Tools for comparing costs between different healthcare providers?
"There really isn't any good ways that I'm aware of. (The exception is in New York or California, where hospitals must post prices.) The law sets price floors on many procedures by setting Medicare and Medicaid reimbursement rates. As a result, the ""list price"" for a given procedure is dramatically inflated, and various health insurers negotiate rates somewhere in the middle. I'd recommend talking to the business offices or financial counselors at medical groups that you do business with. Ask about ""self pay discounts"" or other programs appropriate for folks in your position." When I had a high-deductible healthcare plan, I used http://www.ehealthinsurance.com/ to do comparisons among the plans.  As far as comparing the costs of specific procedures across providers, I'm not aware of any good ways either.
I don't think you're stupid, evil, bad or anything like that.  I'm sure in fact that you are an intelligent, nice person who only wants the best for everyone.  I just think that you are in a willful mannor refusing to understand the difference between insurance and healthcare.  It's not that you are incapable, it is that you simply refuse to do so.  You are doing so to justify making the bad guy out of an industry whose goal is to make health-care accessible to as many people as possible by spreading out the cost of health-emergencies over time, which is mis-directed anger.  I fully appreciate and understand that most health-care is payed for via insurance.  However, this is entirely an artifact of business-tax deductions which make it cheaper for individuals to accept part of their compensation in the form of health insurance benefits.  Health care and insurance aren't intrinsically inseparable, they are bound together in the US due to the tax code.    So what you should be arguing for is the removal of business health-care tax deductions, and direct financial assistance for the poor.  This would make insurance and healthcare a more competitive market, which would in turn drive costs down, and by giving the money directly to the impoverished more of the benefit would reach them, rather than creating some huge bureaucracy that it has to be filtered through first.  But instead you are choosing to vilify a industry for not handing out free health-care, which is misguided at best. I'd share my google sheet I have comparing the two, but in the interest of keeping myself at least a little private, I'll use a made up situation with real numbers.  **Meet Bob.**  Front End dev.  Single.  5y exp in industry.  Likes to live well, in a nice place.  Has no expensive hobbies, or otherwise uncommon expenses.  [Makes 70k in Indianapolis](https://www.paysa.com/salaries/indianapolis,-in--l).  Lives off 50k, puts 20k in the bank yearly.  Receives job offer in Valley. Lets say he makes 170k, which is easily possible.  With a small company, you might expect ~120k.  With a giant, you'd probably be looking at ~200k+.  Both numbers include any RSUs.      **Salary Sources for San Jose**  San Jose was chosen, as many sites simply lump this greater area together as San Jose.  Its just easier, and does not make a huge different in the numbers.  I'm not a front end dev, but 170 is in the ballpark of my offers with larger companies in the valley, as a personal data point.  * [Paysa, which sources salary reports from actual professionals.  Typically from more larger, established companies \(Google, MSFT, Facebook, Linkedin, Amazon, etc\)](https://www.paysa.com/salaries/san-jose,-ca--l) * [Indeed, which is much more bottom of the barrel generally speaking.  No large company is throwing their job on Indeed.](https://www.indeed.com/jobs?q=Javascript&amp;l=San+Jose%2C+CA)  **Cost of Living**  Lets see how the COL breaks down.  Im using [this breakdown of what people spend their money on](http://www.businessinsider.com/how-americans-spend-most-of-their-money-2017-1) to get ideas.  Lets say Bob was spending 60k in Indy, saving 20k/yr.    * Rent - $1400/mo apartment, $17000/yr * Food - $20/d, $7300/yr (Bob is a bad cook/lazy) * Transportation - it looks like we can [estimate high and say 10k](https://www.valuepenguin.com/average-household-budget) * Taxes - $14k - https://smartasset.com/taxes/income-taxes#FB9ktMO6uP * 10k on other misc. - Healthcare, Entertainment, shit around the house, new socks, etc  (breaks down to $190/wk)  **Total: ~60k**  Lets first try just using COL calculators, which were in the ballpark, but generally high, compared to what I found when breaking down my own expenses.  * [Salary.com says 100% COL increase.](http://swz.salary.com/CostOfLivingWizard/Layoutscripts/Coll_Result.aspx) * [Nerdwallet says 100% COL increase for SF \(SJ not available\).](https://www.nerdwallet.com/cost-of-living-calculator/compare/indianapolis-vs-san-francisco) * [Numbeo puts Consumer prices, including rent, to be ~50% higher.](https://www.numbeo.com/cost-of-living/compare_cities.jsp?country1=United+States&amp;city1=Indianapolis%2C+IN&amp;country2=United+States&amp;city2=San+Jose%2C+CA&amp;amount=4%2C500.00&amp;displayCurrency=USD)  For the sake of argument lets run with the the assumption it costs Bob double to continue his standard of living, based off the above.  