Laurie4b Posted October 30, 2015 Share Posted October 30, 2015 I recently had this reaction :svengo: when I found out a family member at high risk of a couple of different cancers did not have health insurance. The reason given was that the cost of the fines etc from not having insurance did not outweigh the cost of the insurance. I was shocked, but then thought maybe I am operating in the old paradigm in which having a pre-existing condition could keep you from getting health insurance. So, is it true that if someone had no health insurance and was diagnosed with cancer that they could essentially just go out and purchase the insurance in a timely manner and the insurance would cover the cost of cancer treatment? That seems kind of crazy to me, but then as I said, I am firmly planted in the old paradigm. What is the new reality? ETA: this is not a case where there is not income to cover the insurance. There is quite a bit of disposable income; however, not enough to comfortably cover something major. Quote Link to comment Share on other sites More sharing options...
ktgrok Posted October 30, 2015 Share Posted October 30, 2015 You generally can only get insurance during open enrollment. Which is once a year. So the person could still end up going a long time with no insurance. 6 Quote Link to comment Share on other sites More sharing options...
Ethel Mertz Posted October 30, 2015 Share Posted October 30, 2015 The diagnosis of cancer often requires biopsies done under anesthetic. My bill for anesthesiology for "conscious sedation" during a biopsy was $1,200. The doctors' appointments leading up to diagnosis were several hundred dollars each. Then there are accidents or other health events requiring an ambulance. Last year my spouse needed an ambulance. The bill was $2,000. Thankfully, our insurance paid it all. Quote Link to comment Share on other sites More sharing options...
Plateau Mama Posted October 30, 2015 Share Posted October 30, 2015 My son had an appendectomy in April. Ended up spending 8 days in the hospital. Bills were close to $100k. This is why you don't go without insurance. 14 Quote Link to comment Share on other sites More sharing options...
EKS Posted October 30, 2015 Share Posted October 30, 2015 It is not rational. Then again, the medical insurance system in this country is not rational. 28 Quote Link to comment Share on other sites More sharing options...
SparklyUnicorn Posted October 30, 2015 Share Posted October 30, 2015 Not rational, but perhaps they can't quite afford it. Truth be told if something major happened here, we'd barely be able to afford it WITH the insurance. Although certainly it would be better than not having insurance. 9 Quote Link to comment Share on other sites More sharing options...
umsami Posted October 30, 2015 Share Posted October 30, 2015 It's not rational. Had two family members ranting on and on about Obamacare and the requirement to buy insurance last Christmas or the previous one. In January, one of them ended up in the hospital with complications from his diabetes. The other one literally just died from a burst aortic anuerysm. He was having stomach pains for a few days...but didn't want to seek help. I don't know if the other cousin ending up in the hospital had encouraged him to get insurance or not. It takes one accident. One illness. You don't have to be at fault. You can do everything right. IMHO, it's stupid. At least buy a catastrophic plan. 6 Quote Link to comment Share on other sites More sharing options...
TranquilMind Posted October 30, 2015 Share Posted October 30, 2015 It's not rational. Had two family members ranting on and on about Obamacare and the requirement to buy insurance last Christmas or the previous one. In January, one of them ended up in the hospital with complications from his diabetes. The other one literally just died from a burst aortic anuerysm. He was having stomach pains for a few days...but didn't want to seek help. I don't know if the other cousin ending up in the hospital had encouraged him to get insurance or not. It takes one accident. One illness. You don't have to be at fault. You can do everything right. IMHO, it's stupid. At least buy a catastrophic plan. It doesn't even matter if you do have insurance. Most people still cannot afford it. The premiums and out of pocket costs are OUTRAGEOUS. One of my family members had a breathing incident that turned out to be nothing. They did NOTHING at the ER except give this person an Advil (that cost $14.00!!!). Cost out of pocket was still over $500. Got a small discount from the insurance. Gee, thanks. I'm sorry about your loss. 9 Quote Link to comment Share on other sites More sharing options...
FaithManor Posted October 30, 2015 Share Posted October 30, 2015 I really don't think it would work like that. If they were at or under the threshold for medicaid then they could sign up for that and deal with using hospitals and docs that accepted 100% of what medicaid pays. But given that private insurance has these once a year open enrollment things, I would think this is a dangerous gamble. I do know people who are playing roulette though because they simply don't have enough income to pay rent, car insurance, fuel to work, utilities, and food and still pay $1000-1500 a month premiums for insurance. They know it's bad; they don't have a choice in the matter. 9 Quote Link to comment Share on other sites More sharing options...
