[JohnFen]

> you might have a catastrophic loss and have your finances wrecked.

If you have health insurance (in the US) and you have a catastrophic event, your finances are going to be totally wrecked anyway. You're likely to have to declare bankruptcy unless you are pretty wealthy. At least, that's how it's gone with every friend and family member of mine that had to navigate such an event. That's on top of the painful nightmare that is dealing with insurance company claims (which, to add insult to injury, you have to do when you're injured or sick).

The premiums are also so high that I'm very far from convinced that holding an actual health insurance policy is a better option than putting that premium money into an emergency fund.

[arjie]

I had a catastrophic event and it was not particularly wrecking to my finances. Judge for yourself: https://wiki.roshangeorge.dev/w/Motorcycle_Accident

I had quite a few not-bills of the sort you see there totaling more than a few hundred thousand. Insurance coverage did work in my case.

[EvanAnderson]

I would agree that it's objectively terrible dealing with insurance companies, providers who are incredulous you care about the pricing of services, etc. There is no free market for healthcare services. Advocating for yourself is tremendously draining.

I'm happy with the ROI I've had with my insurance premiums over my life. I haven't had a catastrophic event but I've certainly had reasonably sizable claims. If I'd invested the last 20+ years of premium expense (about $400K to date) and had no claims I'd have a ton more money, but not enough to cover a catastrophic event later in life. The principal would also have been completely wiped-out a couple of times when I did have claims, however.

I pay the premiums because I'm not comfortable holding bets on both the market and on my health. I'm also unwilling to consider bankruptcy as a morally / socially acceptable solution.

This mixed socialized and capitalist "system" we've allowed to grow up feels like the worst possible one. Healthcare and health insurance expense are a mechanism to extract value from the middle class (i.e. everyone who has money but isn't wealthy enough to buy their way out of the "system").

My preference would be for a fully socialized system, built primarily around protection for catastrophic loss, where everyone contributes w/ no opting-out permitted.

Failing that I'll grudgingly take a fully capitalist system where people who can't afford to pay are left to fend for charity or die.

What we've got is a mix of the worst parts of both.

[hobonation]

Depends.

I got $300,000 in coverage for a catastrophic event and wound up paying $ 3,100.

But I did have good insurance with United Healthcare.

[myrmidon]

Quick numbers that I found suggest lifetime healthcare costs of >$300k even if you're 65 already (with current yearly spending trending more towards $600k-ish).

So even with a (single) catastrophic event just paying yourself might save you money still (which seems insane to me).