7 ms·

Cross my fingers and hope I don't get sick. I do try to stay in shape(workout every day 1-1.5 hours) and eat healthy. But I just can't justify paying for health

by vaksel 18y ago

Cross my fingers and hope I don't get sick. I do try to stay in shape(workout every day 1-1.5 hours) and eat healthy. But I just can't justify paying for health insurance at this point.

tptacek 18y ago
Which is why any sane health care reform will likely include a mandate requiring people like you to carry coverage; insurance works best with a large pool of risk, where coverage isn't biased towards those at most risk of making claims. That's not a dig at you. You might be right that there's economic rationale for you to carry coverage; the risk is remote and the cost is high. That's a problem the system needs to fix.
- fauigerzigerk 18y ago
  If you fix it, try not to break it. In some european countries people shy away from starting a startup because social security contributions are very high from day one even if your income is near zero (Not so in the UK fortunately) It's actually pretty simple to get right. Everyone must be in and everyone must pay proportional to their earnings. The key is not to have minimum contributions because that's what kills you while you earn next to nothing.
  - eru 18y ago
    That confuses insurance with ideas about social justice. Why should people pay in proportion to their income?
    - sho 18y ago
      All tax works like that. You make more, you pay more. You might think it's unfair that rich people pay more, but the system seems to work. And wanting to ensure everyone receives the medical care they need regardless of income is a matter of social justice.
      - eru 18y ago
        Yes, taxes work that way. And it's OK that we have such a system to re-distribute income. But why should we confuse insurance with solidarity? We can use taxes/hand-outs to level people's income somewhat, and leave insurance to the market. Most sectors of insurance seem to work quite fine that way.
        sho 18y ago
        Well, I don't think it should even be called insurance! Health care is pretty close to a basic human right, IMO, and the government should provide it to everyone who needs it. So that should be funded via general tax, like any other essential service. I wouldn't be opposed to a parallel system for people who opted out of or augmented the Govt services, that could be assessed like regular insurance, but the important thing is to have the universal basic care.
        eru 18y ago
        OK, I can understand that you want that. We should just ensure that we do not confuse it with insurance.
- tjic 18y ago
  > Which is why any sane health care reform will likely include a mandate requiring people like you to carry coverage; insurance works best with a large pool of risk, where coverage isn't biased towards those at most risk of making claims. The point you make is technically true, but seems a bit bizarre. It's like saying "if we had an financial instrument that paid for people's airline tickets, we wouldn't want to allow people to choose to join or not join - if we did that, we'd just have all the people who like to travel a lot join, and it would cost a lot! So what we really need to do is force EVERYONE to contribute, so that there are a lot of people who get no benefits who can subsidize those people who draw a lot of benefits". Yes, you're right - unless we do that, people who draw a lot of benefits will have to pay for a lot of benefits. ...but it seems a bit morally autistic to me.
  - akeefer 18y ago
    Depends if you're a believer in the "genetic lottery" (to use John Rawls's term) or not. If you believe that things like catastrophic accidents or health conditions have a large amount of "luck" involved in them, then morally speaking it's more fair to spread the cost of them out over the whole population rather than concentrating it in whoever happens to get unlucky enough to develop leukemia or get hit by a bus. Of course, health is something that people have some amount of control over, but exactly how much is obviously a big open question. Unsurprisingly, people who are on the "winning" side of the lottery (be it health, talent, or success in things like sports and business) tend to under-estimate how much luck has to do with it, over-estimate their own contribution, and thus also over-estimate how much someone else's actions have to do with their "loss" in that lottery.
  - tptacek 18y ago
    Your analogy doesn't hold, because people choose not to travel, but nobody can really choose to avoid medical attention. There are people who are --- right now --- less likely to avail themselves of care, yes; if they don't insure themselves, and others do, you have adverse selection. The term for those young people who avoid insurance is "free rider".
rarrrrrr 18y ago
One easy thing to do in this situation is add medical payments coverage to your auto insurance. It's maybe $20/6 months, and covers what is for many people the most likely cause of injury. Injury only or highest-possible deductible health insurance is also a good option if you're generally healthy.
agotterer 18y ago
I was doing consulting for a few months and considered not getting insurance. I decided to take the safe route and payed $550 a month out of pocket for personal coverage. I eat healthy and exercise (on and off). Long story short, I ended up hospitalized for a week with some crazy stomach infection. To this day, no doctor knows what it was or how I got it. The bill would have been 50 or 60 thousand dollars if I didnt have insurance. Better to be safe then sorry, accidents do happen. I will always get the best coverage possible now.
- vaksel 18y ago
  if you didn't have insurance, that bill would have been 5-10K, with the hospital willing to give you 10-15 years to repay it.
  - tptacek 18y ago
    Can you explain your logic? 50 sounds crazy high, but 5-10k seems like a wild extrapolation.
    - vaksel 18y ago
      hospitals mark up their costs for insurance. If you are paying cash they will always lower their bills big time to accomodate you.
      - menloparkbum 18y ago
        hospitals mark up their costs for insurance No they don't. Hospitals mark up for people paying cash. This is because they know most of the people paying cash won't pay at all. The markup for people paying cash is about 3 times that what they bill the insurance company. If you are paying cash they will always lower their bills big time to accomodate you. This can happen but it's arbitrary. I needed to be hospitalized without insurance and the hospital wouldn't budge on the bill. Likewise I had a roommate who had a $40,000 concussion once and the hospital wouldn't negotiate that bill, either.

