5 ms·

You Don't Need Health Insurance

33 points by surprisetalk 3y ago

jtmarmon 3y ago
This is a pretty good way to go bankrupt when you have a real health emergency EDIT: I doubt OP is reading this but I would highly recommend they get insurance before giving birth...sure, they won't cover your at home birth, but they will cover your hospital stay if you end up having potentially fatal complications
- m3kw9 3y ago
  She did say do so only if you have high risk tolerance
cagenut 3y ago
ah to be young again
- deleted 3y ago
  [deleted]
ceejayoz 3y ago
I'm not sure why the post highlights dental/vision care; these aren't covered by health insurance anyways. I've done the no health insurance thing, and I've done the catastrophic-only health insurance thing. That resulted in a bankruptcy from $90k in medical costs, and that's after the various bits of charity care, neogtiation, and whatnot. It works great, until it suddenly doesn't. These days, I pay the $3,063/month insurance bill... not happily, but I absolutely pay it.
- closewith 3y ago
  Yeah, but the OP's logic, all insurance is unnecessary. Most drivers don't crash, most homes don't burn down, etc.
  - ImHereToVote 3y ago
    This is incredibly entitled against the executives who worked tirelessly their whole life to be the middlemen who steal the resources of a society.
    - closewith 3y ago
      Yeah, I agree. The US should enact free universal healthcare. But until that happens, you've got to deal with the world as it is, not how you wish it would be.
      - readthenotes1 3y ago
        It will be never be free. And in any event, I will believe the US should enact government paid medical care* as soon as the EU does#. * For the ~50% that isn't already on government managed medical care # The constituent states of the EU each do something different.as I understand it, but they don't send gobs of money out of their State so that gormless bureaucrats can take their massive vigorish before sending it back
      - caeril 3y ago
        The only way I could ever be ok with universal health care is if the average BMI of this country drops precipitously. I am 100% fine with helping the guy who gets some random cancer, but I will die on the hill of not supporting the myriad chronic diseases of people who refuse to put the fork down. It's already disastrous enough that private health insurance doesn't adjust premiums for smokers and the obese, like life insurance does.
- m3kw9 3y ago
  Holy f and that’s on top of taxes where govt would provide in most developed countries and many emerging ones
  - lotsofpulp 3y ago
    $3k per month health insurance in the US must be for a family of 4, and must have a very low deductible/oop max (indicating regular use of healthcare). See here for a list of premiums in a state like NJ: https://www.nj.gov/dobi/division_insurance/ihcseh/ihcrates2024.pdf https://www.nj.gov/dobi/division_insurance/ihcseh/ihcrates20... $427 per month would be the cost for a 21 to 24 year old for “BCBS Omnia Silver HSA” (a good representative health insurance), and you can figure out the premiums for other ages using the age rating factors on bottom left (max is $1,287 per month for a 64 year old). Page 6 here shows the deductible and oop max ($2,300 and $7,500). https://www.ehealthinsurance.com/ehealthinsurance/benefits/2024/ifp/NJ/NJHorizon_Blue_Cross_Blue_Shield_of_New_Jersey-2024_IHC_Plan_Guide-10.2023.pdf https://www.ehealthinsurance.com/ehealthinsurance/benefits/2...
    - ceejayoz 3y ago
      Yes, and yes. The blogger in question is pregnant and planning to do a home birth, so they may find themselves in that category surprisingly rapidly.
  - ceejayoz 3y ago
    There's copays and uncovered costs like dental/vision on top of that, too. We reported $49k in medical expenses (which include these premiums, to be clear) to the IRS last year.
    - lotsofpulp 3y ago
      We aimed our two kids’ births to be April/May so that we could take advantage of hitting the annual out of pocket maximum and getting all physical therapy for recovery from birth and anything else that might happen fully covered. And to avoid new resident doctors coming starting in June.
- rthkljlkrj 3y ago
  [dead]
- deleted 3y ago
  [deleted]
- jseliger 3y ago
  It works great, until it suddenly doesn't Precisely: https://jakeseliger.com/2023/07/22/i-am-dying-of-squamous-cell-carcinoma-and-the-treatments-that-might-save-me-are-just-out-of-reach/ https://jakeseliger.com/2023/07/22/i-am-dying-of-squamous-ce.... The best ENT surgeons in Arizona for creating a "flap" that replace part or all of one's tongue after surgery were (and are) at the Mayo Clinic. And I needed radiation after the first surgery. And then another surgery a few months later. I too like the "just don't get seriously sick" strategy, but if it doesn't work, then you have a huge problem.
- MattPalmer1086 3y ago
  I guess if 90k was the max you could pay, it might not make sense. After all, you are paying more than 90k over 3 years. You could just save the money and have savings if you didn't get ill. I bet it could be a lot higher than that though.
  - ceejayoz 3y ago
    > After all, you are paying more than 90k over 3 years. That $90k ran up much faster than that, even with shitty insurance paying at least some of it, and medical needs continued to accelerate for a while afterwards. Savings wouldn't have done a bit of good; it was rapidly exhausted. (That's not part of the $90k, either! It's on top!)
  - closewith 3y ago
    There's essentially no cap on potential medical bills.
    - ceejayoz 3y ago
      There is now; ACA plans have a max out-of-pocket amount, for which I'm very grateful. My bankrutpcy was pre-ACA.
      - imacomputertoo 3y ago
        Be careful because there are two many out of pocket amounts. One for in network and one for our of network. Most ACA plans that I can get in my state do not have an out of network max. That's a huge risk because most hospitals have out of network contractors. That means if you stay in a hospital that is in network, you'll still get billed separately for out of network care. And half the hospital staff might be out of network. So you can still go bankrupt in an in network hospital. The ACA really didn't do much to protect people from bankruptcy.
        ceejayoz 3y ago
