Pros of Health Insurance
When people decide if they want to pay for health insurance it is important to understand the
pros and cons when making this decision for themselves and/or family members. The pros of
having Health insurance are this protects you from unexpected, high medical cost. For example, a
broken leg can cost up to $7,500 to fix and the average cost of a 3-day hospital stay is around
$30,000. By having health insurance, you are only responsible for a small portion of the bill once
your deductible has been covered. Additional pros include reduced cost after the deductible is
met, out-of-pocket maximum, and no yearly or lifetime limits. b Having health insurance also means
getting access to free preventative care such as vaccines, screenings, annual check-ups, and
deductibles (healthcare.gov). By frequently going to the doctors this could help identify early
warning signs of cancer, diabetes, high cholesterol, etc. Health insurance can be accessed by both
employers and private health insurance which typically have a higher monthly fee. Most
Americans still decide to opt into health insurance (if available) to have a “peace of mind” in case
an accident occurs.
Cons of Health Insurance
A lot of times healthy individuals who are healthy decide to opt out of health insurance to save
money. However, if they do get sick this can put them financially at risk for paying full price to
cover medical bills. It is important to understand the cons of having health insurance. 1)
unaffordable high premiums due to pre-existing health conditions because of the high change of
using insurance for cost related to treatment or hospitalization. 2) confusing policies and trying to
understand the differences and nuances between different health care insurance plans. 3) if your
plan does not cover a certain medical attention or if the hospital bill exceeds the allowable
coverage, you still could pay a lot (in addition to medical insurance (Metrobank).
Overall, in my opinion the pros outweigh the cost and even health individuals should opt into
health insurance if they have the financial ability. The financial implications of getting sick and not
having health insurance can cripple an individual or family for a long time.
There are about 30 million people in the United States that don’t have health insurance.
Uninsured people are less likely to get the health care services or postpone them which could
result in poor outcomes. Certain groups like people with low incomes, less education, and
racial/ethnic minorities are more likely to be uninsured (Healthy people 2030, n.d).
Young healthy individuals may choose to not buy health insurance as they think they are healthy
and would not get sick and they do not want to pay high premiums for health insurance when
they rarely see a doctor during the year, and some may even skip annual physicals. But even a
healthy individual can suddenly get sick or be involved in a serious accident requiring
hospitalization, and now with the Covid-19 pandemic that is affecting young and old at the same
time, there are consequences if someone does not have health insurance.
The pros of not having health insurance could be avoiding high insurance premiums, saving
money, etc. The cons of not having health insurance include., negative health consequences;
people may avoid routine screenings and preventive immunizations and could end up being
diagnosed with diseases including cancers at later stages and will have an increased mortality rate
than insured people who may seek medical help and do routine screenings. It will also increase
the cost of controlling chronic diseases. If a patient with a chronic disease like Diabetes or
Hypertension does not have insurance or could not afford it, they could skip the periodic
diagnostic labs and may not take medications as prescribed, and it could result in complications
resulting in hospitalizations costing more money and which could have been preventable. If
parents do not have health insurance, the health of the children will also be affected, they will
avoid childhood screening and immunizations for their children (Garfield et al, 2019).
Overall choosing to not have health insurance could result in negative health consequences to
oneself and result in an economic burden to the society and government as well.
Health insurance is an extremely crucial instrument that has a direct impact on the quality of
health and health-related outcomes of an individual (Kilbourne, 2005). However, in the U.S. many
individuals avoid taking health insurance, believing that they are in good health. This decision gives
rise to both positive as well as negative consequences. The main pro of avoiding medical insurance
is the ability to save health-related costs in case of good health and wellness. In addition to this,
by avoiding medical insurance, individuals can escape from complex insurance policies as they do
not have to choose a final insurance product relating to their health. Since most health insurance
schemes do not cover all kinds of medical conditions and diseases, by avoiding such insurance
plans, it is easier to put the money to better use. By avoiding the insurance, it is possible to avoid
the Co-pay clause in which medical cost is divided between an individual and the insurance
company.
The cons relating to the avoidance of medical insurance are that uninsured individuals are less
likely to receive preventive as well as screening services, and the inability to leverage diverse
health insurance options and plans to secure one’s health (Kilbourne, 2005). Similarly, by avoiding
medical insurance, individuals are not able to take advantage of a broad range of add-on benefits
that come with insurance plans and schemes. They also must give up tax benefits that are
associated with medical insurance. By not having a medical insurance, it is not possible to avail
cashless treatment for oneself and their family members.
