this post was submitted on 12 Sep 2023
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The only time you're better off without insurance is if you never use it.
The insurance company isn't only paying part of the bill, even if it's ridiculously expensive and pays laughably little of the bill.
They're also negotiating the price down. Without insurance you're pretty much bare assed to the healthcare industry, who can and will charge you whatever they want. They'll charge you for every individual wet wipe at hilariously inflated prices. They'll charge you for the presence of a tray in your room to set a drink down on. When a nurse pops her head in for 30 seconds suddenly you're billed for an hour of her time. And you're stuck with that bill, no matter what, without insurance.
The insurance company will require them to verify the hours billed, they'll reject charges for shit they shouldn't be billing for, and negotiate down the price of stuff they can bill for.
The difference even for simple visits can but several thousand dollars. For more serious visits the sky is the limit.
This isn't necessarily true. I've seen and heard of multiple doctors who had a lower price for those without insurance.
That could be true for a GP or something like that, but not for a serious issue where you need tests for a diagnosis, a hospitalization, or ER visit.
Nah, a lot of hospitals do that.
Hospital margins are razor thin because of the constant battling with insurance companies (and the high payscale for doctors and surgeons, high cost of equipment, etc, obviously). They will often negotiate reasonable rates for uninsured people.
I was recently in the ER. Insured. I received a $2000 bill, "negotiated down" from $2,500. $1,800 of it was for 5 minutes with a doctor.
I had a friend recently (regularly... she's a hypochondriac) in the ER. Uninsured. $500. Same ER. Same complaints. Same tests. Same treatment.
so is it better not to have insurance?
i just got a job with insurance for the first time in my life, now covering myself and two kids - pay is just enough to take them off state insurance. the high deductable plan still REALLY hurts to pay the premiums. but not having had insurance in my adult life, i can't tell if it's worth it or not - i have never gone to doctors i couldn't pay for out of pocket at the time of service (so almost never).
I didn't say that. Ignoring tax benefits, it's better not to have insurance "9 years out of 10". The tax benefits (employer insurance is paid is pre-tax) changes the equation a lot.
Admittedly, it also matters about what your doctors charge, and what your medical conditions are.
Heaven forbid, if you have a major critical event that puts you in the hospital for a month or two (happened to a friend this year), then insurance is the only way to maybe not be bankrupt, assuming they even treat you at all (past keeping you from coding) knowing you won't pay.
This is absolutely not true. I have a high-risk, high-expense family member on my plan. Most years, we reach her deductible at the very end of the year and we're ultimately paying all that money for "a rate plan". Of the years we crossed the deductible and the insurance covered much of anything, it was still less than the $12,000 we shelled out that year in all but one case. In that one case, we saved about $5000, still a bit less than the overall money they've made off us. Literal cancer wasn't enough to make health insurance a good investment.
We still need it for three reasons. First, "what if you end up needing $100,000 or more in medical procedures". Second "the doctor won't be able to see you for 6 months unless you're insured" (though this sometimes goes the other way). And finally, it's a lot less of a financial drain through my employer as a pre-tax expense. Napkin math makes it $3-4000/yr saved in taxes.
This might surprise you, but many offices have "uninsured rates" because hitting someone with a $2000 bill for 5 minutes of time is a great way to have someone in collections for years and not actually see the money. They often do that alongside inferior service like an NP instead of a Doctor, but I've never found an office or hospital group who didn't do something for uninsured folks. And you're missing that they charge these things for insured folks much of the time to leverage their negotiated rates with hospitals.
Oh, you're not talking about usual hospital bullshit? You're talking about fraud? Yeah. You call them on it once and that disappears from an entire bill. Most hospitals around here don't do it anymore because there's too much attention on them. TBH, the same hospitals you're talking about are are often getting away with coding fraud, which is still reaching the patient's wallet.
The "sky is the limit" is basically the only time insurance is cheaper than not being insured. And why the government really needs to become a singlepayer for healthcare costs.