Similar to @letterpenny, I've only heard of people forgoing insurance because they cannot afford it.

That $2,000 bill was probably just written off. Or it was sold to a collection agency and this person hasn't received a new bill yet.

The typical cash discount is 40-50%. So if you're good with 50% off a $300K surgery, have at it.

This is definitely a trend I’m seeing and hearing about more as well. For years I had great company insurance but I took a buyout in 2020 and I’m now self employed. I found a health sharing company through my real estate brokerage and it’s been a great switch. They actually coach us to tell these healthcare places that we are cash pay because it is so much cheaper. If we have a major procedure then they shop for the facility and it can be fully covered without anything out of pocket because it saves them so much more money. It’s a good deal.

I recently changed insurance plans due to a move, and I used a broker recommended by a friend to navigate the process because it has become cumbersome (For years I had an old pre-ACA plan that was really good until premiums became unsustainable). The broker said that part of the reason costs are going up is that people are choosing not to pay their bills. I was skeptical, thinking that the system is broken and that medical debt can be crushing. There are good patient advocate orgs that help people negotiate bills and identify shenanigans by medical providers that result in much higher bills than should be the case. They helped me reduce an absurd urgent care bill by identifying illegal upcoding by the provider. Unpaid bills can indeed go to collections. Willfully not paying bills without good faith negotiations affects more than just an individual patient. It may be a symptom of a broken system, but we all feel the effects of this “individual” choice.

It depends on the place you need services from. Some will let it go, others will sue you and get a lien on your property or your wages garnished.

Heck, you can also get away with not paying rent to your landlord in some cases. All depends if they make the effort to take you to court over it. But calling it a good idea is a stretch.

As far as the TikTok goes, he is mistaken in assuming that insurance companies pay the charged amount from the hospital and get no discount. Whether the discounted charge is more or less than what an uninsured person pays varies wildly because our system is too hectic to be logically organized.

And if he was offered a plan that costs $800-$900/month and can’t get a subsidy , that means he’s making 6 figures. Not saying the decision to carry insurance is right or wrong for him. But someone making $50k would not be facing the same numbers.

Irresponsible and terrible advice is pretty much what that platform is known for, however if it's a common sentiment in that generation then maybe that generation will be the ones to finally change US' healthcare system for the better.

It depends on the place you need services from. Some will let it go, others will sue you and get a lien on your property or your wages garnished.

Heck, you can also get away with not paying rent to your landlord in some cases. All depends if they make the effort to take you to court over it. But calling it a good idea is a stretch.

As far as the TikTok goes, he is mistaken in assuming that insurance companies pay the charged amount from the hospital and get no discount. Whether the discounted charge is more or less than what an uninsured person pays varies wildly because our system is too hectic to be logically organized.

And if he was offered a plan that costs $800-$900/month and can’t get a subsidy , that means he’s making 6 figures. Not saying the decision to carry insurance is right or wrong for him. But someone making $50k would not be facing the same numbers.

IMHO, depending on the kindness of others is not an adult strategy. I am responsible for my expenses. You can assume the risk or you can transfer the risk. Buying insurance is the way most adults transfer risk. Trying to get someone else to assume your risk is childish.

I was uninsured for 3 years following my divorce. At the time, I was very lucky. No major issues arose. But I lived always aware of the fact that I might be partially destroyed financially if something major happened.

I didn’t go to the doctor unless I was sick or had a major issue, but as a fairly healthy person (knock wood) I was lucky. I did the math using the figures available to me at the time and benefits would’ve cost me about $16,000 a year. As a single mom who needed to do things like eat and pay rent, it just made no sense to spend that much money every month just in case of an issue.

When I did get a bill for something major, I contested it and appeal to the financial aid offices. I did end up spending about $1200 for a hospital visit that provided me one bag of saline that I did not need. I learned to Never Pay the First Bill. (it’s a book, highly recommend! And the website based on the author’s work is gold - definitely check it out - I’ll add it in a comment) and to differentiate between when I needed to go to the doctor and when I was just concerned about something.

It was a good financial decision for me at the time, however, hindsight is the only way I know this - and setting up a GoFundMe to pay bills, planning for someone else to take care of it, feels like a bad idea, but the system is entirely broken and dysfunctional, and if everyone did that, they might have to fix it. (I have not watched the video because I do not have TikTok.)

As a HCP for over 30 yrs , my wife and I finally walked away b/c the healthcare business model is terribly broken. I can understand where the TikTok influencer is coming from. And maybe one option is to get catastrophic Health Insurance for the potential long hospital stays and intensive treatment - I'm not familiar enough to add info on that type of coverage

The other concern here as a parent is the position of the friend's mindset . Unlike the Tik-Tok person , the friend has no intentions of paying any of the bills they have incurred and would be willing to put the burden of his bills unto others by starting a Go Fund Me. As a parent with older children myself , that would be a follow up conversation to my adult children.

I mean yes it is a growing sentiment. Our medical insurance system in the US is broken. We pay hundreds or thousands of dollars a month for premium and then have a large deductible that has to be paid before insurance covers maybe 80% if they decide it’s something they want to cover. The younger generation are tired of seeing it and have seen that they are charged less for cash payment so they do go that direction. Why our country allows insurance companies or hospitals are allowed to be for profit companies is something I cannot comprehend but we all know that’s not going to change any time soon. Essential structural societal utilities (healthcare, utilities) should not be allowed to be for profit companies IMO.

I'm in between your kid's ages and have never heard of anyone doing this intentionally. Some of my friends don't have health insurance because they can't afford the plans available to them, but it's a "close your eyes and hope for the best" situation, not an intentional strategy. That seems like a recipe for disaster especially as they/we all get older and medical issues (potentially) pop up. A Go Fund Me is not a plan, and it's scary to see people saying that.

As someone who didn’t have insurance for years and now I do. You truly don’t know when an emergency hits when you will need it.

For myself I used to pay out of pocket for emergencies when I was younger (young 20s) Made more sense than paying $400/month. However, when I got in a car accident unexpectedly and was not at fault for the accident it truly hit me that the health insurance was worth it. I ended up saying no to getting medical care and the pain caused by the accident ended up hitting me the next day. It was a head on collision where they crossed over into my lane. Then having the other drivers car insurance pay for everything was a nightmare when I did finally go to a doctor and then a chiropractor. I ended up having to get an attorney to get my medical bills covered.

I personally wouldnt recommend taking that chance now after what happened to me. But older more wiser FI-ers might be able to give more insight why going insurance-less would be beneficial

On a different note, for your friend who hasn’t paid their medical bill. I would be curious if the phone calls stopped because the bill is at collections. speaking from my own experience again from my younger years. I had that once happen over a $200 bill and it was sent to collections then months later they were mailing me notices and the collection agencies themselves were calling me.