SV reX said:I have self-paid for a long time, but I don't think I'd do it now. We may all have different opinions of the health care system in the US, but the one thing I think we can all agree on is that it is phenomenally expensive (and that won't change if you self-insure or self-pay).
Also, extremely well said, and after self pay for 6years in the '90s, agree on your advice to op.
03Panther said:mtn said:I'm not quite sure I understand what this is adding to the conversation here and frankly would call it a flounder.
You delete that flounderous and unhelpful post and I'll delete the above
if you read the rest of my posts, you would see that I agree that it was not adding anything, and that I apologize to the op.
I figured if you could throw out a flounder, I could too. But that's me being petty, since two wrongs do not make a right.
I know what berkeleyed my cost of living, and why it's still berkeleyed. Yes, I'm bitter.As to delete, I see nothing in your above paragraph that is in need of deleting. That paragraph I agree with.
'Course if the op wants me to delete anything, I'd be glad to.
The rest of your statistics, I do not see as applicable to me or the op, but that's not up to me to police either.
You and I glean different info from society (and that's fine) and always will (and that fine too!) so we don't need to go farther with it, on a car forum. I do like your car info.
I did not have any flounder in any of my posts with the exception of the paragraph that I offered to delete.
Most hospitals gets federal funding one way or another. Most hospitals in the United States are not-for-profit entities. Because of this, they are legally required to meet certain charity criteria. This can be found on their websites; the need is typically determined based on a percentage of the federal poverty levels. He has a huge household. The federal poverty levels for a household of that many people (9) is a pretty large number. That is not an opinion or a statement of right or wrong; the federal poverty levels are a concrete non-negotiable number. See here for more information on that: https://aspe.hhs.gov/topics/poverty-economic-mobility/poverty-guidelines.
I provided the financial aid information that is relevant for the nearest major medical center I could find within his state (it is possible that North Carolina hospitals are closer, but usually you have to stay in the same state from what I understand). This is not welfare, unless you call it corporate welfare. He's not getting anything from the government in this hypothetical situation.
My "statistics" are not statistics. They are numbers. They are 100% directly applicable to his question. If the OP's income and asset levels meet the criteria, he would be eligible for free or significantly reduced cost medical care. He is asking about going uninsured. I am putting real numbers to it to see if it would be financially crippling or not in the case of a catastrophe.
1988RedT2 said:jwagner (Forum Supporter) said:One other thing to consider: When you have insurance the company pays negotiated rates. When you're uninsured the provider charges whatever they damn well please. For example, I had a standard set of bloodwork done and I was billed about $2,400 as the hospital lab didn't think I had insurance. When they re-filed with my insurance company the bill was about $250 total and I paid some co=payment portion of that. Big difference.
This, IMO, would be the single most compelling reason to have health insurance. People without insurance have no negotiating power and will get reamed out by the providers.
As a possible alternative to traditional health insurance, you could consider Medi-Share, or similar.
Not an endorsement, and I have no firsthand experience, but they have been around a while and do have their share of enthusiastic supporters.
I'm not convinced the insurance companies always have more negotiating power. My experience was the opposite.
Before each of my 5 children were born, I went to the hospital and met with the business manager. I explained our situation, and asked for a discounted rate for a birth without complications. I agreed to pay the amount in full in advance (and understood there could be up charges if there were complications).
I received discounts off the "going rate" between 60% and 87% on every one of my kids. That's a total of nearly $40,000.
I think the hospital was so accustomed to having to write off large percentages, fight with insurance companies, and wait for extended periods to get paid that they were just happy to receive a little cash up front.
Things have certainly changed, but I suspect the answer is often still "it depends".
In reply to mtn :
Yes. I do know that you feel that way.
In reply to SV reX :
I'm not sure either
In 97 I went to the hospital with a kidney stone with no insurance Cost me $1200
Two years later, I went again for exact same conditions. With insurance. My out of pocket expenses were, yep $1200
no clue what any of that means, but, there it is
EDIT: Sorry. Not trying to muck up the thread any further. I'm out. Good luck jmabarone.
