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joli's avatar

Is living without health insurance risky behavior?

Asked by joli (633points) December 22nd, 2007

I’m 50 years old with a pre-existing condition that might make it expensive to get new coverage later. Any experiences to share? I’d like to take that money and invest it elsewhere for a couple of years. I have no current medical problems and haven’t needed any treatment for over a year. Before that? Never. (My current employer will pay 1/3rd of the cost of my premium and the balance will come out of paycheck prior to being taxed. Would it be russian-roulettish to cancel my policy short-term?

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9 Answers

joli's avatar

Let me mention that I’ve had numerous negative interactions with caregivers in their manner of treatment in this facility, and the policy seems outlandish in cost for a perfectly healthy person. $5000 per year. I spoke to someone just 5 years older than me, and she said they just raised her policy to $7500 per year!

skfinkel's avatar

I think it is imperative to have health care insurance at all times. Even when you’re healthy. The reason is that any even small sick or accident event costs so much money that the cost of a yearly health plan would look like nothing in comparison. I have had family members come down quite unexpectedly with very serious conditions, the cost for the care, tests, and operations was overwhelming. We were fortunate to have the health coverage to pay these bills. I believe that most bankruptcies in the country are caused by impossibly high health care charges.

My own personal nightmare would be neighborhood spaghetti feeds to cover the cost of an operation.

I would opt for catastrophic coverage—which means you pay as little as possible per year, and have to pay up to a certain amount for doctor visits—with a ceiling limit beyond which you don’t have to pay—it could be 3K or 5K.. But I would never be without any care unless it was totally unavoidable.

joli's avatar

Thanks for that answer. I’m trying to be realistic. I thought to opt for a higher co-pay, but the hospitol coverage per day would only be $200!

kevbo's avatar

There are a couple of things to consider.

Primary care (doc visits and everything that goes along with them) will be out of pocket, of course. There are a handful of docs out there who don’t accept medicaid/medicare which lowers their overhead and presumably their fees. Could be an option.

Emergency rooms are required by law to provide care regardless of one’s ability to pay. Hospitals are required by law to make every effort to collect, including use of collections agencies. Recent trends related to the tax exempt status of nonprofit hospitals is motivating them to provide discounted rates to “self pay” patients (20% where I worked) as well as budgeting for annual write offs for “charity care”—free or more heavily discounted care for those who cannot pay.

Lastly, you’ve got the medical tourism options of which I’m sure you’re aware.

So, you probably cobble a coverage plan together with some diligence.

The risk for most un- and underinsured is the disincentive to seek preventive care, allowing health problems to progress to emergent status.

gailcalled's avatar

Skfinkel summed up the issues very cogently.

My own experience was 1) an unexpected diagnosis of breast cancer, requiring all the tests, two lumpectomies, chemo and radiation..

2) and an unexpected bad fall down some steps in the dark – 6 days in hospital w. broken bones, damaged hearing, huge bruises, torn rotator cuff, cuts, etc,—->IC, x-rays, MRIs, CAT scans, etc.

1) I was covered by medical insurance.

2) By then I had Medicare and had, begrudgingly, taken out a Medigap AARP policy, for which I have been very thankful.

Both events took me completely by surprise. A yearly payment of $7500 is a lot until you need the coverage; then you will be grateful. I wish you a healthy life but one NEVER knows.

Spargett's avatar

This is all assuming that your health care provider would actually cover any costs as opposed to avoiding covering your bill through some legal loophole. Profit!!!!

God Bless America.

cwilbur's avatar

I’m 33. In the past two years I’ve had two unforeseeable situations land me in the emergency room. Either of them could have been life-threatening without treatment; but according to both the ER doctors and my physician, they were “freak things – they just happen.” Either one of them alone would have cost 20 times what I pay per year in health insurance, just for 3 or 4 hours in the ER. Without insurance, I would have been bankrupt.

I’m also (due to family history) at high risk for a couple nasty conditions, all of which are better if detected early; paying for the 6-month checkups out of pocket would cost more than I pay in health insurance.

If I didn’t get health insurance through my employer, I’d have one of the Massachusetts state-organized (but not, in my income bracket, subsidized) health insurance group plans instead; I’d lose money on the 6-month checkups, but if I ever wound up in the emergency room again, I’d be a lot better off.

So yes, living without health insurance is very risky behavior, in my book. I hadn’t been to the hospital for anything for the prior 13 years, and that was for my mandatory physical for admission to college – past history is no indicator of future performance.

joli's avatar

Thank you all for your answers. I handed the bill to my Boss today, even though he will pay a mere $150.00 per month and enjoy the entire corporate tax-write for 2008. If I didn’t have a pre-condition of a pre-cancer nature I’d would’ve dumped the bill in the trash. There is no debtor’s prison and I have nothing for anyone to take from me. Bankruptcy in my mind is not a crime but a reflection of the reluctance in corporate capitolism to pay decent hard working people a decent wage for their minor services, which are needed on many levels. I think insurance is for the wealthy. The rest of us benefit in catastophic circumstance and only when there is no special, “clause”, that we missed. (I ain’t talking about Santa.) Add it up. Tell me you’re not getting SCREWED!

cwilbur's avatar

Bankruptcy is not a crime, but blaming “corporate capitolism” [sic] for your probable financial difficulties because you’re unwilling to pay for insurance is just asinine. And “the rest of us,” at least if it includes me also benefit from having routine checkups and preventive care paid for by insurance.

What is the chance that your health care costs will exceed your premium costs? And if your health care costs do exceed your premium costs, how much would they exceed your health care costs by? That’s what you have to look at.

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