I went without health insurance until I was 40.
As a freelance journalist, health insurance seemed like something that I couldn't afford, given my income. So I skipped it. I was a young guy, without any serious health problems, so I figured I could do without health insurance.
When I turned 40, I decided that it might be a good idea to change that, so I joined my University's alumni association and signed up with the group health insurance they offered, and added my wife at the time to that policy. And it was a very good thing I did. Within three years, my wife developed a rare cancer. She survived that cancer, and we're no longer married. Then, when I turned 45, I wound up in the hospital in a coma after getting viral encephalitis. Again, it was a good thing I had insurance, since even my 20% of the costs of that illness ended up being over $20,000.
The thing I realized, after all of that, was that my former wife could have gotten that cancer and I could have had viral encephalitis before I had the health insurance. Neither illness was age-related at all. If that had happened, everything would have changed. My parents and her parents would probably have stepped in, but that doesn't change the fact that I should have been carrying insurance all along.
Instead, I decided to take the risk of not having it, because I was young and healthy and, like many young, healthy people, I couldn't imagine that a devastating illness could ever happen to me.
The bottom line is that I didn't join the pool of people paying into health insurance. I wasn't contributing to the pool of funds available. Had I gotten sick during that period, I'd almost certainly have gotten health care, at the expense of others. My illness and the illness of my wife taught me a valuable lesson. I realized, after that, that everyone needed to be in the pool. If everyone is in the pool, the young and healthy are contributing to everyone's health care, keeping costs overall down for everyone and keeping the health care system in balance. For the young and healthy, being in the pool also means that if they stop being healthy for some reason, which happens far more often than any of the young and healthy think, they'd be covered.
In my opinion, the ideal situation is a single-payer, single-pool system, funded by tax payments by each and every individual, from birth to death, with subsidies and a progressive taxation system to compensate for the poor and elderly. The young and healthy are automatically in that pool, which reduces the per capita costs of the system, since they typically do not use much health care. That ideal seems to be something that's difficult to sell in the US, given the political divisions here.
So, we have this ACA thing. It's far from perfect, and it's very far from being single-payer, single-pool. The mandate, however, included in that system moves partway toward the single-pool system. Eventually, I believe the US will have a single-payer, single-pool system, but not for some time. I may be gone by then, but I'm in the Medicare single-payer system, modified by a supplemental insurance policy that my health insurance company was eager to sell me. In fact, every insurance company that offers that supplemental policy in my state spent a great deal of money trying to sell me their plan.
If you're young and healthy, you may believe you don't need health insurance. You will need it. If you're part of the single-pool, you'll benefit from having it when you don't think you need it, when a time comes when you need it. That time could be tomorrow, or it could be years down the road. A mosquito bite, from a mosquito carrying Eastern Equine Encephalitis is all it takes. Or a random cell in your body that gets screwed up and starts growing uncontrollably. It happens.
Single-payer, single-pool. Failing that, something. Right now, that something is ACA. It's a good thing, even if it's a stopgap. It's a move in the right direction.
The insurance companies? Well, if we end up doing Medicare for All, they'll be selling those supplemental policies like crazy. They love them for Medicare people. Truly.
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has only a 12% GROSS margin (and that isn't GUARANTEED by law.)
Hope this helps.
From a hospital gurney (or a coffin?)?
I don't know if you actually believe this, but I can't be arsed to give you a lesson in basic economics. Suffice it to say that the fundamental business plan for any insurer is to take more in premiums than they pay out in claims. That's because insurers, by and large, are organized a "for profit" entities in the United States.
