As an E.R. doctor in Lousiana, Brian Falkner attends to the kind of gruesome medical cases that would seem to underscore the importance of health insurance.
And yet he doesn’t have any. Nor, for that matter, do his wife or 9-year-old daughter. After they lost their ACA plan last year, Falkner decided to just go without.
He’s happy with the results.
Their spending on doctor’s appointments and prescriptions has come in well under the $1,200 they were shelling out in monthly premiums.
“It’s actually better,” said Falkner, 40.
That is in no small part due to good luck.
No one in the family has encountered any health crises this year, but even the possibility of catastrophe doesn’t give the doctor pause.
Falkner was one of more than 4,000 Americans who responded to a Bloomberg News questionnaire on living without insurance, and among the surprises: health-care professionals who willingly go without coverage.
Nobody knows better how financially devastating a heart attack or even a busted leg can be if you’re going it alone, but that’s how fed up these doctors and nurses are with what they view as a broken model.
“You would think that these are educated folks who understand they’re limited in their ability to predict what kind of health events might happen to them down the road,” said Sabrina Corlette, research professor at the Georgetown University Health Policy Institute.
“On the other hand, there’s certainly a tipping point when premiums keep rising.”
There are no reliable data on how many in the profession are uninsured.
Their income alone would seem to make them outliers.
The lowest-paid doctors -- pediatricians and physicians in public-health and preventative medicine -- typically earn around $200,000 a year, according to Medscape.
A registered nurse makes an average of $80,000 annually.
Some health-care workers make much less and simply can’t afford coverage.
Premiums can be a challenge for those who are well compensated but are independent contractors and not always eligible for employer-sponsored plans, which is the case with many emergency-room doctors.
But for Brad Why, a psychiatric nurse practitioner in Hockessin, Delaware, cost wasn’t the main issue. He canceled his family’s plan this year after developing a “pretty significant disrespect” for insurance companies.
They’re “dictating who is getting what, how much they’re getting, putting limits on the care that you receive and the medication that can be prescribed,” said Why, 49. “I just don’t want to pay them anymore.”
Why found providers will often negotiate with uninsured patients and that appointments can cost less than his co-pays.
He saves the $1,800 he used to pay in monthly premiums. His old plan carried a $13,000 deductible anyway.
Anyone who goes without at least catastrophic coverage, of course, is “rolling the dice,” said Robert Berenson, an internist and a fellow at the Urban Institute in Washington.
True, medical professionals are informed consumers when it comes to health care.
“They know enough to get by,” Berenson said. But “they can get hit by a car, they can get cancer, and no amount of knowledge is going to protect them if that happens.”