Is Health Insurance Really Necessary?

[verbum]

To have bottom of the line health insurance for our family, it's around $450 a month. That's with the government deduction based on our income taken off. That does not include any co pays or deductibles. This is a high deductible plan with around $5,600 Deductible and $13,000 Out of Pocket Max.

So we've been without health insurance for 8 months. In that time we've had 2 well child visits with vaccines, 1 ER visit and admission to hospital, and 1 urgent care visit with x rays / 2 prescriptions. All of these visits/prescriptions paying the cash price have totaled around $3924 dollars... That's less than we would have paid on the monthly insurance alone. Let alone co pays and deductables.

Make it make sense.

 

[ajharmon89]

@verbum What will you do if your child or partner is diagnosed with cancer tomorrow and you don't have insurance?

 

[verbum]

@ajharmon89 Well, we won't qualify for enrollment until November. Short of changing jobs and waiting 90 days there's not much to be done about that. So I guess the same thing I'd do between now and then anyways. 1) see what's charged 2) negotiate rates and payment schedules based on what we can pay 3) keep all medical bills pertaining to myself or my children in my name, and all property in my husband's name incase we end up like 17% of American adults who have filed for medical bankruptcy. 4) save that 450 a month that we aren't spending on insurance, just in case. Honestly, that's all I can do. But I know that this last open enrollment period it would have been health insurance premiums OR groceries. I chose groceries.

If we were denied life saving services based on ability to pay up front, well, I'm not sure that's a company I'd want caring for my child anyways.

 

[ajharmon89]

@verbum Places that dispense chemo have no obligation to treat if you can't pay (ie no insurance), and there are plenty of treatments that cost $10k-$100k+.

You asked why have health insurance, and I'm trying to explain fairly rare, but very real examples of why health insurance is a necessity.

 

[verbum]

@ajharmon89 I'm not sure your information is fact based. Here is a quick Google from what I'd consider a reasonably reliable source stating that you can not be denied cancer treatment based on ability to pay. Will it be the facility of my dreams, probably not. Will it be the exact same medicine, most likely. Also, about 9% of Americans are uninsured, but 17% (of adults) have filed medical bankruptcy. Meaning that insurance does not negate financial ruin in the American healthcare system.

I guess the point of my post is that on average in the last 9 months, I've paid less than my monthly payments would have been for cash prices. Which should, in theory, be the opposite experience. But I guess when BCBS CEO's are making 4 million a year, it makes sense.

 

[layla17293]

@verbum But when a loved one has cancer and needs treatment is that really the time you want to take on the additional burden of dealing with the medical assistance and billing bureaucracy?

 

[verbum]

@layla17293 I think I've been unclear. In November (open enrollment) our family's monthly income was $0. My husband had lost his job and insurance in September. We used all of our savings to make ends meet. Like rent and groceries. So filling out the open enrollment paperwork and being told that for a measly $800/month minus subsidized amounts, I too could still pay a super high deductible, it just wasn't an option. Based on yearly income, we are too rich for Medicaid but too poor for marketplace insurance. Now, 9 months later, we are more stable. But my husband's employer doesn't offer health insurance, we haven't had any qualifying events, and open enrollment isn't until November again. I have made interesting and unexpected observations in the last 9 months about cash prices and posted them here. If you can think of a better option between now and November, please share. If not, I'll keep happily paying cash prices and do the best we can.

 

[layla17293]

@verbum Have you checked to see if your child is eligible for CHIP?

 

[verbum]

@layla17293 I have, we were denied by approx $250 a month income.

 

[joscar]

@verbum No, in theory most people should be taking out less than they put in—that’s how insurance works

 

[resjudicata]

@verbum Bankruptcy won’t always protect your home and property simply because you and your husband made a choice to put the good stuff in one name and the debt in another. It’s still considered community property. Don’t be dumb.

 

[verbum]

@resjudicata I really doubt my husband's house that he bought long before we met and I've never had (or wanted) any legal claim to would suddenly become mine. But whatever. Judging by your comment history you're a certified health insurance expert. Guess I'm just dumb.

 

[joscar]

@verbum

If we were denied life saving services based on ability to pay up front, well, I'm not sure that's a company I'd want caring for my child anyways.

You’d prefer your kid die?

 

[verbum]

@joscar My dear, if my child was diagnosed with cancer tomorrow (the question posed), and we were denied care based on ability to pay up front, I would have no choice but to find somewhere else. Because in this hypothetical situation we've already been denied, right? But if I were to be insured and wealthy in the same hypothetical situation I would not choose to give my money to a company that will let children die based on ability to pay up front. That's all I'm saying.

Accusing a mother of wanting her children to die is a very shitty thing to say, incase you were taking moral stock of yourself today

 

[malikbrother2k9]

@verbum The whole point is to protect you against a catastrophic health care cost. For someone with kids and who already had an ER visit and hospital admission in just 8 months, I don’t get why you’re risking bankruptcy just to save hundreds/low thousands.

 

[verbum]

@malikbrother2k9 I'm not "risking it" to save money. We flat out couldn't afford it, and now don't qualify for open enrollment. The ER visit and hospital admissions were the same event. I just made some unexpected observations while accessing health care while also uninsured.

 

[elvz10]

@verbum Then what is the point of this post? You had no choice but to go without health insurance while knowing the risks, what more do you want to know?

If you know the risk you are taking then that’s all there is to it. If you are OK with the risks, then nothing we tell you will change your mind. If you aren’t in a position to even afford to choose then whether you should or not is irrelevant.

The bottomline is that it’s a good choice to be covered for most average people. We can talk about niche cases but everything depends on your specific location, family history to illness, exposure risk at work, etc.

 

[malikbrother2k9]

@verbum I don’t accept that you couldn’t afford it. I’m very familiar with Obamacare and your premiums wouldn’t be $450 if you were impoverished. The subsidies are quite generous.

 

[verbum]

@malikbrother2k9 I don't really care if you don't accept it. It doesn't change what happened.

 

[malikbrother2k9]

@verbum So you couldn’t afford $3,600 (8 months * $450/month) but you could afford $3,924. Makes sense.