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Is Health Insurance Even Worth It Anymore?

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Re: Is Health Insurance Even Worth It Anymore?

#181

Post by insane_dreamer »

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.

> Obamacare's modeling predicted that significantly more healthy people would sign up, driving costs down. It didn't happen.

That's because the GOP Congress gutted the provisions that heavily incentivized healthy people to sign up.

We could also just do Medicare for All. Every other developed country seems to have figured that out but us :/

Re: Is Health Insurance Even Worth It Anymore?

#182

Post by joquarky »

black6 wrote: post #92
amundskm wrote: post #4

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.

This is pretty much what I'm doing now.

Be warned: ageism is very real in tech.

Re: Is Health Insurance Even Worth It Anymore?

#183

Post by seanmcdirmid »

insane_dreamer wrote: post #181
0xy wrote: post #39

Earlier quoted context omitted.

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. That's because the GOP Congress gutted the provisions that heavily incentivized healthy people to sign up. We could also just do Medicare for All. Every other developed country seems to have figured that out but us :/

Obamacare is basically based on the Swiss system, so not every other developed country has Medicare for all (even the German system is “it’s complicated”). The main difference between the Swiss system and Obamacare though is the Swiss outlaw health insurance being provided as a benefit at work (so basically no group plans, almost everyone is in the same risk pools). Foreigners living in Switzerland need to document their purchase of Swiss health insurance.

Re: Is Health Insurance Even Worth It Anymore?

#184

Post by insane_dreamer »

seanmcdirmid wrote: post #183
insane_dreamer wrote: post #181

Earlier quoted context omitted.

> Obamacare's modeling predicted that significantly more healthy people would sign up, driving costs down. It didn't happen. That's because the GOP Congress gutted the provisions that heavily incentivized healthy people to sign up. We could also just do Medicare for All. Every other developed country seems to have figured that out but us :/

Obamacare is basically based on the Swiss system, so not every other developed country has Medicare for all (even the German system is “it’s complicated”). The main difference between the Swiss system and Obamacare though is the Swiss outlaw health insurance being provided as a benefit at work (so basically no group plans, almost everyone is in the same risk pools). Foreigners living in Switzerland need to document t…

Switzerland does have mandated universal health care, so essentially the same result as "Medicare for All". It's just implemented in a different form: mandatory basic insurance + supplemental insurance, instead of a single-payer system. A number of other European countries have something similar.

Re: Is Health Insurance Even Worth It Anymore?

#185

Post by aDyslecticCrow »

seanmcdirmid wrote: post #183
insane_dreamer wrote: post #181

Earlier quoted context omitted.

> Obamacare's modeling predicted that significantly more healthy people would sign up, driving costs down. It didn't happen. That's because the GOP Congress gutted the provisions that heavily incentivized healthy people to sign up. We could also just do Medicare for All. Every other developed country seems to have figured that out but us :/

Obamacare is basically based on the Swiss system, so not every other developed country has Medicare for all (even the German system is “it’s complicated”). The main difference between the Swiss system and Obamacare though is the Swiss outlaw health insurance being provided as a benefit at work (so basically no group plans, almost everyone is in the same risk pools). Foreigners living in Switzerland need to document t…

much of Europe force a fixes price table too. Different Insurance companies and private individuals pay the same amount for the same things. That create a even playing field where market forces actually help rather than hurt the outcome.

Re: Is Health Insurance Even Worth It Anymore?

#186

Post by josefresco »

tvchurch wrote: post #144
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…

Author here. DPC is terrific if you have an option near you! Paired with catastrophic insurance, it's a great bet for relatively healthy people. The DPC Alliance map is well worth a visit: https://mapper.dpcfrontier.com/ And I wrote about DPC a while back: https://church.substack.com/p/direct-primary-care

Thank you for this. I found my former PCP on this map!

Re: Is Health Insurance Even Worth It Anymore?

#187

Post by JohnFen »

rayiner wrote: post #153
JohnFen wrote: post #136

Earlier quoted context omitted.

Here in the US, I see wait times for medical care comparable from what I hear from my Canadian friends. I don't think we our system can really tout that as an advantage over theirs.

Where are you located? E.g. the average wait times for CT scans and MRIs in Canada is weeks: https://canjhealthtechnol.ca/index.php/cjht/article/download... . UK NHS is 6-18 weeks. Here in suburban Maryland I’ve never had to wait more than a day or two for anything.

I live in the urban west. Most of the people I know have to wait weeks for pretty much anything.

When I had a serious accident involving multiple broken bones and the need for orthopedic surgery, I had to wait two weeks to get an MRI, although I did get a basic X-ray in the emergency room. Then another month (while being unable to move much, let alone work, and being in a great deal of pain) to get the surgery. That was me getting expedited scheduling. It also cost me a fortune out of pocket.

Re: Is Health Insurance Even Worth It Anymore?

#188

Post by OutOfHere »

Healthcare in the US is a complete protectionist racket in all of its aspects. The costs and bureaucracy are 100x to 1000x what they should be in a highly competitive system. No wonder it's unaffordable. Until this is fixed, shuffling around who pays can't sustainably fix it. Regulations in favor of the racket need to be systematically identified at all levels of government and loosened or struck down.

Re: Is Health Insurance Even Worth It Anymore?

#189

Post by seanmcdirmid »

insane_dreamer wrote: post #184
seanmcdirmid wrote: post #183

Earlier quoted context omitted.

Obamacare is basically based on the Swiss system, so not every other developed country has Medicare for all (even the German system is “it’s complicated”). The main difference between the Swiss system and Obamacare though is the Swiss outlaw health insurance being provided as a benefit at work (so basically no group plans, almost everyone is in the same risk pools). Foreigners living in Switzerland need to document t…

Switzerland does have mandated universal health care, so essentially the same result as "Medicare for All". It's just implemented in a different form: mandatory basic insurance + supplemental insurance, instead of a single-payer system. A number of other European countries have something similar.

Yes, but that was what the ACA attempted, and there wasn’t just one simple model that America could have adopted to fix all its healthcare problems.

Re: Is Health Insurance Even Worth It Anymore?

#190

Post by [deleted] »

_DeadFred_ wrote: post #167
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…

We were SPECIFICALLY told this system could do this, that unlike socialized healthcare, it doesn't have 'death panels' (I believe the term the politicians used).

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