[greedo]

If you accept cancer as a death sentence, you're an idiot. I had cancer at age 41. If I left it untreated, sure I'd be dead, probably by age 43. But I'm not an idiot, I had good health insurance, I was treated, and now that health event is over twenty years in the past.

Had I self-funded with a (non-existent) nest egg, I would still be in debt over $600k. Instead, my insurance had to deal with that...

[mothballed]

600k once in 40 years is cheap compared to the total cost of insurance, especially when you consider the compound interest you could have made on premiums not paid, plus with the freedom to get cancer care cheaper someplace privately outside the US.

Your insurance company got the last laugh by a long shot. A typical family on insurance would pay $600,000 (between their take-home and the reduced wages paid by employers to cover insurance) in just 25 years, and that's before considering the opportunity cost of lost investments/yield.

[raw_anon_1111]

Are you really suggesting that a family should not have insurance at all and save the money?

I have been working for 30 years and have never once paid more than $10K a year for insurance across 10 jobs 15 of those years were a family plan.

Hell one of those jobs was with Amazon - the company with the shittiest benefit package in all of BigTech and even then I only $12K with a family plan. Right now we pay around $10K - my wife myself and my adult but under 26 (step)son

[mothballed]

You've likely paid at least $18k if not more like $25k for that insurance in the form of wage income moved to benefit income. The government's tax and regulatory environment post WWII just ensures that unless you choose to take it as 1099 income, your potential 1099 income gets reflected in reduced W2 wages that are paid out in benefits.

You might claim that if your employer didn't offer that benefit they'd just pay nothing, but required health benefits function much as payroll taxes which economists have showed are largely reflected in the form of reduced incomes. That is, you are paying it ~all one way or another.

[raw_anon_1111]

We know exactly how much your employer pays for their share of your health benefits. That was also part of the ACA to disclose it to employees.

You’re not wrong - I think it’s around 2/3rds so for me it would be around $36K a year all in if I had to do COBRA.

[greedo]

My annual premium for insurance was roughly $2400/year. Since then, it's gone to about $6k per annum. Even compounded at whatever the S&P500 returns for a 40 year interval, I'm pretty sure I'm ahead of the game. If you think I've lost $600K by having work provided insurance, we're not dealing with the same level of reality.

[paulddraper]

While I won’t argue insurance wasn’t overall beneficial in your case…

There is no way that $600,000 is the cash price for cancer treatment (especially 20 years ago, but also today).

The average cost of cancer treatment is $150k [1], and lower with cash price + shopping.

[1] https://treatcancer.com/blog/cost-of-cancer/

[greedo]

I stopped cataloging the invoices after it hit $1.6M. Granted that's what the providers would bill my insurance, and we all know those are funny numbers, and while I'm sure that a concentrated effort to negotiate cheaper cash prices might have been productive, there's still the fact that I would have had to have $600k or so readily available. HYSA yields were pretty low for most of this time period, and if I had kept that kind of money in a stock portfolio, taxes would have killed me.

And it's beside the point. 99% of Americans can't afford to build a $600k nest egg just to cover medical expenses. THAT'S WHAT INSURANCE IS FOR!

[greedo]

Also, I wonder if this is skewed by more affordable treatments for things like basal cell carcinoma or prostate cancer that doesn't require surgical intervention. In my case, I had full on chemo, rad treatment, surgery, and more chemo. Wouldn't wish it on my worst enemy, but I'm sure as hell glad I had good insurance. Dealing with the medical side was traumatic enough, I don't think I or anyone in my family had the bandwidth to deal with negotiating cash deals with multiple providers.