The least expensive health insurance plan that I could find with a quick quote (esurance, WA state) was over $600/mo! That's with a $10k deductible. That's more expensive than my mortgage every month, for something that I really am not that likely to need. That's what gets me. If I could afford to throw away $600-750 every month on premiums, I might just save that money and could then EASILY swing $10k in medical costs annually (without really even affecting our savings rate), and more expensive procedures less frequently, especially considering we don't need anything currently.
I understand that the unexpected can happen. That's why I'm very reluctant to just go without. But when it's so expensive, I just have doubts as to whether it's really a cost-effective way of providing good healthcare for the family.
I'm curious. You have a mortgage, which means that you have home insurance. Your chance of making a serious claim for something like fire or flood is probably less than 1 percent a year depending on where you live. Do you plan to drop that insurance when your mortgage is paid off? It seems to me that a serious illness or accident (chance is 5% if I'm young male and healthy) is far more of a wealth destroyer than having my house burn down to the ground (.08% chance) and I'm insured against that. And if my house burns down, I can step up my income earning to make up the money. If I'm in the hospital or laid up in bed, not so much.
My home insurance is $46/mo for full replacement, with a $5k deductible. I've considered going without, but considering that I expect my house to provide future income as a rental, I think relatively inexpensive insurance is reasonable. I think inexpensive catastrophic-type health insurance (say, $20-30k deductible and a low premium) would be acceptable, but that doesn't appear to be anywhere on the market.
And, when you take into account the roughly 100-fold greater chance of requiring health care that costs more than $30k, and the roughly 10-fold lower expected payout, a difference in health insurance premiums of roughly 10x makes perfect sense.
We can look at the short-term health insurance market to see what the difference in deductibles would do to the insurance premium. I looked at short term policies on ehealthinsurance for a zip code in Miami (33014). 6-month policies for a 27 year old male, nonsmoker were as follows:
$2500 deductible: $134/month
$5000 deductible: $116/month
$7500 deductible: $100/month.
Now, those policies have a lifetime max of $1 million, so they don't serve as a panacea because part of the point of insurance is to guard against the multimillion dollar crises. So, let's compare that to the cheapest ACA-compliant "catastrophic" plan, the one with a $6350 deductible, no lifetime caps, you can't be denied coverage, and includes those pesky preventive doctors visits that Beric hates so much. That cost is $153/month.
Now, let's look at the next step up: Bronze plans, which are pretty close to the catastrophic plans ($6300 deductible, no office copay). The cheapest bronze plan is $166/month.
So, there are some data points for you. The difference in premiums between the ACA-compliant plan with max deductible isn't very high, at least in my example (I encourage you to get more data points to compare!). And, we know from other markets that further increases in deductible don't make a huge difference in premiums. You and Beric would both love a $50/month catastrophic plan with some high deductible, but such a plan would lose money because too many people make claims. The actual cost of providing such a plan is much, much higher than you're considering.