As you mentioned, and as I fully agree, housing is the biggest expense, so lets check my assumption there.  A Zillow search for Sunnyvale proper, very close to all of the tech giants HQs, shows [1BR in good conditions and of decent size \(700sqft+\) run anywhere between 2.3k to 3.5k](https://www.zillow.com/homes/for_rent/Sunnyvale-CA/condo,apartment_duplex,townhouse_type/54626_rid/1-_beds/37.395016,-122.002616,37.348838,-122.064414_rect/13_zm/).  Lets plan for the worst, and say its 3.5k.  Thats 42k/yr.  Living this close (literally biking distance) is a luxury, but lets say Bob hates commuting, so hes willing to pay as such.  Lets not forget Uncle Sam, and more specifically, California's uncle Sam, which is extra greedy.  He will want [roughly 65k](https://smartasset.com/taxes/income-taxes#kMLNaWg8M9), rounding up.  The other big expenses are food and transportation.  Lets say food is 50% more expensive, going with your argument.  7300 * 1.5 = 11k.    Lets say the same for Gas, and general transportation (there is no parking situation in the greater valley - that is a San Francisco downtown city issue, so ignore that).  10 * 1.5 = 15k  Same for everything else.  50% markup.  That laptop in Indy that cost 2k now costs 3k (absolutely not true, but lets roll with it.) . Healthcare too.  10k * 1.5 = 15k  Total San Jose / mid-valley COL: 15k + 15k + 11k + 65k + 42k = 130k.  So using high estimates for everything, Bob now spends 130k of his new 170k salary.  **He now gets to save 40k, double what he did before**.  He also now hopefully has a great name on his resume which will literally open doors, a RSU package which will refresh yearly, **making him earn 500k/yr within a decade**, and will be at the center of his industry.  Keep in mind, this is only coming at this from the mindset of someone in tech.  If I wasn't in tech, I would never, *ever*, ***ever*** consider moving to the valley unless I was bankrolling some other job.  But for tech, the logic is there.  I'm sorry if I upset you, but I've literally broken down my expenses and done all this math for my actual situation.  Lets not even get started with the other perks.  For a large tech company, which is a very realistic goal for someone decently good and easy to work with in tech, you get unlimited vacation, a free for all budget of 2k for training, free lunch and snacks, shuttle service if you live in main hubs (the city, etc), great weather, can ski and surf in the same day - all things you likely do not get in a midwest tech job. "First check: Do you have all the insurances you need? The two insurances everyone should have are: Another insurance you might want to get is a contents insurance (""Hausratsversicherung""). But if you don't own any super-expensive furniture or artworks, you might also opt to self-insure and cover it with: Priority 2: Emergency fund. Due to the excellent healthcare and welfare system in Germany, this is not as important as in many other countries. But knowing that you have a few thousand € laying around in liquid assets in case something expensive breaks down can really help you sleep at night. If you decide not to pay for contents insurance, calculate what it would cost you if there is a fire in your apartment and you would have to replace everything. That's how large your emergency fund needs to be. You also need a larger emergency fund if you are a homeowner, because as a homeowner there might always be an emergency repair you have to pay for. Priority 3: Retirement. Unless there will be some serious retirement reforms in the next 40 years (and I would not bet on that!), the government-provided pension will not be enough to cover your lifestyle cost. If you don't want to suffer from poverty as a senior citizen you will have to build up a retirement plan now. Check which options your company provides (""Betriebliche Altersvorsorge"") and what retirement options you have which give you free money from the government (""Riester-Rente""). Getting professional advise to compare all the options with each other can be really beneficial. Priority 4: Save for a home. In the long-run, owning a home is much cheaper than renting one. Paying of a mortgage is just like paying rent - but with the difference that the money you pay every month isn't spent. Most of it (minus interest and building maintenance costs) stays your capital! At one point you will have paid it off and then you never have to pay rent in your life. It even secures the financial future of your children and grandchildren, who will inherit your home. But few banks will give you a good interest rate if you have no own capital at all. So you should start saving money now. Invest a few hundred € every month in a long-term