Health Care / Insurance

So I don't get it. Obviously, the industry has to make money. Premiums, deductibles, etc. have to cover, not just the cost of care, but also the costs of administration and salaries for those pesky insurance salesman. I recently reviewed some old data about health care costs and, assuming that only the rates have changed and not the percentages, have developed some questions that I'd like to find answers to. I may have to print them out the next time I have to sit through an insurance meeting at work.

There is an average dollar figure for actual cost of health care. This is what it would cost if it were just out of pocket. Ignoring the effect of insurance companies contracting lower rates, I'm just looking at what actually gets paid. In other words, I realize that if you walk into a doctor's office you'll pay more than the insurance gets charged, but let's just pretend insurance didn't exist and providers would take the same money.

Approximately 95% of households spend more on insurance every year than the actual health care costs. I personally average hundreds of dollars per year on routine health care, not counting exceptional injury. Insurance premiums alone for an individual are upwards of $4000. That differential is why all the insurance people get paid. Only about 3% of households have health care costs each year that exceed base insurance costs by 10X. Remember that your employer is paying the bulk of the premium, your $60 per month is a pitance.

If you're one of the households exceeding payments by an extreme amount the insurance may be a windfall. An alternative would be getting the premiums your employer pays to someone else. This would leave you at risk, of course, in the event of any major injury or illness. That last statement implies that having insurance alleviates this risk. Does it, though?

What percentage of bankruptcies involve major medical expenses?
Of those, how many had insurance? (Which didn't protect them financially.)
More to the point:
Of households in any given income bracket, say yours, who suffer a major medical problem and have some standard insurance through their employer, what percentage still file for bankruptcy?
Same question for those without insurance.

I found quite a bit of data that looked like any major medical problem was as likely to send you to bankruptcy court whether you were insured or not. New bankruptcy laws now and I have no idea how this will effect things in the future, but financial devistation is devistating whether you can file or not.

Insurance costs thousands of dollars per year. What gets covered and what doesn't on your next potential policy? Even if it gets covered, how? 80/20 split? 20% of $30,000 will still break most households.

I'd rather see a plan where instead of paying my premiums that money would just go into a flex fund. Use it or lose it. Any unused monies to go to a general healthcare fund. It would encourage routine medical because that amount of money is way more than most people would ever spend anyway.