Self Coverage vs ACA Health Insurance

[dresden]

I disagree with the fundamental argument. (Perhaps due to ignorance).  Its my understanding that due to insurance "float" money being invested, insurance companies are able to offer insurance below apparent cost.  Im not sure if this is relevant to healthcare.   

But I'm sure having the middleman operating for profit isn't the cheapest model possible.

This is true of life insurance and long-term care insurance where premiums come in long before the pay-out, but it doesn't compute with health insurance as premiums and expenses are happening at the same time.

[Fishindude]

I have been hesitant to chime in.
I have not had health insurance since 2006.
I am 56.
There are many reason why I don't have it.
I think the concept is ridiculous, middle man entity called the insurance company is placed between those who need coverage and those who provide it. Someone has to pay for all their paychecks, benefits, operating cost and profit.  The cost of medical care is too high and part of that is due to this middle man entity.
I think what you focus on you get, it seems to me too many people who were convinced they needed insurance ended up needing it shortly after they got.
Anyway, doubt I will change anyone's mind, but I am going to just live healthy, do what I can and live life.

So what happens in the event you have a major catastrophic health issue such as a stroke, heart attack, serious accident, bad run with Covid, etc. that racks up several hundred thousand dollars in medical bills?
I guess you'll just go to the ER and since they can't ethically refuse to care for the uninsured, you will be cared for and your medical providers will just be required to "eat the costs". 

Your attitude is a huge part of the reason that healthcare and health insurance are so darned expensive. 
Those of us that choose to buy insurance and pay for medical care have to subsidize the freeloaders.

[iris lily]

I have been hesitant to chime in.
I have not had health insurance since 2006.
I am 56.
There are many reason why I don't have it.
I think the concept is ridiculous, middle man entity called the insurance company is placed between those who need coverage and those who provide it. Someone has to pay for all their paychecks, benefits, operating cost and profit.  The cost of medical care is too high and part of that is due to this middle man entity.
I think what you focus on you get, it seems to me too many people who were convinced they needed insurance ended up needing it shortly after they got.
Anyway, doubt I will change anyone's mind, but I am going to just live healthy, do what I can and live life.

So what happens in the event you have a major catastrophic health issue such as a stroke, heart attack, serious accident, bad run with Covid, etc. that racks up several hundred thousand dollars in medical bills?
I guess you'll just go to the ER and since they can't ethically refuse to care for the uninsured, you will be cared for and your medical providers will just be required to "eat the costs". 

Your attitude is a huge part of the reason that healthcare and health insurance are so darned expensive. 
Those of us that choose to buy insurance and pay for medical care have to subsidize the freeloaders.

All they are required to do is treat acuity and stabilize him They can push him out of the hospital still incapacitated and injured. I know, I saw that with my friend who is uninsured. However – she is truly self insured and she negotiated the bills down and then pays them. The days of spending weeks and weeks in the hospital are over. Even for people with insurance.

[wenchsenior]

I have been hesitant to chime in.
I have not had health insurance since 2006.
I am 56.
There are many reason why I don't have it.
I think the concept is ridiculous, middle man entity called the insurance company is placed between those who need coverage and those who provide it. Someone has to pay for all their paychecks, benefits, operating cost and profit.  The cost of medical care is too high and part of that is due to this middle man entity.
I think what you focus on you get, it seems to me too many people who were convinced they needed insurance ended up needing it shortly after they got.
Anyway, doubt I will change anyone's mind, but I am going to just live healthy, do what I can and live life.

So what happens in the event you have a major catastrophic health issue such as a stroke, heart attack, serious accident, bad run with Covid, etc. that racks up several hundred thousand dollars in medical bills?
I guess you'll just go to the ER and since they can't ethically refuse to care for the uninsured, you will be cared for and your medical providers will just be required to "eat the costs". 

Your attitude is a huge part of the reason that healthcare and health insurance are so darned expensive. 
Those of us that choose to buy insurance and pay for medical care have to subsidize the freeloaders.

All they are required to do is treat acuity and stabilize him They can push him out of the hospital still incapacitated and injured. I know, I saw that with my friend who is uninsured. However – she is truly self insured and she negotiated the bills down and then pays them. The days of spending weeks and weeks in the hospital are over. Even for people with insurance.

