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0 pointsfoldr1y ago0 comments

> I mean how much would your son’s specific situation cost you in a comparable area of America for a family of comparable income?

That's the fun thing about the US system. The only way to find out how much it costs is to wait for the bill. So while your question is a fair one, logically speaking, it's unanswerable in practice.

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foobarian1y ago

I wouldn't go that far. But it is true that there are far many more possible outcomes because of how diverse the private insurance system is.

At the very least one guaranteed difference is that you would NOT not get a bill.

Then, a common scenario is a health insurance setup that covers 100% of the cost beyond a threshold, while the individual is responsible for the cost below that threshold.

My threshold is $6k for example. In the above scenario with the elbow, I estimate that the total cost would be around $100-200k. So I would end up paying the full $6k, and the insurance would take care of the rest.

The other common scenario is one where the threshold is much lower (e.g. $200) but the insurance covers e.g. 90% of the total cost. I find that option more risky, because I know the total costs can be staggeringly high, and 10% of a staggering number is usually also a staggering number :-)

foldrOP1y ago

You might know that you won't have to pay more than $X, but you generally can't find out beforehand the theoretical cost of the procedure as billed to the insurer. So if you're on the hook for any fraction of that (as in your second scenario) then you're very much in unknown territory.

There is also the question of how well you really understand the terms of your insurance policy, which can be extremely complex.

foobarian1y ago

> which can be extremely complex.

What gets me about the insurance billing is that besides being complex for me, it is also complex for the insurance company - people on the other side are just people, after all, not some infallible super-intelligent aliens. And the failures that come out of that are kind of hard to believe for people used to nationalized health care; my favorite example was a $15k bill I received months after a surgery that I called back to get more details, upon which the agent said something like "oh that's coded wrong" and after a few keyboard taps I owed $500. What if I had paid the original amount without asking? How many people do not ask? And the cynical question, how often do the "coding errors" happen the other way?

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foobarian1y ago

I wouldn't go that far. But it is true that there are far many more possible outcomes because of how diverse the private insurance system is.

At the very least one guaranteed difference is that you would NOT not get a bill.

Then, a common scenario is a health insurance setup that covers 100% of the cost beyond a threshold, while the individual is responsible for the cost below that threshold.

foldrOP1y ago

There is also the question of how well you really understand the terms of your insurance policy, which can be extremely complex.

foobarian1y ago

> which can be extremely complex.

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