Guest Posted October 30, 2015 Share Posted October 30, 2015 Cancer isn't the only thing insurance is for. If you have a heart attack, you can't get coverage that goes back to start the day before. 6 Quote Link to comment Share on other sites More sharing options...
umsami Posted October 30, 2015 Share Posted October 30, 2015 It doesn't even matter if you do have insurance. Most people still cannot afford it. The premiums and out of pocket costs are OUTRAGEOUS. One of my family members had a breathing incident that turned out to be nothing. They did NOTHING at the ER except give this person an Advil (that cost $14.00!!!). Cost out of pocket was still over $500. Got a small discount from the insurance. Gee, thanks. I'm sorry about your loss. I know and it's why I support universal medicare for all. (Which will never happen...insurance companies and drug companies make big bucks off of the current system). 15 Quote Link to comment Share on other sites More sharing options...
Lolly Posted October 30, 2015 Share Posted October 30, 2015 I can understand the sentiment. Our marketplace insurance for a high deductible, barely covers anything, I won't go to the doctor unless I am certain I am dying plan will be running $2, 200 a month. I do not understand this. There is no reason for us to be paying this much for nothing. I get that we have to support a million other people, but it is tempting to play roulette. The odds are tremendously in our favor. 9 Quote Link to comment Share on other sites More sharing options...
mamajag Posted October 30, 2015 Share Posted October 30, 2015 I have a catastrophic plan only. For routine medical care it is cheaper to pay the cash price (usually half or less of what insurance pays). I get in faster and the practices love me because my visits aren't a red tape nightmare. I recently had shoulder surgery (we have a medical savings account). If I filed insurance, out of pocket would have been about $13,000 for just the surgery and follow up/PT). I negotiated as a cash up front patient and ended up paying $8,000 total for the above plus all needed X-rays, 2 ct scans, and a nerve study. Insurance for routine medical issues is frankly a ripoff. We don't pay a fine because we have an exemption due to premiums for all of us being over 8% of income. Basically we put the difference between catastrophic coverage and kitchen sink coverage in savings. When I injured my shoulder, the money was there. I have existing issues and so does my daughter. Prescriptions through good rx are usually much cheaper than our old obamacare prescriptions and we had a silver plan. Catastrophic stuff is covered. Sniffles and sneezes are on me. 5 Quote Link to comment Share on other sites More sharing options...
Murphy101 Posted October 30, 2015 Share Posted October 30, 2015 Right. Bc having insurance means everything is covered and everything is paid for and no one ever files bankruptcy bc of medical bills and it makes everything affordable ... Oh wait. It actually doesn't mean any of that. NPR was talking just this morning that 2 million people who had gotten health insurance had dropped off the exchange bc it was too expensive and they couldn't afford to use it. There's a valid reason they are doing that. And it's not them playing roulette. It's our govt forcing citizens to play this crazy shell game scam to get healthcare. 21 Quote Link to comment Share on other sites More sharing options...
FaithManor Posted October 30, 2015 Share Posted October 30, 2015 Oh I agree Martha, it is a shell game by government force. I just know that in my area there are types of care you will be turned down for without insurance period. They are required by law to treat you and turf you in the ER, they don't have to give you a heart stint, or chemo for your cancer, or meds for your Lupus beyond what it takes to stabilize you for 24 hours. So, if you don't at least have the option of billing the insurance and then declaring bankruptcy, there are a lot of procedures, treatment protocols, and meds that are simply not going to happen for the uninsured person. And it's morally wrong. And there is not a thing we can do about it. Well, there is one, but it will never happen, and has to do with career politicians and incumbants and such so can't be discussed here. 4 Quote Link to comment Share on other sites More sharing options...
Carol in Cal. Posted October 30, 2015 Share Posted October 30, 2015 I think calling anything about health care in this country a 'system' is putting things far too generously. 10 Quote Link to comment Share on other sites More sharing options...
KungFuPanda Posted October 30, 2015 Share Posted October 30, 2015 It's not even a good gamble for healthy people to go without insurance. You could develop appendicitis (FOUR people I know had this happen THIS year.), get in a car wreck, break your wrist falling on ice, or get a concussion playing sports. 3 Quote Link to comment Share on other sites More sharing options...
