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Comment by ceejayoz | Hacker News Reader

I'm not sure why the post highlights dental/vision care; these aren't covered by health insurance anyways.

I've done the no health insurance thing, and I've done the catastrophic-only health insurance thing. That resulted in a bankruptcy from $90k in medical costs, and that's after the various bits of charity care, neogtiation, and whatnot.

It works great, until it suddenly doesn't. These days, I pay the $3,063/month insurance bill... not happily, but I absolutely pay it.

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It works great, until it suddenly doesn't

Precisely: https://jakeseliger.com/2023/07/22/i-am-dying-of-squamous-ce.... The best ENT surgeons in Arizona for creating a "flap" that replace part or all of one's tongue after surgery were (and are) at the Mayo Clinic. And I needed radiation after the first surgery. And then another surgery a few months later.

I too like the "just don't get seriously sick" strategy, but if it doesn't work, then you have a huge problem.

Yeah, but the OP's logic, all insurance is unnecessary. Most drivers don't crash, most homes don't burn down, etc.

This is incredibly entitled against the executives who worked tirelessly their whole life to be the middlemen who steal the resources of a society.

Yeah, I agree. The US should enact free universal healthcare.

But until that happens, you've got to deal with the world as it is, not how you wish it would be.

It will be never be free. And in any event, I will believe the US should enact government paid medical care* as soon as the EU does#.

* For the ~50% that isn't already on government managed medical care

# The constituent states of the EU each do something different.as I understand it, but they don't send gobs of money out of their State so that gormless bureaucrats can take their massive vigorish before sending it back

The only way I could ever be ok with universal health care is if the average BMI of this country drops precipitously. I am 100% fine with helping the guy who gets some random cancer, but I will die on the hill of not supporting the myriad chronic diseases of people who refuse to put the fork down.

It's already disastrous enough that private health insurance doesn't adjust premiums for smokers and the obese, like life insurance does.

Holy f and that’s on top of taxes where govt would provide in most developed countries and many emerging ones

Someone has to think of the poor executives in the military industrial complex. The taxes must go to the billions of dollars of infrastructure that is spent annually to support policies like shooting $40M missiles at Iranian drones that cost $100k at most.

https://youtu.be/O3FMV3iugeI?si=PYFqRFssxAeKTPPU

There's copays and uncovered costs like dental/vision on top of that, too. We reported $49k in medical expenses (which include these premiums, to be clear) to the IRS last year.

We aimed our two kids’ births to be April/May so that we could take advantage of hitting the annual out of pocket maximum and getting all physical therapy for recovery from birth and anything else that might happen fully covered. And to avoid new resident doctors coming starting in June.

What the fuck?

When, not what

$3k per month health insurance in the US must be for a family of 4, and must have a very low deductible/oop max (indicating regular use of healthcare).

See here for a list of premiums in a state like NJ:

https://www.nj.gov/dobi/division_insurance/ihcseh/ihcrates20...

$427 per month would be the cost for a 21 to 24 year old for “BCBS Omnia Silver HSA” (a good representative health insurance), and you can figure out the premiums for other ages using the age rating factors on bottom left (max is $1,287 per month for a 64 year old).

Page 6 here shows the deductible and oop max ($2,300 and $7,500).

https://www.ehealthinsurance.com/ehealthinsurance/benefits/2...

Yes, and yes.

The blogger in question is pregnant and planning to do a home birth, so they may find themselves in that category surprisingly rapidly.

Or is it a case where if I pay extra in taxes, but I don’t see the monthly payment, it feels better?

And it's not dependent on my employer, and is far lower due to state negotiating power, and I don't have the prospect of out-of-coverage treatments or co-pays bankrupting me.

I guess if 90k was the max you could pay, it might not make sense. After all, you are paying more than 90k over 3 years. You could just save the money and have savings if you didn't get ill. I bet it could be a lot higher than that though.

> After all, you are paying more than 90k over 3 years.

That $90k ran up much faster than that, even with shitty insurance paying at least some of it, and medical needs continued to accelerate for a while afterwards. Savings wouldn't have done a bit of good; it was rapidly exhausted. (That's not part of the $90k, either! It's on top!)

There's essentially no cap on potential medical bills.

There is now; ACA plans have a max out-of-pocket amount, for which I'm very grateful. My bankrutpcy was pre-ACA.

Be careful because there are two many out of pocket amounts. One for in network and one for our of network. Most ACA plans that I can get in my state do not have an out of network max. That's a huge risk because most hospitals have out of network contractors. That means if you stay in a hospital that is in network, you'll still get billed separately for out of network care. And half the hospital staff might be out of network. So you can still go bankrupt in an in network hospital. The ACA really didn't do much to protect people from bankruptcy.

Thankfully, my state (NY) forbids that little loophole.

https://www.dfs.ny.gov/consumers/health_insurance/surprise_m...

If the hospital is in-network, you're good.

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