the more important one for most. If someone can afford the $40k deductible option, but not the $5k option, you’ll just have to accept the risk. Increasing earnings significantly right now is harder than hoping medical bankruptcy won’t matter in the long run.
30% of US households make less than $50k. That’s more than 100,000,000 people in homes with less than $3.6k/mo for all living expenses. The stories you ask for are simply inevitable
Imagine 2 people get injured in a year, you are now at $60k. Plus, $150 a visit for primary and $300+ for specialist.
My 5 year old has been to the hospital 3 times, stitches once. US healthcare will ruin you if you don't have insurance. A cancer treatment can bankrupt a millionaire.
Had the same reaction when I saw how the 40K was calculated (BTW I strongly believe in Medicare for all to control costs and to pay for civilization. To be paid out of progressive taxes on all income).
If Aaronontheweb had the misfortune of getting seriously sick, required surgery .. he would pay $7,150 for something that could easily cost $100K+++. Saying he's paying premiums just for having a baby really feels like weaselly logic .. so he thinks he or the rest of his family will absolutely never fall sick? What if a cancer diagnosis hits one of you out of the blue (I hope it doesn't, but that's what insurance is for).
The charges you mention are likely all from hospitals. How about Pluvicto for advanced prostate cancer at $42,500 per monthly dose? All the players are in on it.
The sound way to manage costs and avoid these games is via Medicare for all, with premiums paid by progressive rate taxation of income. Maybe even wealth beyond a very large amount.
Based on what? Why even leave this comment if you’re just going to say “would likely be worse off” without giving literally any evidence or even suggestion of why.
Insurance is a pool. The bigger your pool the more you spread the risk/load. It’s brain dead simple. Medical care is a human right, beyond that.
Nothing about our system makes any sense and it is built to pad so many pockets in entirely opaque ways between you and the care you actually receive. Cut out several layers of middlemen and the costs go down. God forbid you have an accident and you end up at the wrong hospital when the one down the road is in-network but the one they took you to is out-of-network and you wake up owing thousands of dollars.
I had pretty good marketplace insurance this year but the plan I’m on now isn’t even offered anymore and if I got the next closest offered plan I’d be paying 6X as much for the premiums with higher copays on top. I’ll be switching to my union offered plan instead which is much better than the new marketplace plan but still worse than the marketplace insurance I had before.
> God forbid you have an accident and you end up at the wrong hospital when the one down the road is in-network but the one they took you to is out-of-network and you wake up owing thousands of dollars.
If you examine the statement of benefits for your plan, you will find that it says something similar to this:
> Emergency Services are covered at the in-network cost-sharing level as required by applicable state or federal law if services are received from a non participating (out-of-network) provider.
> The member is responsible for applicable in-network cost-sharing amounts (any deductible, copay or coinsurance). The member is not responsible for any charges that may be made in excess of the allowable amount.
You’re right. The No Surprises Act did make this a lot better. However it still doesn’t cover ground transport (and specific state laws do in some cases.)
Additionally for post-stabilization care the hospital is going to shove a lot of papers in your face and they’re probably not going to tell you that one of them is the one that says you agree to pay to whatever those services and waive your protection against balance billing. Yes they’re supposed to present it on its own and with your full consent and yes you can dispute that but people sign the forms and then still get screwed.
I think it's telling that people are shocked at the assertion I just made, which is not complicated or outlandish or hard to understand and is in fact backed up by referendum and attempted implementation results for state-level programs. I think two big things are happening that fog people's understanding of this issue:
First, there's a widespread belief that M4A is popular, based on public opinion polling. The problem is that you can make almost anything popular in public opinion polling, and a lot of public opinion polling is deliberately run by interest groups to generate narratives about popularity. It's true: the "M4A" that poll respondents support would be enormously popular: it's proposed as abstraction with no clear tradeoffs. When you confront voters with the prospect of increased taxes and the loss of their current insurance policies, the wheels come off the wagon.
