Quote:
Originally Posted by ShellyCrash
Health insurance works similar to car insurance (or any insurance for that matter), profitability can't be ensured on a case by case basis, but it works / makes money on a larger scale because of the people who pay in not everyone suffers a catostrophic illness. Most people don't.
Also insurance companies form relationships with doctors, pharmeceuitcal companies, hospitals, etc so the rate the insurance company actually pays out is less than what you or I would be able to negotiate.
The big problem with health insurance companies is they put so much stress on profitability within their companies that they start to cut corners to increase their bottom line. When someone gets diagnosed with a serious illness they go over paperwork with a fine tooth comb and cancel someone's policy who's just been diagnosed with cancer because they forgot to disclose they had migraines. Things like this are why we need regulation.
As far as what you pay in vs what you get out, let's go middle of the road and say someone pays $350 a month for health insurance. Over 50 years paying in at that rate that's only $210k. Get seriously ill or wind up having to stay a few days in the hospital for any reason and that money goes out fast. Several surgeries your definitely out over that amount.
It's impossible to see the future and know if you will have a serious health issue or not. You can take excellent care of yourself your entire life, eat healthy, go to the gym, etc and something could still strike you down. Just like driving your car, no matter how well you drive you can still get t-boned by someone else. Just like a bad car accident can devistate someone who is uninsured financially so can a serious illness.
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Doctors have to spend a lot of staff time on dunning insurance companies to pay, so they can afford to give a cash patient, who will just pay at the time of service, a more reasonable price. If insurance companies can negotiate awesome prices, do you really think the USA would have the highest healthcare costs in the world? If insurance is helpful for pricing, then why are government systems like Japan and free market systems like Thailand so much better priced?
Where can you insure a family for $350 a month?
Have you ever had a problem where you needed your car insurance to go to bat for you? Not that long ago, I got rear-ended while stopped at a stop light. Both the other person in the car with me and I were injured. The other guy's insurance company adjuster refused to pay any of our medical and told me I should just get my bumper repainted and they saw no need to replace any crumpled parts, no matter how nice and new the car had been. My insurance company told me that, as the accident was so obviously not my fault, there was no need for them to participate in the negotiation, although they might need to raise my rates, if I had been in an accident.
If I need a cancer operation, I do not want people like that deciding whether I get to receive life-saving surgery?