So if you were stinking rich, like a couple billion USD, and don’t have employer insurance, would you buy it private or just pay as you go? I can’t imagine a disease or procedure one couldn’t afford. What’s your reasoning?
If the answer is pat as you go, what’s the wealth you’d need to have to drop insurance?
If you invest around $220,000 in Canadian businesses, you can apply for permanent Canadian residency, which comes with access to Canada’s free health care system. So figure that as a baseline.
I’m always opting for health insurance because it’s less expensive for my family. We are a family that uses our health insurance.
Rich people stay rich by saving money however they can.
I’d go for insurance simply because the hospitals gouge those who pay privately while insurers (including Medicare/Medicaid) pay negotiated discounted rates. Same model used by the universities.
That’s the issue in a nutshell. Health insurers negotiate steep discounts with providers versus the full sticker price for those providers in their network and I think for prescription drugs too. So it’s much better to have health insurance even if you don’t need it.
There might be tax advantages too, if you are self-employed.
I’d still buy the most gold-plated insurance plan I could. I see no reason to pay more for healthcare than I have to. Plus, how do I know the hospital won’t deliberately price things up for the sake of gouging my money? The same heart surgery that costs a normal person $60,000 should not cost me $60 million, assuming our heart conditions and surgeries were identical.
It’s the same principle why I would refuse to pay $200,000 for a Toyota Camry if everyone else pays only $20,000.
I would use concierge medicine for general primary care
I would have a comprehensive insurance plan for hospital stays simply because medical billing is the most complicated and error-prone billing in the world and I don’t want to deal with the hassles.
I would pay cash as needed when those methods have problems (sorry we can’t get you in for three months).
If you’re that rich, you probably have some people working for you, both at home (housekeepers, grounds crew, nannies, etc) and office staff. So you might need health insurance for the employees as well as yourself and your family.
If I’m rich and an asshole, I might want better health care for myself than I’m willing to pay for my employees to have.
I was just about to say the same thing. Pay the insurance a lot, and let them deal with things, especially if you are out of commission.
Back in 1962, when I lived in the Congo, my dad got a blood clot in his leg for which there were no good remedies back then. He was in the hospital for weeks. Fortunately he had done a lot to set the hospital up (it was run by the Indian Army, it wasn’t private) and he got his own floor and super-good care.
He lived another 50 years, so they did a good job.
Thirded, this is the best answer.
During the decade of my 30s, my employer wanted to provide me with health insurance, but didn’t want to do the paperwork. Instead, he increased my salary by what it would cost to pay for health insurance.
I was a fool and never bothered acquiring health insurance. My 30s were my healthiest decade. No illness requiring medical intervention, no injuries, nothing.
Just got my Ozempic:
Cost: $2632.43
Insurance paid: $2557.43
My cost: $75.00
There were 3 other prescriptions this month, plus routine medical visits.
I didn’t get so stinking rich by paying more out of pocket than the cost of my insurance.
I’m retired military and recently retired from my 2nd career. I kept Tricare Prime as my health insurance for about $700/year family coverage. It does not cover dental or optometry. The pharmacy is free in system, co-pay out of the system. Reasonable health insurance was the single most important factor in whether or not I could retire at age 60 or keep working for the rest of my life.
Tricare covers nine million people in the USA. We can do it for everyone. It will raise my taxes, but good health coverage is the single most important thing we can do to ensure the security of American citizens.