The Advantages and Disadvantages of Private Health Insurance

The Advantages and Disadvantages of Private Health Insurance

Most Americans have private health insurance. This is a big monthly expense and one that many would prefer to do without. But what are the advantages and disadvantages of a country using this type of health care system? Read below to find out.

Advantages:

1. You Choose Your Doctor

In the private healthcare system you often have more flexibility in choosing a doctor as well as medical facility. For patients that want the same doctor all the time, this can be a very important advantage of this type of system.

2. Shorter Wait Times

If you are having a surgery that is necessary but not life threatening, there are often long wait times. In a private health insurance system the patient will often have shorter wait times because the medical facility is less busy. And even if there are a lot of people waiting, you can often by pass the line by paying a little bit extra for faster medical attention.

3. Improved Facilities

Unfortunately, because the public system is funded with government money it does not have access to as much funds as the private sector one do. This means that public hospitals and health care facilities are often overcrowded, and lacking certain comfort amenities. Private health care facilities, on the other hand, are usually well maintained, with private wards, private bathrooms, phones, TVs, and better tasting food.

Disadvantages:

1. Private Health Insurance Costs More than Public Health Insurance

While the US government might be saving a marginal amount of money by having a private healthcare system instead of a public one; there is no doubt that American citizens are paying a lot more money to get a decent level of private healthcare coverage than they would be required to pay in a public system. Most Americans are paying around $200 or more for their monthly health insurance premium plus a co-pay and deductible. Public system costs: under $100 monthly with no co-pay or deductible.

2. Private Health Insurance Creates Inequality

Unfortunately when health care insurance is privatized the healthcare providers and insurance companies are always thinking about their bottom line. This means that if you are willing to pay, you can get priority treatment. In the public system everyone is treated equal, money or no money; order of treatment is based on severity of medical condition and who was there first.

3. Private Health Insurance Seldom Covers All Medical Services

When getting private health care insurance quote you choose the health insurance plan that best suits your needs and fits into your budget. Unfortunately no health insurance plan is perfect so policy holders are forced to pick and choose what health benefits are most important and
which ones they think they can do without. If you choose incorrectly, this could leave you with huge policy gaps that force you to go without treatment or pay the high costs.

20 Comments

  1. thank you i understood and gained more knowledge about private health insurance it was well explained in detail

    Reply
  2. Thank you for such a short and precise article. Easy to understand.

    Reply
    • Thank you
      But I didn’t understand anything

      Reply
  3. Thanks for your precise explanation

    Reply
    • Thank you for the information I will be 65 in August and I think I will choose AARP heard a lot of good things about them

      Reply
  4. Thanks, saved the day

    Reply
  5. is this medical insurance or just private insurance?

