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Is Health Insurance Even Worth It Anymore?

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Re: Is Health Insurance Even Worth It Anymore?

#101

Post by jsbisviewtiful »

Anecdotal - A friend of mine decided to go without health insurance this year and then tore her ACL. So guess who is walking around with a torn ACL until next year because she simply can't afford the surgery...

The US healthcare system is rotten to the core but the populous refuses to educate themselves and keeps voting for losers that won't do anything to fix the system - so we all suffer. Republicans have been promising an alternative to the ACA (for some reason) for over 10 years now and have yet to produce anything - They are just interested in tearing down any progress and not offering fixes to current problems... but thanks to voter education and gerrymandering Republicans are able to keep their vulture capitalism ideals afloat. That's not even mentioning establishment Democrats that don't do much when they have the chance.

Re: Is Health Insurance Even Worth It Anymore?

#102

Post by rayiner »

lotsofpulp wrote: post #94
steveBK123 wrote: post #89

Earlier quoted context omitted.

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. https://news.ycombinator.com/item?id=45800973 https:/…

Sure. But if you make the calculation that granular, you also need to include employer-paid health insurance on the compensation side of the ledger. More than half of Americans have employer-paid health insurance, and employers contribute on average $17,000 per employee: https://www.business.com/articles/health-insurance-costs-thi...

Re: Is Health Insurance Even Worth It Anymore?

#103

Post by rayiner »

ceejayoz wrote: post #98
steveBK123 wrote: post #89

Earlier quoted context omitted.

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. They wind up spending a lot less on healthcare. https://commons.wikimedia.org/wiki/File:OECD_health_expendit...

They spend less because their nurses make poverty wages compared to the U.S. My sister in law is studying to be a nurse. Starting pay is around $70,000 here. In the UK it’s like $42,000. She could make that much being a nanny around here.

Re: Is Health Insurance Even Worth It Anymore?

#104

Post by thehoff »

garciasn wrote: post #90
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...

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.

I just took a look at our annual medical contributions and employer's part.

We pay just over 10k for health insurance through our (different) companies. Our different employers cover almost 28k. So around 38k for insurance. This doesn't even include dental or vision which is separate.

It just seems so crazy how much we pay and still have deductibles. I understand we have small copays and get items covered like age-related screenings but this just feels excessive.

Re: Is Health Insurance Even Worth It Anymore?

#105

Post by Taikonerd »

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…

> for all of that, you earn a 2% to 3% profit margin.

Yeah -- it seems like a paradox that the insurance companies charge so many people so much money, yet struggle to make a profit.

I've heard that they spend a lot of money handling their "internal friction" -- reviewing claims, handling appeals, etc.

Re: Is Health Insurance Even Worth It Anymore?

#106

Post by ceejayoz »

rayiner wrote: post #103
ceejayoz wrote: post #98

Earlier quoted context omitted.

> So UK similar income has $43k more in taxes.. to get you NHS? Well, and all the other services those taxes provide. They wind up spending a lot less on healthcare. https://commons.wikimedia.org/wiki/File:OECD_health_expendit...

They spend less because their nurses make poverty wages compared to the U.S. My sister in law is studying to be a nurse. Starting pay is around $70,000 here. In the UK it’s like $42,000. She could make that much being a nanny around here.

https://www.commonwealthfund.org/publications/issue-briefs/2...

> OECD Health Statistics data show U.S. registered nurses (RNs) earn 1.5 times the OECD12 average salary. These data are adjusted for purchasing power parity. Using numbers of RNs in the U.S. from the Bureau of Labor Statistics,22 we computed total RN earnings using average U.S. pay and OECD12 average pay. The difference was $79 billion, or about 2 percent of 2021 NHE, representing approximately 5 percent of excess U.S. spending when rounded to the nearest multiple of five.

It's not nothing, but it's hardly the only reason, or even a particularly big one.

Re: Is Health Insurance Even Worth It Anymore?

#107

Post by gtowey »

AnimalMuppet wrote: post #78
gtowey wrote: post #20

Earlier quoted context omitted.

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.

All this hypothetical tells us is that you're young, healthy, single, and have a good income. Which is exactly the issue with our health system -- it only works when you don't get sick.

The median household income in the US is $83k. That's for a whole family. I would challenge you to come up with a monthly budget for four people that can support anything like $1000 a month for insurance (which for a family is actually going to be more like $2000) OR handle multiple $200 doctor visits per month. And mind you there is no such things as a doctor visit that costs only $200 unless you're talking about a routine physical. Because the first thing that happens when you're sick is the doctor starts ordering tests and referring you to specialists. And let's hope nobody needs a prescription!

And then you find what life looks like for 150 million Americans -- you're constantly putting off healthcare until it becomes an emergency. You're gambling with your own life and the life of your children trying to not go bankrupt.

Re: Is Health Insurance Even Worth It Anymore?

#108

Post by rayiner »

thehoff wrote: post #104
garciasn wrote: post #90

Earlier quoted context omitted.

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.

I just took a look at our annual medical contributions and employer's part. We pay just over 10k for health insurance through our (different) companies. Our different employers cover almost 28k. So around 38k for insurance. This doesn't even include dental or vision which is separate. It just seems so crazy how much we pay and still have deductibles. I understand we have small copays and get items covered like age-re…

Just talk to people in the healthcare industry about what kind of patients they have. We cover a tremendous amount of treatments in the U.S., at an arguably unsustainable level of service.

My aunt had a kidney infection in Canada and my cousin had to pull teeth to get her scheduled for an MRI. My five year old got a black eye from running into a table and they scheduled him for an X-ray and CAT scan (“just in case “) later that same morning. Had the results by lunch. My dad had a non-emergency scan scheduled the next day, and an outpatient procedure for a kidney stent (to treat high blood pressure) within two weeks. Once the surgeon was in there he realized my dad didn’t need a stent after all.

Re: Is Health Insurance Even Worth It Anymore?

#109

Post by ratelimitsteve »

lisbbb wrote: post #76
ratelimitsteve wrote: post #36

Earlier quoted context omitted.

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.

https://ourworldindata.org/grapher/life-expectancy-vs-health...

The data are there. If there's a problem with the data, it's not enough for you to simply suspect it. You kinda have to determine what the problem is and show it to us. After all, no one waits longer for healthcare than someone who never gets it because they can't afford it.

Re: Is Health Insurance Even Worth It Anymore?

#110

Post by Mordisquitos »

lisbbb wrote: post #76
ratelimitsteve wrote: post #36

Earlier quoted context omitted.

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.

You seem to be more confident in universal healthcare having "long wait times for serious conditions" than in universal healthcare resulting in better health outcomes at a lower cost per citizen. What makes you trust the first premise more than the second one?
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