by vaksel 18y ago

Cross my fingers and hope I don't get sick. I do try to stay in shape(workout every day 1-1.5 hours) and eat healthy. But I just can't justify paying for health insurance at this point.

tptacek 18y ago

Which is why any sane health care reform will likely include a mandate requiring people like you to carry coverage; insurance works best with a large pool of risk, where coverage isn't biased towards those at most risk of making claims. That's not a dig at you. You might be right that there's economic rationale for you to carry coverage; the risk is remote and the cost is high. That's a problem the system needs to fix.

fauigerzigerk 18y ago
If you fix it, try not to break it. In some european countries people shy away from starting a startup because social security contributions are very high from day one even if your income is near zero (Not so in the UK fortunately) It's actually pretty simple to get right. Everyone must be in and everyone must pay proportional to their earnings. The key is not to have minimum contributions because that's what kills you while you earn next to nothing.
- eru 18y ago
  That confuses insurance with ideas about social justice. Why should people pay in proportion to their income?
  - sho 18y ago
    All tax works like that. You make more, you pay more. You might think it's unfair that rich people pay more, but the system seems to work. And wanting to ensure everyone receives the medical care they need regardless of income is a matter of social justice.
    - eru 18y ago
      Yes, taxes work that way. And it's OK that we have such a system to re-distribute income. But why should we confuse insurance with solidarity? We can use taxes/hand-outs to level people's income somewhat, and leave insurance to the market. Most sectors of insurance seem to work quite fine that way.
      - sho 18y ago
        Well, I don't think it should even be called insurance! Health care is pretty close to a basic human right, IMO, and the government should provide it to everyone who needs it. So that should be funded via general tax, like any other essential service. I wouldn't be opposed to a parallel system for people who opted out of or augmented the Govt services, that could be assessed like regular insurance, but the important thing is to have the universal basic care.
        eru 18y ago
        OK, I can understand that you want that. We should just ensure that we do not confuse it with insurance.
tjic 18y ago
> Which is why any sane health care reform will likely include a mandate requiring people like you to carry coverage; insurance works best with a large pool of risk, where coverage isn't biased towards those at most risk of making claims. The point you make is technically true, but seems a bit bizarre. It's like saying "if we had an financial instrument that paid for people's airline tickets, we wouldn't want to allow people to choose to join or not join - if we did that, we'd just have all the people who like to travel a lot join, and it would cost a lot! So what we really need to do is force EVERYONE to contribute, so that there are a lot of people who get no benefits who can subsidize those people who draw a lot of benefits". Yes, you're right - unless we do that, people who draw a lot of benefits will have to pay for a lot of benefits. ...but it seems a bit morally autistic to me.
- akeefer 18y ago
  Depends if you're a believer in the "genetic lottery" (to use John Rawls's term) or not. If you believe that things like catastrophic accidents or health conditions have a large amount of "luck" involved in them, then morally speaking it's more fair to spread the cost of them out over the whole population rather than concentrating it in whoever happens to get unlucky enough to develop leukemia or get hit by a bus. Of course, health is something that people have some amount of control over, but exactly how much is obviously a big open question. Unsurprisingly, people who are on the "winning" side of the lottery (be it health, talent, or success in things like sports and business) tend to under-estimate how much luck has to do with it, over-estimate their own contribution, and thus also over-estimate how much someone else's actions have to do with their "loss" in that lottery.
- tptacek 18y ago
  Your analogy doesn't hold, because people choose not to travel, but nobody can really choose to avoid medical attention. There are people who are --- right now --- less likely to avail themselves of care, yes; if they don't insure themselves, and others do, you have adverse selection. The term for those young people who avoid insurance is "free rider".

rarrrrrr 18y ago

One easy thing to do in this situation is add medical payments coverage to your auto insurance. It's maybe $20/6 months, and covers what is for many people the most likely cause of injury. Injury only or highest-possible deductible health insurance is also a good option if you're generally healthy.

agotterer 18y ago

I was doing consulting for a few months and considered not getting insurance. I decided to take the safe route and payed $550 a month out of pocket for personal coverage. I eat healthy and exercise (on and off). Long story short, I ended up hospitalized for a week with some crazy stomach infection. To this day, no doctor knows what it was or how I got it. The bill would have been 50 or 60 thousand dollars if I didnt have insurance. Better to be safe then sorry, accidents do happen. I will always get the best coverage possible now.

vaksel 18y ago
if you didn't have insurance, that bill would have been 5-10K, with the hospital willing to give you 10-15 years to repay it.
- tptacek 18y ago
  Can you explain your logic? 50 sounds crazy high, but 5-10k seems like a wild extrapolation.
  - vaksel 18y ago
    hospitals mark up their costs for insurance. If you are paying cash they will always lower their bills big time to accomodate you.
    - menloparkbum 18y ago
      hospitals mark up their costs for insurance No they don't. Hospitals mark up for people paying cash. This is because they know most of the people paying cash won't pay at all. The markup for people paying cash is about 3 times that what they bill the insurance company. If you are paying cash they will always lower their bills big time to accomodate you. This can happen but it's arbitrary. I needed to be hospitalized without insurance and the hospital wouldn't budge on the bill. Likewise I had a roommate who had a $40,000 concussion once and the hospital wouldn't negotiate that bill, either.