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.

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.

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.

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.