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For the majority of Americans with no significant health problems, not smoking or drinking excessively, eating well, not obese, and not involved in really dangerous activities (e.g. reckless driving), with savings above $50K, having health insurance is a very bad choice, in terms of ROI.
This actually applies to the self-employed or employees not receiving health insurance from their employer. For these people, not having health insurance is a good decision, from a risk management point of view. Here's why:
With the new Obamacare individual mandate, how can we avoid this inefficient, ill-designed system? What about passing for a very expensive patient that will be rejected by all insurers (you claim that you smoke four packs a day, drink three bottles of brandy a day, do drugs, practice unsafe sex, and have very severe mental problems). In my case, I've joined mathematology, since you can refuse health insurance based on religion principles.
And there's some sort of mild religious belief in my decision: preference to natural solutions, antibiotic avoidance, mistrust in doctors (their incentive is to keep you sick, not to cure you), costs are three times above than what they should be (due to poor analytics and other issues), unecessary costly medical exams, refusal to do business with companies that are very poorly run, gigantic bureaucracy, and frankly even if I wanted to be insured - I don't even know how to find a good doctor or obtain a legit health insurance policy.
What about you (especially if you are self-employed, e.g. a statistical consultant)? What do you think?
Your car policy is still insurance and the original arguments apply to it, apart from the third- party component. Your expected financial return on a policy which covers you and your car compared to a third party only policy is negative.
There are a variety of health systems in industrialised nations and although they cost less than the US system they are not 1/20th of the cost (which I assume is what you mean by 20 times less expensive)
The car insurance that pays for ER visits (in case of a collision) is different from health insurance policies, for the following reasons:
You cannot be more right: USA is first in terms of percentage of GDP spent on Healthcare. In practice, Americans taxpayers already pay more than any other industrial countries, but for most of them, the return is quite low.
Some other oddities of the US system:
It appears that here in America we do many things "the hard way." That may be why so many processes are flawed.
The best way to cope with the insurance problem is to have national insurance or, at least, state insurance. In the UK we have a national insurance scheme which is roughly 11% of your income. However, that is just an additional tax as healthcare, unemployment benefits, state pension are all paid for out of the Treasury funds (tax receipts). This, of course, is not practical. It means that there is a huge burden placed on future tax payers rather than the current insured. Insurance, in its essence, is shared risk, just like healthcare in the UK is socialised but introduce an insurance fund with contributions based on income rather than risk of claiming means that overall there is cover for all.