The Insurance Game

 

Several years ago I conscientiously opted out of health insurance.  

For most people that’s just not an option because of chronic or genetic dis-ease and the cost of medications and doctor’s visits, so I know I’m lucky that I can make this decision.  It’s not for everyone.  And I’m not necessarily recommending it either.  I just want to make a point that

  1. Our healthcare system is deeply flawed.
  2. I don’t want to participate in it.  I choose not to.  

MY HEALTHCARE EXPENSES FOR 2018

I pay out of pocket for the expense of staying healthy.  That being said, I spend most of my money (just a little less than my mortgage LOL) on healthy food. 

  • I pay cash for massages (luckily I can trade for most of my massages),
  • Chiropractic care (around $500 total for 2018),
  • Around $400 total for out of pocket dentist expenses (for myself and 2 kids – just cleanings this year.). 
  • One eye exam for $125.  Glasses cost $12.50 (Zenni.com is fabulous for prescription glasses; you should check it out) and contacts $120. 
  • We had 4 therapy sessions @$65 = $260. 
  • Other out-of-pocket expenses, that insurance wouldn’t even cover anyway:  herbal medicines and nutritional supplements $400 (wholesale :). 
  • I would probably also throw a consultation I had with my psychic in there too.  Talking to her does more good than therapy for me.  Cost:  $80. 
  • Acupuncture I can do for free; but, if I had insurance there’s a 50/50 chance they’d actually cover it, and I would end up paying the $800 or so out of pocket or towards deductible anyway.

Total for myself and 2 kids = $1897.50

Total that insurance would have covered if I had it = $0 (pretty sure, based on deductibles, coverage limitations, etc.)

Total saved every month NOT having insurance = $6000 (x 5 years) = $30,000

I WOULD GET INSURANCE IF

  • If I worked for a company that provided good coverage at a decent price or if – like most other countries in the world – it was included as part of our citizenship
  • If the cost of health insurance didn’t far exceed what you get in return

I’ve had insurance before, and when it came time that I actually needed it, they denied all my claims.  The claim was an emergency trip to the hospital.  They should have covered that.  Even if they had, I still would have had a $7500 deductible.  The hospital bill was $13,000, so I just negotiated the bill with the hospital and ended up paying it with cash over a few months.  A pain in the butt, for sure, but at least I was able to do it.  After that is when I canceled my policy.  “What’s the use?” 

At the very least, they need to be covering emergency trips to the hospital.  If that’s not what insurance is for then I don’t know what.  But a lot of people don’t realize is that you can negotiate with the hospital if you’re paying out of pocket.  Just tell them what you can afford and they’ll work with you.  Don’t be afraid to make demands.  Hospitals routinely bill 10-20x more than what the services actually cost and what insurance would actually pay them.  Insurance companies make deals with hospitals to reduce their cost, and so can you.

THE CONCEPT OF RISK

Buying insurance is buying into a risk pot.  I don’t want to be put into a pot – so to speak – with people that eat McDonald’s for dinner every night and call looking for the remote control exercise.  It’s not fair.  I’m basically paying for their healthcare costs.  

Another healthcare option that is working for some people are healthshare groups like Liberty Healthshare which is still pricey, but not as much, and what they cover is more clear. 

BUT WHAT IF SOMETHING HAPPENS?!?!

Of course.  Yes, my family and I have been lucky so far.  Yes, we could have a terrible accident or – goddess forbid – cancer. 

But here’s probably where I differ from most people.  And I AM NOT NECESSARILY RECOMMENDING THIS AS AN APPROACH TO HEALTHCARE FOR YOU – it’s just what works for me.  If I did come down with a terrible dis-ease, I would not opt to treat it with Western medicine.  That’s just me.  I pass no judgement down on anyone who chooses differently. 

If I or my child need surgery or an in-patient treatment of some kind, I will just pay out of pocket and negotiate with the hospital.  The bottom line of rising healthcare costs is that the big players:  the pharmaceutical companies, the big hospitals, and the big insurance companies keep raising the rates.  Rates that no normal person can afford!

So, what do you think about this?  Do you think I’m overlooking anything?  Just curious.    Health insurance is one of the most controversial topics out there now.  Mostly in the US, though.  Other countries seemed to have figured this out.

1 Comment

  1. Agree! I spent less money paying cash for healthcare when I was single ( if I needed it), then what I would have paid in insurance premiums, not to mention the co-pays, co-insurance and deductibles. Remember the good days when the insurance companies covered 100% of your health care….that’s long gone!

    Reply

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