…right, because that is what a deductible is. My original response was to this statement:

> I figured therapy would just be a copay and that you wouldn't need to pay the entire deductible before insurance kicking in.

I explained why this is not a thing.

I have never heard of that. In health insurance, the only things covered before deductible I have seen are preventative visits mandated by law.

https://www.healthcare.gov/glossary/deductible

What you are writing makes no sense. If the insurer paid before the deductible was met, then it would not be a deductible.

What you want is an insurance plan with no deductible.

The definition of deductible is the amount an insured pays before the insurer pays anything.

Damn, you are correct. I guess they only fixed some parts of it, but I recalled reading it was largely fixed.

https://www.thetaxadviser.com/issues/2019/jun/marriage-tax-penalty-post-tcja.html

The 2017 tax cut and jobs act fixed this.

Tennis needs a lot of surface area per player, plus it has to be dry, so indoor courts are usually needed for colder regions. The surface is also much more expensive to maintain, than say a basketball court.

While it is not the most expensive sport, it is costly, especially in places where land is at a premium.

The repercussion should be workers valuing those promises at zero. Governments lowering the value of deferred compensation at time of payout has been a thing for decades.

The lesson here is cash is king. Do not trust someone to pay you in non fungible, subjectively valued “benefits”, many decades in the future. Especially not someone who cannot print money (i.e. everyone that is not the federal government).

I do not know what you mean by bud, but there is a minimum 20% sales tax on cannabis in Oregon.

https://www.oregon.gov/DOR/programs/businesses/Pages/marijuana-local-tax.aspx

Medicare is federal and states have nothing to do with Medicare reimbursement.

Medicaid is under state jurisdiction.

https://www.fbi.gov/how-we-can-help-you/safety-resources/scams-and-safety/common-scams-and-crimes/health-care-fraud

https://www.nj.gov/oag/law/al.htm

> And to your other point about this being class driven, I have no doubt there was that type of mentality in there, sure. BUT it wouldn't have actually happened if it didn't benefit the insurance company. and it wouldn't have been ALLOWED to happen if legislatures had the good of all people in mind.

Possibly, health insurance companies are going to benefit regardless if everyone was required to purchase health insurance. Theoretically, it makes no difference to them if an employer is involved.

I just specifically remember people up in arms about removing employers from the equation and being dumped onto healthcare.gov where the risk pool would have caused them to pay more.

People are still upset at health insurance costing more than pre ACA, even though it covers a lot more (no benefit maximum, no denial due to pre existing condition, no underwriting for one’s specific health risks, etc.).

And of course, the fake religious “insurance” that is not really insurance or complaint with ACA had to be allowed, and that was not due to insurance companies.

> as a business owner, I understand the importance of margins, but that marginal increase translates to them profiting 2.6BILLION dollars more than the previous year.

Nominal profits are not comparable year to year, especially due to the decreasing purchasing power of the currency, aka inflation. Hence, it is most appropriate to use profit margins when comparing a business’s performance over time.

> Sure, during typical years a 2-4% increase is a sign of good, lean management. but it's the same way flood insurance companies make more money during floods....it sure seems counter intuitive, no?

Health insurance companies are kind of / not really insurance companies, which is why I think managed care organizations is a better term for them.

> I live in NJ and the same plan from Horizon BCBS costing $700/month for a couple (2500 deductible, $20/$50 copays) costs $1500 in Delaware with Highmark BCBS because of the difference in income-driven costs.

What are income-driven costs? I have not seen differences that big between states.

https://www.kff.org/health-reform/state-indicator/average-marketplace-premiums-by-metal-tier/

> We all know the best way to keep premiums down is to enlarge the pool of customers. One way the insurances ruin that strategy is to hack us into groups (not allowing cross-state plans).

This was not because of “the insurances” by the way, this was upper middle class and pretend upper middle class people that forced this issue. White collar workers that worked for well funded and established businesses balked at their insurance premiums going up to pay for poor and unhealthy people.

People are, unfortunately, very tribal.

> Did you know that in 2020, during a pandemic, Indep Blue Cross had its highest profit year EVER!?!? Think about THAT one….

3.4% “profit” margin in 2021, 2.9% in 2020, 2.1% in 2018. And not really a profit margin since Independence Blue Cross is a not-for-profit so there are no owners to distribute profits to.

https://www.ibx.com/about-us/annual-reports

Managed care organizations (aka health insurance companies) have tiny profit margins in general. UHC has 6%, as an outlier, but the rest, Elevance, CVS, Cigna, Humana, Centene, Molina, etc all have 2% to 4% profit margins, year after year for a decade +.

Not really much juice left to squeeze there. The bigger profit margins are in pharmaceuticals, software vendors, equipment vendors, and doctor groups (which PE firms had noticed 10+ years ago).

And no one is making someone else agree to deliver something for less than price they expect.

For the recipient, the effect is the same. Call it agency risk instead of default risk. There is plenty of history where deferred compensation agreements such as retiree healthcare and defined benefit pensions were renegotiated.

Considering NYC does not have the power to issue new USD, default risk is always be a concern for the lender (or creditor), which is proportional to the political pull of the deferred compensation recipients.

I have always seen the options as:

City/state government job: low pay, low volatility, but if you show up you get rewarded with an annuity when you are older. Previously, this annuity was worth a lot, and it started a lot earlier. Now, the annuity will not buy you anywhere near as much, and you will have to work longer. And the city might cut the benefit if it gets into financial trouble over the next 60+ years, like Detroit.

Non government job: higher pay, higher volatility. As long as you stay valuable and are open to moving, earning potential is higher. Can invest in equity index funds, so your retirement is effectively guaranteed by US federal government reliably bailing out stock market, but you also get full control over your funds and the huge advantage to you is you can tell your employer to fuck off without losing any potential retirement benefits.

For example, when the world changes to offer remote work, and your city employer asks you to waste time commuting, you have to decide if it’s worth giving up potential retirement benefits. But if you have a 401k, you can move on to better employers.

I would rather have a nice 401k match than stay tied to NYC for my whole life and then have to bet on them being able to pay me for 20+ years after retirement.

I doubt it. He went out of his way to say he was laying for his “lodging”. I would assume this means he’s only paying for the lodging, and the hotel might even discount his room so they can charge the city for all the other rooms needed for security.

Oops, seems like CA allows it (but many cities in CA do not), and WA/OR do not allow cannabis lounges.

Either way, I assume pushback for “public consumption” if only to grease more political wheels, considering how long and hard fought cannabis stores were.

Those still are not a thing on the west coast after 10 years of cannabis being legally sold, so I would expect to wait a long time for those to come to NYC.

Juice being sugar laden fruit flavoring. Maybe they will use low calorie sweeteners.