The article mentions early a "cancer diagnosis" but puts that aside and moves on, when this is pretty much the crux of the issue. Prostate and Breast cancers are a 1 in 8 chance. The risk of no insurance at 25 is very different than 50, and than 75. And everyone at all ages is paying for those expensive treatments.

The system is broken, but going without insurance is you basically toying with the odds of life.

If you get a very serious and expensive problem, insurance may not help nearly as much as you'd think. My mother had great insurance, but when she got cancer, the insurance didn't stop her from getting absolutely destroyed by the medical bills (not to mention having to constantly fight with the insurance company while being extremely ill).

It drove her to bankruptcy anyway. In hindsight, she commented that had she known that the insurance wouldn't be all that helpful, she would have just saved up all the money she poured into premiums over the decades.

I feel the constant fighting with insurance isn't spoken to enough. I don't want insurance because I don't want to be both a billing department and a sick person. We went through the same mess when both of my parents were sick. We were already taking in an enormous amount of new information about their illnesses and then we were also having to try and learn how their insurance worked, what was covered, what wasn't, trying to vet what would happen in every appointment, which doctors would show up (bc what if one of the doctors is out-of-network), duking it out with insuance over prior authorizations, trying to tie each bill that came in to something that happened months ago and then vetting if the bill was correctly billed, correctly covered by insurance etc, and on and on and on. I'd rather have 0 insurance and just negotiate each bill as it came in with one single entity, the hospital.

Absolutely.

A comment about this, though:

> I'd rather have 0 insurance and just negotiate each bill as it came in with one single entity, the hospital.

That's not how it works, insurance or not. You won't get just one bill from a single entity, you'll get many bills from many different entities and will have to negotiate with each separately.

And getting bills 6 to 18 months after the date of services!

In a perfect world, a healthcare plan should pay for cancer treatments or crucial medical procedures. In the United States, I'm not sure this is a guarantee[0][1]. Going without healthcare seems to be the riskier gamble, but it's a gamble either way.

[0]: https://www.startribune.com/unitedhealthcare-part-of-95m-set...

[1]: https://www.propublica.org/article/unitedhealth-healthcare-i...

It's amazing that Americans are so brow beaten that even in a "perfect world" they still require a "healthcare plan"

Author here. I'm definitely not advocating going without health insurance. Just running simple numbers to get some perspective.

I'd like to see health insurance act like insurance again though. Right now it covers absolutely everything, meaning it's more like pre-payment for routine care + insurance.

Insurance isn't for routine, predictable, or low-cost expenses. But we've mandated that our health insurance cover all of those things.

The comparison to car insurance is overused, but it's a good one. Catastrophic coverage + dedicated savings with lower premiums looks more attractive to a lot more people.

Good thing I became a Taoist before I could no longer afford insurance.

Pre-ACA my mother got cancer in a short window where the University my Dad was president of got wound down for financial reasons.

Destroyed my entire trajectory in life.

The prior system was mega fucked, our current system is still fucked.

If you had a congenital condition prior to the ACA you were a wage slave once you hit 18, no private insurance and couldn't get public. Literally founded a successful startup the minute I got ACA.

Over 40+ years I've seen nearly every profession go through a bubble and lean years, lawyers, mechanics, academics.

But never doctors, in retrospect I should have joined that protectionist racket, but my family couldn't afford to let me at the time.