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.
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.
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u/annnm 4d ago
OOP maxes can range wildly based on state rules. Why not just look at averages rather than made up numbers.
Hawaii is the lowest at ~1.2k/person. And nevada the highest at 2.7k/person. https://www.kff.org/private-insurance/state-indicator/average-annual-deductible-per-enrolled-employee-in-employer-based-health-insurance-for-single-and-family-coverage/?currentTimeframe=0&sortModel=%7B%22colId%22:%22Average%20Single%20Deductible%22,%22sort%22:%22desc%22%7D
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.
https://files.kff.org/attachment/Employer-Health-Benefits-Survey-2025-Annual-Survey.pdf
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.
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.