        Thankfully, my state (NY) forbids that little loophole. https://www.dfs.ny.gov/consumers/health_insurance/surprise_medical_bills https://www.dfs.ny.gov/consumers/health_insurance/surprise_m... If the hospital is in-network, you're good.
bhpm 3y ago
“I’m pregnant, and I’m giving birth at home.” This is how I know not to consider anything this person says.
- 123pie123 3y ago
  why? (from the UK) my partner gave birth at home - twice in a big blow up swimming pool thing - we did have local maternity nurses here, although they was extremely helpful and useful, we could have got by without them. no drugs either - although my partner had studied various breathing techniques
  - tokai 3y ago
    Until something isn't going as normal, and you end up loosing the child or with brain damage.
    - 123pie123 3y ago
      that was my biggest concern, but we had gone through various scenarios and we fully accepted the risks we also mitigated the risks as well with scans and monitoring, and the worse case stuff - we also knew with research what the approx risks where (I really can't rememeber those now) but I do remember that hospitals typically massively over react - which causes harm in itself
      - jacquesm 3y ago
        > but we had gone through various scenarios and we fully accepted the risks That's because you didn't fully understand the risks.
  - jseliger 3y ago
    It works great, unless and until it doesn't. This at least is a good sign: "we did have local maternity nurses here." My wife is an ER doc (https://bessstillman.substack.com/ https://bessstillman.substack.com/), and her and many of her colleagues have seen the results of home births gone sideways.
JohnVideogames 3y ago
This is mad (especially from a UK perspective!) and it doesn't cover the key point of insurance: you insure risks that you couldn't afford if they went wrong. I insure my house, my life and my car because it'd be financial ruin for me and my partner if the worst case scenario happened to any of those. Sure, I could avoid going through insurance for small things and negotiate with 3rd parties to get bills down, but that wouldn't make a difference to a £500k house rebuilding cost, car crash settlement, or medical bill. Similarly, if something went wrong then I couldn't go back and insure that risk afterwards! You can't insure unpredictable events as and when you need them, and there's no point in my organising insurance from the wreckage of my car, house or health.
- kevmo 3y ago
  America would benefit tremendously from adopting any of the universal healthcare models successfully implemented by many other countries. Our existing insurance model is basically a giant racketeering scam. The lack of access to affordable healthcare increases crime, stifles innovation, decreases longevity and quality of life, and has created a breeding ground for lot of the crazier shit we are seeing in America. I think we see Medicare For All sometime in the next 10-15 years. The first major party nominee for President who embraces it is going to get elected.
  - hotpotamus 3y ago
    > The first major party nominee for President who embraces it is going to get elected. And Republicans will use every ability in their power to prevent it from happening, through the filibuster and Supreme Court most likely. Fighting that sort of socialism is their entire reason for existence. That and upper-income tax cuts obviously.
    - imacomputertoo 3y ago
      That "tax cuts for the rich" line buds me so much. Republicans do not simply cut taxes for the rich. I've looked at income tax tables going back to the mid 70's. It's clear that Republicans cut taxes for all, not just the rich. Regan , G.W. Bush, and Trump cut taxes for the poorest, Middle class and the wealthy. I don't know of any case in the past 50 years when Democrats have cut taxes for the poor, though Obama did continue the Bush tax cuts. Now if that's a good policy to cut taxes and spend as much as they do (Trump especially), that is another question.
carlosjobim 3y ago
The greatest desire of almost every person alive is to put the responsibility for their life and decisions in the hands of others. That's what we've been bred for. So health insurance is an absolute must, whether it's private or through the government. It doesn't even matter if the hospitals, doctors and pharmacies were actively hurting their patients, people would still need health insurance. Because the agony of being responsible for your own health would be too much for people to bear.
- ceejayoz 3y ago
  My kids were born three months early. What does "being responsible" for that look like? Should they enter the world a million dollars in debt already?
  - carlosjobim 3y ago
    The desire is so strong that you're even arguing in defence of scammers. There is no medical procedure that actually costs millions or hundreds of thousands of dollars, those bills are simply scams – unless they're surgically switching heads between people or bringing back the dead and buried to life. As the old saying goes, it's ten times easier to fool somebody, than convincing them that they've been fooled. So I don't have any hopes. But complicated medical procedures and births are done everywhere in the world, and they don't cost millions or hundreds of thousands.
    - ceejayoz 3y ago
      No matter how you slice it, two months in a neonatal ICU is gonna cost. I've no doubt insurance negotiates that initial inflated bill down quite a bit, but under no circumstances is it ever going to be cheap. No amount of "personal responsibility" is going to stop you from being born a micropreemie, or autism, or any number of other expensive, long-term medical issues... and quite a few of these sorts of things tend to hit you on the other side as a bonus, in income/earning potential. Healthcare's like national defense; it's simply not the sort of thing you can tackle individually very effectively on a 300 million people scale.
troupe 3y ago
Funny that most of the stuff mentioned is low enough that it doesn't even meet my deductible. I'm not paying for insurance to cover a $250 bill, or even a $2,500 bill. I'm paying for insurance to cover an unexpected $250,000 bill.
- eek2121 3y ago
  Small numbers. My hospital bill was almost 8 figures before insurance. Insurance contract rates down to high six figures. That is basically instant bankruptcy for most folks. Health insurance can also be free for low income folks, so it is incredibly dumb not to have it.