FaithManor Posted October 30, 2015 Share Posted October 30, 2015 I think calling anything about health care in this country a 'system' is putting things far too generously. So very.very.true. Quote Link to comment Share on other sites More sharing options...
ktgrok Posted October 30, 2015 Share Posted October 30, 2015 Right. I meant it was irrational IF one could afford it and was choosing not to. Not being able to afford it is a whole nother matter. Personally, I'm REALLY fed up with it, and would donate an organ if it would get us single payer socialized medicine. Yes, it would raise my taxes. But this year we will pay 12,000 in premiums, and still have a 12,000 family deductible. So I doubt I'd be paying 24K in extra taxes to get socialized medicine. Oh and after that 12K deductible I still pay 20 percent of everything. 15 Quote Link to comment Share on other sites More sharing options...
umsami Posted October 30, 2015 Share Posted October 30, 2015 It's not even a good gamble for healthy people to go without insurance. You could develop appendicitis (FOUR people I know had this happen THIS year.), get in a car wreck, break your wrist falling on ice, or get a concussion playing sports. I've known three people with appendicitis this past year. That's freaky. Quote Link to comment Share on other sites More sharing options...
ScoutTN Posted October 30, 2015 Share Posted October 30, 2015 Truth be told if something major happened here, we'd barely be able to afford it WITH the insurance. Although certainly it would be better than not having insurance. This! Dh had brain surgery this summer. Total bills were close to 250K and insurance paid almost all of it. We have an out of pocket max, but could never afford to pay even that much. The deductible alone is a strain. 1 Quote Link to comment Share on other sites More sharing options...
SparklyUnicorn Posted October 30, 2015 Share Posted October 30, 2015 I can understand the sentiment. Our marketplace insurance for a high deductible, barely covers anything, I won't go to the doctor unless I am certain I am dying plan will be running $2, 200 a month. I do not understand this. There is no reason for us to be paying this much for nothing. I get that we have to support a million other people, but it is tempting to play roulette. The odds are tremendously in our favor. Yep Our premiums aren't anywhere near that bad, but oh my, if they were. Forget it. We could not afford that. Quote Link to comment Share on other sites More sharing options...
Lady Marmalade Posted October 30, 2015 Share Posted October 30, 2015 I do know people who are playing roulette though because they simply don't have enough income to pay rent, car insurance, fuel to work, utilities, and food and still pay $1000-1500 a month premiums for insurance. They know it's bad; they don't have a choice in the matter. This is us completely. Is it rational? I don't know. I know we do not have family history problems to worry about and don't have any kind of behavior that puts us in higher risk categories. We've been self-pay for years. A couple hundred dollars for annual exams for all and we're good for the year. One month insurance premium is more than double what I pay cash for once a year. There's just no way. And of course, as a self-pay person I'm seeing the effects first hand. I now have to pay for everything before we even see a doctor. I check in at the front desk and they ask for payment. No payment, no service, and it's not even a co-pay, it's full payment for all services at that visit. I have a procedure coming up that is necessary and will cost me almost $2000 OOP. I have to pay in full, up front before the procedure AND because they've had so many problems with bad checks, they no longer accept them as a form of payment at my ob/gyn. I have to bring cash or credit card only. This is at an excellent facility in my area, not some kind of downtown clinic. I can't imagine how those kind of places are faring! Quote Link to comment Share on other sites More sharing options...
Guest Posted October 30, 2015 Share Posted October 30, 2015 I can understand the sentiment. Our marketplace insurance for a high deductible, barely covers anything, I won't go to the doctor unless I am certain I am dying plan will be running $2, 200 a month. I do not understand this. There is no reason for us to be paying this much for nothing. I get that we have to support a million other people, but it is tempting to play roulette. The odds are tremendously in our favor.Why so high? Our plan with a $10k deductible for 7 people is right at $1000/month. I think everyone should pay for regular care. There is no reason insurance should cover a doctor's visit. Insurance should keep you afloat if you have a major medical issue. And there is no reason for that kind of policy to cost so much. Quote Link to comment Share on other sites More sharing options...
gardenmom5 Posted October 30, 2015 Share Posted October 30, 2015 right now - with mandatory issuance and no pre-existing condition denials allowed, if the penalty for not buying is less than the cost of the policy - yes, it's rational. it's really easy now to go get health insurance after being diagnosed with a major illness. insurance companies are required to issue the policy. despite insurance only being allowed to be purchased during "open enrollment" - you can get a temporary policy almost any time during the year. what the legislation has done to the industry is an absolute joke - and it's the legislation requirements that have driven rates through the roof. and dh is an insurance agent who represents many different companies. 3 Quote Link to comment Share on other sites More sharing options...
Lolly Posted October 30, 2015 Share Posted October 30, 2015 Why so high? Our plan with a $10k deductible for 7 people is right at $1000/month. I think everyone should pay for regular care. There is no reason insurance should cover a doctor's visit. Insurance should keep you afloat if you have a major medical issue. And there is no reason for that kind of policy to cost so much. Because they are doubling our rates come Jan. No real reason. There are only 6 of us. No smokers in the bunch. No risky behaviors. Our deductible is also $10,000. We are going to check and see how much worse a plan we can get for less. It isn't like we use it. But, only paying, what is it? 2% of our annual income in a penalty sounds awfully attractive! The honest truth, at least 50% of our income goes to insurance in one form or the other. Something is wrong with that. 3 Quote Link to comment Share on other sites More sharing options...
