If avoiding necessary health care because you don’t have insurance is bad, how is having a $4,000 deductible before you receive any assistance paying for necessary health care good⁉️ Both people are uninsured for the most typical health care costs in a year.
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If you understand and plan for the fact that you are getting a lower premium in exchange for basic care being out of pocket it can be very good. My plan has had a $5000 family deductible for years and I’ve currently got about $12,000 built up in an HSA. I also get the insurance negotiated fee instead of the higher uninsured fee. Works nicely for me, I’m convinced it’s saved me a good deal of money money in the long run. If someone buys the plan solely because the premium is lower and can’t actually afford a $4000 or whatever deductible it can be very bad indeed.
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I must assume you and your family have enjoyed good health. Two years ago my wife went through $30,000 in expenses very quickly (without a hospital stay). You are basically self insuring. It works as long as you are low on claims.
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We’ve had some bigger expense years along the way but the number nobody ever talks about is the annual out of pocket maximum. Mine is $6,600 (family.) So yes I am self insuring the low end and being financially rewarded for it with a lower cost while at the same time controlling my risk if bigger expenses occur. I can afford a $6600 risk, particularly since I’ve saved hundreds of dollars every month on premiums for at least 20 years.
This is a non-grandfathered HSA eligible employer plan that I’ve been able to keep in place. When the day comes I have to switch to a metallic plan I’ll consider all the information to make a decision; network, along with the interplay of premium, deductible and out of pocket maximum.
I’ve also paid the premiums for and partially funded HSA accounts for 2 employees. Employee A funded her HSA the rest of the way to the max herself and is also sitting pretty nice at the moment. Employee B withdrew and spent the money. When she complained about our plan’s deductible I reminded her that was what the HSA money was intended for. “But I spent it” she said, to which I replied, “That’s not my problem.” So depending on your circumstances and level of personal responsibility these can be good plans. A higher deductible can save you money in the long run, but it only works if you plan ahead and have a way to cover the smaller costs up to the full deductible if need be and one thing I agree with you about is that most people don’t seem to get that whole thinking ahead thing.
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I’m all for personal responsibility, but you have to admit one needs the ability to put money in the HSA and either not use it for small expenses or be able to replenish it when it must be used. Many people simply can’t do that (especially while also trying to save for retirement). Something has to give. I maintain the problem is not with the patient, but with the delivery system and the ideas more health care is better health care and higher cost care is better care; neither of which are true.
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