That's a weird statement. Why do you believe this?  Two of our friends were in the hospital for 3 and 6 weeks, respectively, in the past few years. Not to mention all the multiple week hospital stays being reported all the time due to Covid.

[Segare]

I have been hesitant to chime in.
I have not had health insurance since 2006.
I am 56.
There are many reason why I don't have it.
I think the concept is ridiculous, middle man entity called the insurance company is placed between those who need coverage and those who provide it. Someone has to pay for all their paychecks, benefits, operating cost and profit.  The cost of medical care is too high and part of that is due to this middle man entity.
I think what you focus on you get, it seems to me too many people who were convinced they needed insurance ended up needing it shortly after they got.
Anyway, doubt I will change anyone's mind, but I am going to just live healthy, do what I can and live life.

 Its my understanding that due to insurance "float" money being invested, insurance companies are able to offer insurance below apparent cost.
But I'm sure having the middleman operating for profit isn't the cheapest model possible.

I don't think they make up the difference.

[Segare]

I have been hesitant to chime in.
I have not had health insurance since 2006.
I am 56.
There are many reason why I don't have it.
I think the concept is ridiculous, middle man entity called the insurance company is placed between those who need coverage and those who provide it. Someone has to pay for all their paychecks, benefits, operating cost and profit.  The cost of medical care is too high and part of that is due to this middle man entity.
I think what you focus on you get, it seems to me too many people who were convinced they needed insurance ended up needing it shortly after they got.
Anyway, doubt I will change anyone's mind, but I am going to just live healthy, do what I can and live life.

So what happens in the event you have a major catastrophic health issue such as a stroke, heart attack, serious accident, bad run with Covid, etc. that racks up several hundred thousand dollars in medical bills?
I guess you'll just go to the ER and since they can't ethically refuse to care for the uninsured, you will be cared for and your medical providers will just be required to "eat the costs". 

Your attitude is a huge part of the reason that healthcare and health insurance are so darned expensive. 
Those of us that choose to buy insurance and pay for medical care have to subsidize the freeloaders.

You do not know what I will do.  Not everyone lives it a high state of fear, not everyone has so much faith in the current medical system.  To say I would have no option but to seek this care from our current system, care that didn't exist before is not correct. Someone would have to force me into one of those places. If they force me in there, they can pay, and they can deal with me if I make it out alive.
An attitude like mine has almost nothing to with the high cost.  Too many government rules and regulations, health insurance and the fear of lawsuits is why it is so high.

[iris lily]

I have been hesitant to chime in.
I have not had health insurance since 2006.
I am 56.
There are many reason why I don't have it.
I think the concept is ridiculous, middle man entity called the insurance company is placed between those who need coverage and those who provide it. Someone has to pay for all their paychecks, benefits, operating cost and profit.  The cost of medical care is too high and part of that is due to this middle man entity.
I think what you focus on you get, it seems to me too many people who were convinced they needed insurance ended up needing it shortly after they got.
Anyway, doubt I will change anyone's mind, but I am going to just live healthy, do what I can and live life.

So what happens in the event you have a major catastrophic health issue such as a stroke, heart attack, serious accident, bad run with Covid, etc. that racks up several hundred thousand dollars in medical bills?
I guess you'll just go to the ER and since they can't ethically refuse to care for the uninsured, you will be cared for and your medical providers will just be required to "eat the costs". 

Your attitude is a huge part of the reason that healthcare and health insurance are so darned expensive. 
Those of us that choose to buy insurance and pay for medical care have to subsidize the freeloaders.

All they are required to do is treat acuity and stabilize him They can push him out of the hospital still incapacitated and injured. I know, I saw that with my friend who is uninsured. However – she is truly self insured and she negotiated the bills down and then pays them. The days of spending weeks and weeks in the hospital are over. Even for people with insurance.

That's a weird statement. Why do you believe this?  Two of our friends were in the hospital for 3 and 6 weeks, respectively, in the past few years. Not to mention all the multiple week hospital stays being reported all the time due to Covid.

When hospitals were simpler and care not as expensive, people lolled around hospitals longer. That was a long time ago, remember, I am old. But it is a well i
Known fact that hospital stays have d3creased over decades.

