This is a fast post which will likely infuriate readers of mine who believe we should all pay out of pocket for medical care. I haven’t much to say except I told you so.
Here’s a blog where the guy admits he made a huge mistake not having health insurance. He took a gamble without health insurance and is now going to pay through the nose. I am guessing possibly bankruptcy, depending on his income.
To sum up, he didn’t insure his pregnant wife and baby. Why? I am guessing they are in their 20s, great health, never see the doctor, had an uneventful pregnancy and figured, what could happen?
Maybe the delivery without medications, complications would cost a few thousand dollars pre-negotiated. Sounds great right to everyone wanting ala carte medical? Too bad one complication and you’re screwed.
The problem with maternity costs, they usually are not covered by HDHP. You have to buy a separate maternity rider and make sure not to get pregnant for 1 year or else it’s pre-existing. Plus you have a high deductible and lot isn’t covered still. It’s no free ride.
It’s the reason why insurance companies charge so much for women between 25 and 40, maternity.
So if young, health, working couples knowinly choose to forgo insurance, and now are basically screwed, how do you suggest we go to an ala carte health care system? Will people intentionally not have health insurance, run up a huge bill, then just walk away declaring bankruptcy?
Sounds to me like the same lack of personal responsibility for mortgages will apply to health insurance. Go Free Market!
I bet this guy Goliath debt would love to pay back all his debts, but the truth is, depending on the size, it could just sink him anyway.
11 responses so far ↓
1 jj // Jul 29, 2009 at 11:37 am
I am glad you’re addressing this topic. I haven’t seen much discussion about Obama’s healthcare proposals in the finance blog world, whereas the mainstream media seems to be gunning for it (i.e. negative press).
If people would take the time to delve into real-life stories, they would realize that change HAS to happen. No system is perfect but the U.S. has the worst system for an industrialized nation.
In our ‘free market’ system, hospitals and the insurance companies are out to make a profit. They have little incentive to provide affordable care. I hope people don’t believe the usual lies about long waits and inadequate care in countries with universal healthcare. That is simply not true. Not to mention that we deal with tons of bureaucracy and delays in our system as well. And on top of that, the insurance companies work hard to deny your claims when you need it most! I hope people finally wake up!
2 JoeP // Jul 29, 2009 at 11:45 am
We need to figure out why health care is so expensive. Once we solve that problem, then that $8k maternity bill might come down to something within reach for more people. High-deductible insurance will give some folks lower premiums at a slight risk, and that should be an option. In any case, payment by a third party affects demand and therefore prices, so minimizing this effect would be a plus in keeping costs low.
3 Roshawn @ Watson Inc // Jul 29, 2009 at 1:09 pm
I don’t think that this scenario along is reason enough that free market healthcare doesn’t work. We need to change the culture, so that going without it seems completely ridiculous. If we make health care affordable and someone goes without it, then that’s their choice. I think with a change in social expectations, free market health care could still work.
4 Jessica // Jul 29, 2009 at 1:11 pm
One of the biggest problems with the system is lack of regulation. I want to see how this government plan addresses that. A hospital charged my Future Father_In_Law $500 for two aspirin being given to him while he was there. And his insurance just payed it (likely more like $450 or something on their end), because his premiums can go up due to a hospital visit. It’s ridiculous. Having a national plan is one way of regulating, as hopefully the government would have a strong hold on institutions like this. It’s the opposite of a monopoly if we can all have insurance: drive the cost down. However, it’s not the only way to deal with it, and I’m curious to see how the bill addresses this stuff when it’s finally finished. I think health care reform needs to stretch over two or three bills to really fix everything anyway, so I’m sure it will be back to the drawing board soon enough if this gets passed.
5 dogatemyfinances // Jul 29, 2009 at 1:25 pm
That post gave me a panic attack. Sometimes it blows my mind that you can even have stories like this in a civilized country, the one that spends the most on healthcare even!!!
6 Meg from FruWiki // Jul 29, 2009 at 1:46 pm
@JoeP
Well, one of the big reasons is that some people can’t or just don’t pay their bills. Then we all end up paying the bill for them anyhow just like shoplifters drive up prices because stores have to assume that X% of their goods will be stolen. A big reason that I support public health care is that I figure since we’re paying for it anyhow, why don’t we pay for them to have preventative care BEFORE they end up in the ER, either because things are really that critical or because they can’t just go to a regular doctor (which would be cheaper) because they can’t afford that but know that they will not be turned away from the ER. I think it would be cheaper in the long term — and better for our economy and society if we had a healthier population.
