Yes, but you won't go bankrupt like so many people claim you will without health insurance. Why don't more people get this $80 plan?

A lot of people do get that plan.

And a lot of people get denied that plan.

Some people get married and start families. There's no way this plan costs $80 for anyone other than an under-40 single healthy nonsmoker. Add kids and a pregnant wife and see where it goes.

Maybe move to a country with more decent healthcare?

That might change his whole budget, no?

Because you will go bankrupt if something serious happens while on this plan. Go see the details of his coverage, I bet it only covers basic things, and 50% of hospitalization drugs, and some crazy deductible. So if he gets cancer or heart disease (most common serious illnesses), he is fucked, and will be fucked every year, if he can still afford that insurance after the first year.

"So if he gets cancer or heart disease (most common serious illnesses), he is fucked, and will be fucked every year, if he can still afford that insurance after the first year."

I already looked. $3000 deductible, no lifetime limits, and it covers major surgery, doctor visits are $40. If you want prescription coverage, there are plans less than $200 (in the $190 range) that cover 80% of prescriptions.

Cable costs this much. I'm not saying this guy should pay for this, but many people that claim they will go bankrupt can easily get a plan like this and not.

Well, the "no lifetime limits" is thanks to the legislative healthcare reforms that were driven by a need to reduce the number of medical bankruptcies, so obviously that's a good step towards making healthcare more affordable to people who previously would have been driven into bankruptcy.

But a $3000 yearly deductible is still likely to be utterly unaffordable to a significant portion of the uninsured, and it would be surprising if they weren't subject to copays as well.

Read his post about HSA and how it plays into his retirement. Most high deductible plans have full coverage ( 100% ) when the deductible is reached.

Worst case scenario it costs him $4000 ($3000 of which is pre tax) a year. Thats ~300/month. Best case he doesn't visit the doctor once and it cost him $1000 and he puts $3000 into his rainy day / retirement account.

You need to have $3000 available day one of each year to do this, but it makes a lot more economic sense.

And I have enough savings to pull this off for decades should it come to that.

Granted if one gets so sick so as to max out the deductible every year consistently, one's life expectancy is probably not that long

If one stays healthy, unused money in the HSA becomes the equivalent of an IRA and can be used for nonhealth-related expenses after a certain age (I forget whether it's 59.5 or slightly higher).

I actually opted out of my employee plan when I was working in order to get in on this for the tax deduction. (My employer wasn't offering HSA eligible plans.)

I'm not talking about him, I'm talking about why these $85/month plans aren't the blanket answer to the question of solving medical bankruptcies among the uninsured.

Because most people get denied. $85 is only for healthy and relatively young, no pre-existing conditions.

Not surprised. This is insurance. You don't get car insurance after you've gotten in a wreck, and you should expect to pay more for it if you're more likely to get in a wreck (e.g. lots of speeding tickets, etc).

If you have a car wreck, your insurance usually punishes you only if it is your fault (which makes sense).

Your sickness, most of the time, isn't your fault.

That's not quite accurate. Depending on how one measures somewhere between 40% and 70% of health care costs are used to treat lifestyle diseases (too much stress, too much food, not enough exercise) like high blood pressure, heart disease, diabetes, tobacco, alcohol, avoidable accidents, etc. Those problems are not genetic. They're behavioral.

Of course one can suffer these things without having the risk factors. I presume the experts who calculated those numbers corrected for that.

So in about half the cases (half the cost to be precise), sickness really is your fault.

One of the reasons high deductible plans have such low premiums despite not screwing people over with small print is that they attract a more healthy segment of the population, because a high deductible creates some incentive to avoid those [preventable] diseases.

As it is, people are only hit on their regular expensive plans if they smoke. Imagine if they were also hit with higher premiums if they were overweight (BMI>25, 2/3s of Americans are overweight), drank too much, smoked too much, didn't engage in regular physical activity, etc. Then the premiums for those who have a lifestyle which wasn't likely to cause chronic diseases would only pay half of what they're currently paying. Those who engage in risky lifestyles would see their premiums increase by 50%.

What you describe sounds reasonable to me. Is there coinsurance on this plan? High deductibles don't bother me. But coinsurance, where you have to pay 20% or 30% of costs, scares me. If you get seriously ill or are hit by a bus or something, the cost to you could be huge, way more than the typical deductible.

0% coinsurance on mine. Go to www.ehealthinsurance.com and see what pops up (that's what I've used ... they may not include your state very well, but for CA, it finds 20 HSA eligible plans for me, 12 of which don't have coinsurance.)

I've never seen a $3000 blood test. A family member got an exceptionally rare blood test this summer though; I'll try and look through his paperwork, but I'd be shocked to hear even that test cost so much.

It is actually really difficult to find out how much stuff costs at a hospital. That is one of my main complaints about the healthcare system. It is wasteful because the hospital environment makes you forget that things cost money, and that some tests have a very low probability of doing anything other than costing you money (not saying that was the case with your family member, just in general).

Hospitals really mess with people's cost-benefit analysis, which isn't normally too good to begin with. I was with someone in the hospital a few months ago, and we got the strangest looks when we tried to find out how much a test would cost. Ultimately we decided not to do the test, which was a long shot to find anything for a problem that wasn't very serious, and save a bunch of money. I wish there were some way to inject some more rationality into healthcare to get around the mindset of always doing everything possible, no matter the costs and possible benefits of treatments or tests.

In this case the exceptionally rare blood test was actually the crux of solving a major, chronic condition. That wasn't obvious until after the fact though.

While I do understand your arguments about rationality, I'd also point out that the prices cited by hospitals have very little relationship to reality and costs. Quite a few tests become far more rational when looking at cost rather than price.

(Not intended as an argument for any particular structure of healthcare, just an observation.)

His plan must be subsidized by the state - I have a very similar plan (with an even higher deductible) for myself and my family and it costs $950 a month.

I haven't seen any indications anywhere that California provides funds to my insurance company. However, plans do cost different amounts in different states.

You are healthy and don't have any dependents. I don't think you could take care of the general population on $1100 per person per year, even if you cover the low cost stuff. My rough calculations show we spend about $7500 person/year right now. Obviously we have lots of cost issues and such, but even with efficiency savings, someone has to be making the difference up.