J-rap Posted October 30, 2015 Share Posted October 30, 2015 I can certainly understand why someone would hesitate to get insurance. It's crazy. On the other hand, when my husband had his stroke, he was in the peak of health: perfect blood pressure, cholesterol was great, slender, athletic, ate only healthy foods. He was then in the hospital for three months at the expense of $15,000/day, and was helicoptered twice (at the expense of $15,000 each time). Our insurance paid every penny of it. That was five years ago, and now that same insurance has an extremely high deductible which it didn't have then, but we wouldn't go without it. The health insurance industry right now is a real mess. I get so mad just thinking about it. 1 Quote Link to comment Share on other sites More sharing options...
Tsuga Posted October 30, 2015 Share Posted October 30, 2015 I don't agree with using the term "rational". Rational is how you fit facts and perceptions together. It may be rational for someone not to buy health insurance based on what they believe, but they might be working with insufficient or incorrect information. Like, I might say that some religious beliefs are wrong but that is based on the experience I have. It doesn't mean that the people who hold those beliefs are irrational. It just means we are working with different assumptions and perceptions and experiences and facts. I can think of a lot of reasons not to have health insurance. "It won't work anyway." <- Not irrational at all considering some insurance companies. "I'm already poor with medium credit. If I go bankrupt, it won't matter, so I should spend my money on my kids right now and enjoy life. I can rack up medical bills if I get sick." <- Also not irrational, but based on a faulty assumption that the type of treatment that poor cash-paying patients get is not drastically different from the treatment one can get with good insurance. "We all die anyway. The treatment might not even work so why should I not spend this money on my kids' birthday party while I'm still here?" <- Not a bad point if some of your cancer risks are really serious, TBH. So no, not irrational at all. It might be illegal, she might be miscalculating her risk, but irrational? No. 1 Quote Link to comment Share on other sites More sharing options...
Butter Posted October 30, 2015 Share Posted October 30, 2015 The other one literally just died from a burst aortic anuerysm. He was having stomach pains for a few days...but didn't want to seek help. My FIL had an abdominal aortic aneurysm burst a few years before I met my husband. He survived and looking back he saw that he did have stomach pains for a few days before, but he figured it was indigestion or something he ate or gas or whatever. Most people don't seem medical attention for stomach pains. My FIL had insurance that would've covered a doctor's visit 100% (TriCare, retired military, not old enough for Medicare yet). He ended up passing out when he leaned back to get his hair washed before getting his hair cut. They called 911 and a doctor at the tiny hospital realized it was far worse than they could deal with and he was airlifted to DC where he spent several weeks in the ICU, had several surgeries, and they gave him many, many blood transfusions. He died of complications of the aneurysm, but he got an extra dozen or so years. They didn't have to pay a penny. Now, had he sought treatment when it was just threatening, chances are the doctor wouldn't have even guessed what was going on. An aneurysm that is presenting as just stomach pains is kind of a zebra, not a horse, so it's not likely to be suspected. So, yeah, just because your family member didn't have insurance, it doesn't mean he could've been saved. The doctors in DC said my FIL was incredibly lucky. Most people never would've made it to them. Aneurysms are scary stuff. All that said, going without insurance is a huge gamble, and not one I want to risk whether it was mandated to have insurance or not. I'll be having surgery within a few weeks that I had no clue I'd need. We have excellent insurance so we only have $1,000 deductible (which I've met between the ER visit and a test I had to have before the surgery could be scheduled). I'll pay 10% of the usual and customary rate of everything else. My expected cost including one night in the hospital, the surgery, the doctor, etc. is somewhere around $500. If I had to pay for everything myself it would be many times that much. However, when people say the fine is less than paying for insurance, they are telling the truth. It is very possible they simply can't afford insurance. Costs are out of control and the AHA doesn't seem to have stopped that even though it was the hope. 2 Quote Link to comment Share on other sites More sharing options...
Tsuga Posted October 30, 2015 Share Posted October 30, 2015 "Costs are out of control and the AHA doesn't seem to have stopped that even though it was the hope." Costs have gone down for people who were already paying the full costs. Before we all lived cheap when we didn't need benefits and then when we needed them we went into debt or suffered. Kicked off the plan, paid cash, whatever. Now, everyone pays in early on. Over time this should even out EXCEPT that we don't have a public option, so cartel/monopoly issues may arise. Also, some of the cost savings have been offset by employers refusing to cover workers which they used to do to a greater extent. So that sucks. :( Quote Link to comment Share on other sites More sharing options...