The second big factor is that the demographics of people with employer-provided coverage --- the majority of all non-Medicare covered people in the US --- are not what you'd expect. As soon as you stipulate employer coverage, the cohort you're describing excludes basically all fixed-income and Medicaid-eligible households. The median household income of a family with employer-provided health insurance is closer to $120k than it is to $50k.
For those households, M4A is not a very compelling deal:
* There is a very clear trend in the data for them to already be satisfied with their existing health care.
* The visible component of their insurance spending (their out-of-pocket, excluding employer side payments) is usually quite small compared to total spending.
* M4A would mechanically eliminate the availability of existing plans (unless you came up with a truly weird and distortionate system of tax incentives to keep Anthem and United and Aetna policies going).
Best case: costs that are hidden from those households today become visible, and you hope people are chill about that (in sort of the same way we hoped that people would be chill about inflation given wage increases outpacing it --- see how that went). Worst case, a lot of these households would lose their existing, favored insurance plans and pay more.
Useful here to note that broad taxes on the middle and especially upper-middle class are how Europe funds generous social service packages; you can't get there by taxing the bejeezus out of billionaires. You should do that anyways, just because it's a good idea, but there aren't enough of them to pay the absolutely gobsmacking cost of a single-payer health system in one of the wealthiest large countries in the world.
I'll cop to this: what I wrote last night, about "currently insured" people, was way too vague. I should have said "households with employer-provided health coverage" (again: that's most non-Medicare households). I plead strep throat; you're going to have to give me a break on clarity today.
Sorry but I reject this thinking. You’re essentially saying that Medicare for all is bad because it’ll seem to cost more because the way the money works isn’t obscured so people will be mad and that it has to be worse than their existing policies.
I’m still not seeing how or why it has to be worse. This just seems like an assumption you’re making. Also sure the exact existing policy you have won’t be available by definition because the system has entirely changed but once again if you want private insurance you will still be able to get it, as is the case in other countries with socialized medicine.
Also really don’t see why you would say that the polls that say people want socialized medicine are rigged and not-representative but the polls that you’re saying show that most people with private insurance are happy with it are accurate. Not really sure how that stands to reason.
I really feel like the argument you’re making here boils down to M4A is bad because it has to be worse and people who have private insurance now are happy with their plans and could only have them replaced with something that would be worse. Or even more simply: Change is scary so I guess we’re stuck with the current system and actually people like it so don’t rock the boat.
Also the median income for someone with employer provided healthcare is 120K? I’m going to need some data on that. Also you’re then cutting out everyone with marketplace insurance which is 24 million people.
More people are poised to lose Medicaid and my marketplace insurance plan, if I chose to accept it for next year was going to cost me 6X for the monthly premiums and require co-pays I don’t have before as well as much larger copays for ones I did.
I’m going to be completely honest. I don’t care if people making 120K/year are upset if their visible cost for healthcare is more obvious or not. From 2024 census data 41.2% of households made above 100K annually. That number becomes roughly 33% when you step it up to $150K/year and drops to something like 12% when you get to $200K/year. By the time you get to $400K/year you’re at like 3%.
Also households as a unit isn’t necessarily representative of the distribution of people within them.
I reject the idea that government system are inherently bad and so we can’t have them. I reject the premise that the wealthy will be forced to have worse healthcare to subsidize the majority of Americans. I absolutely reject any notion that our private healthcare as it exists is efficient, affordable and the superior system.
I didn't say Medicare For All was bad. I said a large cohort of existing insured people would be worse off under it. Those are different claims. Whether or not I think it's good has nothing to do with whether or not what I said was correct.
What I think is funny about this is, if I had left a one-line comment saying "this CEO's story about his health insurance costs tells me we all need M4A", nobody would have blinked. Instead, I made a somewhat skeptical observation about it, and got messages demanding I "show my work", or like this one, about how you "reject my thinking".
