Some smart people will tell you that anyone who can afford to self insure, should. My problem with that advice for anyone who isn't f-you wealthy is that most people have no conception of what that truly means. Yeah, if I'd taken all the health-insurance premiums I've ever paid and banked them, I might have come out ahead so far. But a cancer diagnosis, a transplant, or a bad car accident would wipe all that out. At least at the group rates that I've been fortunate to have.
Two infusions of the WRONG drug for my condition by a misdiagnosis was $150,000 just for the drug. The same company makes a 5% less effective drug, but when you’re slowly losing the ability to walk, you aren’t going to choose to add a 5% risk if you have the option.
Definitely came out ahead or at least even from all medical premiums paid in nearly 30 years in just one year. Nowadays the kids have nice tax-advantaged options to save up their own medical costs in the newer self-insured major medical plus investment plans, but they must start early when they’re healthy and young. For most of us, playing catch up with one of those doesn’t make fiscal sense.
But definitely I have no complaints about the true premiums amortized over three decades vs what paid out this last year.
The only silly thing insurance continues to fight is the orders of magnitude cheaper physical therapy services rendered vs the rest of the medical procedures and Docs. Every underwriter seems to have one pet peeve they don’t like paying for. Mine is PT. Still appealing a relatively cheap series of claims stretching back to over a year ago now, this month. They’ve paid more in bureaucracy fighting it than the bills themselves.
I think that's the problem with modern "health insurance" anyway, because it isn't really insurance, it's a pre-paid health plan. The premiums are outrageous and the hospitals charge absurd fees for simple items because they know insurance companies will pay for it. Ideally, everyone would just pay out of pocket for things like a simple broken arm or stitches. If everyone kept a catastrophic policy to cover the really expensive stuff, it would force hospitals to quit having a 5 different prices for the same procedure depending on which insurance company was paying or if the patient was paying cash. I'm not against insurance companies making a profit, free-market and all, but honestly I think a co-op is better from a healthcare cost standpoint.
Isn’t a co-op on the planet that’ll accept me now. They don’t have regulations requiring them to accept members of work or other groups, so they’re technically far worse than any of the silliness surrounding pre-existing conditions found in traditional insurance right now. Like... they’ll accept virtually zero people who are already afflicted with pretty much anything.
If they got regulated to do so, they’d be as expensive as anything else.
Also most folks don’t realize that what hospitals and Docs bill is simply a calculated ratio of what they know the insurance will pay. They never get the billed amount. Not even close. Most folks don’t make enough claims in a year to see a pile of EOBs to see what’s actually paid vs what was billed. I’ve got about 100 EOBs here showing that info in real dollars and it’s about 20-25% across the board for multiple services, Docs, you name it. Billing $1000 gets them $250 on average, super consistently.
Billing vs paid is just a massive shell game to be able to claim “losses” and other fictional stuff. The only real numbers one will ever see you compare premiums to payments is the EOB after claims complete settlement. The rest of the fictional numbers just fuel political and other fake fodder.
I watch a lot of YouTube and some nurses union started heavy attack ads against my wife’s employer recently. Big claims the company makes exorbitant profits, puts nurses at risk, rips everyone off, making money off of Covid... you name it. They don’t identify themselves anywhere in the ad or on the website they want people to go to.
Pretty hilarious really. The reality is they pay her really well, their leadership has taken massive pay cuts for Covid, not a single nurse took a pay cut, not a single layoff, far better bennies than industry standard, and the only effect was a warning that annual increases might be cancelled this year... which has already been rescinded. They even halted construction on her new clinic she’ll be moving to perhaps next year, to make sure to take care of staff first and buildings later.
Pretty much it’s like any industry. Ask the people actually doing it before trusting information given by ANYONE else. If you didn’t, what you’re hearing is likely pure fiction.
We got a laugh out of the attack ad claiming her employer didn’t provide adequate PPE to staff. Hell, the company lawyers want the staff to wear provided face shields and the staff told them to shove the face shields for anyone NOT in a Covid ward, where the sun doesn’t shine.
Sounds like some nice people to pay forced union dues to, though. Can’t even identify themselves, they’re that confident of their position and ad content. Haha.
I believe one calls that sort of people, cowards.
