I think this isn’t quite right. Part of the problem is that some young folks are smart. Health insurance on the exchanges at the current rates is a bad deal for a healthy young person, and many probably realize this.
People used to say what was preventing young healthy people who didn’t have employer/school/parental provided insurance from getting insurance was the lack of affordable options. It seems like that is what’s false.
They’re either (a) irresponsible or (b) smart, so they calculate that at worst they’ll pay a fine. If they get very sick but aren’t in immediate danger then they can get a policy at the next sign-up period in the unlikely event that they need one. Further, if they need emergency medical care then they’ll be given it … worst case, they simply declare bankruptcy, which isn’t that big a deal for the young and the chance they’ll have to do it is very small and the alternative is dying.
We need are more responsible but dumb kids Failing that, you’re point about coercion is a good one.
Also, I have no idea what people are talking about when they are referring to a huge surge in sign ups. It looks like sign ups are running about 6%-8% higher than last year’s. This is pretty much what was projected. Maybe the extra few days will get more people to sign up though.
I agree–health insurance is a must in our family. We never have any gaps in coverage either. No one can tell what the future will bring and medical costs are too high for self-insurance IMHO.
^^^ I agree that’s what responsible middle-class people with families think they believe, but I don’t think that’s what most people actually believe.
I assume you’d sign up for health insurance even if you’re perfectly healthy if it cost $1 per year. That would be smart.
I assume you wouldn’t if it cost $1,000,000 per year. That would be dumb.
Somewhere in the middle of those two values is the most you’d pay for health insurance. That’s the point at which you’ve decided that it ceases to be a smart thing to sign up and that it’s better to go without health insurance.
Having had a non life threatening non age related condition which cost $15k in dr bills and lab costs over two months to get diagnosis, anyone who goes without health insurance has rocks for brains.
The super rich who can afford to pay $15k or $1mm like it were pocket change.
Those in a situation where the premiums compete against other necessity costs like food, shelter, commuting or other costs to enable holding a job. Obviously, they are taking a financial risk of medical bills, but if even the premium stresses their finances, they may take the risk.
“* The super rich who can afford to pay $15k or $1mm like it were pocket change.”
They’d still be smart to get insurance. The negotiated rates through insurance are SO much cheaper than what you’d get billed without insurance, should you need care. It makes sense for large companies with their own pool of employees and negotiated rates through an administrator to self-insure. I can’t see where it makes much sense for an individual to do so.
If someone got my condition and chose to not get treated they wouidnt be able to hold down a job.
As I’ve said, rocks for brains.
I don’t know any rich person who doesn’t have health insurance. Most are way too smart and money savvy to do that and any insurance policy would be peanuts to their pocketbook.
You may not know any rich person who doesn’t have health insurance. But their picture is different, to begin with.
If you don’t have, say, $3500 sitting around, you can’t afford 3500 in med expenses, to make the deductible. And it can be higher. Being insured brings some advantages, eg, in negotiated rates. But not all insured are going to hit their deductible, much less, their max OOP.
So, without that extra money, you may forego a visit to the doctor, in the first place. That’s not, in theory, what this was built for.
And if the budget is that tight (at even a decent income,) you may not go for a few thousand in premiums, to pay for maybe reaching OOP. Thumper’s son is looking at $4500 before a dime in medical costs. In the plans I’ve seen, that doesn’t make much free. Many here are facing the same.
I don’t know anyone who is rich that doesn’t have medical insurance. The downside completely overwhelms the premiums for anyone who can afford the premiums. Like I wrote previously, for ongoing outpatient care of a chronic condition, to see two MDs and get done tests over two days resulted in a bill of $19,000+, of which I paid $1,900 and insurance negotiated some and paid the balance.
I also had care some of the rest of the year and got bills for the care received, Rx I take, etc.
My AZ kid has a policynwoth the ONE vendor who sells individually in his city. ONE vendor. That vendor is a HMO. Hospital and doctor networks are very limited. VERY. And most important…the doctors just aren’t accepting patients who have this plan.
So…even WITH this insurance, if my kid needed surgery for his eyes, he WOULD be facing an out of pocket cost for having it done…because he could NOT find a specialist who would,take his plan…never mind that he doesn’t want to switch doctors.
If he got into an auto accident, he would receive ER treatment…but then would.have to be transported to a hospital that takes his plan…with doctors who also take his plan. And we haven’t yet figured out who would paynfor an ambulance transport from the ER to another hospital.
To me…this is just awful…and is the state of the ACA in many areas for 2017.
“And if the budget is that tight (at even a decent income,) you may not go for a few thousand in premiums, to pay for maybe reaching OOP. Thumper’s son is looking at $4500 before a dime in medical costs. In the plans I’ve seen, that doesn’t make much free. Many here are facing the same.”
But he has it in case something serious happens that costs many, many thousands of dollars to treat.
I’d say he’d be pretty darn happy paying $4500 instead of $50k, or $100k or even more.
Even $4500 plus whatever his premium costs is a lot better then the $15k just getting a diagnosis can cost.
People say they can’t afford insurance - I say they can’t afford not to have it.
Himom. yes, but you have a known, serious chronic condition. Many people just look at a few hundred (or a few thousand) in costs for actual care. They’re trying to do risk assessment.
Of course we could break a leg or develop what Emilybee or you did. But we’ve been talking about people who opt out. They don’t know if they will or won’t run higher med costs.
We try to balance what we know versus what we don’t. And some people will have a hard time paying what they feel is a high premium and paying up a tough deductible.
@al2simon Regarding your scenarios in which “smart” people make the calculation not to get insurance, you only prove my point. A lot of people simply can’t be trusted to do what’s best, even for themselves. The trouble is that their bad decisions are crashing down on those who actually did the real smart thing. If nothing else, ACA has taught us that insurance has to be compulsory. Take the smartiness (that which sounds smart, but isn’t) out of the decision loop.
So @thumper1, why does he have the insurance at all?
Why haven’t you told him not to bother signing up?
I don’t understand why a state like NY is able to have 17 different insurers each with many, many different plans and some states have so few.
If I had to guess it’s either something that is happening at the state level that is preventing more insurers coming in or, more likely, that a state’s population decided they’d rather go without so insurers couidnt make any money and they left the market.
DS lives in AZ. @emilybee you are likely right…that there is state level stuff going on that made the providers just pull out of the Phoenix market.
DS has RX coverage…and he does need that. Plus, if he had a catastrophic issue, guess we would all figure out how to get him to a hospital that would cover him with his insurance.
And we also don’t want his coverage to lapse…period.
I feel everyone should have health insurance. I’ve said it before…I would,scrub floors to pay for my kids to have coverage if necessary.
DD…her premium increased $100…from $275 a month to $375 a month. We told her…just do it.
We are of the strong opinion…NEVER be without coverage…even if it’s crappy.
Failing that, you’re point about coercion is a good one.