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.
So it was my extremely poor choice to inherit kidney disease? Or maybe it's my extremely poor choice to undergo dialysis thrice weekly so I can survive? Or my extremely poor choice to even bother living it?
There are a ton of reasons for ill health in this world before you should even suggest character flaws.
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.
The third option that becomes more tantalizing every year in the US is to not have insurance, pay OOP for routine matters, and when something catastrophic happens let the medical debt go to collections and settle for pennies on the dollar. It doesn't feel right, but it's the direction the medical-pharmaceutical-insurance cartel is pushing us.
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-…
Indeed, healthy or not, once you hit 40s .. the number of friends/family/self dealing with accidents/injuries/serious illness/death grows exponentially.
That seems... fine? That's $14,000 annually. For an income in the $75k-$100k range, Maryland health connection shows me a premium of $700/month for two parents/two kids. Judging by your premium and assuming 2 adults/2 kids, your income is probably over $200k. With that income in Canada, you'd be paying over $20,000 in taxes attributable to healthcare: https://www.fraserinstitute.org/sites/default/files/price-of... .…
Right I think a lot of upper income Americans don't understand how it compares globally. Seeing what my UK colleagues deal with, a $200K income would land you solidly in the 40% marginal tax bracket over there, vs (if married) .. 22% here. US federal effective tax rate (before getting into deductions) would be like 17% on that 200k, for a $166k take home.. versus equivalent UK take-home would be as low as $123k (agai…
Effective tax rates are not that easy to compare.
In fact, the portion of a US health insurance premiums IS a tax, based on your age! Not to mention the myriad ways tax policy (including the age rating factors that cause young people to pay a tax via their health insurance premium) vary among not only the 50 states, but the smaller jurisdictions within the states.
I wonder how many incredible founders and companies we're missing out on because the potential founders never left their jobs due to health insurance costs. Same for rising housing costs. High rent and mortgages reduce risk taking, and that's bad for the economy.
> I wonder how many incredible founders and companies we're missing out on
The many countries that don't have this healthcare issue do not seem to be producing a notable excess of incredible founders or companies.
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.
Do you mean a life-time $50k? Otherwise an annual deductible of $50k sounds ludicrous. Maybe if they tied it to yearly income, it would make more sense.
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...
I pay around $1100 a month for me and my two children through my employer. Yes; I have a $25 copay for many services, but most are simply not covered under that $25 copay. They refused an age-appropriate colonoscopy last year. It's basically fucking useless and expensive. So; is it worth it anymore? No. Is it necessary? Yes; unfortunately.
Yeah, I think that's a big part of the overall grievance. If we paid these high premiums and got great care, that'd be one thing. But I've almost never walked away from a sizeable medical expense in my family thinking I wasn't being ripped off somehow.
That seems... fine? That's $14,000 annually. For an income in the $75k-$100k range, Maryland health connection shows me a premium of $700/month for two parents/two kids. Judging by your premium and assuming 2 adults/2 kids, your income is probably over $200k. With that income in Canada, you'd be paying over $20,000 in taxes attributable to healthcare: https://www.fraserinstitute.org/sites/default/files/price-of... .…
Right I think a lot of upper income Americans don't understand how it compares globally. Seeing what my UK colleagues deal with, a $200K income would land you solidly in the 40% marginal tax bracket over there, vs (if married) .. 22% here. US federal effective tax rate (before getting into deductions) would be like 17% on that 200k, for a $166k take home.. versus equivalent UK take-home would be as low as $123k (agai…
> So UK similar income has $43k more in taxes.. to get you NHS?
Well, and all the other services those taxes provide.
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.
> Obamacare's modeling predicted that significantly more healthy people would sign up, driving costs down. It didn't happen.
It was intentionally fucked with. The requirement to get insurance was nulled out for those young, healthy folks. The end result was obvious - eventual collapse of the system.
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 kn…
I feel the constant fighting with insurance isn't spoken to enough. I don't want insurance because I don't want to be both a billing department and a sick person. We went through the same mess when both of my parents were sick. We were already taking in an enormous amount of new information about their illnesses and then we were also having to try and learn how their insurance worked, what was covered, what wasn't, trying to vet what would happen in every appointment, which doctors would show up (bc what if one of the doctors is out-of-network), duking it out with insuance over prior authorizations, trying to tie each bill that came in to something that happened months ago and then vetting if the bill was correctly billed, correctly covered by insurance etc, and on and on and on. I'd rather have 0 insurance and just negotiate each bill as it came in with one single entity, the hospital.