Lolly Posted October 30, 2015 Share Posted October 30, 2015 However, when people say the fine is less than paying for insurance, they are telling the truth. It is very possible they simply can't afford insurance. Costs are out of control and the AHA doesn't seem to have stopped that even though it was the hope. And, most likely has made it worse. I've never seen my rate actually double before. Big increases, yes. Double? insanity. 1 Quote Link to comment Share on other sites More sharing options...
Lolly Posted October 30, 2015 Share Posted October 30, 2015 "Costs are out of control and the AHA doesn't seem to have stopped that even though it was the hope." Costs have gone down for people who were already paying the full costs. Before we all lived cheap when we didn't need benefits and then when we needed them we went into debt or suffered. Kicked off the plan, paid cash, whatever. Now, we pay huge premiums and still live cheap when we don't need benefits. When we do need them, we still go into debt or suffer. Now, everyone pays in early on. Over time this should even out EXCEPT that we don't have a public option, so cartel/monopoly issues may arise. Also, some of the cost savings have been offset by employers refusing to cover workers which they used to do to a greater extent. So that sucks. :( Employers aren't refusing to cover workers, at least in most instances. They are being charged such high rates that they cannot afford to cover them. Dh is no longer covering his employees. One reason he has retired is because he cannot afford to pay health insurance premiums. Yes, he could have just dropped it. But, paying them (along with the other crazy expenses businesses are expected to pay) made it so that it just wasn't worth his time to go into work any longer. Now, his employees are all taking advantage of the $ he paid into unemployment. Only one has become employed. She is currently working at a gas station convenience store. It is quite a step down for her. 2 Quote Link to comment Share on other sites More sharing options...
goldberry Posted October 30, 2015 Share Posted October 30, 2015 Costs have gone down for people who were already paying the full costs. ?? We had a catastrophic plan for the last 5 years or so that was affordable ($300/month for our family of three, deductible of $10,000). That plan jumped to $800 per month, which we cannot afford. So I don't agree with your statement. 4 Quote Link to comment Share on other sites More sharing options...
creekland Posted October 30, 2015 Share Posted October 30, 2015 Every time I read one of these threads I wonder why our country can't figure out something to cover everyone. We (universal) act like health care is a want, not a need. I'm also thankful that health share works for us, but wish congress had allowed more of those to be set up to work for more people. Non-profit works so much better IME. My personal plan (if I got to design one) would probably have a number of (secular/religious) health share options that folks had to pick from and join based upon what they wanted covered from hangnails to catastrophic, (but with a savings account to cover the difference). The gov't would cover those who couldn't afford one AND those with super high bills that could seriously dent the finances of one. That said, even if a "not quite best," but "better than we have now - or before" option were to be up for a vote, I'd vote for it. We also spend a fair bit of our donated money to medical causes/bills others have. The "system" we have now is really unfair to an extreme and I shake my head in frustration when I google the salaries of health insurance CEOs. 3 Quote Link to comment Share on other sites More sharing options...
PinkyandtheBrains. Posted October 30, 2015 Share Posted October 30, 2015 And these kind of stories is why universal healthcare is ideal. No one should die because they couldn't afford medical care. I just can't wrap my head around the idea that no one has a right to medical care. 13 Quote Link to comment Share on other sites More sharing options...
PinkyandtheBrains. Posted October 30, 2015 Share Posted October 30, 2015 Every time I read one of these threads I wonder why our country can't figure out something to cover everyone. We (universal) act like health care is a want, not a need. I'm also thankful that health share works for us, but wish congress had allowed more of those to be set up to work for more people. Non-profit works so much better IME. My personal plan (if I got to design one) would probably have a number of (secular/religious) health share options that folks had to pick from and join based upon what they wanted covered from hangnails to catastrophic, (but with a savings account to cover the difference). The gov't would cover those who couldn't afford one AND those with super high bills that could seriously dent the finances of one. That said, even if a "not quite best," but "better than we have now - or before" option were to be up for a vote, I'd vote for it. We also spend a fair bit of our donated money to medical causes/bills others have. The "system" we have now is really unfair to an extreme and I shake my head in frustration when I google the salaries of health insurance CEOs. We can, we refuse to. 9 Quote Link to comment Share on other sites More sharing options...
Laurie4b Posted October 30, 2015 Author Share Posted October 30, 2015 Right. I meant it was irrational IF one could afford it and was choosing not to. This is indeed the case. Quote Link to comment Share on other sites More sharing options...