rthkljlkrj 3y ago
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tokai 3y ago
The author's community "college" is currently running a course on sacred geometry and consciousness. Its a safe bet to disregard anything they write. edit: sorry not currently. It starts 21th January.
rybosworld 3y ago
I wouldn't recommend foregoing health insurance but there are some good takeaways here. Negotiating bills is something a lot of people aren't aware of. I personally wasn't aware I can buy contact lens from the UK - will be giving that a try.
addandsubtract 3y ago
The idea of getting a dental exam through Groupon is absolutely hilarious. And by hilarious, I mean shocking, bewildering, and absurd. Negotiating ER appointments, even more so. This reads like an article from the Amish telling us "You Don't Need Electricity".
joshstrange 3y ago
Yes, because when you find out you have cancer is the best time to go and try sign up for insurance it's not like you are under any other stressors... And I hope you like waiting for open enrollment, cancer can wait right? This is terrible advice and I'll be flagging this article which I don't do often at all. My dad just went through this (cancer). He was on a co-op plan (snake oil if you ask me), had to pay out of pocket then fight to get reimbursed. The co-op said they wouldn't pay the outstanding bills if he left the plan and also refused some of the treatments doctors suggested. In the end he was able to get real insurance (not during open enrollment) through some loophole since the co-op was refusing to pay for something. I'm not sure if he died due to not getting treatment earlier or if earlier treatment would have resulted in the same but this advice is not just stupid, it's dangerous.
padolsey 3y ago
> If you are diagnosed with a chronic illness, explore your insurance options. Isn't it incredibly hard to find insurance if this is the case? Quite curious how it works in the US. I think this all changed under the Affordable Care Act?? Here in the UK it's hard to find insurance that would accept you with a chronic illness unless it's quite low-risk. The only way I was able to "lock-in" a policy was by contuining a medical-history-agnostic one I had under an employer. To get it as a private citizen would have been impossible due to my medical history. So basically I'm now never letting that policy go. TBF the main reason to get private health insurance in the UK is for a shorter waiting list and better aftercare or rehab, but it can also provide hugely life-changing medical intervention if you can carry the policy into old age, AFAIK. But yeh.. I'm privately uninsurable. I cannot purchase life insurance anywhere ... trust me I've tried. Which is funny because I thought the whole point of insurance was to equitably balance out the risk amongst a collective. Ultimately, for me, the whole point with insurance is that it can cover you if something super-super-awful happens. It protects from financial ruin in the case that e.g. you need life-saving emergency surgery. It's there for the unpredictable.. not routine dental appointments lol.
- MattGaiser 3y ago
  > I cannot purchase life insurance anywhere ... trust me I've tried. Which is funny because I thought the whole point of insurance was to equitably balance out the risk amongst a collective. It is, but if you are higher risk, adding you is inequitable to the pool of already insured lower risk people. You have to buy insurance before the need for it to be equitable to the others in the pool.
dschuetz 3y ago
Good luck with living and surviving after cancer. Might outright rather die than having 200k in debt for getting sick once.
TrueGeek 3y ago
This is complete and utter entitled bullshit
Workaccount2 3y ago
TL;DR: You don't need medical insurance as long as you have no major medical incidents. Just like you don't need an umbrella as long as it doesn't downpour. What a bad article.
SkyLemon 3y ago
Insurance is never a good deal. They are betting you’ll never use more then you pay and you are hedging that the day you really do need it, it’ll be worth it. Anything an insurance company covers out of pocket is purely them hedging that those services will save them money in the long run or they have factored it into the price you pay up front. So yes, insurance is never worth it... unless it is... and then often it really was worth it all along.
- dghlsakjg 3y ago
  I doubt this is true for health insurance, but for many competitive insurance industries insurers will frequently break even or even take a loss on premiums. Warren buffet explains it well in his letters to investors. Basically, insurers make most of their money by investing the float, so their incentive is to have a bigger float by offering competitive rates to bring in more customers. They don’t really care if they pay out every dollar they take in, because they made money by holding onto the premium in the time in between when you paid it and when a claim was made. So for things like car insurance, it actually is a pretty good deal. Many companies expect to pay out as much as their clients put in, with the added benefit that you can take out more than you put in if you have a claim immediately after getting insured.
theaccordance 3y ago
This is a reckless opinion piece and it's going to leave some unfortunate soul with a bill that absolutely wrecks their financial situation. I'm billed $1M annually for my health care (Stage IV Cancer), and yes, I likely could get that dollar amount lowered through different tactics, but for a measly $9k a year (premiums + deductible), I don't have to deal with any of that nonsense. $9k for $1M in health care is a deal.
jermaustin1 3y ago
Without insurance, my wife and my medicines would be close to $2000/mo (using services like GoodRX). That is not even considering the every 3 month lab work both my wife and I have to get done for managing our chronic disorders, the 1-2 times a year we get actually sick and need a doctor visit, the vaccines we take yearly due since we both have compromise immune systems, the various flare ups of immune disorders. We are both self-employed, so we get our health insurance on HealthCare.gov, so if we let payments laps on our health insurance, we are barred from getting new health insurance for the remainder of the year. Health insurance is not just insuring our health, it is also insuring our ability to be insured. But beyond any of that, our health insurance is a positive return on investment. Our $900/mo = $2500/mo in benefits. So maybe it is true that you don't NEED health insurance... until you do, and then it is too late.
