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My Neighbor Has Gone Without Health Insurance For 30 Years.

And he can afford it – it’s not about the monthly cost. It’s about the fact that even if you have insurance, they don’t necessarily cover much of anything, especially with private insurance. (He is self-employed.) Since he was 22 years old, he has gone without health insurance, choosing instead to lead a VERY healthy lifestyle, a monthly visit to the chiropractor for his back, and using a lot of natural medicine and healing techniques on himself. He is fit, doesn’t eat any junk or man-made food, only drinks water and tea, and exercises daily. Once a year or so he pays to go to a doctor for a physical and a few blood tests – that’s it. Otherwise, he never goes to a Western doctor for anything and he heads down to Mexico for any dental work he needs. (Which MANY Americans due because of the cost here in the States) Is he crazy or is he doing the smarter thing than the rest of us who don’t get subsidized insurance through their employer?

If I had to choose again between paying for private insurance or going without, I would go without. That is, if I could even get it again after having cancer – considered a pre-existing condition.

For several years after I quit my corporate gig, I paid for private health insurance through BCBS. It was nearly $400 a month just in premium payments – and in 2008 alone I ended up spending $14,296 of my own money on health care. That was WITH health insurance. It’s not that the tests were really that much more money than that and that if I didn’t have insurance I would have owed more – it’s that the insurance didn’t cover A, B, or C tests. So much for insurance coming to the rescue. I do remember my corporate group insurance being better, and my wife’s plan at her work is also better, but private insurance just does not cover individuals to the same extent as group plans. Even after paying that premium for years, it really didn’t help when it came time to actually use the insurance I had been paying for. And thus, if I am ever in that situation again, I will go without. I will start an HSA and just put a few hundred in it every month, and get some medical coverage on my automobile policy just in case. After all, if private insurance isn’t going to pay for the care I might need some day, why continue to pay the monthly premiums?

As I mentioned in the title of this article, my neighbor has gone without insurance for 30 years. If his monthly premium for private insurance had been around $300 a month (let’s keep it at that figure for simplicity sake and to account for inflation), insurance would have cost him $300 X 12 X 30 = $108,000 over the last 30 years. That’s a lot of dough to shell out for not a lot of coverage. And unlike most people, especially in America, he takes incredible care of himself. And sure, an accident could still befall him at any time. But private insurance isn’t likely to pay much of his bill anyway if he did have one, so he took his chances on not sending them hundreds of dollars every month.

NeeNar
Creative Commons License photo credit: photomequickbooth

So, this leads me to my question – what do you guys think about this? Plenty of people cannot afford health insurance still end up going to the doctor and owing thousands upon thousands of dollars. Some people, like my neighbor, choose to go without insurance and would also owe thousands if he did get sick or had an accident. And people like me can afford it and did pay for it, but also end up owing thousands. So…what do you think?

Reform is needed in this country, no doubt about it. I am not sure of the best way, but something needs to give. Doctors are going out of business or into private doctor-run plans because they aren’t getting paid what they should be insurance companies. Insurance companies are canceling policies of the insured, sometimes without a reason, and giving out bonuses to employees who reject claims. And hospitals are barely breaking even because of underpayment by insurance companies and the influx of the uninsured into their emergency rooms. Something needs to give, and I am betting it will be a public option of some sort by the time we are through. Personally I welcome the concept, as long as people still have a choice as to which company they want to pay and what doctor they see. Affordable health care really shouldn’t be a privilege; it should be a basic human right.


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Comments (25)

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  1. Miranda says:

    Amen! We should have access to affordable health insurance. Additionally, it would be nice if we had better access to reliable health information. Unfortunately, it is in the best interests of a number of lobbying groups, from the food industry to pharma to the health insurance industry, to have us live relatively unhealthy lifestyles and then buy drugs and insurance to “protect” us from problems.

  2. I live in Canada, so access to free/cheap medical care is always available to me. If I ever feel sick, I go to the walk-in clinic. If I ever need anything more serious, I can go to a doctor. If I get in the accident, I go to the emergency room.

    For me, for now, because I make less than a certain amount, it is absolutely free. And the horror stories of long waiting times are just that – horror stories. I’ve never had a problem.

  3. Marilyn says:

    You should have a little bit of medical coverage on your auto insurance anyway, even if you have medical insurance. If you have an accident and your health insurer thinks that an accident was another party’s fault, they may require you to sue their insurance and pay them back for any coverage (subrogation).

    I’ve had some rather negative insurance experiences from a law firm employer offering insurance plans only from a client of the firm, which then refused claims or was slow to pay while our employer refused to step in our behalf to having to fight to get coverage of properly executed medical procedures to having to fight to get bills paid for visits or medication that was ordered toward the end of coverage on one policy when some time of change was forthcoming.

    I’ve been unemployed for more than a year. My boyfriend was able to add me to his insurance as a domestic partner but now he is changing jobs and his new employer does not permit same-sex domestic partner coverage. I would welcome a public plan and know a lot of people who would opt for it.