Just my first tryst with Mr. Google revealed this result which shows 1960’s hospital stay was 20.5 days and 2005 stay was 6.5 days. Currently,4.5 days is the average.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2917661/#Sec4title

[wenchsenior]

I have been hesitant to chime in.
I have not had health insurance since 2006.
I am 56.
There are many reason why I don't have it.
I think the concept is ridiculous, middle man entity called the insurance company is placed between those who need coverage and those who provide it. Someone has to pay for all their paychecks, benefits, operating cost and profit.  The cost of medical care is too high and part of that is due to this middle man entity.
I think what you focus on you get, it seems to me too many people who were convinced they needed insurance ended up needing it shortly after they got.
Anyway, doubt I will change anyone's mind, but I am going to just live healthy, do what I can and live life.

So what happens in the event you have a major catastrophic health issue such as a stroke, heart attack, serious accident, bad run with Covid, etc. that racks up several hundred thousand dollars in medical bills?
I guess you'll just go to the ER and since they can't ethically refuse to care for the uninsured, you will be cared for and your medical providers will just be required to "eat the costs". 

Your attitude is a huge part of the reason that healthcare and health insurance are so darned expensive. 
Those of us that choose to buy insurance and pay for medical care have to subsidize the freeloaders.

All they are required to do is treat acuity and stabilize him They can push him out of the hospital still incapacitated and injured. I know, I saw that with my friend who is uninsured. However – she is truly self insured and she negotiated the bills down and then pays them. The days of spending weeks and weeks in the hospital are over. Even for people with insurance.

That's a weird statement. Why do you believe this?  Two of our friends were in the hospital for 3 and 6 weeks, respectively, in the past few years. Not to mention all the multiple week hospital stays being reported all the time due to Covid.

When hospitals were simpler and care not as expensive, people lolled around hospitals longer. That was a long time ago, remember, I am old. But it is a well i
Known fact that hospital stays have d3creased over decades.

Just my first tryst with Mr. Google revealed this result which shows 1960’s hospital stay was 20.5 days and 2005 stay was 6.5 days. Currently,4.5 days is the average.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2917661/#Sec4title

Ah, so you mean the median hospital stay length has decreased, not that individual people are no longer allowed to stay for long stretches in hospitals.  Gotcha.

[bacchi]

I have been hesitant to chime in.
I have not had health insurance since 2006.
I am 56.
There are many reason why I don't have it.
I think the concept is ridiculous, middle man entity called the insurance company is placed between those who need coverage and those who provide it. Someone has to pay for all their paychecks, benefits, operating cost and profit.  The cost of medical care is too high and part of that is due to this middle man entity.
I think what you focus on you get, it seems to me too many people who were convinced they needed insurance ended up needing it shortly after they got.
Anyway, doubt I will change anyone's mind, but I am going to just live healthy, do what I can and live life.

So what happens in the event you have a major catastrophic health issue such as a stroke, heart attack, serious accident, bad run with Covid, etc. that racks up several hundred thousand dollars in medical bills?
I guess you'll just go to the ER and since they can't ethically refuse to care for the uninsured, you will be cared for and your medical providers will just be required to "eat the costs". 

Your attitude is a huge part of the reason that healthcare and health insurance are so darned expensive. 
Those of us that choose to buy insurance and pay for medical care have to subsidize the freeloaders.

You do not know what I will do.  Not everyone lives it a high state of fear, not everyone has so much faith in the current medical system.  To say I would have no option but to seek this care from our current system, care that didn't exist before is not correct. Someone would have to force me into one of those places. If they force me in there, they can pay, and they can deal with me if I make it out alive.
An attitude like mine has almost nothing to with the high cost.  Too many government rules and regulations, health insurance and the fear of lawsuits is why it is so high.

Reducing the risk of malpractice lawsuits doesn't lower the cost of healthcare. It does lower the cost of malpractice insurance but the savings go into providers' pockets. This has been seen in the few states that have limited malpractice payouts.

Re: cost and regulations, all of the OECD countries have lower costs than the US.

[Segare]

So, being nosey, what would you do if say you were in a bad accident and transported to a hospital for care? If you have no say in what happens and have some assets it is likely you will have to pay big bucks (maybe ALL your bucks) even if you don't want or plan too.