Another big problem is the cost of malpractice insurance. It’s driving a lot of good doctors out of business. But when doctors have to see more people to cover their bills, then they are more likely to make mistakes (and we all get worse care even if it’s not something we can sue over). And even when docs do make mistakes, studies show that if their patients feel a connection with them (like if they have time to really talk and both feel heard, and docs can apologize, etc.) that lawsuits are much less likely.
And third, there’s the cost of student loans. Doctors with huge student loans have to make a high income — especially as they are practically unbankruptable. Education is it’s own problem, but there is some overlap in this respect. I’d like to see more programs where doctors spend time helping out low-income people in exchange for college credits and/or scholarships and/or forgiveness of their student loans.
Anyhow… there are plenty of other reasons, too. Drug research is expensive, but drug companies also push people onto their new drugs as the patents are on their old ones expire. On case I know of from a friend is Provigil and Nuvigil. Practically identical drugs, but the company has jacked up the price of the old drug Provigil because the patent is about to expire — jacked it up so high that it’s harder to get even with insurance (you have to have an additional doctor’s note saying you need it for one of only two specific conditions and then maybe they’ll cover it — and most docs can’t be bothered anyhow). Most people will make the switch, but not switch back after they jack up the price of Nuvigil. Most with insurance won’t even notice when the price of Nuvigil goes up because they probably will pay the same copay either way. So why mess with what works? Except that it costs us all in the end.
7 LAL // Jul 29, 2009 at 1:50 pm
Definitely insurance companies are out to make a Profit.
JoeP, how do you make someone buy insurance? What about all the 20-30 somethings who say I’m healthy what do I need it for? So what if it cost $100/month, if they’d rather be eating out, paying down student loans (like Goliath Debt), etc, and figure I’m relatively healthy let’s take a gamble, what then?
Sounds like you are ASSUMING people will want cheap insurance, when Goliath Debt even said he knew he should get it, but didn’t. He took a gamble. How many more people would also gamble?
Roshawn, how do propose making it seem ridiculous to go without? Not provide care? That seems inhumane. Not allow BK? That’ll never happen either.
Jessica hospital bills are outrageous. But if you are young and healthy, don’t you think many would assume I never get sick, why do I need insurance? Why should I care?
Dog, it’s stupidity of people. And the truth is that gambles like this make people end up in BK.
8 LAL // Jul 29, 2009 at 1:51 pm
Meg that’s it. People just run up bills/mortage/CC debt and walk away. Why should healthcare be different, beside the fact that it’s sort of cruel to say, before we treat you we need your credit card.
9 Kristy // Jul 29, 2009 at 8:44 pm
No surprise here, but I agree with Roshawn. Something needs to change, but I don’t think government run healthcare is the answer…I mean look what they have done with Social Security.
10 fengshui // Jul 29, 2009 at 9:49 pm
I’ve only heard of separate “pregnancy riders” when it pertains to purchasing private/ individual health insurance such as the policies that self-employed people get.
No one seems to get it, that we will ALL PAY unless something changes. The uninsured will continue to use the ER as their primary source of care, or those who run up bills and can’t pay will file for bankruptcy, and the costs will go up for everyone else. People just don’t understand this concept.
Thankfully, I’ll have insurance again as of October 1st. It is through the teachers union, and without a monthly premium, deductibles, or co-pays. (I’m SO lucky to get this benefit. The salary was lower than I had hoped for, but the benefits make up for it!)
Thankfully, the last 7 months that I’ve been without insurance have been uneventful. Not a single illness, injury, or accident
I’ve still got 2 months to go before I get insurance. I’m keeping my fingers crossed…..
11 LAL // Jul 29, 2009 at 10:49 pm
Kristy, here’s something someone said to me, you can’t legislate stupid. People know it’s wrong to drink and drive. They still booze up and drive or drive high and stoned.
We can try to get people to buy insurance, but in the end it’s their decision. No one can force anyone to buy insurance.
Look at Fengshui. No insurance for 7 months. It’s a gamble. But how do we force her to buy it? We can’t.
Same with my BIL, can’t force him to buy it. If something happens, my DH and I figure, he’s broke anyway no assets. What’s the big deal? What are they going after? A $500 crap car?
LOL. Instead taxpayers and people who have insurance will pick up the bill in the form of more expensive premiums and higher taxes.
I also believe fengshui like my BIL has a graduate degree, so they aren’t stupid or ignorant. It’s a very conscious decision.
If people can’t make a conscious decision to pay back debt, not walk away from mortgages, we’ll never get them to not walk away from medical bills.
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