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We, never had insurance until we got on Medicare. We had broken bones, misc problems that we paid for out of pocket. When our son was born, we paid for it, when he had a minor operation, we paid it. I was self employed and never make more than $50M. I know darn well that for what insurance would have cost me over those years would have been a lot more than what out of pocket costs cost me. BUT- like the OP, we are a very health family and lucked out. And one of my pet peeves is that employer provided insurance isn't taxed as income.
I view insurance as a product that should cover MAJOR unexpected expenses, not a case of the sniffles.
That is exactly as it should be. However, consumers have demanded more and more first dollar coverage, so we have gone from a point where insurance covered only hospitalization to coverage for many things with no copay or deductible. It's akin to buying automobile insurance that pays for oil changes. The cost of all of the "free" stuff is bundled into the premium. That just means that while copays and deductibles have gone up, so have premiums.
Quote:
Originally Posted by ashpelham
Thanks all for your thoughtful replies. Your points are well-argued. Nothing ground breaking, but you guys and girls are very convincing!
We have the health insurance because we CAN afford it. We cannot afford a 50k medical bill. most people probably can't. I do not think it is efficient nor is it beneficial for Americans to have to pay 500 per month plus high deductibles, to subsidize people who have enormous insurance bills. A lot of which is probably waste or doctors taking advantage of that patients' insurance policy to line their own pockets.
the 3rd party payer system is BS.
If we do not move to a single payor system, we need to divorce insurance from employment. That would mean premiums would find a compromise between those subsidized by an employer and those paid in whole by the policy holder.
The whole purpose of insurance is to mitigate the cost of expensive illnesses. You get the same opportunity to use money from the insurance pool as anyone else in the pool, even if you are fortunate enough not to need it.
There is a lot of waste, a good bit of which could be mitigated by tort reform. However, any treatment rendered by a doctor requires the consent of the person being treated. Insurance companies require pre-authorization for many of the most expensive treatments and clear indications before they will pay. How do you perceive that doctors are " ... taking advantage of that patients' insurance policy to line their own pockets" ?
Sounds like the OP has a high deductible plan. So do I-deductible is $3k for individual and $6k for family IIRC. One benefit I get, perhaps OP does too, is discounted rates when I do see the doc.
Frankly, I prefer the high deductible plan I have that is mixed with an HSA. I prefer to pay less on a monthly basis, but have to "write a check" for services rendered. I view insurance as a product that should cover MAJOR unexpected expenses, not a case of the sniffles.
I'm in the same boat, with the same deductibles, and I LOVE my HDHP. We managed to hit our deductibles last year, because my very healthy 16 year old needed an MRI of the brain and an ultrasound of the heart. Turned out he was (and is) as healthy as he could be, but those two were recommended for a good reason, and I'm glad we had coverage to do it at a discount, and I was able to pay everything from my HSA.
I was diagnosed with Stage IV cancer at 23. Before that, I had been relatively healthy with only minor, unrelated complaints as a child. Suddenly, my world was turned upside-down. In 6 months, my insurance was billed over $300,000. To date in the last 4 years, my treatment, follow up care, and related care for side effects of both the cancer and the chemo have cost over $500,000. Even with insurance, my medical care cost more during my 6 months of treatment than a year's take-home pay at the time.
And my cancer was relatively cheap. I just had chemo, no major surgery, no radiation. In fact, my only surgery was a quick half hour procedure to remove a lymph node for testing. If I were to relapse, the additional chemo and stem cell transplant would cost over $1 million even with minimal complications.
You never know. THAT'S why you get insurance. I was the first person in my family to be diagnosed with cancer before the age of 80. I am the ONLY person in my family to be diagnosed with a blood cancer. My cancer has no known cause and nothing I could have done would have prevented it.
I'm in the same boat, with the same deductibles, and I LOVE my HDHP. We managed to hit our deductibles last year, because my very healthy 16 year old needed an MRI of the brain and an ultrasound of the heart. Turned out he was (and is) as healthy as he could be, but those two were recommended for a good reason, and I'm glad we had coverage to do it at a discount, and I was able to pay everything from my HSA.
Yep, quit your whining and go get a physical.
OP, you are not necessarily required to buy your insurance through your wifes employer. Have you shopped around?
OP..If you chose to Discontinue HC..I don't care if there's no health issues or not..You'd be just ONE car accident or trauma away from "Bankruptcy"..Because you know full well..Insurance Company's don't give a flip if you cancelled and had accident..You'd get a "Too bad so Sad" response from then and TY for your patronage..then sign off while they breathed a sigh of relief NOT having to payout the claim for your your massive hospital bills etc....
Roll the dice...What are the chances?? They call it insurance for a reason..If you want to gamble..go to the craps table..why gamble with your future ??
If you have a high deductible plan, your yearly physical (adults and kids), mammograms, pap smears, vaccines, and a slew of other preventative care should be covered at 100% (because you have no co-pay). Sick appointments should be much cheaper than paying cash, as you should be paying the negotiated rate that your insurance provider would pay if they were paying for the appointment. Prescriptions CAN be affordable, if you're willing to do the leg work. You need to look online or call each pharmacy and find the best price. I've had an antibiotic be over $100 at one pharmacy and then less than $20 at another. Costco often has the best prescription prices, and you don't have to have a membership to use their pharmacy. Also ask your doctor for samples and generic options. And don't forget to check the manufacturer websites to look for discounts on brand name drugs.
High deductible plans can be a great option if you take the time to learn what's covered and do the leg work on getting the best prices for everything else.
We, never had insurance until we got on Medicare. We had broken bones, misc problems that we paid for out of pocket. When our son was born, we paid for it, when he had a minor operation, we paid it. I was self employed and never make more than $50M. I know darn well that for what insurance would have cost me over those years would have been a lot more than what out of pocket costs cost me. BUT- like the OP, we are a very health family and lucked out. And one of my pet peeves is that employer provided insurance isn't taxed as income.
Amen.
4/2005-4/2015 Single coverage
Premiums paid $86,744
Deductibles paid $1250
Insurance paid -0-
I'm really looking forward to Medicare!
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