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Not sure I get you. "But only for unpredictable, irregular events." But if I went into the Doctor's office without insurance, could they turn me away? The bill

by weka 9y ago

Not sure I get you. "But only for unpredictable, irregular events." But if I went into the Doctor's office without insurance, could they turn me away? The bill would be too high? We looked into ACA... but we thought that the process of switching over from AETNA to COBRA would be painless (weeks at most). So we just went through with it. We did not know it would end up like it has. The operations for insurance is a daunting, slippery rope. Can you not lay some fault onto insurance and its operations? What would you characterize this as? People slipping up? That's how the "system has always worked"? People forgetting to process paperwork needed so people can get to their appointments?

kelnos 9y ago
I think the parent is objecting to the use of the word "insurance". By definition, insurance is a form of risk management, to protect yourself against unexpected cost or loss. You can't be "insured" for regular wellness checkups and screenings; that word just doesn't make sense there, as those are expected, regular costs. Coverage for that is more like a "health plan", which is, in reality, what we have, despite the industry's insistence on calling it insurance. (But yes, admittedly, this is just pedantry.)
- weka 9y ago
  Ah, I understand - thank you.
lallysingh 9y ago
I believe OP is talking more generally about insurance (not just health). Insurance covers you for unusual unexpected large-cost events at the cost of regular, predictable payments. They are useful in capping your risk exposure. But if the events are rather certain, then the insurer can only act as a payment plan on the events. The risk is 100%, so at least 100% is priced into your premium (profits, a overhead, etc take it over 100).
- ams6110 9y ago
  Except even the 100% risk is spread over the group. So if I have some known condition that will definitely incur $10,000 in medical expenses this year, it's still possible that my premiums total less than that, but everyone's premium is a bit higher than it would otherwise be, to cover my extra costs. Even covered wellness care probably comes out a bit less than it would otherwise cost, because not everyone uses it even though it's covered. Some people, like me, just don't go to the doctor.
  - taeric 9y ago
    This is why the poster called it a socialized system. You are literally spreading the costs to the society of individuals in the plan. That is not insurance. Now, it is common for "socialized" to be a scary word. So that people try and name it other things. But you aren't spreading the risk here. You are only spreading the costs. Well, I'd also argue that you are spreading the benefits. Which is a good thing to me. Point being, though, it is not insurance.
  - rsync 9y ago
    "Except even the 100% risk is spread over the group. So if I have some known condition that will definitely incur $10,000 in medical expenses this year, it's still possible that my premiums total less than that, but everyone's premium is a bit higher than it would otherwise be, to cover my extra costs." This is why I used wellness checks and tire changes as examples - they are regular and universal.
xapata 9y ago
I'd say that healthcare is just one of the fields where bureaucratic incompetence is horrifying. There are many others, like the legal system confusing two people with the same name in the same town.
- ethbro 9y ago
  The takeaway is that one shouldn't predicate success on lawyers creating a Borges-fidelity 1:1 mapping of the real world into law.

by weka 9y ago

kelnos 9y ago

I think the parent is objecting to the use of the word "insurance". By definition, insurance is a form of risk management, to protect yourself against unexpected cost or loss. You can't be "insured" for regular wellness checkups and screenings; that word just doesn't make sense there, as those are expected, regular costs. Coverage for that is more like a "health plan", which is, in reality, what we have, despite the industry's insistence on calling it insurance. (But yes, admittedly, this is just pedantry.)

weka 9y ago
Ah, I understand - thank you.

lallysingh 9y ago

I believe OP is talking more generally about insurance (not just health). Insurance covers you for unusual unexpected large-cost events at the cost of regular, predictable payments. They are useful in capping your risk exposure. But if the events are rather certain, then the insurer can only act as a payment plan on the events. The risk is 100%, so at least 100% is priced into your premium (profits, a overhead, etc take it over 100).

ams6110 9y ago
Except even the 100% risk is spread over the group. So if I have some known condition that will definitely incur $10,000 in medical expenses this year, it's still possible that my premiums total less than that, but everyone's premium is a bit higher than it would otherwise be, to cover my extra costs. Even covered wellness care probably comes out a bit less than it would otherwise cost, because not everyone uses it even though it's covered. Some people, like me, just don't go to the doctor.
- taeric 9y ago
  This is why the poster called it a socialized system. You are literally spreading the costs to the society of individuals in the plan. That is not insurance. Now, it is common for "socialized" to be a scary word. So that people try and name it other things. But you aren't spreading the risk here. You are only spreading the costs. Well, I'd also argue that you are spreading the benefits. Which is a good thing to me. Point being, though, it is not insurance.
- rsync 9y ago
  "Except even the 100% risk is spread over the group. So if I have some known condition that will definitely incur $10,000 in medical expenses this year, it's still possible that my premiums total less than that, but everyone's premium is a bit higher than it would otherwise be, to cover my extra costs." This is why I used wellness checks and tire changes as examples - they are regular and universal.

xapata 9y ago

I'd say that healthcare is just one of the fields where bureaucratic incompetence is horrifying. There are many others, like the legal system confusing two people with the same name in the same town.

ethbro 9y ago
The takeaway is that one shouldn't predicate success on lawyers creating a Borges-fidelity 1:1 mapping of the real world into law.