mhalle 3y ago
Beyond the risk of medical bankruptcy in the US, lack of health insurance can prevent you from getting some lifesaving treatments. If you are uninsured, for instance, you stand almost no chance of getting an organ transplant. There are not enough organs for too many people, the operation is very expensive, and lifetime support medication is also expensive. In my experience, transplant centers won't even start the evaluation without proof of insurance. While it might be possible to get insurance after diagnosis for people like the OP who choose not to have insurance, that isn't always feasible. Sudden organ failure, while rare, certainly happens. And should it happen, it is hardly the best time to be scrambling to find insurance. Yes, the system is screwed up. But it is the system (in the US).
justinhj 3y ago
You can really buy insurance after being diagnosed with cancer? That’s the polar opposite of anecdotes I have heard, and my understanding of how most insurance works.
- ceejayoz 3y ago
  You can, via the ACA exchanges (ACA compliant plans can't deny coverage for pre-existing conditions), but only at the end of each year. You wouldn't want to get a diagnosis in Feb. Once it gets bad enough you may get Medicare/Medicaid for disability/income reasons, but that's... a suboptimal approach.
- mminer237 3y ago
  Since the ACA you can. As long as it's a Marketplace plan, they can't deny you or charge you more for preexisting conditions, and I've never met someone with a private plan nowadays. The catch is that you can only change plans for the next calendar year unless you move or lose your job or something.
- joshstrange 3y ago
  I can tell you from personal experience that you cannot, unless you want to wait till the next year (and sign up during open enrollment). But it's not like cancer moves fast or anything right? You can just wait, nothing bad will happen... /s I'm a bit salty, I lost my dad to cancer last year and he was on a bullshit co-op plan that delayed treatment and made the whole experience even worse than it already was. Would insurance have saved his life? I can't answer that but the delays (before he got real insurance) couldn't have helped.
  - justinhj 3y ago
    Sorry for your loss. Where insurance meets critical health care is an ugly boundary
blackhaj7 3y ago
Monumentally bad advice. Lost for words
francisofascii 3y ago
You should never go completely without insurance, but the article does have some good points. I have health insurance, but they still find ways to not cover unforeseen expenses. Most recently an ambulance bill for my daughter at a school sporting event. So even with insurance I don't feel safe. The best advice is similar to that of the court system, try to avoid the system completely.
mminer237 3y ago
This is called gambling. Health insurance isn't so expensive for no reason. You save a modest amount until you fall off a ladder and lose your house. Buy the cheapest plan with an HSA. You essentially get an above-the-line deduction of all medical expenses even OTC things, you cap your expenses, and you get insurance-negotiated rates.
eek2121 3y ago
Yes you do. Negotiation will still leave you hundreds of thousands in debt if you are hospitalized. I know from experience. You can probably negotiate the bill down to what the insurance pays, but not beyond that. Plus, hospitals don’t think highly of folks that don’t carry insurance. They may refuse to bargain with you at all. Do you think that 3 million dollar hospital bill will just go to collections? No they are going to sue you and get a judgement on you.
beej71 3y ago
Wow--so if I get smashed up on my bicycle by a hit-and-run, I can talk them down to $250? Amazing! If you have assets, carry insurance to protect those assets. Maybe you get lucky with no insurance and come out ahead in the casket, but if you lose, you can lose big. I have exceptional insurance through work now, but when I didn't, I carried high-deductible insurance with an out-of-network max-out-of-pocket. They might get me for 12 grand, but they had to weasel a lot harder to get me to pay more. Also, I've been blessed with pretty good health. But my total hospital bill for life is probably about $250,000 due to a ruptured appendix. (The work was in a socialist hospital so I didn't get a bill--that's just my estimate.) > Insurers can’t refuse to cover you or charge you more due to a "pre-existing condition." This is absolutely true, however one does not simply buy insurance outside of open enrollment; you'd best hope you only get sick or injured in that particular month.
geor9e 3y ago
Clickbait and sensationalism. The author knows they're wrong, but that people will read it, because it's backwards. Commenters will be baited into engagement. The Americans bankrupted every year by simply lacking health insurance won't be acknowledged in the article, even indirectly.
daft_pink 3y ago
I feel this really underplays the proper way to purchase health care, the importance of relationships and the quality of having great providers. I would compare this to my first dog vs my next dogs. The first dog I took him to the low cost clinic to get shots and did minimal cheap health care for him. But as he got older, it became clear that when you start having complications you need to see the same person and you can’t just skate by with different vendors and there is a lot of value to being seen repeatedly by the really highly qualified person as you get older or know where to go if you have an emergency. It’s totally true that you can negotiate and find cheaper prices on things, but like the best veterinarians, the best doctors generally accept the top quality healthcare usually BCBS and aren’t going to discuss or negotiate price with you. They didn’t spend a decade in medical school to deliver transparent billing. I’m all for transparent billing and think it should exist, but my health is too important to try to fight some philosophical price battle and I want the best.
fabiofzero 3y ago
This is a very US-specific problem, for the record. Most of the world is fine without health insurance and without worrying about going bankrupt.

