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Is Health Insurance Even Worth It Anymore?

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Re: Is Health Insurance Even Worth It Anymore?

#61

Post by crazygringo »

lostapathy wrote: post #31
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.

> but one cleaning as a "cash payer" cost more than the annual premiums to buy insurance privately.

This is my situation too. It's baffling to me. It's not really "insurance" at all, it's more like a yearly Groupon.

It's 0% about actual insurance, 100% about negotiated rates.

Re: Is Health Insurance Even Worth It Anymore?

#62

Post by ethin »

vablings wrote: post #5
John23832 wrote: post #3

Earlier quoted context omitted.

The ACA didn't do away with HSAs.

I was about to chime in. I still have a HSA? Something interesting is that the ACA was probably making normal people's insurance cheaper because for people with the Medicaid plans were specifically targeted for aggressive coding knowing that the taxpayer was footing the bill It really does baffle me that the USA continues to subvert "socialism" by taking socialist programs and painting them with a capitalist brush^[1…

Ah, but don't you know? Socialism is evil! Capitalism is GOD and is perfect!

- Republicans pretty much everywhere in the US

Seriously. This is pretty much why single-payer/universal healthcare systems aren't available in the US. It's also why UBI has never been tried. I'm sure someone is going to come in and say that I'm painting an overly-simplistic picture, but we seriously do have people still thinking that people willingly come to the US for healthcare because every other healthcare system is supposedly worse in every imaginable way (which somehow magically proves that what we have is better).

Re: Is Health Insurance Even Worth It Anymore?

#63

Post by rayiner »

whatever1 wrote: post #40
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?

You don't pay the deductible for many typical services if you're in-network. We have a mid-tier United Healthcare plan, and we only ever pay a $25 copay per doctor visit.

United Healthcare's net profit margin is about half that of Chipotle in a good year: https://www.macrotrends.net/stocks/charts/UNH/unitedhealth-g...; https://www.macrotrends.net/stocks/charts/CMG/chipotle-mexic...

Re: Is Health Insurance Even Worth It Anymore?

#64

Post by Taikonerd »

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…

My big question about DPC is: what about people who just don't think about primary care until they have something wrong? How long is the wait list at that point? Or can they go see a doctor for $X as a one-off, without a subscription?

Re: Is Health Insurance Even Worth It Anymore?

#65

Post by gambiting »

nonameiguess wrote: post #8

Reading the comments is hilarious. That "healthy 34 year-old male with minor sports injuries" was exactly me when I was 34. Then I hit my out-of-pocket max 7 out of the next 10 years and exceeded a million in insurance spend twice due to a whole lot of major surgeries. It also feels male-centric. Surely pregnancy and childbirth are all but guaranteed to put you over an out-of-pocket max, especially with how common c-…

And then you have to wonder how many operations are done just to bill insurance companies money. I have injured my shoulder(here in the UK) and I saw a specialist shoulder surgeon who basically said that the state of the art research into these kinds of injuries is to just leave them alone and let them heal - but if you were in the US you would have had two operations on it already because they just love operating on things that don't need operating on for dubious medical benefit because they would charge 100k for each operation, easy.

Re: Is Health Insurance Even Worth It Anymore?

#66

Post by baggachipz »

The only reason we have this broken system in the US is because of "lobbying" in an environment where unlimited money is "free speech". As long as these "insurance" companies continue to own the politicians, there will never be any meaningful progress. A 6% tax hike each year would induce riots in the streets, but somehow this same scenario in premiums is accepted by the population with anger and a shrug.

Re: Is Health Insurance Even Worth It Anymore?

#67

Post by efunnekol »

In the last two years, my mother had a tumour (successfully) removed from her brain and my sister had day-long heart surgery. Two extensive processes with lots of consults before and after, both requiring significant hospital stays. At the time I was a bit grumpy that I had to pay $15 a day for parking at the hospital, which was really the only out of pocket cost to the family here in Canada.

We do have a major shortage of GPs and wait times can be longer than you want, so I would not say that we necessarily have the best health care system in the world. But you really need to go to the cafeteria in a hospital to find cash registers. And when I picked up my mother from the hospital, we said goodbye to the nurses and just walked right out.

Re: Is Health Insurance Even Worth It Anymore?

#68

Post by lisbbb »

opwieurposiu wrote: post #54

When I was child, our dog got hit by a car. The dog had two broken legs and was bleeding from the nose. My dad said, "Come with me son, I will show you what to do." So we went into the woods behind the house and dug a hole. I put the dog in the hole and my dad shot the dog in the head. After we filled in the hole my dad said. "Now you know what to do with me when I get old." So my health insurance is healthy living,…

I have buried many pets, but last year my wife got cancer and while insurance was a huge headache, it came through in terms of protecting our wealth. She's currently in remission a year later after a very, very difficult fight that she nearly lost multiple times. It was extraordinarily stressful. I learned not to worry about the insurance crap, it all eventually worked itself out despite how frustrating it all was. So I'm not sure 9mm, 45, 357, or any other caliber for the "Hunter S. Thomson" solution, would have been a smart move for us. I totally understand the sentiment, because there are fates worse than death for sure.

What didn't hold up was not our insurance but my employer, who found a sneaky way to get rid of me and not have to deal with an employee who needed to dip out for his wife's numerous medical appointments.

Re: Is Health Insurance Even Worth It Anymore?

#69

Post by danielmarkbruce »

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…

The actual cost to treat "cancer or whatever" is extremely high in many cases. 15k a year to know you have that covered for a family isn't so bad given the true underlying cost.

A family member has a rare disease and I've gone through the details of the various treatments, how many people are involved in ongoing care and treatment etc. It's a lot of very well trained people spending a lot of time. A concrete treatment example - the process to create some blood plasma treatments is very complex, expensive etc. In the end, it will be millions of dollars of real underlying costs.

There is probably no cheap solution. Maybe GLP-1 type magic can put a real dent in the overall cost, but there will always be a desire to save people's lives even if the cost is very high.

Re: Is Health Insurance Even Worth It Anymore?

#70

Post by lotsofpulp »

whatever1 wrote: post #40
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?

>How can I start an insurance company?

One requirement is to be willing to earn returns less than SP500.

Look up profit margins and annual returns for UNH, Elevance, CVS, Cigna, Humana, Centene, and Molina.

You have a billion laws to follow, you’re used as a punching bag by politicians and customers, have to get the price of your service approved by a government employee, and for all of that, you earn a 2% to 3% profit margin.

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