If people understand and strongly support the policy, they should probably make a point of not being totally bumfuzzled by arguments about it!
Well you can’t prove a negative so I’m not sure how useful a theoretical one line comment about a CEO saying his insurances means we need M4A would be received.
Regardless if you’re not willing to support your argument that’s fine, but at the same time if you’re going to put something out there and and then be upset if other people being skeptical of your skepticism then I don’t know what to tell you.
I still don’t really see how anything you’ve offered necessarily means people who currently have employer provided private insurance plans will be worse off. I especially don’t see it because people with incomes like you proposed the median income for households with employer provided insurance plans often have employer provided private insurance plans in countries that also have a public health system.
I guess maybe here is the meat of it and what matters. How are you defining worse off? Are you defining it based on quality of care/outcomes or in a financial sense? Either way seems pretty speculative to me but I’d be interested to know which (or both) of those you think makes them worse off.
What argument did I not support? The one you assumed I was making, but did not actually make? You still haven't responded to the actual argument I did make.
I agree by the way that a one line comment of “show your work” is not useful or constructive, much like your original one line comment. (I don’t mean that as a slam against you either, I appreciate that you actually followed up with additional information)
I disagree that I’m not responding to your actual argument and am specifically asking you to clarify the terms of what “worse off” means so that I can address it with more specificity or at least understand what you’re saying.
I still think citing an opinion poll to argue that people are happy with their employer insurance while also making an argument about how opinion polling is deeply flawed is a very strange way to back up your own argument.
I have yet to actually hear anything that supports the idea that people with employer provided insurance will be worse off because of M4A other than you saying they the way the costs would be less obscured means people would be more upset. This wasn’t even an argument about the real cost of M4A vs Prost insurance, it was just a statement saying that the money looks different.
Sorry, I can't follow any of this. It sounds like you want to have an argument about whether M4A is better than our current system. I'm not a good debate partner for that.
I skimmed your 2400-word article a second time just now, and I still don't understand why your math is allocating 100% of your family's health insurance premiums to childbirth. And now I additionally don't understand your abrasive tone in answering this fairly straightforward question.
Multiple commenters are raising this point, so perhaps you should consider that you aren't conveying this information well?
1. I mentioned, in multiple places, that this is the cheapest PPO offered to me through a limited selection of potential brokers / marketplaces - and that's important because it covers our current health care providers AND child birth as a benefit.
2. If we weren't trying to have kids, our options for purchasing health insurance expand drastically. Individual marketplace plans become a viable, for instance, since the "not covering childbirth" issue goes away. I mention the short-comings of the individual health insurance marketplace at least twice in this regard, including a big pull quote explaining the ACA work-around with child birth coverage.
> If we weren't trying to have kids, our options for purchasing health insurance expand drastically.
Yes, but crucially none of those expanded options cost $0, so I still don't understand your math at all. I feel like we're talking in circles here.
You should be deducting a substantially non-zero number from the amount in the headline to account for your "normal" non-childbirth-year best-case medical insurance premiums (or out-of-pocket cash costs if foregoing insurance altogether).
What exactly does covering childbirth mean? We've had two children now and it's not something I've considered when choosing insurance (my company's vs my wife's), so maybe we just got lucky. Is there anything different about child birth vs simply in-network hospital coverage? I assumed we'd just hit our out-of-pocket max.
I think OP here is just keeping a completely dominated plan (and his health insurance company knows it). He has less than 50 employees, he is not required to offer health insurance to his employees and he should go on the ACA market.
Given he has 3 children, 400% of FPL in 2026 is $150,600 so he's easily eligible for ACA subsidies (which, by the way, in 2021-2026, were available to everyone) by tweaking his income (easy to do when you have a company).
He also says uninformed things like:
> My wife and I are healthy, but we’re building our family and I have yet to see a marketplace plan that supports child-birth. Maybe the subsidized ones do, but I earn too much money to see those.
