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Is Health Insurance Even Worth It Anymore?

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Re: Is Health Insurance Even Worth It Anymore?

#71

Post by lisbbb »

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…

This happened because of inflation. Costs rose so much that people had to make claims.

Re: Is Health Insurance Even Worth It Anymore?

#72

Post by aDyslecticCrow »

0xy wrote: post #39
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.

Why is that only an major issue in the US? we have to step back look at the purpose and functionality of an insurance to realise something is fundamentally off in the calculation (Like this post does the napkin maths for).

Corruption greed and blooming price gouging in a market devoid of regulation is to me the only thing that can make the situation this bad.

We already know insurance companies pay less than the out of pocket price, so why is the premium so high that paying out of pocket can even come close to beating insurance.

Re: Is Health Insurance Even Worth It Anymore?

#73

Post by whatever1 »

lotsofpulp wrote: post #70
whatever1 wrote: post #40

Earlier quoted context omitted.

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% prof…

No it will be a zero profit company. All of the revenues will go to my compensation and bonuses.

Re: Is Health Insurance Even Worth It Anymore?

#74

Post by JohnFen »

notfried wrote: post #9

The article mentions early a "cancer diagnosis" but puts that aside and moves on, when this is pretty much the crux of the issue. Prostate and Breast cancers are a 1 in 8 chance. The risk of no insurance at 25 is very different than 50, and than 75. And everyone at all ages is paying for those expensive treatments. The system is broken, but going without insurance is you basically toying with the odds of life.

If you get a very serious and expensive problem, insurance may not help nearly as much as you'd think. My mother had great insurance, but when she got cancer, the insurance didn't stop her from getting absolutely destroyed by the medical bills (not to mention having to constantly fight with the insurance company while being extremely ill).

It drove her to bankruptcy anyway. In hindsight, she commented that had she known that the insurance wouldn't be all that helpful, she would have just saved up all the money she poured into premiums over the decades.

Re: Is Health Insurance Even Worth It Anymore?

#75

Post by sssilver »

freetime2 wrote: post #30

Is medical tourism a potential option for uninsured people to decrease costs in the event of major illness like cancer? How about for a chronic condition?

It is and many immigrant families frequent their origin countries for this purpose (my own as well as many others I know), but it’s hard for someone born and raised in the United States to conceptualize what this looks like in a country like Portugal, Armenia, Russia, Turkey, Korea, etc. There’s issues of trust, risk, learning new and unusual systems, travel discomfort, and the incumbent American system benefits from this. It’s a massive thing for someone in Nebraska to say “let me check treatment options for my chronic back pain in Seoul and run the numbers”.

There’s nothing, absolutely nothing that as an immigrant I loathe more in the United States than the healthcare system. It is disgusting. The mediocrity of the average doctor combined with how much they charge for that mediocrity blows my mind every time life forces me into their wretched cabinets.

Re: Is Health Insurance Even Worth It Anymore?

#76

Post by lisbbb »

ratelimitsteve wrote: post #36
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?

I tend to question that--I don't see how long wait times for serious conditions leads to better health outcomes. It would logically seem like it would lead to more and earlier deaths if truly spending less per patient. I suspect there are statistical shenanigans.

Re: Is Health Insurance Even Worth It Anymore?

#77

Post by Taikonerd »

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…

Executive order 14221 (passed in 2021, [0]) was supposed to provide transparency about what the actual negotiated rates were. The idea was that it would be a lot harder for hospitals to engage in price discrimination when they had to publish what everyone was paying.

The actual effect has been... mixed. IIUC, the hospitals mostly haven't complied with the order, or they're maliciously complying while trying to keep their real rates secret.

[0]: https://www.cms.gov/priorities/key-initiatives/hospital-pric...

Re: Is Health Insurance Even Worth It Anymore?

#78

Post by AnimalMuppet »

gtowey wrote: post #20
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.

OK, but...

Let's suppose that a doctor's visit costs $200 for someone without insurance. And let's say that the two options are 1) insurance premiums are $1000/month, but it's only a $20 copay to visit the doctor, and 2) major-only insurance at $100/month. I can visit the doctor pretty regularly on that difference of $900/month.

Re: Is Health Insurance Even Worth It Anymore?

#79

Post by minton »

enraged_camel wrote: post #18
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.

Isn’t idea of insurance at odds with the idea of a pre-existing condition? Like car insurance is a hedge against a crash. We don’t let people buy it after totaling their car.

We really need an alternative system to cover pre-existing and not force it into insurance.

Re: Is Health Insurance Even Worth It Anymore?

#80

Post by accrual »

0xy wrote: post #39
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.

I don't think it's fair to characterize unhealthy people as making bad choices. Many choices do affect health, but plenty of healthy people end up needing medical care every day through no fault of their own. Then there's the systemic issues of our healthcare system, low-cost low-quality food (HFCS and other garbage), and even if the consumer knows how to take better care of themselves, they may not have the resources to do much better depending on their life situation (think juggling jobs and taking care of kids, etc). So, I don't think it's strictly a choice to be healthy or to be a drain on the system.
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