4 ms·

One thing I've always been curious about: what insurance plan, if any, do the rich use in the US? I'm not talking about the 1% but the 0.1%. Let's say, a famous

One thing I've always been curious about: what insurance plan, if any, do the rich use in the US? I'm not talking about the 1% but the 0.1%. Let's say, a famous movie actor or singer. Do they use fully non-insurance, out of pocket healthcare for primary physicians and specialists? What about surgeries? I wonder if there is in practice a separate health care system for them.

tylergetsay 5y ago
In my experience, they have the same doctors and insurance; the difference is they have their doctors cell numbers and hang out on the weekends. Doctors want the perks of billionaire friends too.
gumby 5y ago
I’m far from in the .1% but can afford to self insure. I still carry a high end insurance plan because if I break my leg on the ski slopes I don’t want to end up being triaged into the “indigent” bucket at the ER (this happened to me once, luckily with something less serious than a broken leg). Likewise it’s hard to get into some specialists unless you are in network. This isn’t a case when a call from my primary can’t get me an appointment (that call has gotten me seen even by docs who are “not accepting new patients”) but because the hospital administration doesn’t like cash payers even though they are charged the most. The real differences lie elsewhere. For example my primary doctor simply doesn’t accept insurance of any sort. I see her, I pay the bill as I leave. She chooses tests and therapies based on whether she thinks they are worth it (risk vs informative value), and has the time to discuss with me. The longest I’ve had to wait for an appointment was once when I called in the morning and couldn’t be seen until the afternoon. She seems to be friends with the heads of various departments of a few local hospitals which cuts through red tape. The wealthy 1%ers and 0.1%ers have special areas of high end hospitals and various sherpas who can make sure the patient gets the attention they want. I wonder how that system is operating these days in light of what COVID has done to the hospital infrastructure. Apart from my primary care physician, I’ve had better care from more egalitarian systems in Europe and Australia. Even there though, the informal networks are quite valuable.
- danielrpa 5y ago
  Thank you, that's very informative! If you don't mind me asking, what would be an example of a high end insurance plan? Is this like a low deductible ("Gold") plan from regular carriers like Kaiser and Anthem?
  - gumby 5y ago
    Since aca I just use a platinum aca plan though I would not choose either of the companies you mention. Kaiser has its own network which defeats the purpose for me while Anthem is…just so terrible a company I will never ever buy from them.

tylergetsay 5y ago

In my experience, they have the same doctors and insurance; the difference is they have their doctors cell numbers and hang out on the weekends. Doctors want the perks of billionaire friends too.

gumby 5y ago

I’m far from in the .1% but can afford to self insure. I still carry a high end insurance plan because if I break my leg on the ski slopes I don’t want to end up being triaged into the “indigent” bucket at the ER (this happened to me once, luckily with something less serious than a broken leg). Likewise it’s hard to get into some specialists unless you are in network. This isn’t a case when a call from my primary can’t get me an appointment (that call has gotten me seen even by docs who are “not accepting new patients”) but because the hospital administration doesn’t like cash payers even though they are charged the most. The real differences lie elsewhere. For example my primary doctor simply doesn’t accept insurance of any sort. I see her, I pay the bill as I leave. She chooses tests and therapies based on whether she thinks they are worth it (risk vs informative value), and has the time to discuss with me. The longest I’ve had to wait for an appointment was once when I called in the morning and couldn’t be seen until the afternoon. She seems to be friends with the heads of various departments of a few local hospitals which cuts through red tape. The wealthy 1%ers and 0.1%ers have special areas of high end hospitals and various sherpas who can make sure the patient gets the attention they want. I wonder how that system is operating these days in light of what COVID has done to the hospital infrastructure. Apart from my primary care physician, I’ve had better care from more egalitarian systems in Europe and Australia. Even there though, the informal networks are quite valuable.

danielrpa 5y ago
Thank you, that's very informative! If you don't mind me asking, what would be an example of a high end insurance plan? Is this like a low deductible ("Gold") plan from regular carriers like Kaiser and Anthem?
- gumby 5y ago
  Since aca I just use a platinum aca plan though I would not choose either of the companies you mention. Kaiser has its own network which defeats the purpose for me while Anthem is…just so terrible a company I will never ever buy from them.