The premiums have nothing to do with the plans. Every single plan on the marketplace has to cover child-birth, that's sort of the point of the ACA.
> HMOs or EPOs that have some issues with them: coinsurance
What matters at the end of the day when you have a child is your maximum out of pocket (which you will 100% hit the year you have a child!). Whether you have copays or coinsurance after a deductible does not matter here. The ACA caps your maximum out of pocket at $18,400 no matter what (which, yes, is too high), so what you need to optimize for is premium + OOP for the providers that you care about.
Like, I get it, it's America, for healthcare like many other things (student loans, credit card debt, ...) it's easy to end up in a bad situation, but at some point you have to spend time understanding the game.
> Given he has 3 children, 400% of FPL in 2026 is $150,600 so he's easily eligible for ACA subsidies
I am absolutely not eligible. I earn more than $150k. And "manipulating your income" is not really feasible with a pass-through entity.
> The premiums have nothing to do with the plans. Every single plan on the marketplace has to cover child-birth, that's sort of the point of the ACA.
As I mention in the piece, I check every year. I have no idea what subsidized plans include, but the other marketplace plans definitely do not include child birth.
I explicitly address this point:
> The Affordable Care Act (Obamacare) barred insurers from turning down applicants based on existing pre-conditions; the way insurers get around this for pregnancy and child-birth is not by rejecting pregnant applicants (illegal), but by simply refusing to cover the care those applicants need to survive pregnancy (legal and common.)
and
> My wife and I are healthy, but we’re building our family and I have yet to see a marketplace plan that supports child-birth. Maybe the subsidized ones do, but I earn too much money to see those. All of the ones I’ve found through eHealth Insurance or Healthcare.gov never cover it - and I check every year.
Love the over-confidence though. The best outcome for me in even writing this article would be to get some internet commenter pissed off enough to find me a cheaper version of my plan. That would solve my problem immediately!
Which does cover childbirth according to page 3. And has a 7150 deductible per person - the $14300 is the family out of pocket max, so the childbirth should top out at the 7150. Other expenses might put you at the same 40K cost for the year, but not the childbirth alone.
You know they charge you, separately, for both the mother's care AND the infant's during a delivery right? Those count as two people. I am, with 100% certainty, going to hit the out of pocket max - I have every time.
Like I've paid for three kids all on the same plan, including one born in January so my deductible got spread over two different billing years.
I'm not defending it. I'm correcting your misinformation. You are claiming that ACA plans do not cover childbirth. They do. You are claiming that this event alone costs 40K, which is not accurate. It hits your out of pocket max, exactly as designed.
It sounds like you have never looked at an ACA silver plan, which is the lower deductible/out of pocket max option. I also have a family of 5, and have a $1800 per year out of pocket max from an ACA plan. You would still have the same level of premiums as you do now for silver plans, but you would save 13K a year. You are picking bad plans, dude.
Our system has problems, but when you make enough to not be subsidized, yet still pick a crappy 40K per year plan, that is beyond the systemic problems. It is a bad choice. There are insurance consultants who work with people, especially high income people, to find good plans for their family. You should be calling them.
Dude, you don't even have your own facts straight and you are embarrassing yourself. It's clear you have no experience, don't understand your own sources you provided, or any clue how child birth actually works from a medical billing standpoint.
Edit: what do I have to gain from spreading "misinformation?" I just want better / more options?
That's not what the link the OP included said and not what I said either, but I concede your point - that's my fault for checking individual health care marketplaces (like eHealthInsurance and Aetna direct) or not looking closely enough on healthcare.gov.
Looking through some plans now, but TBH these are genuinely not much of an improvement in the cost department and a massive downgrade in the provider selection department. Hence my whole section on trade-offs.
The logic you're using about out-of-pocket costs versus your deductible appear also not to be valid, and are causing you to misstate your out-of-pocket liability by a factor of roughly 4x.
I can assure you they are, if anything, understated - as I am not including the expenses my health insurance will not cover. So no, you are fully in the wrong there. What do I have to do to prove it? Show you itemized receipts?