33 points by surprisetalk 3y ago

This is a pretty good way to go bankrupt when you have a real health emergency EDIT: I doubt OP is reading this but I would highly recommend they get insurance before giving birth...sure, they won't cover your at home birth, but they will cover your hospital stay if you end up having potentially fatal complications

m3kw9 3y ago
She did say do so only if you have high risk tolerance

cagenut 3y ago

ah to be young again

deleted 3y ago
[deleted]

ceejayoz 3y ago

I'm not sure why the post highlights dental/vision care; these aren't covered by health insurance anyways. I've done the no health insurance thing, and I've done the catastrophic-only health insurance thing. That resulted in a bankruptcy from $90k in medical costs, and that's after the various bits of charity care, neogtiation, and whatnot. It works great, until it suddenly doesn't. These days, I pay the $3,063/month insurance bill... not happily, but I absolutely pay it.

closewith 3y ago
Yeah, but the OP's logic, all insurance is unnecessary. Most drivers don't crash, most homes don't burn down, etc.
- ImHereToVote 3y ago
  This is incredibly entitled against the executives who worked tirelessly their whole life to be the middlemen who steal the resources of a society.
  - closewith 3y ago
    Yeah, I agree. The US should enact free universal healthcare. But until that happens, you've got to deal with the world as it is, not how you wish it would be.
    - readthenotes1 3y ago
      It will be never be free. And in any event, I will believe the US should enact government paid medical care* as soon as the EU does#. * For the ~50% that isn't already on government managed medical care # The constituent states of the EU each do something different.as I understand it, but they don't send gobs of money out of their State so that gormless bureaucrats can take their massive vigorish before sending it back
    - caeril 3y ago
      The only way I could ever be ok with universal health care is if the average BMI of this country drops precipitously. I am 100% fine with helping the guy who gets some random cancer, but I will die on the hill of not supporting the myriad chronic diseases of people who refuse to put the fork down. It's already disastrous enough that private health insurance doesn't adjust premiums for smokers and the obese, like life insurance does.
m3kw9 3y ago
Holy f and that’s on top of taxes where govt would provide in most developed countries and many emerging ones
- lotsofpulp 3y ago
  $3k per month health insurance in the US must be for a family of 4, and must have a very low deductible/oop max (indicating regular use of healthcare). See here for a list of premiums in a state like NJ: https://www.nj.gov/dobi/division_insurance/ihcseh/ihcrates2024.pdf https://www.nj.gov/dobi/division_insurance/ihcseh/ihcrates20... $427 per month would be the cost for a 21 to 24 year old for “BCBS Omnia Silver HSA” (a good representative health insurance), and you can figure out the premiums for other ages using the age rating factors on bottom left (max is $1,287 per month for a 64 year old). Page 6 here shows the deductible and oop max ($2,300 and $7,500). https://www.ehealthinsurance.com/ehealthinsurance/benefits/2024/ifp/NJ/NJHorizon_Blue_Cross_Blue_Shield_of_New_Jersey-2024_IHC_Plan_Guide-10.2023.pdf https://www.ehealthinsurance.com/ehealthinsurance/benefits/2...
  - ceejayoz 3y ago
    Yes, and yes. The blogger in question is pregnant and planning to do a home birth, so they may find themselves in that category surprisingly rapidly.
- ceejayoz 3y ago
  There's copays and uncovered costs like dental/vision on top of that, too. We reported $49k in medical expenses (which include these premiums, to be clear) to the IRS last year.
  - lotsofpulp 3y ago
    We aimed our two kids’ births to be April/May so that we could take advantage of hitting the annual out of pocket maximum and getting all physical therapy for recovery from birth and anything else that might happen fully covered. And to avoid new resident doctors coming starting in June.
rthkljlkrj 3y ago
[dead]
deleted 3y ago
[deleted]
jseliger 3y ago
It works great, until it suddenly doesn't Precisely: https://jakeseliger.com/2023/07/22/i-am-dying-of-squamous-cell-carcinoma-and-the-treatments-that-might-save-me-are-just-out-of-reach/ https://jakeseliger.com/2023/07/22/i-am-dying-of-squamous-ce.... The best ENT surgeons in Arizona for creating a "flap" that replace part or all of one's tongue after surgery were (and are) at the Mayo Clinic. And I needed radiation after the first surgery. And then another surgery a few months later. I too like the "just don't get seriously sick" strategy, but if it doesn't work, then you have a huge problem.
MattPalmer1086 3y ago
I guess if 90k was the max you could pay, it might not make sense. After all, you are paying more than 90k over 3 years. You could just save the money and have savings if you didn't get ill. I bet it could be a lot higher than that though.
- ceejayoz 3y ago
  > After all, you are paying more than 90k over 3 years. That $90k ran up much faster than that, even with shitty insurance paying at least some of it, and medical needs continued to accelerate for a while afterwards. Savings wouldn't have done a bit of good; it was rapidly exhausted. (That's not part of the $90k, either! It's on top!)
- closewith 3y ago
  There's essentially no cap on potential medical bills.
  - ceejayoz 3y ago
    There is now; ACA plans have a max out-of-pocket amount, for which I'm very grateful. My bankrutpcy was pre-ACA.
    - imacomputertoo 3y ago
      Be careful because there are two many out of pocket amounts. One for in network and one for our of network. Most ACA plans that I can get in my state do not have an out of network max. That's a huge risk because most hospitals have out of network contractors. That means if you stay in a hospital that is in network, you'll still get billed separately for out of network care. And half the hospital staff might be out of network. So you can still go bankrupt in an in network hospital. The ACA really didn't do much to protect people from bankruptcy.
      - ceejayoz 3y ago
        Thankfully, my state (NY) forbids that little loophole. https://www.dfs.ny.gov/consumers/health_insurance/surprise_medical_bills https://www.dfs.ny.gov/consumers/health_insurance/surprise_m... If the hospital is in-network, you're good.

bhpm 3y ago

“I’m pregnant, and I’m giving birth at home.” This is how I know not to consider anything this person says.

