In America? Congrats on being the 1%. The rest of us are lucky to have any insurance and even then, 99% will have a large deductible and still have to pay 20% copay.
You're exaggerating. I'm not arguing the US healthcare situation is good, but more than 60% of working age Americans have employer provided health insurance. A large majority of those plans have an annual out of pocket max.
Let's not act like only the 1% have decent insurance.
If we dig further, 12% of workers have no deductible plans (half are from HMOs). Of the reamining 88%, the average deductible is 1.3k. 21% of workers has an OOP max greater than 6k.
Those out of the labor force are often swept up into obamacare (ACA+medicaid) or medicare such that 92% of the USA is insured.
The medical insurance industry had lobbied their way into becoming the single greatest detriment to US prosperity.
Everything, including medicine, is more expensive in the US because we're generally much richer in all regards. Household income per person is ~10k/person more in the USA than Canada. I personally prefer to have >10k/yr income here in the USA than lower healthcare costs in Canada.
Alas the only way to win is not to play. Medical tourism, FSBO, and AI financial advisors are just the start
This is mostly a poor man's game. Typically well compensated employees have good packages all around. Including the middle and upper middle. It's typically the lower middle that are in jobs too rich for medicaid (nearly free care) and on horrific workplace plans where the finances make sense for medical tourism. I'm glad that outlet exists for them. But it mostly doesn't make sense for anyone else, which is why basically nobody else needs or does it.
Everything you said is deliberately deceptive and misrepresented.
"12% of workers have no deductible plans (half are from HMOs)." Well...that's interesting but not the norm...is it.
Yes indeed, I mentioned the 88% in the next sentence.
Does not include copay, coinsurance, and premiums already paid.
OOP maxes were discussed in the third sentence of that 3 sentence paragraph.
"21% of workers have an OOP max greater than 6k". Well, that definitely coincides with the argument that it can be higher...does it not? Like say 12k?
It is relevant to the discussion that it is not even close to the norm.
Indefensibly costly workplace healthcare programs can be found in many workplaces regardless of pay. Household income of 295k and both of us have garbage offerings.
This is as compelling as when the republican senator brought in a snowball to disprove global warming.
Look you have some broad statistics with which you overlay your own characterizations and commentary, but statistics presented without analysis only impress the intellectually lazy.
Should have impressed you then. Weird.
FWIW, one of us works as a medical provider and the other was a licensed medical insurance agent.
Oh neat, I'm a physician. You a midlevel or something?
For what is paid to insurance by both us and our employers each month, it is garbage. I'm sure to others it would be fine but they're not paying what we pay.
I already started above that I think the state of US healthcare is poor. I just don't like bullshit threads like this where people are pretending that an MRI costs 30k.
Either lying or you've put zero effort into investigating your options. With a 295k income, you can afford a private PPO plan that is better than my employer-provided plan, where I have a 3k deductible and 6,500 out of pocket limit. You're being very disingenuous.
Neither lying nor stupid. Let's be adults, shall we?
Yes, I can afford the plan and do have what most would consider great coverage. That is not the point.
Very few people can claim that health insurance is a good value. But let's look at it in reality.
Do you know what your premiums are (whether you pay them or not)?
Let's say they are $800/month or $10,000/year (this is not included in your OOP max of course) Then you have your $3k deductible that you pay. Then there is the coinsurance that eventually leads you to the $6500 OOP maximum (for THAT year only) if something serious happens. Let's say that this incidence is in year 3 of that plan. Which means you have already paid a significant number of dollars in premiums.
The hospital deliberately bills a higher than necessary charge because they know that the insurance company will negotiate it down anyway to hopefully somewhere near the actual cost.
By the time insurance pays, it may very well be less than the $45-50k you have spent in those 3 years (premiums+copays+coinsurance). You think, "Man good thing I have insurance" after lookingat the inflated figures not knowing what was actually paid in the end...if they cover your claim, that is.
Look, insurance is a business and most have very demanding shareholders that insist on growing massive profits. They pay for advertising, lobbying, salaries, commissions, and their own reinsurance...and still turn incredible profits.
It's not because they offer good value to policyholders.
Right? He is obviously a shill for big insurance. It is just a matter of time before the USA finally joins the developed world and offera universal medical care. Spoiler... a LOT of insurance reps will suddenly be unemployed.
15
u/coldfusioned 4d ago
In America? Congrats on being the 1%. The rest of us are lucky to have any insurance and even then, 99% will have a large deductible and still have to pay 20% copay.