Tsuga Posted October 30, 2015 Share Posted October 30, 2015 ?? We had a catastrophic plan for the last 5 years or so that was affordable ($300/month for our family of three, deductible of $10,000). That plan jumped to $800 per month, which we cannot afford. So I don't agree with your statement. ​Goldberry, I know you're an awesome person and your family is hurting but I am going to use this particular point, taken out of context, as illustration. I know every situation is complex and so is yours so please don't think I'm judging you, because you were doing what everyone else was doing and it's not fair to single you out. So please don't take what I'm going to say as a personal attack. It's a critique of the system, not you, personally. I've made my own choices at varied times, sometimes out of desperation, that are no less practical than yours, so no judgment of the individual here. That said... --- Catastrophic plans are exactly the type of plan that doesn't pay the full cost over a lifetime of treatment. You were paying too little counting on your good health while you had it. Now, I don't blame you, but $300/month is nothing. You'd only be paying in like $75k over the kids' childhood. 20 years. Considering that you must plan to subsidize at least one old person who hadn't paid in, whose costs for meds are about $500 per month, PLUS part of another sick person who can't pay, another $500 per month for all their meds and needs split between you and some other healthy adults, averaged over 20 years... you were way, way underpaying. Every healthy person must pay for at least one old person, their own children, plus about .1 or so of a disabled or otherwise medicated or unemployed person. And of course you are basically saving up for end of life care, which cost about $90k just at the very end (this is not the old-person meds I was referring to earlier) or so on average: http://circoutcomes.ahajournals.org/content/2/2/127.full The lifetime cost is over $300,000 for each person. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1361028/ If we pay cradle to grave just for ourselves, even assuming we've been paying in our whole lives, which we have not, then each person would be paying about $333 every month. $300,000 and dividing that by (75 years * 12 months per year), this assumes that your parents pay your premiums and you pay in until you die, which is not happening by the way, so this is a LOW estimate. But we haven't been paying all along. In fact, the majority of our population bubble is nearing retirement and they have been paying in many cases less than a third of that. There is a huge backlog. $300 is not the full cost, not at all. You pay in while young, healthy, and working so you can take out. Right now it hurts because we have a whole, huge generation that did not pay in while young and healthy, and a much smaller generation in their prime years (Gen X) and then millennials whom we foolishly told to take on student loan debt equal to a down payment to enter the job market. It was set-up very poorly. The question of increasing health care costs due to obesity and longer lives of the Silent Generation as well as the Boomers combined with recreations birth rates has really set us up where Gen X and older Millennials are going to be paying for way, way more than one person. Costs will go up until the population evens out. Right now they are desperately, desperately trying to get the bulk of boomers, who haven't been paying in but who will take out in much larger numbers, to pay in before they retire or disable-out, at 65-70. So we will pay. There is no way around it. We're going to pay. It will be into insurance, or taxes, or in human life. But everybody's going to pay more. I didn't even have my kids in the hospital. Our family takes exactly zero meds. We don't even go to well-child visits unless they need a shot. I get what it feels like to pay in. Even my own mother has an end of life plan and my sister has power of attorney AND my mom has an attorney so she won't be paying a penny for end of life care. We won't be burdening anyone with our medical costs if we can help it. But my dad? He paid in for all of 15 years, minimal, and he pulls out. Every month. For ongoing cancer and addiction treatment. Basically everything me, my partner, my sister and her husband pay in medical bills all goes to support my dad and her MIL who can't pay (MIL was a housewife, who got divorced). Neither of those people paid substantially for insurance in their youth. Not even a small fraction of what it costs for them to live now. So we pay. We pay for them. We have to. I don't mean that we get their insurance bills directly. No, we pay in now and that goes to their care because we won't take until later. So I get the frustration. But $100/person is nothing, even if you look mostly at catastrophic care. Considering that we are dealing with a backlog, it would be rational to ask everyone in the country to pay about $500/person. And that's actually what's happening, though people who work are paying much more, because they pay through their benefits which come out of their paychecks and are paid directly by employers (supply and demand would dictate that even if employers did not do this, they'd just have to pay their employees more to pay for insurance costs out of pocket so overall it's not like we could just say employers don't have to pay therefore nobody pays). http://kff.org/other/state-indicator/individual-premiums/ http://kff.org/other/state-indicator/family-coverage/ The employee one is for a family over a year. So that would be for a family of 4.5 people (on average, parents and 2.5 kids), that's about $305 per month. Would you look at that... We're still underpaying by about $200/month per person even at current rates, if we look at average costs over a lifetime! And don't forget that backlog. It's actually more that we need to pay because the people who will be the biggest users right now haven't been paying in nearly what's needed, so it hasn't accrued any interest... This is all just to say we're screwed. We could always socialize medicine and control the production of some key drugs that are causing the lifetime expenditures to be so high. Just sayin'. 6 Quote Link to comment Share on other sites More sharing options...
