I face a dilemma faced by many: My current health insurance costs $700 a month for a policy that has a $2,500 deductible, $5,000 maximum out of pocket costs, and a 70-30 split for expenses in the donut hole between $2,500 and $5,000. “Routine” costs, such as checkups, are not covered. Maximum coverage is $1 million.
So here is how it pans out: I am guaranteed to spend at least $10,900 before I have one nickle of coverage. For the $2,500 after that, I will pay $750, so that for the first $13,400 in costs each year, my insurance will pay $1,750. So my out-of-pocket each year is guaranteed to be $8,400, and can go as high as $12,150 without regard to routine expenses.
Typically my actual costs run less than a thousand dollars. If I have a complaint, I always weigh what I am already paying against and know that I am 100% out-of-pocket. So unless I am seriously ill, and I never have been, I usually opt not to see the doc. Most things take care of themselves. I have a blood test twice a year, and beyond that, not much.
Here’s the problem, and I know it is one that every self-paid insured person wonders about: Given good health, is it worth a guaranteed expense of $8,400 a year, and a total exposure of $11,650 each year when actual costs are probably only going to run a thousand or so? I can do a lot with that $8,400 in premiums I pay, including getting checkups and paying for injuries. Even when I am most at risk, when I drive, I’m pretty much covered, as insurers are liable for 100% of my costs if I am not at fault. I’ve never caused an accident.
Of course, the insurance is to cover all of the people who exceed the thresholds – the cancer and heart patients. I could be one of them, but I am in in pretty good shape, running ten miles a week, lifting weights and hiking. My mental outlook is healthy.
I have been thrown into a pool that attracts people with very high risks, and excluded from the normal risk groups due to a preexisting condition.
My temptation is just to go bare. I think about it. Alot. Knock on wood?
Piece of Mindful 
Well, what I would do is get to calling/writing/sleeping on the doorstep of your representatives to get health care reform pushed through.
This is exactly what it is all about. People like you should not be facing this dilemma.
Your situation certainly sucks. Are you supporting any dependents? In that case I wouldn’t risk going it naked. If not – maybe….
But the long term solution is to get reform passed.
— hippieprof
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Want to join a pool with me and my wife? My situation is exactly the same as yours. $1,600/mo going into an interest bearing bank or bond acount. After 1 year, we’d have $19,200 to cover our expenses, and even without interest or rate increases, we’d have $96,000 in that pool after 5 years. At 5%, it would generate $4,800/yr. after 5 years to offset routine care (glasses, dental, etc.). Self-insurance, anyone? It would take a little discipline, but we could do it.
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The risk, of course, is high-end stuff, and that is where the private insurers have us over a barrel. By going bare, we are really throwing ourselves on everyone else, as if something bad happens, we go bankrupt and all of the providers have to eat their bills.
But these people are leeches, and simply giving them the finger seems satisfying, even if basically counterproductive. The very idea that anyone thinks they give a rat’s ass for anyone but themselves and what they can skim off the top is ludicrous.
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For me, this answers the question: Why health insurance reform, not health care reform? Tens of thousands ARE “going naked.” As primiums and deductibles rise, more will opt out of private plans, including many employee groups. Insurance companies want to lock in record-high prices and profits now, before too many opt out, lowering the currently-inflated price for their “services.” Hospitals, doctors and others receiving inflated prices also see the coming trend and too want subsidies to prop up prices. It’s seldom, if ever, about real people in need. Industry (not just insurance) demands that government reach for the “falling knife” whenever prices and profits head South.
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