Is there a fallacy here in trying to think too much about fairness/limits/billing/etc? If we abstract ourselves from the complexities of the system, we end up with:
1. Your yearly premium in the low end plan is $4800
2. Your annual out-of-pocket cap is $8000
3. Your total annual cost is $12800 in the worst case scenario
If you were employed by a company, a similar amount (https://www.kff.org/report-section/ehbs-2020-summary-of-findings/) would be paid on your behalf by your employer and thus effectively paid by yourself as an invisible tax. If you were instead living in Europe or Canada where they have "universal healthcare", you'd instead lose money by paying higher income taxes, so you won't be better off than before.
So if you want to feel like you've got "universal healthcare" - you can! Just pretend you're spending the $12800 no matter what and go get whatever treatments you need.
I think abstraction is a very useful rubric if you were deciding *between* employment vs self-employment, or the US versus Canada, etc. But it doesn't really offer guidance once you're trying to evaluate your decisions *within* a single avenue unless you dial back the abstraction.
I feel like I can't even have an opinion on health insurance because I 1) require really good health insurance and need it and 2) pay through the nose to get it. Since I'm likely a leech despite paying so much (and able to thank goodness) ive always felt bad complaining.
You need to get married and have a spouse with insurance where the company will also include you. That is the only way I managed for the last 20 years. One person I know did a fake marriage to get the insurance.
The outcome you describe is very much possible. I know I'm taking a risk to an extent, but one which I have already taken into account, otherwise the decision would not have been so one-sided.
The moral argument you posit is interesting. I think the salience is somewhat lost because the costs are so widely distributed that they end up looking like a faint mist on the far horizon. It's not clear to me *who* exactly would bear the burden on my probabilistic cost. Further, the situation I'm in is because of a technically arbitrary legal quirk around the classification of my employment status. Both of those almost completely deaden the moral implications to me (or maybe that's motivated reasoning!).
Are you also being immoral by doing outdoors rock climbing, where your risks are through the roof and you might end up a burden on tax payers? Even if you do have health insurance, your extreme sports activities will end up subsidized by other participants of the insurance pool, so someone might be harmed by your actions. Or you might end up crippled and eventually land on Medicaid because you cannot work.
Is there a fallacy here in trying to think too much about fairness/limits/billing/etc? If we abstract ourselves from the complexities of the system, we end up with:
1. Your yearly premium in the low end plan is $4800
2. Your annual out-of-pocket cap is $8000
3. Your total annual cost is $12800 in the worst case scenario
If you were employed by a company, a similar amount (https://www.kff.org/report-section/ehbs-2020-summary-of-findings/) would be paid on your behalf by your employer and thus effectively paid by yourself as an invisible tax. If you were instead living in Europe or Canada where they have "universal healthcare", you'd instead lose money by paying higher income taxes, so you won't be better off than before.
So if you want to feel like you've got "universal healthcare" - you can! Just pretend you're spending the $12800 no matter what and go get whatever treatments you need.
I think abstraction is a very useful rubric if you were deciding *between* employment vs self-employment, or the US versus Canada, etc. But it doesn't really offer guidance once you're trying to evaluate your decisions *within* a single avenue unless you dial back the abstraction.
I feel like I can't even have an opinion on health insurance because I 1) require really good health insurance and need it and 2) pay through the nose to get it. Since I'm likely a leech despite paying so much (and able to thank goodness) ive always felt bad complaining.
I'm interested to know more about why you require really good health insurance if you want to share
I have some health issues so it's pretty critical
You need to get married and have a spouse with insurance where the company will also include you. That is the only way I managed for the last 20 years. One person I know did a fake marriage to get the insurance.
Great, I need to change my Tinder bio again!
The outcome you describe is very much possible. I know I'm taking a risk to an extent, but one which I have already taken into account, otherwise the decision would not have been so one-sided.
The moral argument you posit is interesting. I think the salience is somewhat lost because the costs are so widely distributed that they end up looking like a faint mist on the far horizon. It's not clear to me *who* exactly would bear the burden on my probabilistic cost. Further, the situation I'm in is because of a technically arbitrary legal quirk around the classification of my employment status. Both of those almost completely deaden the moral implications to me (or maybe that's motivated reasoning!).
Are you also being immoral by doing outdoors rock climbing, where your risks are through the roof and you might end up a burden on tax payers? Even if you do have health insurance, your extreme sports activities will end up subsidized by other participants of the insurance pool, so someone might be harmed by your actions. Or you might end up crippled and eventually land on Medicaid because you cannot work.