What do we need health insurers for anyway?

No, I've decided that it doesn't make sense for me right now. When I stopped working at at a law firm, my cobra payments were $600/month. Since the law firm ceased to exist (heller ehrman), even the option to even pay $600/month for that premium care lasted only a few months. Independent of some sort of union, my cost will be around that same $600/month for the lowest level of HMO with large copays, and this is what I did for a few months before deciding it didn't make sense.<p>I am relatively young (33), relatively healthy (knock on wood), and I have a decent enough network in India such that I can drop in on a moment's notice. In India, healthcare is 10-30% of the cost for similar care (American run hospitals, often by universities like Harvard). There are other concerns, but purely on cost, its actually cheaper to fly from NY to India or another country and have many popular medical operations performed. An MRI costs $1500 here, in India its $100. A broken arm can cost $25,000* here with hospitalization, less than $1000 in India.<p>This leaves me wide-open for catastrophic events, for which I wish I could buy "urgent-only" insurance to cover this small probability. I'd like to insure my urgent care in the US but for anything else that requires a doctor and is not urgent, I'll take care of it elsewhere, likely planned around vacation.<p>Some people seem to have decent rates and plans for their small companies, but I'm finding quoted rates much higher for very new companies or individuals than they used to be.<p>(* edit: I've never broken my arm but I got the 25k # from a reddit conversation about ridiculous emergency room hourly costs for the uninsured. A quick google search for "broken arm cost" reveals that though 25k may be high, ppl have reported 20k and 5 figures seems to be the norm -- looks like it depends on the amount of emergency room time req'd.)

Ask America: how much more wildly dysfunctional does your healthcare industry have to get before you finally admit what every other industrialized country on earth already understands: that health care is a public service, not a commodity?

Unemployment+more_elderly+healthy_young_uninsured=non-sustainable-business<p>There are many young entrepreneurs in this community. With youth we feel invincible and aren't typically "unhealthy".<p>So, do you insure yourself? Many 20 somethings I know do not. This LA Times article discusses if we even need "health insurers" and explains what we all know: For health insurers to be profitable, they need young healthy people to have policies and pilfer elderly sick people.<p>Now that the baby boomers are here and for the first time in history we have more people that are near/over the age of retirement than under the age of 5, how can insurers make money without having premiums go through the roof?

Next time you have some kind of operation, ask for the precise billing code for that, e.g. "49585" is "repair umbilical hernia" IIRC.<p>Then, look up what the government pays under Medicare/caid for the various pieces of the operation. Compare with what you paid.<p>In the case of the above operation, I was quoted $7-12K from the various local hospitals that are always running ads about how much they "care". The "cash price" they offer to Amish and Old Order Mennonites is $3500. Price under Medicare/caid was even less than that.<p>What we NEED is price transparency and the ability to shop around.

This isn't asking if people here have health insurance, but is linking to an opinion piece about the US health insurance industry. (Title has subsequently changed - article is still off topic in that it's essentially about politics. IMO).<p>Yes, by the way, I have health insurance: I live in Italy and it's provided by the government, and is pretty good, although it has problems of its own. In a way, my favorite aspect of it is that it's one less hassle in my life: I simply don't have to worry about it.

Insurance companies may be expensive, but at least you have some choice when it comes to picking a provider; we would have even more choice if the government would allow competition.<p>When the government takes over you effectively have no choice and in the case of health care they decide who lives and who dies.<p>FYI: If your a staunch republican for government health care(i know not likely); one day a democrat will be deciding your fate. If your a staunch democrat for government health care; one day a republican will be deciding your fate.<p>As expensive as today's health care is, I'd rather decide my own fate by having more choice of insurance providers.<p>Oh and for anyone out there who thinks, "but the government works for the people." If your a democrat "how were the bush years for ya" If your a republican "how's the obama administration working out so far"<p>Less government is all I'm saying. :)

I live in Canada, and I still have health insurance. For a couple reasons; I play rugby and hockey, thus I like the little extra assurance that if something catastrophic were to happen, I am protected (or should an even worse situation happen my family is protected).<p>Secondly, Canadian Medicare does not cover eyes and mouth, and I love to see my computer screen and eat big juicy steaks so I want to keep maintenance costs associated with those two functions as cheap as possible. I pay about $30-40/month for that plan which if you add up is only $360-480, and otherwise if I did not have insurance I would spend more money than that at the dentist/optometrist so to me, its a good deal.<p>However, I am moving to the US within the next couple of months. I won't be THAT from from the Canadian border that if something small happens and I don't need immediate care, I could easily hop the border for some cheap health care but I will definitely be looking into Health plans as soon as I arrive (if not before hand).

Playing devil's advocate; If the government takes over health care, they effectively set the terms. Just to be sure we are all on the same page here; we all know that this is where it's ultimately going right..??<p>Ok if you are a startup, there is much less incentive to invest your time and energy into anything health care related as your return is noticeably less.(they set the terms)<p>Thus any advancements in medical care will ultimately be funded by the government via. you rather than the market. Will it be cheaper in the long run?<p>I think the fundamental difference is that some people personalize everything related to the health care system; understandably; and cannot/will not look at it from a completely logical standpoint.<p>We hate paying high insurance premiums, but time is the most valuable asset.

A friend of mine once remarked that what consumers really want is health <i>maintenance</i>, not health <i>insurance</i>.<p>With my car <i>insurance</i> policy, if, say, someone dings my bumper, I can decide whether it’s really worth pursuing a claim through the insurer or whether I should just settle with the other guy for a smaller amount of cash.<p>Some people in the health <i>insurance</i> industry, thinking along the same lines, seem to believe that if I have a funny feeling in my chest, I should be making a judgement call about whether I should go to the emergency room (and suffer a copay if it turns out to not be an emergency after all) or take some aspirin and see if it gets better by itself. I think this is fundamentally the wrong approach.

Sure. Healthcare is quite affordable for healthy 24-year-olds with no dependents.

no, health insurance is of negative expected utility. if it was of positive expected utility insurance would have to run at a loss.<p>on top of being young and healthy with a fantastic family history of health and longevity, I am highly risk averse. If anything happens to me it will much more likely be due to someone else's negligence, not mine. in addition I am poor and the state of CA allows you to retroactively sign up for medicare if you were qualified at the time the injury occurred. my cost benefit analysis will change I'm sure when I start making more money.

I don't have health insurance. I'm 26 and healthy. I could probably get insurance that I can afford, but with 4-digit deductibles, co-pays, rescissions and lifetime maximums in the mix, there's absolutely no point as I see it. If I get sick, I'll move everything important into someone else's name and declare bankruptcy... and if someone refuses to treat me because I can't pay, I have a "medical second" (this will be a booming business if we don't fix our healthcare mess) who will be healthy and able take care of the situation. The reason to buy insurance is not to have to worry about something, but insurance doesn't provide that because health insurers only pay out <i>if they feel like it</i> (e.g. if the future stream of premiums exceeds the cost of the claim).<p>Our grandchildren are going to think of our times as barbaric. <i>People had to buy insurance policies on their own bodies?</i> It will sound to them like 96-hour workweeks for coal miners sound to us.