4 ms·

> Hmm, counting the insurance premiums 100% towards the birth of the child is a bit misleading. I see your point, but do you not think that if you're a family

by BeetleB 11mo ago

> Hmm, counting the insurance premiums 100% towards the birth of the child is a bit misleading. I see your point, but do you not think that if you're a family of 4, having to pay $40K before insurance kicks in is ridiculously expensive, and out of reach for most Americans? I'd wager that most self employed folks in the US almost never benefit from insurance (except for things covered by Obamacare which come nowhere near justifying the premiums). The deductibles can be so high that you're pretty much always paying out of pocket.

avgDev 11mo ago
The problem is the healthcare cost is insane. You will go through $40k after a good injury that may need a major surgery or few smaller surgeries. Average cost for hip replacement is $40k. I've had a sports hernia and the bill was about $30k.
- BeetleB 11mo ago
  > I've had a sports hernia and the bill was about $30k. And what the OP is pointing out is that if your injury is $30K, insurance covers nothing, because the premium + deductible is $40K.
  - bonsai_spool 11mo ago
    > And what the OP is pointing out is that if your injury is $30K, insurance covers nothing, because the premium + deductible is $40K. The point of insurance is to mitigate risk. If you think you have enough money to cover your risk, there's no reason to buy insurance. The sleight of hand here is first complaining that you did not incur enough hazards to offset the risk premium and then citing this as a reason the risk premiums should not exist. Where is the story of the family being weighed down by bills? Or of not getting physical therapy after an injury and having permanent, income-reducing disabilities?
    - BeetleB 11mo ago
      > The point of insurance is to mitigate risk. Agreed - both to you and to society. What's under debate is "how much risk." For most people in the US, they'll need help before they hit $40K. They can't afford paying $40K every year for medical and medical related expenses.
    - anon7000 11mo ago
      Risk is not the only factor. Premium cost is probably the more important one for most. If someone can afford the $40k deductible option, but not the $5k option, you’ll just have to accept the risk. Increasing earnings significantly right now is harder than hoping medical bankruptcy won’t matter in the long run. 30% of US households make less than $50k. That’s more than 100,000,000 people in homes with less than $3.6k/mo for all living expenses. The stories you ask for are simply inevitable
      - expedition32 11mo ago
        In my country people are already complaining about a 300 euro deductible (my mom has a chronic illness so she hits that every year)... I surmise that either Americans are all rich and have 40k in savings that they can lose with no sweat or America is hell for anyone not rich
        encrypted_bird 11mo ago
        It's the latter.
        slater 11mo ago
        ^ That.
  - avgDev 11mo ago
    OP was talking about a family for $30k. Imagine 2 people get injured in a year, you are now at $60k. Plus, $150 a visit for primary and $300+ for specialist. My 5 year old has been to the hospital 3 times, stitches once. US healthcare will ruin you if you don't have insurance. A cancer treatment can bankrupt a millionaire.
- stephen_g 11mo ago
  That's crazy, I looked it up and the average cost for a hip replacement here in the private system in Australia is about $24k (US$16k). You can get it for basically nothing in the public system but you might have to wait a year or so if it's considered elective (emergency surgery is immediate of course), but most people with private health insurance can get the procedure done within in a few weeks and would only have to pay about $1000 (US$650) out of pocket with a $500 excess (which is pretty common), because the anaesthetist and surgery are usually invoiced separately. Some plans do have lower excesses (like $350) though if you pay higher premiums.
gishh 11mo ago
I am a male breast cancer survivor. I had a mammogram the other week. $620. No, nobody benefits from insurance in America. Well, nobody ill.
- PaulDavisThe1st 11mo ago
  You had health insurance but it did not cover that?
  - gishh 11mo ago
    Oh, the bill was 12.3k
    - PaulDavisThe1st 11mo ago
      So this was sarcasm? Or a remark on the co-pay/deductible being too high?
PaulDavisThe1st 11mo ago
> I'd wager that most self employed folks in the US almost never benefit from insurance (except for things covered by Obamacare which come nowhere near justifying the premiums). Self-employed here. My wife and I paid $470/month last year, $618/month next year, for a gold insurance plan than has a $3400 deductible with typically a $20 co-pay. It covers 3 prescriptions, therapy sessions for each of us, various older age diagnostic checks, and almost all office visits. In addition, if either of us develops cancer or is hit by a truck, we will not be rendered bankrupt. So I'd say ... nah.
- wampwampwhat 11mo ago
  i'm 36, self-employed. silver plans in my state are ~800/month next year, with 8k deductible, no out of network coverage at all, with no in-network providers out of my state, so god forbid I get injured while traveling to visit my in-laws. the marketplace is a joke and health insurance in this country is pointless.
  - PaulDavisThe1st 11mo ago
    Too expensive? check Deductibles too high? check Stupid coverage limitations? check Pointless? nope
  - BeetleB 11mo ago
    > no out of network coverage at all I thought they'll all cover ER visits out of network. Is that not required by law?
    - ceejayoz 11mo ago
      As usual, they find ways to limit that. https://www.emergencyphysicians.org/press-releases/2017/10-10-2017-health-insurers-refuse-to-Cover-ER-Visit https://www.emergencyphysicians.org/press-releases/2017/10-1... > In a controversial decision, health insurance giant Anthem Blue Cross Blue Shield is warning policy holders—in Georgia, Kentucky and Missouri—that they may have to pay for their trips to the ER. The company has developed a secret list of diagnoses that they will not pay for, such as "chest pain on breathing" and blood in the urine, even if the patient thought it was a medical emergency.

by BeetleB 11mo ago

avgDev 11mo ago

The problem is the healthcare cost is insane. You will go through $40k after a good injury that may need a major surgery or few smaller surgeries. Average cost for hip replacement is $40k. I've had a sports hernia and the bill was about $30k.