Moreover, what are you even trying to accomplish by asking for this? Please provide me with a forthright defense of the modern U.S. health insurance markets and why it makes sense for me to have to pay this much to keep our population above replacement level.
Do you have non-ACA insurance? One explanation for why your costs are so much higher than the national average is that you're on a non-complying plan (you can also still buy plans that will exclude preexisting conditions --- they just can't be sold on the ACA marketplace). I'm pretty confident KFF isn't making these numbers up.
As for your second question, one easy response is that prospective parents in other health care systems aren't paying less (with everything factored in) but rather differently: that people making your $119k "true" poverty rate in Europe tend to be taxed at their top marginal rate, which is substantially higher than ours (in fact, in a lot of places in Europe, a Chicago Public School teacher would also be paying the top marginal rate).
A thing worth pointing out is that while the system we have is especially punishing on the uninsured, it's actually not that bad a deal for the insured, demographically/actuarially speaking. That's because being insured definitionally puts you in the cohort that excludes Medicaid-eligible poor/working class people and fixed-income seniors. If you move the typical household from that cohort to the UK, they're likely to be worse off. In surveys, insured families tend to be satisfied with their insurance, which is why taking existing health insurance off the table is such a third rail in American health policy.
Anyways, unless you personally are responsible for keeping our population above replacement level (which sounds exhausting), your numbers just aren't probative for the cost of bringing new citizens online. Other numbers might be!
While I might not have been happier income-wise when I was on Medicaid vs now, I was much happier with my medicaid insurance than I have ever been with any private insurance. I could see basically any provider and didn’t have to deal with any of the typical insurance bullshit.
Also when you’re beyond the Medicaid threshold but not that much beyond it absolutely sucks. One year I was paying for dramatically worse insurance with a deductible that would have just made it better for me to just not make more money because if I hit that deductible I would be net negative on my income vs the threshold for Medicaid.
Also I think this is such a false premise. You can still have private plans if you want in the UK or elsewhere with a public health system. Nobody is forcing you to use the public system if you don’t want to. To wit, I don’t have children but I still pay for schools with my taxes. You might not want to use the public health system and instead go private, but yes, you should still be paying for a freely accessible healthcare system.
Here’s the rub on that too: The prices we pay here are so much higher than in Europe even if you go private in those countries. Our system is terrible. Point blank.
I would agree that the NHS in the UK has gotten pretty bad. A large part of that is the result of the Tory government actively working against it though for a very long time. The waitlists for a lot of things are quite long and my fiancé who is from the UK and still lives there has to do some things there are crazy to me. On the other hand she still is able to get care freely. She’s paid private for some dental work but that also cost her pennies on the dollar compared to what I’d be paying if I did the same thing here.
If you’re happy with your insurance I am truly thrilled for you because I don’t think of that as being a common experience.
> Most people with private health insurance like it.
Most people don't use it all that much, and in the common case of employer-paid premiums, the actual cost is significantly masked. As your link notes, the more care you need, the less likely you are to enjoy the experience. They dig their heels in more; sometimes egregiously so. https://www.propublica.org/article/unitedhealth-healthcare-i...
Seems like a just-so story given the numbers. Why would heavy users of health services be concentrated in the minority cohort that is dissatisfied with their insurance?
> Why would heavy users of health services be concentrated in the minority cohort that is dissatisfied with their insurance?
"Why would people who drive a lot care the most about gas prices?"
The more you use health insurance, the more chances you have to run into the kafkaesque bits. Someone who sees a GP once a year and thinks their premium is $50/month because that's the bit they have to chip in while their employer covers the rest is largely gonna go "this is fine!"
Right but there's no such selection effect for whether or not people have employer-provided coverage, and the cohort of households that do strongly approve of their current insurance coverage. I don't see how the argument you're making could hold up statistically. There are a lot of chronically ill people with employer-provided coverage; in fact, most non-senior chronically ill pts fall into that bucket.