The decision to avoid medical insurance can give rise to both positive as well as negative impact
for individuals. So before buying or avoiding medical insurance, it is vital to evaluate the pros and
cons so that the quality of health can be positively affected by making the decision.
There are many in the United States that are currently uninsured with regards to health care
insurance. Most all the research suggests that at least 25.3% of these uninsured is because they
are not eligible for coverage and 21.3% state they do not want or need coverage (Porretta, 2022).
In my college years, before healthcare reform took place in Congress, I was uninsured. I was too
old to be on my parent’s plan and I worked part-time and therefore did not qualify for any type of
insurance through my work. I was in pretty good health and thankfully I did not need any
specialized care or emergency treatments. I do remember the day that I was able to receive health
care insurance through my job. It was a great piece of mind that if something happened, I would
be covered.
Pros of not having health insurance:
Money in your pocket: Insurance premiums, co-pays and deductibles can cost a lot of money. b A
lot of people think they are better off without paying for insurance if they are not going to use it.
Health insurance plans can be confusing and time consuming depending on the carrier. There are
so many different plans, it is hard to decide which one is a right fit. Some plans cover certain
treatments where others do not. Some people do not want to deal with the stress of picking out a
plan, even if it will help them in the long run.
Cons of not having health insurance:
Spend MORE money on medical bills for those emergency room visits or even primary care visits,
immunizations, and prescriptions.
Research suggests that uninsured adults are less likely than adults with any kind of health
coverage to receive preventative and screening services. They are also less likely to receive these
services on a timely basis. (Institute of Medicine, 2002). This increases more reactive type of
health care, more expensive treatments and increase in hospital stays.
Maria Rose for The Medium wrote: "Even when insured, people can’t cover their bills, the answer
was even more obvious — what is the point of insurance if it doesn’t even serve the purpose to
which it was created?" (Rose, 2019). Which is true, what good is insurance when it does not cover
the innovative surgery, the experimental drug, the high ER bills. I have had multiple surgeries
throughout my life, my most expensive ones were before I was one years old. My parents paid a
tremendous amount out of pocket and the tax payers paid the rest (Thank you, I appreciate it.)
because my dad was a Marine and had insurance. My parents were fortunate to have family well
off enough at that time to help pay off my medical bills, even with that help it took years. I also
had to go for yearly follow-ups. My mom still has those old bills, I think I will go through them and
see how much did the insurance really pay. I am grateful for my life and my situation in life. I likely
would not be here without the surgeries, but not everyone can take a risk on a 4-month-old baby
like that. Why pay for health insurance if a situation like that is going to arise. A family could likely
use that money to support the rest of the family during a trying time, especially with how
expensive health insurance is in America (Rose, 2019). It does not cover enough anymore to even
be worth the cost sometimes. It makes sense to go without health insurance especially if it would
keep you from being able to afford healthy food or a better housing situation (Rose, 2019).
31.2 million people under 65 do not have any type of health insurance in 2020 according to the
CDC (CDC, 2021). While some of them do experience large bills from this, it in some ways must
still be cheaper than insurance. If people stopped buying insurance, could we eventually crash the
system? Maybe that should be the goal...let us destroy what clearly is not the best option and
create a new one. One that could allow families to thrive. One that would not force families to
have to make choices that should not even have to be considered. That is the better option than
continuing to drown people in insurance cost as only a few profits.
It is crazy to think that in 2022, over 20% of Americans are still uninsured with health insurance.
We routinely see that in younger, healthier people such as teenagers and young adults. The
general attitude usually consists of "there's nothing wrong with me so why spend the money?" As
a guy who works 80 hours a week, I get it. Health insurance is expensive, complicated, and at
times is a major source of stress. In the grand scheme of life, most healthy people in the earlier
stages of their life will not utilize health insurance like those of an older population. I will say, as
the son of a working-class family who happen to have good health insurance for most of my life,
you also tend to not totally understand how much you are indeed using health insurance and I
believe that happens because you are not necessarily paying for it. When talking to some of the
younger kids on my EMS squad, it is amazing to see how many of them do not even know they
have insurance. One kid told me that his mom just hands "hands him a card to give to the staff at
the office" and admitted he thought it was a credit card. I laughed but was very confused and
annoyed after that conversation otherwise.
For the pros and cons of health insurance, I think it is a pretty simple argument. Having health
insurance is like any other insurance. You have it in the event you need it. It is there for those
with no medical ailments as a "back up" in case anything was to happen to you. Certainly,
everyone is different as are their individual needs. Health insurance for me is really all about
specialties. My insurance covers excellent chiropractic care for a herniated disc. My co-pay is $10.
