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Is health insurance REALLY necessary?

lwf said:
I'm sorry to hear that. That should never happen in a first world country, and we ought to work to bring the American Healthcare system up to the standards of the rest of the first world countries.

SDET said specifically: "I can choose not to pay a medical bill and get away with it. Wage garnishment is illegal in Texas." Therefore, if this is in fact true, his medical bill would then be paid by your and my tax dollars. Obamacare didn't pay the medical bills of those who could pay their own medical bills. It paid for those who couldn't, much like Medicaid does. The difference is, it forced those people who couldn't pay outrageous healthcare costs to contribute what little they could into a federally managed system, rather than letting them pay nothing and then get free emergency medical care paid for on the back end by our tax dollars anyway.
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Still, if we were like other countries? You mean with rationed care? So you can wait 18 weeks for an MRI? Lower survival rates of cancers like Breast and Prostate? No thanks, you want that crap move there, don't force your **** on me.
Wage garnishment is legal in Texas. Up to 50% But that is for taxes, child support, student loans.
 
SDET said:
My health insurance lapsed a few months ago. The negotiated cash price with my primary care physician is less than my co-pay was. I have found cash based lab test providers and radiology providers that charge less than what I paid previously as a co-pay. Emergency care can't be denied for lack of insurance. My family premium would have been $1,500 per month. I now put that money in a 401-k much of which I can access if I need to penalty free (see rule of 55). A 401-k cannot be attached by a healthcare provider. All my assets are judgment proof. That means I can choose not to pay a medical bill and get away with it. Wage garnishment is illegal in Texas.
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Same here. Even with my employer health plan (which isnt very good but comparable with the silver and bronze plans the state has), I can pay cash at the time of my visit and it's been about $70-80 less than with copay & ins.

Lab tests too. Pay cash, or within 30 days and save 40%.


Of course, none of these are for on-going treatment, surgery, catastrophic injuries, etc.
 
Helix said:
Yes. Going without it in the US is a horrible idea.
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I did it one year, during the period when there were tax penalties for not having it.

The penalty was a third of what the monthly payments totaled...and they would have been for nothing...for medical care for other people. (yes I know that was the purpose. Too bad, the monthly cost was way too much, I didnt qualify for any subsidies.)

Yes, I played the odds.
 
Renae said:
Still, if we were like other countries? You mean with rationed care? So you can wait 18 weeks for an MRI? Lower survival rates of cancers like Breast and Prostate?
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That's conservative propaganda. Healthcare in general is well established to be superior in most countries with comparable wealth to the U.S.

The U.S. has worse rates of Amenable Mortality than in comparably wealthy countries
The mortality rate for respiratory diseases is higher in the U.S.
Disease burden is higher in the U.S.
Hospital admissions for preventable diseases are more frequent in the U.S.
The U.S. has higher rates of medical, medication, and lab errors
Post-op suture ruptures are more common in the U.S.
Mortality rates for endocrine, nutritional and metabolic diseases are higher in the U.S.
Use of emergency services in place of regular doctor visits is more common in the U.S.

These aren't one or two countries with particular issues, like in your example. This is in the Netherlands, Australia, Sweden, Japan, Austria, Germany, France, Switzerland, Canada, Belgium and the United Kingdom.

The U.S. isn't even in the top 10 for quality of or access to healthcare.
 
Lursa said:
I did it one year, during the period when there were tax penalties for not having it.

The penalty was a third of what the monthly payments totaled...and they would have been for nothing...for medical care for other people. (yes I know that was the purpose. Too bad, the monthly cost was way too much, I didnt qualify for any subsidies.)

Yes, I played the odds.
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i'm glad that you didn't end up financially ruined. i definitely wouldn't recommend living in the US without health insurance for any length of time.
 
Some people are proud of their ignorance; others are proud of their immortality. Interesting that is.
 
lwf said:
That's conservative propaganda. Healthcare in general is well established to be superior in most countries with comparable wealth to the U.S.