> Right but there's no such selection effect for whether or not people have employer-provided coverage…
False. Someone with significant medical issues may well need a higher acuity plan than the employer offers. I, for example, was on the exchanges until last year, for this very reason; my employer's coverage would not have made financial sense.
> There are a lot of chronically ill people with employer-provided coverage…
The chronically ill are less likely to be employed.
> Do you have non-ACA insurance? One explanation for why your costs are so much higher than the national average is that you're on a non-complying plan (you can also still buy plans that will exclude preexisting conditions --- they just can't be sold on the ACA marketplace). I'm pretty confident KFF isn't making these numbers up.
Asked and answered in the piece dude - I wish I had the confidence of a Hacker News commenter who didn't read the article.
I read the article. It's extremely unclear to me whether you have ACA-compliant health insurance or not. I've been a startup principal since 2005 and have had PEO coverage at various points since the ACA passed, and it was always ACA-compliant. Could you just answer the question? It shouldn't be a riddle!
(Note that "non-ACA insurance" doesn't mean "insurance you didn't buy on the ACA public marketplace". I've got Anthem Blue Cross through our benefits provider. It is very definitely ACA-compliant.)
that link doesn't even say what you says it does - it said you can apply for coverage, not that there are plans that cover child birth. Have you never done this before?
This same price gets you a platinum plan with Sharp or Kaiser in San Diego and wouldn't have those gigantic deductibles.
He moved his business from California to Texas and is now complaining about pricing problems in markets caused specifically by the lack of regulatory environment in Texas.
In America, you basically need insurance to act as a larger stronger party in the negotiation of prices with the hospital on your behalf. Without the bargaining power of the insurance company the prices you'd pay can be significantly inflated. So paying for the insurance is the slightly lesser of two evils. Supposedly. From your question it seems perhaps you live somewhere with a saner system in place. I'm envious.
I’ve been told that too. But I’ve done self pay for the last year, and every time I go to the hospital they instantly give me a 30% discount.
That makes me think they are artificially inflating prices so that when the insurance company negotiats their discount, well, it might be the same as what I pay
Birth injuries are insured by the ob/gyn, which is part of the very high cost of delivering a baby in the US (because such injuries often lead to a lot of care).
Claiming $200/month for a phone makes one wonder which numbers are valid. I'm not saying everyone needs to make a $100 phone last 5 years and use a $15/month plan, but I'm not even sure how I would get to $200/month in phone bill, even including financing an iPhone 17 Pro Max.
$200 seems valid - it comes from the linked article [0] and it includes home internet (I pay $110 / month Comcast just for home internet in Bellevue. In Seattle I paid $130 / month). Maybe Aaron could have phrased it better. (I also recommend to read the linked article as it is a phenomenally well done financial analysis.)
With $85/month service (AT&T unlimited premium with only a single line) and financing a $2,000 phone (The smaller storage version of the Galaxy Z Fold 7 at MSRP) over 18 months, you’d hit almost exactly that; you could so the same with a cheaper service and/or phone with some add-ons (e.g., while Apple Care is billed directly by Apple and so wouldn't be on a phone bill, insurance for non-Apple phones is often billed by carriers on phone bills.)
$200 doesn't seem that crazy if they are buying several phone lines. I assume he pays at the least his wife as well, so that's two. If they have home internet bundled in as well, that would easily explain that figure. All to say, AT&T. He may also have a home phone line for a fax machine. It is perhaps a bit disingenuous to bundle it all together, but it also isn't the main point of the article.
> Having a $200/mo smartphone is now a participation cost for many things such as getting access to your banking information remotely, medical records, and work / school.
That makes it sound like this is the minimum that you have to pay to get a smartphone and service to get by in modern life.
$200/mo is definitely high for that. An iPhone 17 Pro Max with maxed out storage (2 TB) is under $85/mo for 24 months.