Jane in NC Posted October 30, 2015 Share Posted October 30, 2015 Our community hospital is facing desperate times due to the number of historically uninsured in my area. I read regularly that some people would prefer to "pay as you go" with health care, but paying for major surgeries or chronic conditions are often beyond the budgets of the uninsured. Please understand that I believe all people should receive medical care. I believe in universal coverage. But at the same time, it has bothered me that some people in my area believe that the insured should subsidize the uninsured at my local hospital. In some cases, this is reasonable. Yes, some of the uninsured deserve our help. But I also live in an area with an underground economy. People in construction and tourism related industries are often paid in cash. Could they pay for their own insurance or health care? Possibly. It is clearly complicated. All I know is that my local hospital is in financial trouble. And I suspect it is not alone in this country. 4 Quote Link to comment Share on other sites More sharing options...
Guest Posted October 30, 2015 Share Posted October 30, 2015 I know what I'm about to say sounds horrible. I think we need to get more comfortable with death. My 63yo aunt had a stroke a month ago. She was in the hospital a few days when she had another massive stroke. It was pretty evident that it was a terminal event. It took half a day to stabilize her blood pressure so she could be air lifted to a bigger hospital where it was confirmed that this was a terminal event. She languished in the hospital for 10 days waiting for her brain to finish shutting down. At no point after the second stroke did anyone think she would recover. Not that long ago, she would have been sent home to die in her bed. Instead, she died hooked to machines with nurses checking on her every hour. My sister is a doctor with Hospice and she sees it every day. People want to "do everything you can for Mom" when Mom has had terminal cancer for 5 years and her organs are failing. There is no coming back from that but some doctors (not my sister) will try everything to make the family feel better. Which is great but very expensive. I get that watching people die is hard. But people did it for thousands of years and still do it in most countries. Death is a natural part of life and shouldn't always have to cost more than a 3-bedroom home. 22 Quote Link to comment Share on other sites More sharing options...
Mergath Posted October 30, 2015 Share Posted October 30, 2015 I don't think it's irrational to go without health insurance. I'm at a high risk for a couple different kinds of cancer. If we had to pay something like $1000 a month just for catastrophic insurance, I'd probably go without. In my mind, that's a thousand dollars a month I could use on healthy, organic produce. On a gym membership. On things to try to prevent the cancer and be healthy now, instead of having insurance possibly make a dent in my bills someday. The system itself is so insane that I don't think it's possible to make a rational decision within it. It's nuts to pay a third of your income for health insurance. It's nuts to not have insurance when medical costs are so outrageous. 7 Quote Link to comment Share on other sites More sharing options...
Laura Corin Posted October 30, 2015 Share Posted October 30, 2015 I get that watching people die is hard. But people did it for thousands of years and still do it in most countries. Death is a natural part of life and shouldn't always have to cost more than a 3-bedroom home. A friend of mine works for the Department of Health in the UK. She visited various countries, including the US, to look at how many lines of treatment are used for cancer before there's a conversation with the family/patient about length of life vs. quality of life. The extra lines in the US were very noticeable: yes, sometimes there was extra time, and I'm sure that for some people that might be valuable, but there was also a lot more suffering. FWIW, my father had a standard line and an experimental line before calling it a day. 3 Quote Link to comment Share on other sites More sharing options...
skimomma Posted October 31, 2015 Share Posted October 31, 2015 This is us completely. Is it rational? I don't know. I know we do not have family history problems to worry about and don't have any kind of behavior that puts us in higher risk categories. We've been self-pay for years. A couple hundred dollars for annual exams for all and we're good for the year. One month insurance premium is more than double what I pay cash for once a year. There's just no way. And of course, as a self-pay person I'm seeing the effects first hand. I now have to pay for everything before we even see a doctor. I check in at the front desk and they ask for payment. No payment, no service, and it's not even a co-pay, it's full payment for all services at that visit. I have a procedure coming up that is necessary and will cost me almost $2000 OOP. I have to pay in full, up front before the procedure AND because they've had so many problems with bad checks, they no longer accept them as a form of payment at my ob/gyn. I have to bring cash or credit card only. This is at an excellent facility in my area, not some kind of downtown clinic. I can't imagine how those kind of places are faring! I am impressed that someone will give you the cost up front. I wish I could get an idea of cost before medical procedures. I am so frustrated with unexpected and inflated costs (we have a high deductible plan through dh's work....no other option available) that I am at the point that we do not seek medical care unless death is at the door. Seriously. Because that is great for people. I had my first mammogram this year (two weeks before the new age recommendations) and it is supposed to be covered 100%. But they had to recheck something and I had the pay for the recheck out of pocket. I did not know this. I was shocked to get a $600 bill. We cannot just eat an extra $600 bill out of the blue. I feel really bad that I have cost our family that deficit in our budget. I am not going to get another physical anytime soon. I cannot deal. 1 Quote Link to comment Share on other sites More sharing options...