I'll throw in another option. There are some cost sharing options like Christian Healthcare Ministries that are supposed to be a lot cheaper than traditional insurance. Note, I have not used this service so I do not have first hand knowledge. I do know that it meets the Obamacare requirements even though they claim it's not insurance.
I needed a nuclear stress test. Through insurance, the cost was going to be a $1200 copay and insurance would cover the rest. I told the scheduler that I would need to see if I could find it cheaper.
After a couple of dozen phone calls, I found a cardiologist who did it for $300 cash. As mentioned in another thread, cash is king. Especially for a small business owner.
Insurance as it's required to be written, isn't doing anything except insulating you from the actual cost of medical coverage. It's a product designed to fleece the public while lining the pockets of the medical industry complex.
Nobody gets into a medical job for altruistic reasons and they sure don't want you to know what the actual cost and markup is for their product.
For instance. From what I've been told by hospital administration, a CT machine at my local hospital brings in about $28k per day. That means the $2.5m machine is paid for in less than 90 days. Add in the tech's salaries, maintenance, and building costs. Call it $50k-$100K a month per machine. What does that profit margin look like? The entire medical industry looks just like that and we are getting screwed because no one knows what anything costs. You only get to know what your copay is.
In reply to Toyman! :
Exactly.
The thing I keep coming back to is yes, there are cases you can negotiate. But that is the best case scenario (once you are past the bad of needing a thing). There isn't any promise that the negotiations will be fruitful, or that your need will allow the time to shop providers.
There's just a fallancy of "well it worked this one time" not equating to "it will always work that way".
I don't mean this as any kind of adversarial call-out, just an observation of a vulnerability that would drastically reduce the comfort of my sleep.
Toyman! said:Nobody gets into a medical job for altruistic reasons and they sure don't want you to know what the actual cost and markup is for their product.
I don't think every single person in the medical industry is a sophisticated ripoff artist - almost the opposite, in fact, I think a majority of people in the medical industry, especially at the customer (err, patient)-facing level, are in it for altruistic reasons. And then most of those who aren't are still just looking for a decent job like anyone else. People with the required book smarts for medical jobs can make similar amounts of money in tech or finance with less education, working less hours with less stress and hazard. I think most of the malfeasance is at the upper levels where executives are exploiting an industry with the closest thing to perfectly inelastic demand that can exist. And remember that the issue is largely specific to one nation's market, it doesn't affect the medical industry everywhere.
In reply to GameboyRMH :
I have been the invisible service guy in the back halls of the medical industry for over 20 years. I've listened to the talk. Listen to a few doctors plan to bill each other's patients consult fees a few times and you will probably be as jaded as I am. They are there to milk the world for as much cash as they can and the insurance industry willingly helps them hide the fleecing.
In reply to GameboyRMH and Toyman!:
You're both right, and both wrong.
Gameboy, your bias against business and profits is blinding you a little. You are trying to put the medical providers in the neat little box of "altruists", and the executives in the box of "evil profiteers". What you are missing is they are often the same people. 50% of doctors work in private practices. After that large medical corporations often have medical executives (Drs who run the place). Older hospitals are often owned privately by Drs (although new relationships like this were outlawed by the ACA). And treatment centers are definitely frequently owned by doctors (the cancer treatment center I worked at had over 40 doctors who worked there, and every one of them had an ownership stake. The executives reported to the doctors, not the other way around). So the bottom line is that there are definitely a massive number of doctors who are deeply involved in the profits.
Toyman, I have seen a very similar thing, but it is a huge overstatement to say that nobody gets into a medical job for altruistic reasons. I think the vast majority of nurses, PAs, NPs, etc are definitely in it for altruistic reasons, and most get no share of the profits. (Also some doctors).