  4. Matt SF says:

    Good to know I’m not the only one that hates paying out the wazoo for private health insurance. I often ask the question that, if you had enough savings, should you even bother with health insurance? In reality, it’s really just a hedge that you won’t go into debt due to an unforeseen medical expense.

    As you said, you’re likely going to have to pay thousands of extra dollars plus years of monthly premiums, so is the current state of the insurance business so (purposely?) fallible that it’s becoming a plausible option to go without health insurance if you have the financial wherewithal?

    As long as your neighbor is rolling his savings into an emergency healthcare fund, and making capital gains on his savings/investments (which is what insurance companies do), I don’t see a problem with it.

  5. david says:

    I figured Alan – they find the 1 person who had to wait and use it to scare the entire population. Health care should be for everyone – not just for those who can afford it!

  6. Andy Hough says:

    I have private health insurance now and I wouldn’t consider going without it. I don’t want to take the chance of a catastrophic illness or injury wiping me out. I have a $5000 deductible plan now and am considering getting a higher deductible plan. It does bum me out to pay all this money for insurance I never use.

    I have gone without health insurance most of my adult life and was lucky enough to get away with it. The one hospitalization I’ve had came nine days after I had a health insurance plan take effect. That was lucky.

    A single-payer system is needed but until then I’ll have private insurance as long as it is reasonably affordable and available.

  7. david says:

    Andy, that’s my point though – I had private insurance too, with a $2500 deductible, and I still had to shell out over $10,000 in “other” costs that they wouldn’t cover. Don’t think that private insurance actually pays for much, because when it comes time for them to do so, they won’t. Trust me on that one!

  8. dawn says:

    I don’t like p aying for health insurance anymore than the next gal, but franklin, i thin your neighbor is playing Russian roulette with his health.

    A lot of people can get away with no health coverage while they’re younger, in their 20s and 30s, but things sometimes catch up with you in your 40s, even more so in your 50s and, let’s face it, everyone eventually gets sick with something.

    I don’t care how healthy a lifestyle you lead, you can still get Lyme Disease, come down with MS, which hits most people mid-life, get hit by a car etc etc. Our healthcare system is far from perfect, but going without is just crazy, IMO. Epecially if you have any kind of family history of various cancers or other medical conditions.

  9. david says:

    Did you see the part about how private insurance doesn’t pay for much anyway? It’s a joke. That’s his point, and I dont blame him, really.

  10. Johanna M. says:

    I used to think that my health insurance “Didn’t pay for anything” – I’m reasonably healthy and I’ve been lucky when it comes to infections and accidents.

    But I went without insurance for almost three years, when I could’t afford it, and it was horrifying. Simply the ongoing anxiety was bad enough, and if I got a cold or twisted my ankle, it’d kick into high gear – and that kind of stress takes a toll of its own.

    Fortunately, I was able to re-instate insurance for myself and my husband a few months *before* he was diagnosed with cancer. If we didn’t have insurance, he’d be dead and I’d be bankrupt. Every time I kvetch about paying the premiums, I look at how much his bimonthly chemo costs and I calm down a bit…

    I agree that the health insurance system needs major revision and something’s badly wrong when folks can *still* be ruined by costs even when insured – but angry statements that the insured don’t get “anything”? I can’t agree with that.

  11. I’d have to disagree with the part about private insurance not paying for much – and my family’s situation is a good illustration of why people need to have medical insurance of some kind.

    My wife was a healthy 26 year old woman when she had a catastrophic health event last year. She had a freak blood clot in her entire left leg which meant that she had to be in the hospital for over 3 weeks. When all was said and done we had amassed over 250,000 dollars in medical bills. Luckily we had insurance – and basically everything was covered after our $2000 deductible. We did have a couple of things that weren’t allowed, but after appealing those they were covered as well.

    I know that not everyone has as good an experience with their insurance as we did, and a good deal of our medical system in this country is broken. But for many, the system does work now, and going without insurance is a huge gamble.

    For me having paying to transfer the risk of a huge medical event like we had is worth the cost. We’ve already gotten our money’s worth.

  12. Ziggie says:

    I’ve had health insurance (private, group, medicaid at one point) for years, and despite me paying out hundreds of dollars a month (yes month) in a group plan, I still end up paying 5000 or more dollars a year in other healthcare costs.

    If I didn’t have kids, I’d probably drop it and throw it all in savings and move on with my life.

  13. david says:

    Pete – do you have private insurance you pay for yourself, or is it through your employer? There are huge differences in what is covered, a la my own example.

  14. david says:

    That’s what I am doing if I ever have to go back to paying for my own…if they even give it to me. It’s a sad situation here in the US when it comes to insurance. It’s only for those who can afford it…and even then they dont cover everything. Same thing goes for home insurance – make a claim or 2, and they drop you. Why bother even having it?

  15. david says:

    Curious as to where the angry statement is about the insured not getting anything is? Can’t seem to find that comment.

  16. I also have been through a few extremely expensive medical events and would not dream of going without insurance, especially with 2 young sons.

    Even now, in unemployment, with COBRA premiums of $1,500 per month (reduced thanks to the government,) I would never give up my medical insurance.