123pie123 3y ago
why? (from the UK) my partner gave birth at home - twice in a big blow up swimming pool thing - we did have local maternity nurses here, although they was extremely helpful and useful, we could have got by without them. no drugs either - although my partner had studied various breathing techniques
- tokai 3y ago
  Until something isn't going as normal, and you end up loosing the child or with brain damage.
  - 123pie123 3y ago
    that was my biggest concern, but we had gone through various scenarios and we fully accepted the risks we also mitigated the risks as well with scans and monitoring, and the worse case stuff - we also knew with research what the approx risks where (I really can't rememeber those now) but I do remember that hospitals typically massively over react - which causes harm in itself
    - jacquesm 3y ago
      > but we had gone through various scenarios and we fully accepted the risks That's because you didn't fully understand the risks.
- jseliger 3y ago
  It works great, unless and until it doesn't. This at least is a good sign: "we did have local maternity nurses here." My wife is an ER doc (https://bessstillman.substack.com/ https://bessstillman.substack.com/), and her and many of her colleagues have seen the results of home births gone sideways.

JohnVideogames 3y ago

This is mad (especially from a UK perspective!) and it doesn't cover the key point of insurance: you insure risks that you couldn't afford if they went wrong. I insure my house, my life and my car because it'd be financial ruin for me and my partner if the worst case scenario happened to any of those. Sure, I could avoid going through insurance for small things and negotiate with 3rd parties to get bills down, but that wouldn't make a difference to a £500k house rebuilding cost, car crash settlement, or medical bill. Similarly, if something went wrong then I couldn't go back and insure that risk afterwards! You can't insure unpredictable events as and when you need them, and there's no point in my organising insurance from the wreckage of my car, house or health.

kevmo 3y ago
America would benefit tremendously from adopting any of the universal healthcare models successfully implemented by many other countries. Our existing insurance model is basically a giant racketeering scam. The lack of access to affordable healthcare increases crime, stifles innovation, decreases longevity and quality of life, and has created a breeding ground for lot of the crazier shit we are seeing in America. I think we see Medicare For All sometime in the next 10-15 years. The first major party nominee for President who embraces it is going to get elected.
- hotpotamus 3y ago
  > The first major party nominee for President who embraces it is going to get elected. And Republicans will use every ability in their power to prevent it from happening, through the filibuster and Supreme Court most likely. Fighting that sort of socialism is their entire reason for existence. That and upper-income tax cuts obviously.
  - imacomputertoo 3y ago
    That "tax cuts for the rich" line buds me so much. Republicans do not simply cut taxes for the rich. I've looked at income tax tables going back to the mid 70's. It's clear that Republicans cut taxes for all, not just the rich. Regan , G.W. Bush, and Trump cut taxes for the poorest, Middle class and the wealthy. I don't know of any case in the past 50 years when Democrats have cut taxes for the poor, though Obama did continue the Bush tax cuts. Now if that's a good policy to cut taxes and spend as much as they do (Trump especially), that is another question.

carlosjobim 3y ago

The greatest desire of almost every person alive is to put the responsibility for their life and decisions in the hands of others. That's what we've been bred for. So health insurance is an absolute must, whether it's private or through the government. It doesn't even matter if the hospitals, doctors and pharmacies were actively hurting their patients, people would still need health insurance. Because the agony of being responsible for your own health would be too much for people to bear.

ceejayoz 3y ago
My kids were born three months early. What does "being responsible" for that look like? Should they enter the world a million dollars in debt already?
- carlosjobim 3y ago
  The desire is so strong that you're even arguing in defence of scammers. There is no medical procedure that actually costs millions or hundreds of thousands of dollars, those bills are simply scams – unless they're surgically switching heads between people or bringing back the dead and buried to life. As the old saying goes, it's ten times easier to fool somebody, than convincing them that they've been fooled. So I don't have any hopes. But complicated medical procedures and births are done everywhere in the world, and they don't cost millions or hundreds of thousands.
  - ceejayoz 3y ago
    No matter how you slice it, two months in a neonatal ICU is gonna cost. I've no doubt insurance negotiates that initial inflated bill down quite a bit, but under no circumstances is it ever going to be cheap. No amount of "personal responsibility" is going to stop you from being born a micropreemie, or autism, or any number of other expensive, long-term medical issues... and quite a few of these sorts of things tend to hit you on the other side as a bonus, in income/earning potential. Healthcare's like national defense; it's simply not the sort of thing you can tackle individually very effectively on a 300 million people scale.

troupe 3y ago

Funny that most of the stuff mentioned is low enough that it doesn't even meet my deductible. I'm not paying for insurance to cover a $250 bill, or even a $2,500 bill. I'm paying for insurance to cover an unexpected $250,000 bill.