portfolio. You might also get some additional free money for this purpose from your employer (""Vermögenswirksame Leistungen"")." and seems to do better than the S&P 500 too. No, that's not true. In fact, this fund is somewhere between S&P500 and the NASDAQ Composite indexes wrt to performance. From my experience (I have it too), it seems to fall almost in the middle between SPY and QQQ in daily moves. So it does provide diversification, but you're basically diversifying between various indexes. The cost is the higher expense ratios (compare VTI to VOO). Either the healthcare will be paid for in the form of insurance, often through the company, or in the form of taxes on wages and corporate profits. Either way, the costs of healthcare is paid for out of the productive efforts of the citizens.  The question regarding healthcare is: which system is more efficient? Which system provides the health outcomes that we want for the proportion of our productivity that we are willing to spend on it? There is some magic involved in that calculation, because what health insurance is worth to you is not necessarily the same it is worth for the employer. Two examples that illustrate the extreme ends of the spectrum: let's say you or a family member have a chronic or a serious illness, especially if it is a preexisting condition - for instance, cancer. In that case, health insurance can be worth literally millions of dollars to you. Even if you are a diabetic, the value of health insurance can be substantial. Sometimes, it could even make financial sense in that case to accept a very low-paying job. On the other extreme of the scale, if you are very young and healthy, many people decide to forego insurance. In that case, the value of health insurance can be as little as the penalty (usually, 2% of your taxable income, I believe). It's difficult to quantify the intangible benefits, so I would recommend that you begin by quantifying the financials and then determine whether the difference between the pay of the two jobs justifies the value of the intangible benefits to you. Some Explainations You are making $55,000 per year, but your employer is also paying for a number of benefits that do not come free as a contractor.  Begin by writing down everything they are providing you that you would like to continue to have.  This may include: You also need to account for the FICA tax that you need to pay completely as a part time employee (normally a company pays half of it for you).  This usually amounts to 7.8% of your income. Quantification Start by researching the cost for providing each item in the list above to yourself.  For health insurance get quotes from providers.  For bonuses average your yearly bonuses for your work history with the company.  Items like stock options you need to make your best guess on. Calculations Now lets call your original salary S.  Add up all of the costs of the list items mentioned above and call them B.  This formula will tell you your real current annual compensation (RAC): Now you want to break your part time job into hours per year, not hours per month, as months have differing numbers of working days.  Assuming no vacations that is 52 weeks per year multiplied by 20 hours, or 1040 hours (780 if working 15 hours per week).  So to earn the same at the new job as the old you would need to earn an hourly wage of: The full equation for 20 hours per week works out to be: Assumptions DO NOT TAKE THIS SECTION AS REPRESENTATIVE OF YOUR SITUATION; ONLY A BALLPARK ESTIMATE You must do the math yourself.  I recommend a little spreadsheet to simplify things and play what-if scenarios.  However, we can ballpark your situation and show how the math works with a few assumptions. When I got quoted for health insurance for myself and my partner it was $700 per month, or $8400 per year.  If we assume the same for you, then add 3% 401k matching that we'll assume you're taking advantage of ($1650), the equation becomes: Other Considerations Keep in mind that there are other considerations that could offset these calculations.  Variable hours are a big risk, as is your status as a 'temporary' employee.  Though on the flip side you don't need to pay taxes out of each check, allowing you to invest that money throughout the year until taxes are due.  Also, if you are considered a private contractor you can write off many expenses that you cannot as a full time employee. I would suggest that you try ClearCheckbook.  It is kind of like Mint, but you can add and remove things (graphs, features, modules) to make it as simple or diverse as you need it to be.  It should be a workable solution for simply tracking both income and expenses, yet it will also provide extra features as needed. There is a free option as well as a paid option with added features.  I have not used ClearCheckbook before, but according to their features page it looks like you may have to upgrade to the paid option if you want to have complete tagging/custom field flexibility.