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Is Health Insurance Even Worth It Anymore?

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Re: Is Health Insurance Even Worth It Anymore?

#31

Post by lostapathy »

dtnewman wrote: post #13

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…

Dental insurance is even worse. My dental insurance has ridiculously low limits, but it gets you access to the "real" negotiated rates rather than whatever silliness "retail price" is.

I tried going without when I switched jobs to an employer that doesn't offer it, but one cleaning as a "cash payer" cost more than the annual premiums to buy insurance privately.

Re: Is Health Insurance Even Worth It Anymore?

#33

Post by jabroni_salad »

electric_mayhem wrote: post #10

Direct primary care was a completely game-changing improvement in healthcare for me. $95/mo to basically subscribe to a local doctor. Covers most things other than tests or surgery or limb setting. But tests are often very discounted relative to what insurance charges for them (with my previous dpc provider an entire battery of tests cost less through them than just the copay for two of them added up to). It’s remark…

I do this too and I love it, and it highlights what to me is the healthcare's system biggest constraint. It is amazing how little healthcare can cost when you do not need to staff seven paper pushers for every doctor.

Re: Is Health Insurance Even Worth It Anymore?

#34

Post by wklauss »

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".

Define "budding system that was working". Before the ACA, the number of uninsured Americans was around 50 million and insurance companies routinely denied coverage or charge higher premiums based on pre-existing health conditions. ACA is not perfect (due in no small part to the concessions that had to be made in congress to get enough votes) but i'd say it's been a net win.

Going back to a pre-ACA system won't lower premiums that much. Medical costs have risen in the last decade, same as any other goods or services, and the way US healthcare is structured, with hospital and doctors negotiating with a profit driven middleman (insurance companies) makes it almost impossible to change the rising premiums.

US healthcare will continue to be a mess until there's a universal healthcare system or single payer system similar to any other developed country on earth.

Re: Is Health Insurance Even Worth It Anymore?

#35

Post by ChrisMarshallNY »

I'm not (yet) willing to do this for general health insurance, but I made this decision for dental, a couple of years ago. It has not been an issue. I've had a couple of crowns, and paid a fraction of what insurance would have covered, minus the ridiculously high deductible, and the monthly premiums.

Of course, now it's time to re-up for next year, and the message seems to be "Squeal, boy!".

Re: Is Health Insurance Even Worth It Anymore?

#36

Post by ratelimitsteve »

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…

if this were true why is it that countries w universal healthcare spend less per patient and get better health outcomes with a longer life expectancy?

Re: Is Health Insurance Even Worth It Anymore?

#37

Post by seanmcdirmid »

lenerdenator wrote: post #29

You can always make the argument that insurance, no matter what it covers, isn't worth it. You're paying for coverage in the case something goes wrong. If it doesn't go wrong, you don't get your money back. The one exception to this is Old-Age, Survivors, and Disability Insurance, better known as Social Security. For some reason, we feel the need to mail checks to, statistically speaking, the wealthiest age demograph…

Risk pooling is also broken. People with jobs good enough to get health insurance are generally cheaper risks than people who have to buy health insurance on the market. So your corporate policies wind up cheaper than if you joined the rabble risk pool of people who have to purchase their own insurance.

Re: Is Health Insurance Even Worth It Anymore?

#38

Post by hypeatei »

toast0 wrote: post #15
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.

Bankruptcy is not an easy path out of debt. I've seen others go through it and it's stressful: they pry into all your finances, you still have to pay it off (just at a lower amount), and it destroys your credit. There are weird restrictions also like not being able to pay it off early even if you're able to.

EDIT: don't forget you have to pay the bankruptcy lawyer too.

Re: Is Health Insurance Even Worth It Anymore?

#39

Post by 0xy »

Brendinooo wrote: post #14

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 $1…

It was never sustainable. Because the model relied on healthy people subsidizing the people who make extremely poor choices (obesity, smoking, drugs or a combination of that). Obamacare's modeling predicted that significantly more healthy people would sign up, driving costs down. It didn't happen.

Now it is a system that ONLY the unhealthy benefit from. Everyone else pays for extremely bad choices.

Re: Is Health Insurance Even Worth It Anymore?

#40

Post by whatever1 »

Brendinooo wrote: post #14

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 $1…

So you have to pay like $30k out of pocket in a year before the insurance chips in a single dollar? And if you ever ask for a dollar, I can also reject your coverage.

How can I start an insurance company?

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