<prompt> Human: So, with the open enrollment periods why even do this? and the crazy high deductibles and monthly costs of health insurance, I have to ask..why get it? Ive been paying cash out of pocket for all doctor visits and medication, and it has been cheaper than paying for insurance. Sure, something could happen that would cause huge hospital bills, but at that point a type of catastrophic health insurance could kick in if that was a concern. Im a small business owner, and I dont qualify for any special programs for health insurance that I know of. And, since im my own employer I dont have anything there either. Am I missing something here?Assistant: Sure, something could happen that would cause huge hospital bills, but at that point a type of catastrophic health insurance could kick in if that was a concern.If you can afford the high deductibles of the HDHPs then by all means chose those. The problem is, even 7,500 or whatever the deductible is is going to be a sizable burden that many Americans cant afford.So, with the open enrollment periods why even do this?So you cant go without then just sign up the second you get cancer.Human: Im lucky enough to have some decent cash flow, so I may just go the HDHP route you mentioned.I am just amazed nobody mentions how easy hospitals and doctors are with payment plans.From what I can tell and personal experience, just about any issues can be put on a payment plan.Im not sure the process with cancer and the like though. Im assuming it wouldnt be as easy to get on a payment plan at that point.It is just hard to justify paying 500 a month for insurance, THEN also paying a 30,000 family deductible when I can pay cash for a fraction of that.  <response>: Preface this by saying that I work in the industry.1 out of 120 people in the US will have a claim in excess of 1,000,000 at some point during their working years based on todays medical services cost.The frequency of million dollar claimants have increased by more than 85 since 2014.Cancer is both the costliest and most common cause of high dollar claimants claims in excess of 100,000 in a twelve month period.Health insurance has morphed. Originally it was designed for catastrophic scenarios. Back in the 40s and 50s it morphed into a more enticing way to attract and retain employees when the labor workforce was struggling and Unions were competing for employees.Private healthcare coverage should never have been designed to cover regular doctor office visits and standard prescriptions, however, thats what people have come to expect.In standard fully insured health insurance contracts, 40 of the dollars budgeted for health insurance premiums will be paid out to cover the risk associated with high cost claimants. 15 is budgeted for insurance carrier overhead, sales, administration and profit. The remaining 45 is now spent to pay typical claims covered under most plans.Self funded programs are similar but are usually more along the lines of 30 for high cost claimants 5-10 for administrative expenses and fees and the remainder for typical claims.And yes, providers will almost always negotiate payment plans, whether you have insurance or not. 