Health Insurance EV question

[ZBTHorton]

Anything done at the hospital is hella expensive.

I passed a kidney stone not to long ago and it ran me 12K. They didn't do crap.

Health insurance is so ridiculously necessary. I can't believe you would even think about not getting it if you make enough money to pay for it.

[grinin]

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I thought the same thing before, health insurrance is -EV and only necesary for those w/o a large enough BR. However, this fails to take into consideration the power that health insurrance companies have in negotiating lower rates. So their rake is mitigated.

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are you saying health insurance companies actually get better deals, enough to offset the costs of health insurance? I find this somewhat hard to believe, can you be more specific or provide evidence somewhere? I'm not saying you're wrong I want to believe you I just want proof. Would this fall under getting better deals on regular medicine, or would this fall under getting better deals if I needed to undergo multiple serious operations?



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A few years ago, my wife was hospitalized for 40 days, 10 of which was intensive care. The Hospital bill alone (not including doctors, specialists, x-rays, catscans, procedures, etc.) (ie; just room and board and nursing care) was $225,000. I owed the hospital $500 or some such amount from our deductible and I asked how much the Insurance company was paying of the rest and the hospital told me that their agreement with the insurance company had them paying something around $24K.

[ZBTHorton]

Honestly. I think you may be looking at this the wrong way.

To me, Health insurance is a luxury I hope that I can afford. Not a discretionary item I hope I don't have to pay for.

There are millions of people in the US who wish they had it.

[TheNoodleMan]

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I thought the same thing before, health insurrance is -EV and only necesary for those w/o a large enough BR. However, this fails to take into consideration the power that health insurrance companies have in negotiating lower rates. So their rake is mitigated.

[/ QUOTE ]are you saying health insurance companies actually get better deals, enough to offset the costs of health insurance? I find this somewhat hard to believe, can you be more specific or provide evidence somewhere? I'm not saying you're wrong I want to believe you I just want proof. [img]/images/graemlins/smile.gif[/img] Would this fall under getting better deals on regular medicine, or would this fall under getting better deals if I needed to undergo multiple serious operations?


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Insurance pays far less than you would pay if you paid out of pocket without insurance. My mother and Step father are both doctors and I helped them out with billing for a while and it is unreal.
In most surgeries, there are actually multiple procedures that are all billable separately. If you had surgery w/o insurance, you would pay full price for all of them. Medicare (just as an example) pays their rate (which is always less than what the doc charges) for the first billed proceedure, they pay 50% OF THEIR OWN RATE ON THE SECOND AND 25% ON EVERY ADDITIONAL PROCEEDURE.
Insurance companies have negotiated rates for everything a doctor does, from a physical to major surgery. Having health insurance entitles you to the rate they have negotiated. In the Bill Gates example, it would still make sense for him to have insurance with a million dollar deductable, just so he could get the negotiated rates.

[primetime32]

The issue is not how much medical expenses would cost you in a given year. 90 percent of the time it won't be too bad. And you may pay out more than you recieve. but how do you know that you won't wake up with a tumor, cancer or fall and break your neck? these things happen every day to people (young and old), and if you dont have health insurance you could be looking at hundreds of thousands of medical debt.

And if you have insurance you can get the best treatment and services, while without insurance you will look for the cheap way out. Personally, i dont want to be cheap with my health.

Again, not having health insurance is utter stupidity (provided you can afford it).

[grinin]

You can probably afford to break your arm for a couple thousand (as long as it is not the one you use with your mouse). Its the: shatter a few bones while skiing, needing pins to hold you together and lots of physical therapy; or contract some rare illness that ends up having you hospitalized for more than a week that will simply break you.

As someone mentioned you at least need major medical.

Besides why should all the rest of us have to pay extra when some cheap ass poker player decides he should have a good time with that $300 per month rather than pay for insurance.

[Guthrie]

If you're young, single, healthy, and never go to a doctor, buy major medical with a very big deductible and play the odds on the small stuff. One night in a hospital can easily be 30K. The big stuff can bankrupt you. These days it may well bankrupt you even if you do have health insurance.

None of it really matters anyway. Within five years there will be no more employer-paid health insurance, and within ten years the health care industry will have bankrupted the entire country with their obscene prices.

[moondogg]

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I thought the same thing before, health insurrance is -EV and only necesary for those w/o a large enough BR. However, this fails to take into consideration the power that health insurrance companies have in negotiating lower rates. So their rake is mitigated.

[/ QUOTE ]are you saying health insurance companies actually get better deals, enough to offset the costs of health insurance? I find this somewhat hard to believe, can you be more specific or provide evidence somewhere? I'm not saying you're wrong I want to believe you I just want proof.

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The example I gave yesterday was I got a series of routine (but thorough) bloodwork done this summer. The hospital charged over $700, but the insurance company only paid $200 or $300, and the hospital got stiffed on the difference. If I didn't have insurance, I would have had to pay that $700 myself.

The insurance companies get better rates because they are big enough to negotiate it. This is why many doctors I know won't accept Medicare patients without a referral, because Medicare will stiff them.

You're not buying the insurance, you're buying the discount. I don't think it should be called "insurance" in the first place, as the insurance aspect is only part of the benefit.

My wife and I self-insure a lot of risks, either by not carrying insurance at all (dental, vision), or by carrying a very high deductible (auto, homeowners).

We both have employer-provided medical, and despite a significant net worth, we would not self-insure this risk. As others have mentioned, at least get coverage to take care of the big injuries.

1. Catastrophic/long-term medical care is outrageously expensive.

2. If you can pay regular doctor visits/lab work/meds out of pocket, fine (although even that stuff can add up)

3. If you are seriously injured, you will likely also lose your earning power due to being incapacitated... so medical injury is a "double whammy"

[FlFishOn]

...under usual circumstances. If you can somehow 'past-post' then you might find a +EV situation.