JFSinIL Posted October 31, 2015 Share Posted October 31, 2015 Blue Cross eventually paid a bit over $500,000 for hubby and my medical bills after our car crash. The twits who caused the accident had no insurance of any kind. We'd have been hung out to dry without our own insurance. Plus hubby, only 56, had to have a second cataract surgery last year, and I had half my thyroid removed. We are just too old and creaky to not have insurance ;-) 2 Quote Link to comment Share on other sites More sharing options...
Splash Posted October 31, 2015 Share Posted October 31, 2015 Going without insurance isn't an option I'd be comfortable with. Twice since I've been married a family member has had a catastrophic illness that we could not have prevented, that we had no risk factors for and had no idea were coming our way. Twenty five years ago dh ended up with osteomyelitis and then a blood clot. He was in the hospital for a total of 5 weeks. He was 26 healthy and athletic. His hospital bill $75,0000 Three years ago my daughter was rushed to local children's hospital. She was in PICU for 35 days and ultimately diagnosed with an ultra rare genetic life threatening/ life shortening disease that we had never even heard of before this. Hospital stay was $880,000 plus additional charges. Medication she is on is $24,000 every 14 days., plus doctors visits, blood work, procedures, ER visits, etc. With medication she is doing great and most of the time people don't even know she has anything wrong. I can't imagine where we'd be without insurance. In many other countries like Australia, Canada, India she would not receive this medicine as the government won't pay for it. Others like England it depends on where you live if she'd receive the medicine. Without it she would have died as they'd tried every other option first. So as messed up as the system is at the moment we strongly encourage people to have insurance because you just never know if something like this is just around the corner. Quote Link to comment Share on other sites More sharing options...
DragonFaerie Posted October 31, 2015 Share Posted October 31, 2015 Going without insurance is not really a choice for me. I would LOVE to have insurance. I simply cannot afford it. No, I can't afford to be sick or hospitalized either, but that does not change the fact that I don't have an extra $400 per month to pay for an insurance policy with a $10,000 deductible "just in case." 5 Quote Link to comment Share on other sites More sharing options...
Joker Posted October 31, 2015 Share Posted October 31, 2015 Nm Quote Link to comment Share on other sites More sharing options...
sbgrace Posted October 31, 2015 Share Posted October 31, 2015 My BIL had an accident that involved a life flight, ICU, and therapy for a head injury and broken back. Uninsured. It took him 10 years to pay off the bills. I've had kids with head CT's and illnesses that required surgeries and week long hospital stays. A parent with an emergency surgery from a fall. A cousin who had a stroke. Bad stuff can happen. Even small things cost a lot in this broken health care system. I would be terrified to be without insurance. 1 Quote Link to comment Share on other sites More sharing options...
Laurie4b Posted October 31, 2015 Author Share Posted October 31, 2015 Going without insurance isn't an option I'd be comfortable with. Twice since I've been married a family member has had a catastrophic illness that we could not have prevented, that we had no risk factors for and had no idea were coming our way. Twenty five years ago dh ended up with osteomyelitis and then a blood clot. He was in the hospital for a total of 5 weeks. He was 26 healthy and athletic. His hospital bill $75,0000 Three years ago my daughter was rushed to local children's hospital. She was in PICU for 35 days and ultimately diagnosed with an ultra rare genetic life threatening/ life shortening disease that we had never even heard of before this. Hospital stay was $880,000 plus additional charges. Medication she is on is $24,000 every 14 days., plus doctors visits, blood work, procedures, ER visits, etc. With medication she is doing great and most of the time people don't even know she has anything wrong. I can't imagine where we'd be without insurance. In many other countries like Australia, Canada, India she would not receive this medicine as the government won't pay for it. Others like England it depends on where you live if she'd receive the medicine. Without it she would have died as they'd tried every other option first. So as messed up as the system is at the moment we strongly encourage people to have insurance because you just never know if something like this is just around the corner. So glad that your dd is doing well now. That sounds very scary. Quote Link to comment Share on other sites More sharing options...
Seasider Posted October 31, 2015 Share Posted October 31, 2015 The only rational reason to go without insurance is independent wealth. A lot of wealth. In that case, one is functionally self-insured. Being at high or low risk for disease is only part of the story. Debilitating accidents happen every day. 3 Quote Link to comment Share on other sites More sharing options...
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