The U.S. has worse rates of Amenable Mortality than in comparably wealthy countries
The mortality rate for respiratory diseases is higher in the U.S.
Disease burden is higher in the U.S.
Hospital admissions for preventable diseases are more frequent in the U.S.
The U.S. has higher rates of medical, medication, and lab errors
Post-op suture ruptures are more common in the U.S.
Mortality rates for endocrine, nutritional and metabolic diseases are higher in the U.S.
Use of emergency services in place of regular doctor visits is more common in the U.S.

These aren't one or two countries with particular issues, like in your example. This is in the Netherlands, Australia, Sweden, Japan, Austria, Germany, France, Switzerland, Canada, Belgium and the United Kingdom.

The U.S. isn't even in the top 10 for quality of or access to healthcare.
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It's not propaganda. You're in denial hoss.
 
lwf said:
That's conservative propaganda. Healthcare in general is well established to be superior in most countries with comparable wealth to the U.S.

The U.S. has worse rates of Amenable Mortality than in comparably wealthy countries
The mortality rate for respiratory diseases is higher in the U.S.
Disease burden is higher in the U.S.
Hospital admissions for preventable diseases are more frequent in the U.S.
The U.S. has higher rates of medical, medication, and lab errors
Post-op suture ruptures are more common in the U.S.
Mortality rates for endocrine, nutritional and metabolic diseases are higher in the U.S.
Use of emergency services in place of regular doctor visits is more common in the U.S.

These aren't one or two countries with particular issues, like in your example. This is in the Netherlands, Australia, Sweden, Japan, Austria, Germany, France, Switzerland, Canada, Belgium and the United Kingdom.

The U.S. isn't even in the top 10 for quality of or access to healthcare.
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What are the data sources on these?
 
SDET said:
My health insurance lapsed a few months ago. The negotiated cash price with my primary care physician is less than my co-pay was. I have found cash based lab test providers and radiology providers that charge less than what I paid previously as a co-pay. Emergency care can't be denied for lack of insurance. My family premium would have been $1,500 per month. I now put that money in a 401-k much of which I can access if I need to penalty free (see rule of 55). A 401-k cannot be attached by a healthcare provider. All my assets are judgment proof. That means I can choose not to pay a medical bill and get away with it. Wage garnishment is illegal in Texas.
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So basically you plan to steal from your health care providers and the government by not paying your bills.
 
Helix said:
i'm glad that you didn't end up financially ruined. i definitely wouldn't recommend living in the US without health insurance for any length of time.
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For the plan that the state tried to force me to buy, that I could afford (I didnt qualify for any subsidies) I got almost nothing. It was worthless. I never go in for preventative visits anyway.

It made more sense for me to spend my money on my own health care, which I did.

Why should I spend all that $$, get nothing, and then STILL have to pay alot of $$$ for actual treatment since my forced payment wouldnt cover it until I spent almost $7000?

Do you see how Obamacare made no sense for many middle income Americans? Was cost prohibitive, even felt punitive?
 
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Lursa said:
For the plan that the state tried to force me to buy, that I could afford (I didnt qualify for any subsidies) I got almost nothing. It was worthless. I never go in for preventative visits anyway.

It made more sense for me to spend my money on my own health care, which I did.

Why should I spend all that $$, get nothing, and then STILL have to pay alot of $$$ for actual treatment since my forced payment wouldnt cover it until I spent almost $7000?

Do you see how Obamacare made no sense for many middle income Americans? Was cost prohibitive, even felt punitive?
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Had I not enrolled in COBRA in between jobs when the gamblers wrecked the economy a decade ago, I probably would have been sunk when I got hit unexpectedly by a serious illness partially brought on by the stress. I suppose that if you want to gamble with the US healthcare system, good luck. As for me, I'll vote to change it while purchasing overpriced, for profit health insurance until we can vote enough naysayers out to get a first world solution enacted.
 