A Visible+ Pro prepaid plan is $45/mo ($37.5/mo if you pay for 12 months at once) if you don't use one of their frequent promo codes to get a discount.
That includes unlimited premium data on Verizon's 5 G UWB, 5 G, and 4 G LTE networks, support for a cellular smartwatch, 4K UHD video, and unlimited mobile hotspot. By "premium" data they mean no deprioritization. Visible users get the same priority as user's of Verizon's own postpaid plans.
The hotspot is only 15 Mbps, so you probably wouldn't want to rely on it if you have frequent or long internet outages, but I've found for the occasional short outage it was fine for email, HN/Reddit/etc, and YouTube videos.
This will be massively more than enough to cover the smartphone hardware and service needs for everything probably 99% of the US population needs to get by, at $130/mo.
Note that includes getting a new top of the line iPhone every 2 years. With a more modest phone and keeping it for 5 years we are looking at more like $60/mo.
> I pay that at least much for my family, hence why I used it
and your article says
> Having a $200/mo smartphone is now a participation cost for many things such as getting access to your banking information remotely, medical records, and work / school.
It sounds like you're trying to communicate that you pay at least $200/month per smartphone for your family? Or you don't value precision in communication.
I know you've got a lot going on with a small business, and a new kid... but if money is important to you, maybe spend the time to switch to prepaid phone plans. There's lots of options [1], whatever network you need, you can do direct operator plans, MVNO owned by the operator, or like actual MVNO. If you're short on time and T-Mobile's network works for you, MintMobile has a promo going right now where $180 pays for 12 months of "unlimited" which is $15/month if you divide it out.
> I also pay $1250 per month to TriNet for the privilege of being able to buy their health insurance in the first place - sure, I get some other benefits too, but I’m the only US-based employee currently so this overhead is really 100% me.
Do you live in a state with a reasonable healthcare exchange? You might want to shop and see if an off the shelf plan from the exchange is better than paying TriNet to get access to their insurance; it may well be, but you should check. If you only have one US employee, and it's you, there's a lot of expense for not a lot of value IMHO. It's not really Apples to Apples though --- I think a lot of the TriNet plans have out of state coverage where a lot of exchange plans don't.
> It sounds like you're trying to communicate that you pay at least $200/month per smartphone for your family? Or you don't value precision in communication.
You're moving the goal posts here. You have to have service, realistically, in order to use it like a real person.
I'm trying to figure out what you're getting for $200/month.
Is it for "a smartphone" with service, and presumably financing the phone as well? Or is it the total for all of your family's smartphones, which is how many phones/lines?
Do they come with free mid-tier phones? What if you need 4-5 lines? What if, as a CEO, he needs a better plan than "basic prepaid, lowest-priority-subject-to-throttling"?
And what if the CEO needs international numbers across all continents?
What if the CEO needs to supply an entire 1,332 person company with business phones?
What about an assistant to answer them! What if we're sleeping!
Oh god!
But just to put my comment in context, here is what he said:
> Having a $200/mo smartphone is now a participation cost for many things such as getting access to your banking information remotely, medical records, and work / school.
Okay, so on the non-budget side, I pay ~$64/mo for T-mobile's "unlimited[1]" plan and a Google Pixel phone. ($57/mo for the service, and I've amortized the phone price to ~$7/mo based on my lifetime average phone lifetime. Even if you amortize the phone over only its ridiculously short warranted lifetime, that's $42/mo for the phone, or $99/mo, but that implies purchasing a new phone yearly, which most people do not do (the average phone lifespan is just under 3y).)
In over a decade, the only time I hit that cap was because I let my kid watch too many videos on it.
5 GB is pretty reasonable for the bulk of the country. The only common things that can make it go over are games and streaming - both of which really are luxuries if you simply can't wait till you have Wifi access. So yeah - of course you should pay a lot more if you insist on doing those things.
