This is a guest post I did about my befuddled search for health insurance, reprinted below in its entirety. Don’t tell me it’s not interesting. I know health insurance is “not interesting.” Kafka’s bureaucracies are also, in a quantitative way, not interesting. And no I’m not comparing myself to Kafka.
Health Care is a Drag
It was an hour into the conversation with the insurance agent when I realized that the policy I was about to buy didn’t really cover very much. I would have a high deductible*, coinsurance* and for an additional $40/month I could buy an “accident benefit” that covers the deductible if I “fall off the roof,” as Sue the agent put it. Why not get a plan with no deductible, then? But I didn’t get into it. I was afraid to ask the question, it seemed like one question would only open the floodgates on a dozen more, and I knew the answers would be as slippery as the carefully written language of the policy itself, and would be calculated not to give me the basic information.
How many thousands of people had had similar conversations with clueless agents, 24-year-olds, aspiring to have interesting jobs (Sue wants to be a music manager) but had graduated at the worst time ever, forced to pay her dues instead as a professional obfuscator.
Poor Sue, she didn’t even know. The confusion was built-in, showing wear, like an apartment in a pre-war building that has ten coats of paint. The newest coat is easy to pick at and magnifies bumps and irregularities instead of covering them over.
The real question I kept at bay was why buy health insurance if it’s so bad to begin with….
I’m one of the (lucky) few who literally has no medical needs. When I did go to the doctor regularly—the physical therapist for back pain—it felt slightly wrong, like getting massages on the company dime, and didn’t cure the problem. The only other regular med I have taken, birth control, I went off years ago. So I’m in a position to wait.
I looked at Sue and felt lost for words, thinking of how to ask the questions in the right way to force a simple answer. I thought about how much my “one annual wellness visit” or “four regular doctor visits” was worth to me. One moment a very basic question occurred to me. “Well, how much does it cost to just go to the doctor without insurance?” She had no idea.
The answer is that it depends. Seeing a doctor is like going to a car mechanic. It’s the diagnosis that will cost you.
The answer I finally uncovered was that the policy didn’t cover critical care. That means I was buying a high-deductible accident policy, what I like to call a Hail Mary policy. If I get pregnant, get cervical cancer or have a stroke, I am still SOL (shit out of luck).
So I answered the big question. Why have health insurance? It lacks the security it’s supposed to give. It doesn’t really cover the scary potentialities. And as for the basics, I don’t strictly need it. I’m healthy and fairly young still, so I’m coveted by insurance agencies. I should be one of those people subsidizing care for the sick folks. I’d love to, I can’t wait for mandatory health care, because I know I’d be better off with insurance anyway. I hope it will be more affordable and comprehensive, and several degrees less complicated. I know my solution is a stop-gap measure at best. But until then, I’ll keep my money, and my fingers crossed.
A few defined terms:
Deductible: Your expenses before insurance kicks in. Many low cost plans have high deductibles, around $5000-$10000. Doesn’t apply to annual checkups, usually.
Copay: What you pay at the doctor. Usually $15-$35.
Coinsurance: You pay a percentage of most medical costs. 80/20 is common, meaning you pay 20% and the insurance company pays 80%. Not so good plans will make you pay all costs upfront and reimburse you the 80% they owe you, rather than the other way around aka the sane and helpful way.
Wellness visit: Annual physical/check-up.