  17. Strick says:

    I’m in the middle of this realization right now that private health insurance is pretty much a scam. I thought I was doing the right thing by getting a high deductible plan ($5K ded./, but also $5K is the max out of pocket) and putting $5K in an HSA, I’d always be covered, right?. I made sure I had maternity coverage for my wife. I used a well known ins. co (Aetna). I made sure all of our doctors including my wife’s OB used the plan.

    Now its a month before my wife’s due date. I was just informed that though the OB is covered, the hospital that he has admitting privleges to is not. Therefore, that would go under a separate out-of-network $10K deductible on top of the $5K for the doctor. Worst yet, $15K is no where near the amount I expect to be out of pocket due to “balance billing” which is legal for out-of-network providers and this will be an expensive ceasarean procedure b/c of prior complications. I think we all know that Aetna will decide reasonable charges for this procedure will be somewhere around $9999, and so I cover that with my deductible, and then consider the rest unreasonable, so I will be balance billed the rest.

    I went to the hospital to try to negotiate, or pre-pay, or at least discover what this is gonna cost me. They said they can’t tell me that ahead of time (seemed confused as to how in the world I thought I could get a price before the delivery), said I should just wait and we could work out a payment plan after the fact.

    Because of the complications and my wife’s trust for this doctor (she previously lost a baby in delivery), I don’t exactly consider finding someone else last minute a viable optioneven if possible.

    If I didn’t have insurance, at least I’d have another $6k or so in premiums saved to help pay these bills. For those who think this only happens b/c this is some unique situation, I can’t agree. The only other big hospital bill I ever had was for an emergency room trip as a college student. At that time I had a different insurer and a low deductible, but the hospital was out of network (you’re not exactly shopping hospitals as you ride in an ambulance to the emergency room) and I ended up paying almost the whole bill b/c of “unreasonable and non-customary” charges. This is the main reason why I use high deductible plans now, I realized you’re gonna end up paying for just about everything anyway.

  18. Abigail says:

    Well, depending on how long ago you had cancer, you would probably be accepted by individual companies. Here in WA, there are high risk insurance pools.

    We definitely need a better health care system. Goes without saying, for most of us.

    But I think he is gambling. I was fine at age 19. Til I got a stomach flu. Less than a week later, I was in the ICU on life support. Which I stayed on for most of 3 months. For the hospital I stayed at for 2 months, ONE of my doctors sent us a bill for $70,000. I also had: respiratory care, occupational therapy, physical therapy, the bed, the medication, etc.

    It was incredibly unlikely that I’d get that illness, which is rare to begin with and rarely strikes people of that age. But I did. Statistics are dangerous because they seem so solid and… likely. But you never know if you’re going to be an exception or not.

  19. Strick says:

    Abigail – I think David (given his history)would be the last to suggest bad things and the resulting hospital bills that follow are statistically unlikely enough to make ‘insuring’ against them not worth it. He is saying that he (and other self-employed individuals) CANNOT insure against it. Paying premiums to an insurance company that will not pay out claims is not insuring yourself.

    Insurance provided by employers necessarily have to provide some value or they will eventually lose their large contract with an upset employer. With individual private plans, the only people who are ever upset are the ones who, at the same moment they become upset with their policy, just became a possible liability to the insurance company that may outweigh future premiums (the past premiums are already booked).

    Whether private insurance is really this bad at paying out is obviously up for debate and obviously colored by our own individual experiences, but I don’t think David (or his neighbor or myself) would question the value of health insurance that would actually pay all of your bills after the deductible. It just doesn’t ever seem to work that way for me (and I’ve tried different plans)

    All that said, I still have insurance for my family because I think its cost to me is worth the possibility that I get lucky enough they actually will pay out some day when I most need it. But I’ve been proven wrong more than once on this theory, so so far the jokes on me.

  20. David says:

    That’s exactly it!

  21. Ilene Frank says:

    I like the posts above that point out that the guy who goes for 30 years without any significant health care costs is… lucky! While you can eat right and stay fit, that alone won’t do it. Does anyone go out in the morning planning on getting in a traffic accident? If you don’t pay health insurance and self-fund your medical care, you might come out ahead financially – or you might not!

  22. Strick says:

    David – Ha, why do you even try?

  23. Strick says:

    Ilene – the point of the post and all of David’s remarks is that, even if you did plan on getting in a car accident today, why would you buy private health insurance that will likely not pay the bills anyway. Why not self-fund your medical care instead of paying health insurance AND self-fund your medical care (which us privately insured folks seem to have to do anyway).

  24. David says:

    Strick – sometimes, I wonder 🙂

  25. DME Supply says:

    I’ve been self employed for 4 years now. My premium for insurance for my family of 6 is about $400 a month BUT it is only designed for catastrophic events.’ My deductible is $3000 per person/$12,000 for the family. It did work out nice when my son fell out of a tree when he was 7 and broke his arm. It was so bad they had to insert steel pins with surgery and keep him overnight in the hospital. The charge from the hospital was $60,000. The insurance talked them down to $35,000 and we ended up paying our $3,000 deductible so I was glad I had it.

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