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Is Health Insurance Even Worth It Anymore?

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Re: Is Health Insurance Even Worth It Anymore?

#11

Post by righthand »

The truth is that Us health insurance industry has proven it is not about providing healthcare but instead capital extraction. The whole thing is seen as rotten by every participant.

What has happened is that it’s now more affordable to get healthcare in foreign countries as an American. I can vacation and get whatever care I need by doctors in countries with healthcare systems. Doctors that are incentivized to provide healthcare. In economies where people are proud to have a job.

There are some good doctors in the Usa but they are incentivized to charge as much as possible and put patients into studies or experimental drugs to get kickbacks. It costs me $50 to get my results from my doctor. They refuse to send an email and a phone call means it’s a “telehealth” appointment. Which is not a medical or technical health term but the name of the product category.

Usa does __not__ have a healthcare system but instead a capital extraction health-insurance system that rarely helps with your health costs.

I wish this topic was better understood and was in the spotlight during Biden’s term as Potus. But we made extra sure to snub Bernie when Biden ran the first time. No surprise for me if nothing changes. Seems to only be a major topic during the years when affordability is an issue. So when affordability isn’t an issue we’re just A-Ok as Americans with the grifting health-insurance industry.

Re: Is Health Insurance Even Worth It Anymore?

#12

Post by infecto »

It is worth it imo but it could be better. This is my back of napkin mental model but I have convinced myself that most of our troubles are because health insurance morphed from truly emergencies to every day care. Routine care (both primary and specialist) have to hire deep staff to handle insurance claims with the different payers. It’s a constant game.

For myself I always pick the high deductible plan. It’s the next best thing to an emergency only plan in my opinion. I am also lucky that I have an employer that picks this kind of plan as an option. Everyone should be on this type of plan imo. I think have a direct primary care (directs don’t take any insurance) for the family that costs $200 a month for 3 of us. The insurance cost is $100 with a max out of pocket I think around $8000. Now we are lucky in that these dollar figures don’t bother us, not true for everyone but I do think most of us would be better off if we have better forms of true emergency insurance. I want to pool the risk of a catastrophic illness or accident, not my doctors visit for a cough.

I pay my dpc directly for all testing and it’s cheap. A lot cheaper than if it was billed via insurance.

Re: Is Health Insurance Even Worth It Anymore?

#13

Post by dtnewman »

I think what this misses is that insurers handle the hassle of dealing with negotiated rates.

As an example, if you go to the ER and get a strep test, you might be billed $500, and insurance will pay $7 (as ridiculous as this sounds). If you go at this on your own, they'll probably bill you $100 and tell you they are giving you an 80% discount. With lots of phone calls, you can maybe get them down to $50.

This is all obviously crazy. But it makes it such that you really do want insurance if you can afford it. More so, even if you are a billionaire and can afford to self insure, it still makes sense to have health insurance (whereas property or life insurance probably don't make sense for you).

Also, don't forget that insurance premiums are often tax deductible for wealthy people, so the actual amount paid is less.

Re: Is Health Insurance Even Worth It Anymore?

#14

Post by Brendinooo »

I just looked at the local marketplace plans. The absolute dirt-cheapest I could do for my family is ~$1,225/month premium with a deductible of $13,400 and out-of-pocket max of $21,200. Most of the structure is some form of "zero help until the deductible, then I pay 20%-40% of everything up until the OOP max".

In other words, I'm being asked to buy a product, and the cheapest form of it is to basically pay almost $15k in a year to hedge against someone getting cancer or whatever, and actively incentivizes me to not use it[0].

There is no meaningful shopping around, there is no incentive for me to do anything other than continue not smoking, there's no accounting for where I live or my health.

I dunno what the solution is. I'm just glad that the ACA included health sharing co-ops as an exception. Been doing that for awhile now and have saved a lot of money. (And they'll give me a discount if I get my weight down a little more!)

[0]: Because even if you get a free wellness visit or whatever, it's really easy for them to drop in some random test that ends up getting billed. Had this happen with my kids a few times if memory serves.

Re: Is Health Insurance Even Worth It Anymore?

#15

Post by toast0 »

amundskm wrote: post #4

I have been struggling to find the breakeven point for me and my family. On one side, it keeps getting more and more expensive even though we are young and healthy. On the other, if one of us needs an expensive operation or months of treatment, no amount of HSA savings will be enough. I don't know if there is a 3rd option that would be more reasonable.

Third option is pay what you can reasonably pay and file for bankruptcy. Which sucks, but is an option.

Try to get assets into bankruptcy protected holdings when possible (401k, house, etc, depending on state of residence), so you have more flexibility post bankruptcy.

Re: Is Health Insurance Even Worth It Anymore?

#17

Post by OptionOfT »

infecto wrote: post #12

It is worth it imo but it could be better. This is my back of napkin mental model but I have convinced myself that most of our troubles are because health insurance morphed from truly emergencies to every day care. Routine care (both primary and specialist) have to hire deep staff to handle insurance claims with the different payers. It’s a constant game. For myself I always pick the high deductible plan. It’s the ne…

I'm on the other side. A high deductible plan for me means I'm guaranteed to have to pay that amount, due to medication and visits.

If I take the low deductible plan with the higher Max OOP I am actually spending less on a yearly basis because the insurance kicks in immediately.

Of course, when something catastropic happens, like cancer, yea, the high-deductible plan would've been better, but that (knocks on wood) doesn't happen every year.

Re: Is Health Insurance Even Worth It Anymore?

#18

Post by enraged_camel »

exabrial wrote: post #2

Repeal Obamacare, go back to HSAs. Nobody should be taxed on health expenses, which was the whole point of HSAs in the first place. We literally had a budding system that was working and affordable, and it was "fixed".

It was “working” if you didn’t have a pre-existing condition, which could literally be anything the insurance company wanted it to be.

Re: Is Health Insurance Even Worth It Anymore?

#19

Post by modeless »

All I want is health insurance with low premiums, freedom to choose my providers, and a $50k deductible. Like, actual insurance for catastrophic risks. What we have now should not properly be called insurance. It's more like a mandatory membership in an extremely expensive and dysfunctional club.

Re: Is Health Insurance Even Worth It Anymore?

#20

Post by gtowey »

infecto wrote: post #12

It is worth it imo but it could be better. This is my back of napkin mental model but I have convinced myself that most of our troubles are because health insurance morphed from truly emergencies to every day care. Routine care (both primary and specialist) have to hire deep staff to handle insurance claims with the different payers. It’s a constant game. For myself I always pick the high deductible plan. It’s the ne…

Study after study finds that a health care model where you can visit a doctor frequently leads to much better overall heath for people.

The system we have here forces people to wait until minor issues turn into life or death situations that require much more intensive and expensive care.

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