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birb_cromble  2d ago (text post)   684 thread views

Qeekly Finance Thread - 2026-10-24

A weekly thread to discuss financial matters - from personal all the way up to global.

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Apparently, the average cost of a health insurance plan for a family of four in the United States is now $28k. When I was shopping last year, unsubsidized Obamacare was in that price range. Gallingly, the plans still come with large deductibles that must be met before insurance pays for anything.

So we simply canceled our health plan. Now we're raw-dogging it and have saved probably $20k this year. Might join again for 2027 for anticipated maternity bills.

It feels good not to be subsidizing the bad life choices of others.

Remember how Obamacare originally fined people for not buying insurance because obviously people wouldn't pay outrageous rates to subsidize other people unless they were forced to? Well, there is no mandate anymore. Why are people still buying insurance?

I really don't recommend this. If you are rich then you are likely advancing in age and therefore inevitable comorbidity. If you have kids they can have complications. Also, if you are rich they will make you pay if something expensive happens.

Maybe you get cancer. Maybe you get T-boned at an intersection by someone running a red light and then you end up in an ICU for 4 weeks followed by another 6 weeks of various step down care and end up with a 450k medical bill. Which they will make you pay if you can pay.

If a half a mill in medical debt doesn't make you blink then you can afford to just pay for the health insurance.

It's just not a good bet. Sure, you will probably be fine, but the level of catastrophe that can happen is immense, and just assuming it will never happen to you is not wise.

Maybe you get cancer. Maybe you get T-boned at an intersection by someone running a red light and then you end up in an ICU for 4 weeks followed by another 6 weeks of various step down care and end up with a 450k medical bill. Which they will make you pay if you can pay.

You can negotiate this much lower, and lots of discounts if you pay with cash. Even with insurance, people report being denied or incomplete coverage. Refusal to pay medical bills is not as bad as it sounds and it's not like they can take your property (homestead laws apply).

You can but they don't have to do that, and if you have a lot to lose and can actually afford to pay that can become a problem.

Paying 30k for 10k worth of insurance is not something I’m interested in doing.

If I get T-boned I’ll happily pay the 450k but I’ll also make sure I don’t pay more than I would owe in a just system. I’ll pay my fair share but I won’t pay their phony rack rates. Since I’ll be paying cash I’d expect a lower rate than an insured patient.

Mostly I don’t want to participate in a corrupt system.

Since I’ll be paying cash I’d expect a lower rate than an insured patient.

This is true to some extent, but it's mostly about an ability to pay. If you can afford to pay you will pay.

With respect to injustice and a corrupt system, you'll be using insurance (ex: Medicare) when you are older, not self-insuring. That's what you are supposed to be subsidizing now. That would make you the corruption you are complaining about.

Do hospitals actually have the investigative power to go find your accounts and know if you have money? This sounds highly doubtful since the majority of uninsured probably don’t have money.

The hospital doesn't do it. they would likely outsource it to a debt collection agency, assuming it ever got that far. Because it's a service, like student loan debt, it cannot be repossessed . This means trying to garnish wages, and courts can block this. Medical debt is like delinquent student loans: a long drawn out legal process that works to the debtor's favor, and lots of wiggle room. The best bet is to negotiate as much as possible and pay as little as you can, but do not ignore the bill.

They can't collect. It won't go on your credit. And you have the legal right to tell them to stop harassing you.

For the record, I don't recommend doing this since it's morally wrong. I would pay the hospital a fair price far before it ever got to this.

If they can’t collect and you don’t take a credit hit there’s zero incentive to pay. I 100% recommend doing this, contra your point about ethics. I’m selfish. I’ll own it.

My knowledge of this is less intimate than I'd like because most of my career involves decreasing autonomy and the hospital does shit in the background with little involvement from me, but it's usually pretty obvious that someone can't pay. You can ask for a payment plan or pretend to be homeless or whatever but you have to convince them if they are going to adjust.

As others note the amount they charge the insurance company isn't going to be the same amount they charge you (or the insurance company pays) but that's only mostly. Private equity run physician groups will be aggressive about seeking professional charges even if you are homeless or other similar things can pop up. The hospital can refuse to negotiate and does do that.

If you can afford to pay you will pay.

Is that really true? My impression is more like "the bill will eventually be sold to collectors for pennies on the dollar and then you can bargain with them to pay a few more pennies than they paid and it all goes away." Why is that wrong?

Even that's too optimistic. Apparently, you can pay them zero and they have to stop harassing you.

They can reduce the bill but they don't have to, and even if it goes to a debt collecting agency thats going to show up on your credit etc. which if you are a person of wealth can be a problem.

It seems like it's only a problem if you aren't a person of wealth. I have good credit, but unless I'm planning on buying a house I can't see it mattering in the near future.

It's not allowed to go on your credit and as a rich person I have zero need of credit anyway.

Again, it's wrong to not pay and I would never recommend doing that, but the hospital has zero leverage.

I believe it does affect your credit once it goes to collections.

This strategy for dealing with healthcare was has been on Twitter for a while. If people here are talking about dropping health insurance then a spiral on Obamacare seems well underway. The only people that should have insurance are already sick and if the risks pool is 4 sick people for every healthy person than obviously the healthy person is paying way more than the benefit they get.

Yes, and I view it as a personal service to help accelerate the collapse of Obamacare. It's pretty much the only thing I'm an accelerationist about.

Just get term life insurance and tell them to pull the plug

Better yet, kick the plug out of the wall and claim it was an accident.

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