Helix said:
Had I not enrolled in COBRA in between jobs when the gamblers wrecked the economy a decade ago, I probably would have been sunk when I got hit unexpectedly by a serious illness partially brought on by the stress. I suppose that if you want to gamble with the US healthcare system, good luck. As for me, I'll vote to change it while purchasing overpriced, for profit health insurance until we can vote enough naysayers out to get a first world solution enacted.
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I'm open to change. Just not punitive, useless proposals.
 
SDET said:
Why not just go for affordable subsidized universal emergency care? The cash for service routine care is growing and becoming more available.
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Oh my god somebody with a sensible plan.
 
lwf said:
How does the quality of the U.S. healthcare system compare to other countries? - Peterson-Kaiser Health System Tracker

How do healthcare prices and use in the U.S. compare to other countries? - Peterson-Kaiser Health System Tracker

U.S. pays more for health care with worse population health outcomes – Harvard Gazette
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Okay. We've got a long way to go, certainly (as does every system) but some of those metrics are a little bit questionable. I love KFF (and indeed have worked with them at points in my life) but they use a vastly higher figure for U.S. amenable mortality for their international comparisons than they do for their domestic state-by-state comparisons (and indeed have used yet a third, different, measure in your first link). I don't know the explanation for any of that but it's rather odd.

Similarly, using patient survey data for medical errors--and not even really medical errors, but medical errors or delays, which aren't the same thing at all--is odd. Indeed, our patient perception of what constitutes a "delay" or timely care does seem to be more exacting here, which is one of the driving factors in the makeup of our system relative to others. (Measuring post-op clots or post-op sepsis, where we're doing better than other nations, is perhaps a more objective measure. But then of course there are others where we're not as good.)

Using that data you can say mortality from respiratory diseases is higher, but by the same token mortality from breast, colorectal, and cervical cancers are lower here. Which one is better? I don't know. What does that question even mean? That's why these international comparisons are generally somewhat meaningless.

We can and should do better than we're doing. The international comparisons don't add a lot to that point. Indeed, the "U.S." numbers mask the huge state-level variation we experience. Our best-performing states (e.g., Minnesota, Massachusetts) tend to boast work-class results that stack up well against international comparators. Our worst-performing states (e.g. Mississippi, Louisiana) are awful and drag down our national average. We're a big country, with a lot of variation. We've got a lot of baggage that cherrypicked comparators don't.

Is Mass General one of the best hospitals on earth? Yeah. Is Louisiana a public health nightmare? Yeah. Does averaging out that data and then comparing the arbitrary averaged stats to France's tell me something meaningful or actionable?
 
Lursa said:
For the plan that the state tried to force me to buy, that I could afford (I didnt qualify for any subsidies) I got almost nothing. It was worthless. I never go in for preventative visits anyway.

It made more sense for me to spend my money on my own health care, which I did.

Why should I spend all that $$, get nothing, and then STILL have to pay alot of $$$ for actual treatment since my forced payment wouldnt cover it until I spent almost $7000?

Do you see how Obamacare made no sense for many middle income Americans? Was cost prohibitive, even felt punitive?
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If you feel that then pay for your own health care. Don't plan on stealing from the rest of us.
 
Greenbeard said:
Okay. We've got a long way to go, certainly (as does every system) but some of those metrics are a little bit questionable. I love KFF (and indeed have worked with them at points in my life) but they use a vastly higher figure for U.S. amenable mortality for their international comparisons than they do for their domestic state-by-state comparisons (and indeed have used yet a third, different, measure in your first link). I don't know the explanation for any of that but it's rather odd.

Similarly, using patient survey data for medical errors--and not even really medical errors, but medical errors or delays, which aren't the same thing at all--is odd. Indeed, our patient perception of what constitutes a "delay" or timely care does seem to be more exacting here, which is one of the driving factors in the makeup of our system relative to others. (Measuring post-op clots or post-op sepsis, where we're doing better than other nations, is perhaps a more objective measure. But then of course there are others where we're not as good.)

Using that data you can say mortality from respiratory diseases is higher, but by the same token mortality from breast, colorectal, and cervical cancers are lower here. Which one is better? I don't know. What does that question even mean? That's why these international comparisons are generally somewhat meaningless.