BeetleB 11mo ago
> I've had a sports hernia and the bill was about $30k. And what the OP is pointing out is that if your injury is $30K, insurance covers nothing, because the premium + deductible is $40K.
- bonsai_spool 11mo ago
  > And what the OP is pointing out is that if your injury is $30K, insurance covers nothing, because the premium + deductible is $40K. The point of insurance is to mitigate risk. If you think you have enough money to cover your risk, there's no reason to buy insurance. The sleight of hand here is first complaining that you did not incur enough hazards to offset the risk premium and then citing this as a reason the risk premiums should not exist. Where is the story of the family being weighed down by bills? Or of not getting physical therapy after an injury and having permanent, income-reducing disabilities?
  - BeetleB 11mo ago
    > The point of insurance is to mitigate risk. Agreed - both to you and to society. What's under debate is "how much risk." For most people in the US, they'll need help before they hit $40K. They can't afford paying $40K every year for medical and medical related expenses.
  - anon7000 11mo ago
    Risk is not the only factor. Premium cost is probably the more important one for most. If someone can afford the $40k deductible option, but not the $5k option, you’ll just have to accept the risk. Increasing earnings significantly right now is harder than hoping medical bankruptcy won’t matter in the long run. 30% of US households make less than $50k. That’s more than 100,000,000 people in homes with less than $3.6k/mo for all living expenses. The stories you ask for are simply inevitable
    - expedition32 11mo ago
      In my country people are already complaining about a 300 euro deductible (my mom has a chronic illness so she hits that every year)... I surmise that either Americans are all rich and have 40k in savings that they can lose with no sweat or America is hell for anyone not rich
      - encrypted_bird 11mo ago
        It's the latter.
        slater 11mo ago
        ^ That.
- avgDev 11mo ago
  OP was talking about a family for $30k. Imagine 2 people get injured in a year, you are now at $60k. Plus, $150 a visit for primary and $300+ for specialist. My 5 year old has been to the hospital 3 times, stitches once. US healthcare will ruin you if you don't have insurance. A cancer treatment can bankrupt a millionaire.
stephen_g 11mo ago
That's crazy, I looked it up and the average cost for a hip replacement here in the private system in Australia is about $24k (US$16k). You can get it for basically nothing in the public system but you might have to wait a year or so if it's considered elective (emergency surgery is immediate of course), but most people with private health insurance can get the procedure done within in a few weeks and would only have to pay about $1000 (US$650) out of pocket with a $500 excess (which is pretty common), because the anaesthetist and surgery are usually invoiced separately. Some plans do have lower excesses (like $350) though if you pay higher premiums.

gishh 11mo ago

I am a male breast cancer survivor. I had a mammogram the other week. $620. No, nobody benefits from insurance in America. Well, nobody ill.

PaulDavisThe1st 11mo ago
You had health insurance but it did not cover that?
- gishh 11mo ago
  Oh, the bill was 12.3k
  - PaulDavisThe1st 11mo ago
    So this was sarcasm? Or a remark on the co-pay/deductible being too high?

PaulDavisThe1st 11mo ago

> I'd wager that most self employed folks in the US almost never benefit from insurance (except for things covered by Obamacare which come nowhere near justifying the premiums). Self-employed here. My wife and I paid $470/month last year, $618/month next year, for a gold insurance plan than has a $3400 deductible with typically a $20 co-pay. It covers 3 prescriptions, therapy sessions for each of us, various older age diagnostic checks, and almost all office visits. In addition, if either of us develops cancer or is hit by a truck, we will not be rendered bankrupt. So I'd say ... nah.

wampwampwhat 11mo ago
i'm 36, self-employed. silver plans in my state are ~800/month next year, with 8k deductible, no out of network coverage at all, with no in-network providers out of my state, so god forbid I get injured while traveling to visit my in-laws. the marketplace is a joke and health insurance in this country is pointless.
- PaulDavisThe1st 11mo ago
  Too expensive? check Deductibles too high? check Stupid coverage limitations? check Pointless? nope
- BeetleB 11mo ago
  > no out of network coverage at all I thought they'll all cover ER visits out of network. Is that not required by law?
  - ceejayoz 11mo ago
    As usual, they find ways to limit that. https://www.emergencyphysicians.org/press-releases/2017/10-10-2017-health-insurers-refuse-to-Cover-ER-Visit https://www.emergencyphysicians.org/press-releases/2017/10-1... > In a controversial decision, health insurance giant Anthem Blue Cross Blue Shield is warning policy holders—in Georgia, Kentucky and Missouri—that they may have to pay for their trips to the ER. The company has developed a secret list of diagnoses that they will not pay for, such as "chest pain on breathing" and blood in the urine, even if the patient thought it was a medical emergency.