1st, I don't focus on that stuff, but I know, it still could happen. 2nd, maybe the insurance people are forced buy to drive a car will cover it, assuming it was an auto accident.  I wouldn't want tons of the care they offer, but as you said in your example, I have no say and they do it.  Well, they best not expect me to pay (for example) $10.00 for a Tylenol. (BTW, I haven't taken a Tylenol, aspirin, Pepto, Ibuprofen etc for 15 years),   I would be unwilling to pay ridiculously crazy prices for care I didn't ask for. Yeah, I'd rather be taken home and assess the situation myself, like I have done for 15 years.  As I eluded to before, I don't fear death.  As Kwai Chang Caine in the TV serious Kung Fu said "As sure as you know a man is living you know that man will die, why fear the inevitable".

[DaMa]

@Segare, what would you do if you found you had something curable or treatable but high cost? (Hodgkin's Lymphoma comes to mind.)  I ask, because it's the scenario that gives me the most concern if the ACA is overturned.  It's one thing to just opt out of health care for terminal illnesses, but what about things that are really treatable?

[EricEng]

You do not know what I will do.  Not everyone lives it a high state of fear, not everyone has so much faith in the current medical system.  To say I would have no option but to seek this care from our current system, care that didn't exist before is not correct. Someone would have to force me into one of those places. If they force me in there, they can pay, and they can deal with me if I make it out alive.
An attitude like mine has almost nothing to with the high cost.  Too many government rules and regulations, health insurance and the fear of lawsuits is why it is so high.

So you would rather die of a preventable illness or injury with your insurance money in your pocket than survive it with less money in your pocket? 

When you are in a car accident, should the ambulance just leave your broken, battered, bleeding body beside the road when they could save you?
When you come down with pneumonia would you rather act like it is the Dark Ages with no medical care or go the hospital for treatment so you live another 30+ years?
When you fracture your shoulder and dislocate an arm...should you just accept you'll never have use of that arm again or seek medical care so you can recover 99% of your mobility?  (personal exp)

[Gone_fishing]

That does sound expensive.  For my son and myself, our bronze plan is $568 per month.  Husband has VA so he doesn’t need ACA (it has been very good healthcare, wish our whole family had it.). There was a month this year when I didn’t have health insurance due to moving, and I was really anxious the whole time.  As a health care provider, I know how bad it can get.  I try to use my health system (Kaiser) in ways that minimize paying deductible, such as using messaging and telephone visits instead of in person visits.

[Segare]

I think I'd fear living with a curable/preventable painful life altering disease or injury more then I'd fear death. Being wheelchair bound and totally dependent on others to care for me for decades because

I guess the difference is that I don't see the current expensive medical system as having all or many answers. I find, and many others also are finding natural ways. I know too many people that ran to the medical system and ended up worse off.

[slappy]

I think I'd fear living with a curable/preventable painful life altering disease or injury more then I'd fear death. Being wheelchair bound and totally dependent on others to care for me for decades because

I guess the difference is that I don't see the current expensive medical system as having all or many answers. I find, and many others also are finding natural ways. I know too many people that ran to the medical system and ended up worse off.

I'm so confused by everything you've posted. What does this even mean? You don't "believe" in health insurance because you don't fear death? People you know ended up worse off by "running to the medical system"? We look for "natural ways" as well (stretching, massage, exercise, healthy eating) but that doesn't mean we won't get cancer or some other disease that requires care. It seems strange that you would rather shorten your life unnecessarily in one of those situations than get/pay for medical care. Honestly, it seems the opposite of mustachian.

[Much Fishing to Do]

I've always gotten my health insurance from the private market. 

The couple of times I looked into ACA the plans were just way too expensive, for my family of 5 it would be like $1900/mth with high deductibles/co-insurance etc.  Of course after I RE the subsidies will make it much much cheaper and definitely the way to go.

My current plan is about $1300/mth with fairly good co-pays, deductibles not too bad if I remember right. And very importantly I've had good experiences with this plan/ins. co covering things.  I've had horrible experiences with other private plans in the past denying stuff for being too high above market rates, and not being accepted at a lot of places, etc, so I'm sure I'll stick with this one until RE.

There's no way I would self-insure, medical costs and general liability seem to be the two things where potential costs for an unlucky event seem almost infinite.

[jim555]

I've always gotten my health insurance from the private market. 

ACA plans are private market plans. 

[Much Fishing to Do]

I've always gotten my health insurance from the private market. 

ACA plans are private market plans.

Yes, but just a subset of all available I guess.  My current private plan is not on the ACA marketplace.  I'm just saying I've found there are cheaper private plans than what the marketplace offered me, or maybe its the same plan but just cheaper than what it is on the marketplace, no idea.