Without insurance, each visit would cost me almost $200. My specialty visits to an orthopaedic
doctor as well as primary care run $40 and $30 respectively. Without health insurance, my
orthopaedic doctor likely would not even take me as a patient. Primary care doctors would run
otherwise $80-$100 per visit. Health insurance makes total sense to me. The cons to such are
obvious. While there are programs like charity care or Medicaid, there is a qualifying process to
access that. In the event of a medical emergency and accident, it could very potentially cause
financial ruin. When my father suffered a near fatal heart attack in 2018, I followed the
"explanation of benefits" that they kept sending. My mother & I stopped counting at $700,000.
With her insurance, they ended up paying less than $2,000 out of pocket after everything was said
and done. That speaks volumes.
The main reason that individuals in the United States skip medical insurance is because of the
cost. In a recent survey of 2,500 U.S. adults, “over the past year, 22% of Americans say they have
steered clear of some sort of medical care — including doctor visits, medications, vaccinations,
annual exams, screenings, vision checks and routine blood work — because of the expense”
(Leonhardt, 2020). Most individuals receive health insurance through an employer but not all
workers are offered coverage, or if offered can afford their premiums. Medicaid covers many low-
income individuals; however, it is limited in some states.
Millennials ages 24-39 reported avoiding doctors’ offices at higher rates than baby boomers (age
56 to 74). People are not poor; they just cannot afford health insurance. Also, many insurance
plans have a deductible per person ranging up to $5,000. The healthcare costs make a big
difference in many people’s household incomes.
People with health insurance has been proven to be a good thing. Insured individuals pay less out
of pocket on medical care. They see physicians often and get more preventative care.
Without health insurance, serious accidents or health issue that result in emergency care and/or a
expensive treatment plan could result in poor credit or lead to bankruptcy. “And as a result, for
several years, medical debt has been the No.1 cause of personal bankruptcy, according to De La
Torre.” (The Balance, 2021). People without health insurance have worse access to care than
those who are insured.
Health insurance is one of those things where you do not realize you need it, until you need it.
However, with very expensive costs and access to health insurance, we can see why people
choose not to purchase health insurance.
References
Leonhardt, M. (2020, March 12th). “Nearly 1 in 4 Americans are skipping medical care because of
the cost”. Retrieved from cnbc.com/2020/03/11/nearly-1-in-4-americans-are-skipping-medical-
care-because-of-the-cost.html
The Balance. (2021, September 12th). "Medical Bankruptcy and the Economy,”.
https://www.thebalance.com/medical-bankruptcy-statistics-4154729
CDC. (2021, October 19). FastStats - health insurance coverage. Centers for Disease Control and
Prevention. Retrieved February 4, 2022, from https://www.cdc.gov/nchs/fastats/health-
insurance.htm
CDC. (2021, October 19). Fast Stats - health insurance coverage. Centers for Disease Control and
Prevention. Retrieved February 3, 2022, from https://www.cdc.gov/nchs/fastats/health-
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Rose, M. (2019, September 15). I live without health insurance. Medium. Retrieved February 3,
2022, from https://medium.com/@mariarosedoeseverything/i-live-without-health-insurance-
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Institute of Medicine (US) Committee on the Consequences of Uninsurance. Care Without
Coverage: Too Little, Too Late. Washington (DC): National Academies Press (US); 2002. 3, Effects of
Health Insurance on Health. Available from: https://www.ncbi.nlm.nih.gov/books/NBK220636/
Poretta, A. (2022, January 21). Is it ok to be uninsured? 5 things you need to know ... eHealth.
Retrieved February 4, 2022, from https://www.ehealthinsurance.com/resources/individual-and-
family/is-it-ok-to-be-uninsured
Kilbourne, A. M. (2005). Care without coverage: too little, too late. Journal of the National Medical
Association, 97(11), 1578.
Garfield, R., Orgera. K., Damico, A. (2019). The Uninsured and the ACA: A Primer - Key Facts about
Health Insurance and the Uninsured amidst Changes to the Affordable Care Act. Retrieved from
https://www.kff.org/report-section/the-uninsured-and-the-aca-a-primer-key-facts-about-health-
insurance-and-the-uninsured-amidst-changes-to-the-affordable-care-act
Healthy People 2030. (n.d). Retrieved from https://health.gov/healthypeople/objectives-and-
data/browse-objectives/health-insurance
Health coverage protects you from high medical costs. HealthCare.gov. (n.d.). Retrieved February
1, 2022, from https://www.healthcare.gov/why-coverage-is-important/protection-from-high-
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