May 22, 2019

Three common arguments that Health Insurers make to convince you to get coverage

1. Medical Coverage is extremely expensive and you can go bankrupt if you get sick without coverage.

Scary argument. Especially when the prospect of losing everything you have on top of being sick would make for the worst day of your life.  Researchers disagree on how much medical bills cause bankruptcies. The biggest problem in answering the question is that those filing for bankruptcy aren't required to state the reason. As a result, estimates are based on surveys. The methodology differs from study to study. It depends on how the researchers and the survey respondents define medical debt.  In 2009 Elizabeth Warren said that 62% of bankruptcies were from medical bills, which were defined as bills greater that $1,000, and having lost two weeks of work because of those wills. I cannot even understand how a $1,000 debt gets you into a bankruptcy court, and subsequently it was discovered that 78% of the survey had health insurance. But that comment helped pave the way for Obamacare, so it worked.

A variety of factors cause bankruptcies. Most people with medical debt have other debt. They may also have low income, little savings, and job losses. That makes it difficult to determine whether the bankruptcy was because of medical debt alone. For example, the Kaiser Family Foundation study found that only 3 percent said their bankruptcy was because of medical debt. But another 8 percent said it was because of a combination of medical and other debt.

It also found that the insured were a bit more likely to declare bankruptcy (3 percent) than the uninsured (1 percent). Most probably thought their insurance protected them from medical costs. To pay for unexpected deductible and coinsurance costs some people took out mortgages which caused them to be overleveraged. . Almost a third weren't aware that a particular hospital or service wasn't part of their plan. One-in-four found that the insurance denied their claims.

How did those with insurance wind up with so many bills? After high deductibles, co-insurance payments, and annual limits the insurance ran out. Other companies denied claims or just canceled the insurance.

It turn out the medical bills for ages 26 to 48 years olds, are extremely low. They are the most profitable customers in the health insurance world. So while its true that cancer and hemophilia, and HIV can lead to very expensive treatments, they are rare under the age of 48.

So it really depends on where you are at in life. For most health insurance is a loser proposition financially. And the risk of not having it, well about 23 million live with that risk and are getting by. SO maybe the argument is not really germaine.

2. You could end up delaying essential care of you don?t have insurance.

This is basically an argument that cannot be proven. To get the  results, researchers ask questions like...have you gone for an annual physical and would you go if the price were $400. You may be ready to say yes to the first part, but want to say no to the second part. Here is the truth.

No one wants to be sick. If you are really sick, you will go to a Doctor and worry about how to pay later. Early detection sometimes works, but most studies find that Americans are over medicated because of micromanagement of minor symptoms.

Consumer Reports said..

? It turns out Americans take more pills today than at any other time in recent history (see ?Pill Nation: The Rise of Rx Drug Use?)?and far more than people in any other country.?

A lot of this is the result of going to the Doctor for preventative medicine, which is why Health Insurance companies want you to go. They make it easy and inexpensive. Without insurance, it costs about $140. So if you premium is $400+ than you should just pay out of pocket and save yourself $260. BTW, over 1.3 million people went to US emergency rooms last years due to adverse drug reactions. In the age group of 26 to 48, you cannot even early detect. It?s why most tests for prostate and cancer and heart problems happen after 50. So the argument that somehow paying $8,000 a year in premiums is going to save you life...not true.

3. You will have to wait to get covered.

There are two arguments here. First is that you cannot sign up for health insurance right now. So if you went to the Doctor and they said..you have cancer in your brain and need a brain operation right now, you wouldn't be able to get treated because you couldn?t afford the surgery and you would die before your insurance kicked in. It?s a scary story, and you would be hard pressed to find that it has actually happened. Groups like rethinkmyhealthcare.com and PriceMds, regularly negotiate treatments for people without insurance and help them pay to get necessary treatments done. Again, if you saved the $8,000 in a bank, that you would normally pay to health insurers, you will have enough to cover most medical emergencies you will face.

Where having insurance pays, is pregnancy. If you plan on having a baby, health insurance is a great thing to have. Well worth the price. But if that isn?t in your cards, you won?t have to delay any treatments or wait, if you are sick get help.

The second argument is that they may put back the practise that allows an insurer to block you if you have a preexisting condition. An odd scenario. Health insurer create pools of risk where they assume that a certain portion will get sick. So you are already accounted for in the risk parameters. Faced with someone who is already a built in conclusion, they will send you away because doing so increases there profits. I believe that makes them very mean people. Basically they only want to have customers they can make a lot of money on, not ones who needs their service. We are talking about people here, sick people, the ones health insurance risk pools were created around and a way of making medical care affordable by everyone paying a little. So that when 1 out of 500 of us got really sick, we would be covered. Instead, let find a way to not pay anything, making us a charlatan, a con of the most despicable degree and wolf in sheepskin.

If you want to trust a health insurance company who operates and acts that way, don?t be surprised when they find a reason not to pay your medical bills.

The Truth

Americans are healthier than ever. Between the ages of 26 and 48 the health insurers see a 78% profit margin between health insurance premiums and claims paid. If you want to save yourself a lot of money, pay as you go or join cost savings groups like rethinkmyhealthcare.com.  Look beyond the hype and sensationalism. First sign of the pressure sale is the prospect of fear. The belief that the unseen may happen to you. The opposite is knowledge, which tells us, chances are so slim of that happening, I should spend my money more wisely. And if it's in my account rather than someone else's I am much better off.

Stay healthy.

Our plans provides discounts at certain providers for healthcare, wellness, and lifestyle services. Members must pay for all services at the time of service, but will receive a reduced price from those providers who have contracted with the program operator. Providers may not be available in all locations. Offers are subject to change without notice.