This is akin to him saying that average American needs X money for the car to participate in society, and you suggest that his numbers don't math because one could:
1. Walk around everywhere (Idaho, Iowa)
2. move to New York (with ok public transportation)
Mobile phone and unlimited high-speed internet are requirements for participation in society.
> unlimited high-speed internet are requirements for participation in society
I pay $7/mo (not a typo) for 1GB mobile data via US Mobile, and I have never hit that cap in many years. I just don't stream video or audio unless on WiFi, which is not a hardship. Respectfully, what on earth are you talking about?
My monthly mobile internet usage is 5-25GB. And this is me working from home using wifi, having cheap internet (slow, but unlimited) and barely being outside. Phone wifi usage is 150-250GB/month.
Well, I have to wonder what you are doing on your phone. I don't restrict my usage at all outside of video and audio streaming, so I'm befuddled as to how you use 10-50 times more data than I do.
Last month, 429MB used:
107 YouTube music
91 Google maps
70 Firefox
22 Amazon
Miscellaneous other small amounts
WiFi usage 26GB
I don't doubt that you use a lot of internet, but that amount is far away from a "requirement to participate in society" .
I watch a lot of videos (with increased speed). Also Telegram is a big consumer of bandwidth.
Also, since I live in Europe, I don't use car (otherwise would obviously not able to watch videos during travel), but public transportation. And using mobile internet is normal, nobody cares to ask for cafe wifi or to even type it in despite being visible on the wall. This is very freeing. Perhaps more than Americans can imagine, since the limits are internalized. Analogy would be the freedom Americans feel, after they move to Europe and realize that they don't have to worry about becoming broke due to sudden health problems. This is a constant worry that Americans have, but the extend of which is fully understood only after the shackles have been dropped.
Like, a lot of people here don't even have a separate internet connection at home, but are simply using their phone's shared internet with their laptops. That's how normal it is. And these "no limits" contracts are what allows the change in behavior to FULLY utilize the technology, without the need to limit oneself.
A lot depends on how one understands the word "participate". I mean, is eating the diet of only oats, eggs and protein powder enough to "have eating needs met" or is the requirement limit at "balanced food diet, with cost not influencing decisions"?
In my opinion requirement can be rephrased into "can fulfill all the phone/internet needs, without limits, without restricting oneself". So in this sense your internet requirement is 26.5GB and we have to look at the price of the phone connect that would provide at least this much at full speed.
Worrying about what the wifi password is for this place is such an old-school thing in America. Europeans and Asians find it baffling.
If you have internet access on your phone while you're actively moving, it should work all the time, without any traffic limits or the need to keep asking for shitty cafe wifi (because your mobile internet is even worse).
It really reminds me of the Healthcare System conversations, when Americans are justifying why their way of doing things is logical and correct, while the rest of the world shakes their heads.
It’s also what critical thinkers do when evaluating “what percentage full of shit do I think this author is?”
If a glaring innumeracy or terrible estimate is in the article, why did the author include that? What was their angle? Does that make me trust the rest of the article more or less?
Because it indicates dishonesty and/or innumeracy which calls the accuracy of the rest of the piece into question. "Checking if the author can actually count" is basic media literary stuff, not some sinister agenda.
I think he's quoting that from the other article, not necessarily computing it himself. I think that article was about the cost of broadband + smartphones.
We pay ~$100/month for 1G broadband (I realize this could be lowered somewhat), and ~$100-120 for 5 phone lines for the family (AT&T prepaid). I'd like to see you make a household with multiple lines + broadband work for less than $100-125.
And that's not even that hard - I know some people spend $300+ JUST on their phone plans, in addition to broadband. And then if you factor in amortized cost of phone replacement? It's closer to $200 than to $50 for example, IMHO.
$200 seems to include home internet (which I think everyone needs these days to function). The $200 quote comes from the linked article [0] (speaking as a former financial analyst, this is an amazingly well done financial analysis). Maybe Aaron could have phrased this better.