eek2121 3y ago
Small numbers. My hospital bill was almost 8 figures before insurance. Insurance contract rates down to high six figures. That is basically instant bankruptcy for most folks. Health insurance can also be free for low income folks, so it is incredibly dumb not to have it.

rthkljlkrj 3y ago

[dead]

tokai 3y ago

The author's community "college" is currently running a course on sacred geometry and consciousness. Its a safe bet to disregard anything they write. edit: sorry not currently. It starts 21th January.

rybosworld 3y ago

I wouldn't recommend foregoing health insurance but there are some good takeaways here. Negotiating bills is something a lot of people aren't aware of. I personally wasn't aware I can buy contact lens from the UK - will be giving that a try.

addandsubtract 3y ago

The idea of getting a dental exam through Groupon is absolutely hilarious. And by hilarious, I mean shocking, bewildering, and absurd. Negotiating ER appointments, even more so. This reads like an article from the Amish telling us "You Don't Need Electricity".

joshstrange 3y ago

Yes, because when you find out you have cancer is the best time to go and try sign up for insurance it's not like you are under any other stressors... And I hope you like waiting for open enrollment, cancer can wait right? This is terrible advice and I'll be flagging this article which I don't do often at all. My dad just went through this (cancer). He was on a co-op plan (snake oil if you ask me), had to pay out of pocket then fight to get reimbursed. The co-op said they wouldn't pay the outstanding bills if he left the plan and also refused some of the treatments doctors suggested. In the end he was able to get real insurance (not during open enrollment) through some loophole since the co-op was refusing to pay for something. I'm not sure if he died due to not getting treatment earlier or if earlier treatment would have resulted in the same but this advice is not just stupid, it's dangerous.

padolsey 3y ago

> If you are diagnosed with a chronic illness, explore your insurance options. Isn't it incredibly hard to find insurance if this is the case? Quite curious how it works in the US. I think this all changed under the Affordable Care Act?? Here in the UK it's hard to find insurance that would accept you with a chronic illness unless it's quite low-risk. The only way I was able to "lock-in" a policy was by contuining a medical-history-agnostic one I had under an employer. To get it as a private citizen would have been impossible due to my medical history. So basically I'm now never letting that policy go. TBF the main reason to get private health insurance in the UK is for a shorter waiting list and better aftercare or rehab, but it can also provide hugely life-changing medical intervention if you can carry the policy into old age, AFAIK. But yeh.. I'm privately uninsurable. I cannot purchase life insurance anywhere ... trust me I've tried. Which is funny because I thought the whole point of insurance was to equitably balance out the risk amongst a collective. Ultimately, for me, the whole point with insurance is that it can cover you if something super-super-awful happens. It protects from financial ruin in the case that e.g. you need life-saving emergency surgery. It's there for the unpredictable.. not routine dental appointments lol.

MattGaiser 3y ago
> I cannot purchase life insurance anywhere ... trust me I've tried. Which is funny because I thought the whole point of insurance was to equitably balance out the risk amongst a collective. It is, but if you are higher risk, adding you is inequitable to the pool of already insured lower risk people. You have to buy insurance before the need for it to be equitable to the others in the pool.

dschuetz 3y ago

Good luck with living and surviving after cancer. Might outright rather die than having 200k in debt for getting sick once.

TrueGeek 3y ago

This is complete and utter entitled bullshit

Workaccount2 3y ago

TL;DR: You don't need medical insurance as long as you have no major medical incidents. Just like you don't need an umbrella as long as it doesn't downpour. What a bad article.

SkyLemon 3y ago

Insurance is never a good deal. They are betting you’ll never use more then you pay and you are hedging that the day you really do need it, it’ll be worth it. Anything an insurance company covers out of pocket is purely them hedging that those services will save them money in the long run or they have factored it into the price you pay up front. So yes, insurance is never worth it... unless it is... and then often it really was worth it all along.

dghlsakjg 3y ago
I doubt this is true for health insurance, but for many competitive insurance industries insurers will frequently break even or even take a loss on premiums. Warren buffet explains it well in his letters to investors. Basically, insurers make most of their money by investing the float, so their incentive is to have a bigger float by offering competitive rates to bring in more customers. They don’t really care if they pay out every dollar they take in, because they made money by holding onto the premium in the time in between when you paid it and when a claim was made. So for things like car insurance, it actually is a pretty good deal. Many companies expect to pay out as much as their clients put in, with the added benefit that you can take out more than you put in if you have a claim immediately after getting insured.

theaccordance 3y ago

This is a reckless opinion piece and it's going to leave some unfortunate soul with a bill that absolutely wrecks their financial situation. I'm billed $1M annually for my health care (Stage IV Cancer), and yes, I likely could get that dollar amount lowered through different tactics, but for a measly $9k a year (premiums + deductible), I don't have to deal with any of that nonsense. $9k for $1M in health care is a deal.

jermaustin1 3y ago

Without insurance, my wife and my medicines would be close to $2000/mo (using services like GoodRX). That is not even considering the every 3 month lab work both my wife and I have to get done for managing our chronic disorders, the 1-2 times a year we get actually sick and need a doctor visit, the vaccines we take yearly due since we both have compromise immune systems, the various flare ups of immune disorders. We are both self-employed, so we get our health insurance on HealthCare.gov, so if we let payments laps on our health insurance, we are barred from getting new health insurance for the remainder of the year. Health insurance is not just insuring our health, it is also insuring our ability to be insured. But beyond any of that, our health insurance is a positive return on investment. Our $900/mo = $2500/mo in benefits. So maybe it is true that you don't NEED health insurance... until you do, and then it is too late.