We can and should do better than we're doing. The international comparisons don't add a lot to that point. Indeed, the "U.S." numbers mask the huge state-level variation we experience. Our best-performing states (e.g., Minnesota, Massachusetts) tend to boast work-class results that stack up well against international comparators. Our worst-performing states (e.g. Mississippi, Louisiana) are awful and drag down our national average. We're a big country, with a lot of variation. We've got a lot of baggage that cherrypicked comparators don't.

Is Mass General one of the best hospitals on earth? Yeah. Is Louisiana a public health nightmare? Yeah. Does averaging out that data and then comparing the arbitrary averaged stats to France's tell me something meaningful or actionable?
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Certainly there are nearly unlimited metrics to compare if someone on either side wants to cherrypick, and U.S. healthcare is certainly better by far than most countries. But it is also unequivocally orders of magnitude more costly to those receiving it than any other country, and the vastly more affordable healthcare to be found in some of the other wealthy countries is at the very least comparable to U.S. healthcare.

And the long wait times argument in European countries applies to those without insurance taking advantage of the state provided healthcare. Those with private insurance don't have the same wait times, just like in the U.S.

So: Americans who can afford private health insurance have very short wait times, and poor Americans who can't afford insurance must go without preventative care. Europeans who can afford private health insurance also have short wait times, and poor Europeans without insurance can still get preventative care at little or no cost, they just have to wait for it. What is the down side?
 
Lursa said:
I did and I do. I also wrote that.
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Good luck when you have an aneurism and can't get admitted to a hospital. You'll have to wait until it bursts to get in through the ER. Of course there is always charity care if you can find it.
 
lwf said:
Certainly there are nearly unlimited metrics to compare if someone on either side wants to cherrypick, and U.S. healthcare is certainly better by far than most countries. But it is also unequivocally orders of magnitude more costly to those receiving it than any other country, and the vastly more affordable healthcare to be found in some of the other wealthy countries is at the very least comparable to U.S. healthcare.

And the long wait times argument in European countries applies to those without insurance taking advantage of the state provided healthcare. Those with private insurance don't have the same wait times, just like in the U.S.

So: Americans who can afford private health insurance have very short wait times, and poor Americans who can't afford insurance must go without preventative care. Europeans who can afford private health insurance also have short wait times, and poor Europeans without insurance can still get preventative care at little or no cost, they just have to wait for it. What is the down side?
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Exorbitant taxes.
 
Lursa said:
I did and I do. I also wrote that.
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Just double, triple and quadruple check that you are judgment proof. Does your state allow wage garnishments? Do you have any real estate that can have a lien put on it? Remember that a 401-k can't be touched by those who sue you for medical debt.
 
Lursa said:
For the plan that the state tried to force me to buy, that I could afford (I didnt qualify for any subsidies) I got almost nothing. It was worthless. I never go in for preventative visits anyway.

It made more sense for me to spend my money on my own health care, which I did.

Why should I spend all that $$, get nothing, and then STILL have to pay alot of $$$ for actual treatment since my forced payment wouldnt cover it until I spent almost $7000?

Do you see how Obamacare made no sense for many middle income Americans? Was cost prohibitive, even felt punitive?
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And.... the medical costs that you file to help satisfy your deductible are MORE than what you would pay negotiating a cash in advance price with the provider.
 
SDET said:
My health insurance lapsed a few months ago. The negotiated cash price with my primary care physician is less than my co-pay was. I have found cash based lab test providers and radiology providers that charge less than what I paid previously as a co-pay. Emergency care can't be denied for lack of insurance. My family premium would have been $1,500 per month. I now put that money in a 401-k much of which I can access if I need to penalty free (see rule of 55). A 401-k cannot be attached by a healthcare provider. All my assets are judgment proof. That means I can choose not to pay a medical bill and get away with it. Wage garnishment is illegal in Texas.
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Anyone that risks going without health insurance is really asking for trouble. Of course, people that are younger and have no obvious health problems might consider it. But for anyone else, not a good idea.
 
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