[emidln]

    It isn't gambling, it isn't a risk, it's certain. You need to be insured.

Why? I have money to pay my family's medical expenses. I've done very well investing it. Giving it to an insurance company whose primary goal is to not pay my medical expenses while collecting premiums over versus investing it myself for future payment of services rendered seems like a really bad trade. I realize this isn't a trade that every person is in a position to make, but why do I need the insurance? If I don't need the insurance, then why do I have to pay a fine to opt out of taking it from an insurance company?

I don't know many who are making an argument against lowering health costs or enabling access to more people. Neither of those things necesitate compulsory purchase of an insurance product.

[joshontheweb]

This. I have enough to cover most things. Also I plan on doing any non-emergency procedures in another country where the prices are reasonable. Even if I do get hit with something catastrophic, I'd rather have them send me the bill and let me negotiate and pay it off myself. Insurance companies shouldn't be obligatory.

[aestra]

>Even if I do get hit with something catastrophic, I'd rather have them send me the bill and let me negotiate and pay it off myself.

You do realize medical bills can be in the millions of dollars, right? It isn't even vary hard to get into the hundreds of thousands. Requiring everyone to have insurance solves the "free rider problem," where some individuals pay less than others for the same thing. You can "negotiate" all you want, but that just means person A pays less than person B for the same thing. Especially if you get a $200,000 hospital bill and you had to declare bankruptcy. If there are a lot of Person As, it makes the costs for all the person Bs rise. If there is no incentive to be a Person B, then many people would be a Person A. Requiring insurance tries to eliminate the Person As.

Disclaimer: In the real world of US healthcare, prices are nuts and different for insured and uninsured.

> I realize this isn't a trade that every person is in a position to make, but why do I need the insurance?

Because most people can't deal with a $30,000 medical bill.

Also most people are, for lack of a better word, stupid. They don't make rational choices. My sister for example, thinks that she doesn't need health insurance because juice fasts can cure all diseases. How many of my sisters are out there vs people who are responsible with their money?

You may think you will be completely healthy, but really, we are all human and something terrible (and expensive) can happen to you tomorrow.

Do I think this is a good system or a good solution to the problem? No, I do not.

[joshontheweb]

A lot of my resistance is due to the fact that I've been burned in the past by the fine print and ended up having to pay 80% instead of the agreed upon 20%. If I truly trusted that the insurance company would be there for me when I need them, I would have a different approach. As it stands I paid monthly insurance premiums + deductible + most of the bill. No thanks. I'll take my chances on my own.

Edit: For clarity, the insurance company decided to pay 80% of what they claimed the procedure was worth, not what it actually cost. Apparently there was something in the fine print about that.

[aestra]

>If I truly trusted that the insurance company would be there for me

I don't believe they will be there for me either, and I've been burned before too. That's one of the reasons why I don't support the ACA. However, making others take on your risk is any sane solution. You are just shifting the burden to others.

> As it stands I paid monthly insurance premiums + deductible + most of the bill

You can appeal and appeal and appeal, then go to your state insurance board. This is a government required right. There wasn't any reason to just accept what the insurance company told you. You can even get an external review. Over 90 percent of insurance decisions are reversed on appeal.

Just several phone calls sometimes resolves the issue. I've been on the phone so many times I've practically gotten them on speeddial.

[couchand]

If I don't need the insurance, then why do I have to pay a fine to opt out of taking it from an insurance company?

One or both of these scenarios probably applies: you are young and healthy, so your purchase is necessary to spread risk over the population as a whole; or you're underestimating the odds of getting a major disease and the cost of paying out-of-pocket.

I'm not saying we shouldn't work to lower health care costs. What I'm saying is that insurance companies pay less than cash customers for health care and they spend a lot of time checking their risk calculations. Over the long term, over the population as a whole, you can't win that game.

Let's work to lower costs and fix that, but realistically, right now, in America, it's not a game you want to play.

[jamroom]

I think what we need for people who don't want insurance is some way to "opt out" of the health care insurance system - maybe a special card you carry that indicates to the emergency room or hospital (where maybe you have been admitted, unconscious and close to death from a car accident) that indicates any medical assistance provided will be 100% your responsibility - i.e. bill me or whatever. The only problem is that someone could then just claim bankruptcy and push the burden back onto the insured - so we'd need to make it so bankruptcy could not remove that outstanding debt.

[emidln]

    I think what we need for people who don't want insurance is some way to "opt out" of the health care insurance system - maybe a special card you carry that indicates to the emergency room or hospital (where maybe you have been admitted, unconscious and close to death from a car accident) that indicates any medical assistance provided will be 100% your responsibility - i.e. bill me or whatever. 

Why do I need to carry a card? What purpose does the card hold other than to tell the medical provider to treat me differently (as if I could either not pay (unfair to me, how do they know my assets) or could pay for better treatment (unfair to everyone else, why are some suffering through mere insurance while I have the good stuff that daddy greenbacks bring))? If you are differentiating for those without insurance, you surely must do the same for those with the comically legal 60/40 plans that have no practical out of pocket cap. 40% of a 100k bill is practically the same as being uninsured when looking at the effect of causing a bankruptcy to most of the country.

    The only problem is that someone could then just claim bankruptcy and push the burden back onto the insured - so we'd need to make it so bankruptcy could not remove that outstanding debt.

Would you prevent people who signed up for 60/40 co-insurance from Aetna or Blue Cross to file for bankruptcy when they cannot afford to pay their 40%? If not, why? They choose* to not pay for better plans that limit their out of pocket liability.

Making bankruptcy harder isn't the right solution. Complete nationalization is only solution that doesn't leave uninsured and underinsured individuals who need to take a bankruptcy after an illness or accident. If that is truly the goal, then that is what should be worked at.

[jamroom]

I don't disagree with you - I just believe there must be some way for someone to "opt out" if they want - but if they do that how do we prevent someone from gaming the system who doesn't have the money to actually pay for what they need? It's not that far fetched to be in a situation where medical expenses can be in the hundreds of thousands or even millions of dollars. Ultimately we need Medicare for everyone, but until that time (if it ever comes) is it possible to make the current law more palatable for everyone?

[Datsundere]

Uninsured person doesn't need a card. Doctors cannot deny treating a sick person in emergency care. Hospitals will however take all your assets away.

[panarky]

If you have the resources to self-insure, you don't need to pay an insurance company.

http://healthjournalism.org/resources-tips-details.php?id=65...