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The problem not many of us are 30 years old and those that are only manage it for one year. You are trying to take one scenario and extrapolate it across the population. And it simply doesn't work.
The difference in premiums goes up with age not down, so the argument only gets stronger
Which is why I described the lack of transparency as the primary problem.
Which is why I described the exercise of getting data as "like pulling teeth".
The providers don't want to reveal their pricing or be clear about policies.
As it stands they have no authority imposing that expectation on them.
They'll continue to dig in their heels when pressed.
Maybe one day we'll have a medical industrial complex that works for patients.
I won't be holding my breath waiting for it though.
I find that when facilities really want your business they will give you a price.
This is a GOOD thing. The whole point of insurance (of any kind, business, car, home, health, disability, life) is to protect you from the financial impact of a catastrophe you aren't expecting and can't afford. Not to subsidize ordinary, mundane expenses such as some perfectly manageable and reasonable doctor bills!
If you want "insurance" to cover everything, you'll end up paying MORE in the long run, since you have to pay higher premiums not only for the health care cost itself, but for the increased overhead resulting from middle-men and bureaucracy costs...
Low deductibles are a colossal waste of money in the long run, especially once you factor in just how much staff and how many hours in a medical clinic are spent on billing insurance for reimbursement. If the patient just freaking paid for it, you'd avoid all the nonsense!
Very well said.
Consider this:
Does your auto insurance pay for new tires and oil changes? Mine doesn't.
Does your homeowner's insurance pay when you need a new refrigerator? Mine doesn't.
Do I bear the ultimate responsibility for my own health care? You betcha. And if folks were paying out of their pockets, they'd demand better care and it would be priced competitively.
And, on average, you saved more than that amount out of your premiums.
Insurance is supposed to cover you in face of something you could not otherwise afford. The only real reason to buy a plan other than a high-deductible plan is either:
Your risk profile is higher than would be expected for your age group
You're living paycheck to paycheck.
A plan with a $25K+ deductible would work great for me, for example. I have much more than that saved, and I'm very healthy male at age of 24.
In the real world, each of us has inside information about our health. We trade in that inside information in the marketplace for insurance -- information we withhold from insurance companies.
Let's suppose that you suffer a torn rotator cuff after a bad fall. According to the NIH the best case scenario is going to cost about $26,000 for surgery, which you can afford since you have $25,000+ saved up. What happens when you break your arm the next year (about $4000) or you need a new car, or you put money down on a house before any of your accidents.
I'm glad that you have managed to save such a hefty sum, but the average American household has only $5000 saved, and most have less than that.
You say the company COST of rotator cuff surgery is about $26,000.
Actually, that is the PRICE, not the COST. The cost is much lower.
Let's suppose that you suffer a torn rotator cuff after a bad fall. According to the NIH the best case scenario is going to cost about $26,000 for surgery, which you can afford since you have $25,000+ saved up. What happens when you break your arm the next year (about $4000) or you need a new car, or you put money down on a house before any of your accidents.
I'm glad that you have managed to save such a hefty sum, but the average American household has only $5000 saved, and most have less than that.
Well, I happen to have multiple years of the $25K deductible saved. I also would have the choice to change my insurance policy to a lower deductible if I really thought my issues would continue for the long term, or I otherwise exhausted my savings.
I guess my biggest annoyance is that the max deductible allowed by the ACA is $6K, because most Americans don't have much saved. Why should I be forced to pay more because most people don't save?
Quote:
Originally Posted by SportyandMisty
You say the company COST of rotator cuff surgery is about $26,000.
Actually, that is the PRICE, not the COST. The cost is much lower.
This is also a really good point - by paying out of pocket we would have a lot more motivation to negotiate prices lower. We'd also be free of the insurance company overhead.
Quote:
Originally Posted by SportyandMisty
In the real world, each of us has inside information about our health. We trade in that inside information in the marketplace for insurance -- information we withhold from insurance companies.
My secret is that the only medical care I need is in a catastrophic event. Where can I trade that information? All legal health plans are too conservative for my risk level.
Well, I happen to have multiple years of the $25K deductible saved. I also would have the choice to change my insurance policy to a lower deductible if I really thought my issues would continue for the long term, or I otherwise exhausted my savings.
I guess my biggest annoyance is that the max deductible allowed by the ACA is $6K, because most Americans don't have much saved. Why should I be forced to pay more because most people don't save?
This is also a really good point - by paying out of pocket we would have a lot more motivation to negotiate prices lower. We'd also be free of the insurance company overhead.
My secret is that the only medical care I need is in a catastrophic event. Where can I trade that information? All legal health plans are too conservative for my risk level.
Because you would get a lot of people buying the cheapest insurance and then dumping the bill onto the taxpayer when they get sick or have an accident and cannot pay.
Because you would get a lot of people buying the cheapest insurance and then dumping the bill onto the taxpayer when they get sick or have an accident and cannot pay.
So basically, I have to pay for others' lack of responsibility. Just great.
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