i would never self insure medical in usa.

We are rather new to having to obtain our own insurance, last year being the first time, as DH being eligible for Medicare kicked us off retiree health care and sent me scrambling. The ACA for us is no bargain, so we looked elsewhere, eventually being hoodwinked into buying into a much cheaper plan that essentially provided little to nothing. We are not stupid people, but insurance has been made so complicated that it is unlikely that you will understand it until you need coverage. You don't know what you don't know, including the right questions to ask, particularly when dealing with a salesman that knows the topics to steer you away from. The insurance we went with sounded great, until pretty far in I discovered max coverage was $150K/year. That is worse than self-insuring. We went with the much more expensive ACA for me this year. Being healthy, I am unlikely to use it, but at least now I feel as though my premiums are at least making it easier for those less well off to be insured, rather than simply making a for profit health insurance company more profitable. More importantly, to be part of ACA, there are essential basics you must provide. We still are constantly flummoxed by my plan, and Medicare for that matter, but at least for me it has been positive surprises, not negative, with them covering in full things I expected to have to be paid for until my deductible was paid for.

Regarding property insurance, while ours has gotten much more expensive, we do insure. We are however selling off one of our properties and possibly not replacing it. Insurance and taxes are part of that equation, but not all, as we expect to step up our travel and use 30 day + furnished rentals to explore areas in depth. On our riverfront property we are keeping, we are self insured for flooding. Even if we do eventually get water in the house, the payout is limited, with our already having saved about $85K in premiums. (Flood insurance is much higher for second homes, even when out of the floodplain.) We mitigated the degree of risk with our choice of properties. Many downstream from us get flooded repeatedly. I guess when that property becomes our primary residence, we will re-evaluate with the new premium.

For dental, we pay into something that gives us negotiated rates for dental work. It basically pays for itself just with two cleanings a year, and still offers some protection for bigger jobs like the crown DH needed last year. Regular dental insurance premiums were astronomical for us, once we got off corporate coverage.

IMO, insurance is something you pay for if the alternative could ruin you. Medical insurance is never optional. Product insurance on things like TVs a no brainer to decline. Everything else is somewhere in between.

IP

Insurance is always about balancing risks.