    Reply
  6. Thanks for your precise explanation

    Reply
  7. Reasons number 1 and 2 regarding choosing your doctor and wit times do not necessarily have to be true. I live in Japan where there is one national health insurance and then there are private and public hospitals but almost all clinics are private – it is simply that they are reimbursed by the government run health insurance. We still have to pay 30% so it is pricy but the overall cost of care is very low. Let me give you an example. I had some skin spots that I was worried could be cancer. I asked around about skin doctors and went to the one recommended by several on a Friday (no appointment necessary) I just walked in. The entire visit with wait times probably took about 45 minutes. She called the public hospitals which do the biopsies to schedule a biopsy. She git me an appointment for the next Tuesday (though she said she preferred another of the public hospitals and I could wait an additional 10 days for an appointment there.) I chose the quicker one and was plenty pleased with it. They had plenty of high tech equipment too like Nikon digital cameras that took microscopic pictures of your skin in addition to the biopsy. Anyway the picture showed it was likely not malignant and asked if I really wanted to proceed with the biopsy which I did. The results came back one week later at which point I got a phone call to visit the original small private clinic in my neighborhood (which I forgot to mention)- must doctors clinics are spread throughout the city and located in neighborhoods. Doctors usually live in the second and third floors of their clinics, which are actually quite nice houses. Anyway. Everything was completed in just two weeks. The entire cost of everything was just around $100 , since we pay 30% that means the total cost would have been just under $400 if I had not had insurance but insurance is required by law because that is how you keep the insurance down. You have total control in Japan about which doctor you want to see and you almost never need appointments except for more serious procedures at the public hospitals. And even then the wait times are often way way shorter than America’s private system. One time I went to three eye doctors in one afternoon because I was unhappy with the care. Sure i had to pay around $15 for each visit but I finally found the doctor I wanted. Now I still go back to him. I think the health care industry always uses the bad examples from some systems especially from the UK and and Canada which get worse and worse as they privatize more. Japan is an example of how you do not have to compromise doctor choice and wait times with nationalized insurance. Every single doctor takes it. All care is covered. There are no questions. You do jot have to find a doctor that will take your insurance it is far superior in every example. There are times that you can choose to pay extra too for a procedure not deemed necessary but it is never much. An example of this is I wanted white fillings at the dentist but the insurance only covers the metal ones. It cost me $80 more. I opted to pay. Other examples are when you have a baby you get 2,000$ to cover the coat which is the basic fee in public hospitals. However you can use that money and apply it to the cost of a more expensive intimate private hospital. My friend did this and all the baby carts were wooden. It was a really nice clinic. All the rooms were private. It cost them 2,000 dollars more but they still could apply the public money for the overall fee of around 4,000$. Its still all so reasonable. Rich people opt for more but they pay for it and it helps the public and private health care PROViDER industries flourish but insurance remains PUBLIC and this is key I think. It is not free but all reasonable. Also you can buy private insurance to help cover the extra 30%. This is advised especially as you get older because long hospital stays or major illnesses like cancer can end up costing a lot over time.

    Reply
  8. Not being able to go back to Medicare Part A&B after moving to an Advantage plan makes it clear to me which is the best decision. I will stick with the original and get a supplement so I can have health care choices.

    Reply
  9. I’m on an advantage plan now for 8 years. I’m very grateful for my plan.

    Reply
  10. Choosing a drug plan each year is not a big problem and sometimes you don’t even have to change from one year to the next.

    Reply
  11. Now I know why they’ve been pushing me so hard. I qualify for extra benefits, but only under their HMO or PPO. They tell me I’ll get a credit card with $150 on it and health club membership – but my community already provides those at a huge discount. The $150 would screw me up I’m sure with my income somehow…. And….my dentist and eye doctor aren’t on their list. So I’ll go w/o. If I can’t keep my doctor, stuff it. My guess is they’re going to limit certain meds as well. There is a war on pain patients right now, and there are meds that I need for other conditions I’m afraid they won’t approve. I asked about the preapproval issue and referrals and they said there would be no problem. I don’t believe them.

    Reply
  12. Another point is there’s tens of millions of seniors who are also on Medicaid so when they have both Medicare and Medicaid, they can get a dual eligible Medicare advantage plan that has unbelievable coverage so many extras all for zero co-pay zero deductible zero premium all zeros except for the bill that goes to the taxpayer in the state but that’s another topic lol thank you for your video very informative.

    Reply
  13. thank you this helped me with my school assignment!!!!

    Reply
  14. Excellent advice – chose a plan based on what plan would you want when you are sick.

    Reply
  15. Thank you so much for the clear and encompassing explanation. It was most helpful.

    Reply

Submit a Comment

Your email address will not be published. Required fields are marked *

css.php
      Site Search:

MedicareHelp.org is a privately-owned Non-governmental agency. The government website can be found at HealthCare.gov.

Please contact Medicare.gov, 1-800-MEDICARE, or your local State Health Insurance Program (SHIP) to get information on all of your options. Enrollment depends on the plan’s contract renewal.

Every year, Medicare evaluates plans based on a 5-star rating system.