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Is Health Insurance Even Worth It Anymore?

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Re: Is Health Insurance Even Worth It Anymore?

#121

Post by righthand »

Workaccount2 wrote: post #84
righthand wrote: post #11

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 provi…

Health insurance companies are a not the problem, their stocks are trash because their business sucks for profitability. They're not the rich misers swimming in gold piles that they are made out to be. People just get that feeling because the insurers are the proxy for medical costs, but you don't have to dig deep to see that they are getting bent too.

Right what reality is this where the insurers are innocent? Did Luigi Mangione allegedly shoot an insurance CEO in the back for life-taking business practices or not?

If insurers aren’t the rich misers and are getting screwed too, then why do they lobby Congress to destroy the ACA and destroy any chance at a real healthcare system? If it’s so terrible for them why wouldn’t they help build a better system and fix the issues with them getting screwed?

Re: Is Health Insurance Even Worth It Anymore?

#122

Post by FeloniousHam »

y-c-o-m-b wrote: post #96
modeless wrote: post #19

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.

@modeless is essentially arguing for self-insurance, which is perfectly sensible. You don't need insurance for things you can plan for, or have savings for (make sure you're analyzing your total financial tail risk).

Dental "insurance" is basically a savings plan with a negative return, considering the low lifetime maximums, and the fact that biannual cleanings aren't that expensive out of pocket. I have a $20k deductible (with lower premiums), and I'm coming out ahead. There's societal side benefit that paying with your own money makes you a more discriminating consumer.

The $50K is not outrageous, assuming you have the savings to cover it. You need insurance for the big things, which is basically anything more than a two-day stay in a hospital. The costs blow up from there.

Re: Is Health Insurance Even Worth It Anymore?

#124

Post by dh2022 »

antisthenes wrote: post #120
rayiner wrote: post #63

Earlier quoted context omitted.

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...

Profit margins are irrelevant if you inflate your costs to reduce them.

Not really... If you want more $s by inflating costs and keeping the margin constant, then you will need more capital for paying these higher costs. This additional capital will either come from equity or from debt. Currently both equity and debt are expensive....

Profit margin is quite relevant...

Re: Is Health Insurance Even Worth It Anymore?

#125

Post by thehoff »

dh2022 wrote: post #118
rayiner wrote: post #63

Earlier quoted context omitted.

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...

What is a typical service that you only pay $25? This year I had two shoulder injuries. I paid for every single thing (doctor visits, X-Ray, MRI, Physical Therapy).

For my family, annual screenings are around a $40 copay (no other bills after). I think I paid that for some age related screenings.

Re: Is Health Insurance Even Worth It Anymore?

#126

Post by rayiner »

actionfromafar wrote: post #116
rayiner wrote: post #88

Earlier quoted context omitted.

> but there will always be a desire to save people's lives even if the cost is very high. Also, Americans place extraordinarily high value on life. My wife's grandmother had cancer in her 60s and had a quarter of her lung removed. She then had a stroke in her late 80s. She was in rural Oregon, and they evacuated her via helicopter to Portland. They wanted to give her an aggressive treatment, but she refused, and pass…

+1 The whole system is setup to maximise the "care" whenever possible. IMHO it would be better with a universal healthcare that asked itself some tough questions. Start from a pile of money and calculate maximum impact backwards from there. But maybe that's impossible for the US. (It's satanic and/or communist or something.)

I like universal healthcare in principle, but I don't think the funding mechanism is the problem. We see the same cost inflation in the U.S. in sectors that everyone agrees should be publicly funded, like community colleges or transit. U.S. public spending on tertiary education is about 0.95% of GDP, which is higher than the U.K. (0.5%), Ireland (0.57%), Italy (0.62%), Australia (0.68%), and not that much lower than Germany (1.1%): https://www.oecd.org/en/data/indicators/public-spending-on-e.... Most of those countries have what Americans would call "free college," but we spend just as much as a percentage of GDP--and more in absolute terms--without college being free.

Our colleges simply spend way more money than European colleges. I grew up in Virginia, where George Mason University (GMU) is the second tier public school (behind UVA, William & Mary, and JMU). It's got a budget of $1.4 billion for about 40,000 students.

Compare that to Heidelberg University, which I understand is a renowned university in Germany. Excluding the medical school (which GMU doesn't have), the budget is about 629 million euros, or about $725 million, for about 30,000 students. GMU, which is not a world-famous university, spends almost twice as much money for only 1/3 more students.

Re: Is Health Insurance Even Worth It Anymore?

#127

Post by ceejayoz »

dh2022 wrote: post #124
antisthenes wrote: post #120

Earlier quoted context omitted.

Profit margins are irrelevant if you inflate your costs to reduce them.

Not really... If you want more $s by inflating costs and keeping the margin constant, then you will need more capital for paying these higher costs. This additional capital will either come from equity or from debt. Currently both equity and debt are expensive.... Profit margin is quite relevant...

The capital comes from raising premiums.

Mine went from $3k/month to $3.6k/month this year.

Bonus points if you can steer the increased costs to providers you own. https://www.statnews.com/2024/11/25/unitedhealth-higher-paym...

Re: Is Health Insurance Even Worth It Anymore?

#128

Post by csa »

oliwarner wrote: post #123

A question to everyone unhappy paying for their insurance: would you be happier paying 50% income tax, 20% sales tax and not having to ever worry about paying for healthcare?

> A question to everyone unhappy paying for their insurance: would you be happier paying 50% income tax, 20% sales tax and not having to ever worry about paying for healthcare?

I hope it’s obvious that this is a false dichotomy.

There are many ways to have affordable health care that don’t involve “50% income tax, 20% sales tax”.

There is very good healthcare in places that don’t have those conditions. It’s not hard to find.

In the US, in most cases, incentives for the insurance companies and the insured are not aligned. Ditto for hospitals and patients. These are two very obvious systemic flaws in the US system that, if addressed in a constructive way, could have a significant impact on healthcare affordability.

Re: Is Health Insurance Even Worth It Anymore?

#129

Post by John23832 »

exabrial wrote: post #6
John23832 wrote: post #3

Earlier quoted context omitted.

The ACA didn't do away with HSAs.

Correct, instead it made them unaffordable and disappeared them out of existence. Previously to ACA, I paid $280/month for a direct (non-employer sponsored) plan that had a $5k deductible. The plan was discontinued as the base fell out. There is so much wrong with ACA and the hardliners are not capable of self-reflection, and cannot admit that overregulation has done nothing but make things incredibly expensive.

Insurance middle-men have made healthcare expensive. That has nothing to do with the ACA.

Re: Is Health Insurance Even Worth It Anymore?

#130

Post by jrs235 »

angmarsbane wrote: post #100
JohnFen wrote: post #74

Earlier quoted context omitted.

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, t…

And getting bills 6 to 18 months after the date of services!
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