I think the more accurate way to put it is that the majority of medical providers are in it for altruistic reasons, but 80% or more of the people in executive positions are deeply profit driven (and the majority of these positions are held by doctors)
I couldn't imagine having a large family with small children and not having health insurance. Simply put, shizz happens, and it happens to kids all the time. I wouldn't want to have to worry about how I'm going to pay to have my child taken care of, I just want them taken care of.
docwyte said:I couldn't imagine having a large family with small children and not having health insurance.
We had very low medical costs until my son was diagnosed with Type1 diabetes. Wouldn't like to pay full for any of it.
Thanks for the input guys. A few more notes to throw in now that I've reviewed the thread.
Yes, my employer does cover a large portion of our medical plan. They are only offering HSA options for 2024.
We have looked at Medishare and CHM. My SIL has it and we were advised to avoid it if we were planning/expecting to have more kids.
We are also looking at other options for doctors in our area. Sucks when the PC is not available and the solution is "go to the ER" that just happens to be in the same hospital group.
Ultimately, I am more leery of going without any insurance because of the noted family circumstances. If there were plans that were more affordable and for truly catastrophic events, that would be my goal. Unfortunately, there are not, so we're stuck with the crap system we have.
OT from thread: We know the current system sucks. I have my beliefs about why it is that way and how to fix it, but this is not the time or place. Thanks to everyone for keeping it civil in here.
In reply to jmabarone :
Can you clarify something?
You said your employer is only offering HSA options. I don't think there is such a thing as an HSA only plan. It has to be associated with a High Deductible Health Plan (HDHP). An HSA is not a health plan.
Im also pretty sure that the HDHP is not a substitute for a low cost health plan (which employers with over 50 employees are required to maintain).
Are you saying that your employer has fewer than 50 employees, and is offering an HDHP with an HSA?
SV reX said:In reply to jmabarone :
Can you clarify something?
You said your employer is only offering HSA options. I don't think there is such a thing as an HSA only plan. It has to be associated with a High Deductible Health Plan (HDHP). An HSA is not a health plan.
Im also pretty sure that the HDHP is not a substitute for a low cost health plan (which employers with over 50 employees are required to maintain).
Are you saying that your employer has fewer than 50 employees, and is offering an HDHP with an HSA?
Yeah, good point. Employer is only offering HDHP with HSA for next year, sorry for the confusion.
In reply to jmabarone :
Do they have 50 employees?
In your original post you mention $2500 in premiums, is that a year? If so, that's a screaming deal, and trying to go cheaper with 7 kids would be tough. I can't imagine how expensive every day is with 7, and planning more. You realize 1 birth will be way more than $2500, right?
In reply to Steve_Jones :
But what is the deductible and OOP Max?
Still likely smarter to get the insurance, unless he meets the financial aid criteria.
A major medical event without insurance is the number two cause of bankruptcy in the U.S. behind loss of job at the number one spot. Being uninsured is folly in the current economic situation unless you are "independently wealthy "; think six zeros minimum probably seven zeros to be safe.
mtn said:In reply to Steve_Jones :
But what is the deductible and OOP Max?
Still likely smarter to get the insurance, unless he meets the financial aid criteria.
I pay $1950 a month, with a $5500 deductible for 3 for reference. At $2500 a year my deductible could be $20k and I'd win.
In reply to tester (Forum Supporter) :
I have an acquaintance that was considering filing for bankruptcy because of medical debt... WITH insurance. I don't know what happened with that situation; We kind of had a falling out, partially because I couldn't stand what I perceived as a persecution complex and victim mentality which definitely contributed to their situation. But they did legitimately have a serious problem with their finances because of their medical debt, even with insurance.
And that is one reason why this situation is more nuanced than it seems. What is your overall net worth? It very well may be worth the risk. I personally can't come to terms with that as soon as kids are involved and likely even as soon as a spouse is involved, but it is worth considering.
Self insurance is a gamble.
Don't gamble with anything unless you're prepared to lose it all.
Gambling with cars? Sure. Go for it. I love my S2000, but if it get hit by a big truck and balled up on the side of the road, it will be an annoying frustration rather than a devastating loss.
Would you feel that way about one of your children?
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