mhalle 3y ago

Beyond the risk of medical bankruptcy in the US, lack of health insurance can prevent you from getting some lifesaving treatments. If you are uninsured, for instance, you stand almost no chance of getting an organ transplant. There are not enough organs for too many people, the operation is very expensive, and lifetime support medication is also expensive. In my experience, transplant centers won't even start the evaluation without proof of insurance. While it might be possible to get insurance after diagnosis for people like the OP who choose not to have insurance, that isn't always feasible. Sudden organ failure, while rare, certainly happens. And should it happen, it is hardly the best time to be scrambling to find insurance. Yes, the system is screwed up. But it is the system (in the US).

justinhj 3y ago

You can really buy insurance after being diagnosed with cancer? That’s the polar opposite of anecdotes I have heard, and my understanding of how most insurance works.

ceejayoz 3y ago
You can, via the ACA exchanges (ACA compliant plans can't deny coverage for pre-existing conditions), but only at the end of each year. You wouldn't want to get a diagnosis in Feb. Once it gets bad enough you may get Medicare/Medicaid for disability/income reasons, but that's... a suboptimal approach.
mminer237 3y ago
Since the ACA you can. As long as it's a Marketplace plan, they can't deny you or charge you more for preexisting conditions, and I've never met someone with a private plan nowadays. The catch is that you can only change plans for the next calendar year unless you move or lose your job or something.
joshstrange 3y ago
I can tell you from personal experience that you cannot, unless you want to wait till the next year (and sign up during open enrollment). But it's not like cancer moves fast or anything right? You can just wait, nothing bad will happen... /s I'm a bit salty, I lost my dad to cancer last year and he was on a bullshit co-op plan that delayed treatment and made the whole experience even worse than it already was. Would insurance have saved his life? I can't answer that but the delays (before he got real insurance) couldn't have helped.
- justinhj 3y ago
  Sorry for your loss. Where insurance meets critical health care is an ugly boundary

blackhaj7 3y ago

Monumentally bad advice. Lost for words

francisofascii 3y ago

You should never go completely without insurance, but the article does have some good points. I have health insurance, but they still find ways to not cover unforeseen expenses. Most recently an ambulance bill for my daughter at a school sporting event. So even with insurance I don't feel safe. The best advice is similar to that of the court system, try to avoid the system completely.

mminer237 3y ago

This is called gambling. Health insurance isn't so expensive for no reason. You save a modest amount until you fall off a ladder and lose your house. Buy the cheapest plan with an HSA. You essentially get an above-the-line deduction of all medical expenses even OTC things, you cap your expenses, and you get insurance-negotiated rates.

eek2121 3y ago

Yes you do. Negotiation will still leave you hundreds of thousands in debt if you are hospitalized. I know from experience. You can probably negotiate the bill down to what the insurance pays, but not beyond that. Plus, hospitals don’t think highly of folks that don’t carry insurance. They may refuse to bargain with you at all. Do you think that 3 million dollar hospital bill will just go to collections? No they are going to sue you and get a judgement on you.

beej71 3y ago

Wow--so if I get smashed up on my bicycle by a hit-and-run, I can talk them down to $250? Amazing! If you have assets, carry insurance to protect those assets. Maybe you get lucky with no insurance and come out ahead in the casket, but if you lose, you can lose big. I have exceptional insurance through work now, but when I didn't, I carried high-deductible insurance with an out-of-network max-out-of-pocket. They might get me for 12 grand, but they had to weasel a lot harder to get me to pay more. Also, I've been blessed with pretty good health. But my total hospital bill for life is probably about $250,000 due to a ruptured appendix. (The work was in a socialist hospital so I didn't get a bill--that's just my estimate.) > Insurers can’t refuse to cover you or charge you more due to a "pre-existing condition." This is absolutely true, however one does not simply buy insurance outside of open enrollment; you'd best hope you only get sick or injured in that particular month.

geor9e 3y ago

Clickbait and sensationalism. The author knows they're wrong, but that people will read it, because it's backwards. Commenters will be baited into engagement. The Americans bankrupted every year by simply lacking health insurance won't be acknowledged in the article, even indirectly.

daft_pink 3y ago

I feel this really underplays the proper way to purchase health care, the importance of relationships and the quality of having great providers. I would compare this to my first dog vs my next dogs. The first dog I took him to the low cost clinic to get shots and did minimal cheap health care for him. But as he got older, it became clear that when you start having complications you need to see the same person and you can’t just skate by with different vendors and there is a lot of value to being seen repeatedly by the really highly qualified person as you get older or know where to go if you have an emergency. It’s totally true that you can negotiate and find cheaper prices on things, but like the best veterinarians, the best doctors generally accept the top quality healthcare usually BCBS and aren’t going to discuss or negotiate price with you. They didn’t spend a decade in medical school to deliver transparent billing. I’m all for transparent billing and think it should exist, but my health is too important to try to fight some philosophical price battle and I want the best.

fabiofzero 3y ago

This is a very US-specific problem, for the record. Most of the world is fine without health insurance and without worrying about going bankrupt.