Friday, December 30, 2016

Saying No to Health Insurance...The Poor Farm Budget 2017

Image result for Obama Care Cartoon




First, a bit of background.

I grew up without consistent health insurance. Depending on the jobs our parents had at the time, neither had college degrees, we had either no insurance at all, minimal insurance like ER visits only, or just plain poor coverage. Consequently, the only time we saw a physician was for required school physicals or when a piece of our body was hanging off at an odd angle.

For better or worse, we survived.

When I was sixteen I started working as a nurses aide and as a bonus, received some health benefits. At twenty five I graduated form nursing school and the health care benefits came rolling in, high on the hog style. For a minimal paycheck deduction I had excellent coverage in and out of the hospital for my children and spouse. This hey day of health care continued for over three decades until I retired from nursing in 2010.

During that time I saw every kind of abuse of this system one could imagine. From patients who claimed toothaches were medical emergencies and clogged up our ER's, to physicians who billed for patient visits when they never stepped into a patients room. I witnessed medical supplies being marked up 300% and insurances being billed astronomical fees for dressing changes or other procedures that took mere minutes.

The US's health care system was destined to crash and it is is losing altitude daily. The initiation of Obama's Affordable Care Act was not the cause of this collapse, but merely a symptom of a convoluted system that rewarded crooked health care providers and third party payers and ruined the health of a people by focusing on the pharmacy of illness instead of on the educational requirements required to promote health.

Our current situation is this. When I returned to college in 2014, I was automatically enrolled in the university's group insurance and the small premium was paid by my Children of Veterans Scholarship. That coverage ceased last May when I graduated. Keith was covered through one of the marketplace plans and received a nice subsidy making his monthly premium very affordable, about $20 a month. Then, when we did our taxes  last Jan. we were fined several thousand dollars because ACA had miscalculated his subsidy based on our income (we were still receiving monthly payments from our contract for deed people on our Chatsworth farm.) It was ACA's mistake but we had to pay.

So we did and we promptly did not sign up for any other plans. A few months later Keith cut his thumb badly with a circular saw and required 17 stitches. The ER bill was over $1500 but when we informed the hospital we had no insurance, they immediately dropped the charges to just over $800, which they allowed us to pay over time, about $100/month. Funny, how the "costs" of treating a patient suddenly lesson, when there is no deep pocket third party to bill.

This year, before ACA's December deadline, we again investigated our options. Based on our projected low income we appeared to qualify for subsidies towards our monthly premium, our out of pocket costs and our deductible. But we also would qualify for our states Medicaid program (with an income limit up to 138% of the Poverty level of $16,200 annually, or around $22,000) if we did not elect a plan through one of ACA's approved providers. So, do we pay anywhere between $20-$100/month with assistance not guaranteed, for healthcare we may never use, within a program Trump is threatening to demolish, or do we take our chances, do all we can to stay healthy and, if a catastrophic event occurs, apply for Medicaid coverage when we need it?

We elected the last option.

Keep in mind, we have no plans to apply for government assistance via Medicaid, even though I paid into that system for decades, but if we must, we will. It's also important to know, all of our children are grown and financially independent of us, if we still had wee ones at home, we'd make different decisions.

Over the years we've pulled far away from modern day physician care since it is the very rare one who doesn't rely heavily on pharmaceutical intervention rather than diet changes, or alternative medicine which was accepted medical practice until the  "alternative" label took hold in the 1960's. Drug prescriptions interactions is the number one cause of death in the elderly and the number of drugs prescribed every year continues to escalate.

It's not just the physicians fault, as many will tell you that patients come into their offices not only insisting on a new prescription for whatever ailment they have, but actually making suggestions for specific drugs and their doses.

We also want to keep as much money in our own pockets as we can, and not toss it into the heathcare wind circling around us, hoping it will benefit it. I'd rather spend the premium money on lotto tickets. It is rare that either of us feels ill but when we do we go to to the basics; lots of fluids like healthy bone broths and raw milk, extra rest, fresh air every day, essential oils for stuffy noses, chests, honey for coughs and the occasional generic ibuprofen, for aches and pains. It is the last over the counter med we use and neither of us are on any prescription meds. We used to be on several meds, but over the last three years we have taken ourselves off them and substituted improved nutrition in their place.

We understand fully either of us could suffer a stroke, an MI, debilitating cancer, but we feel strongly the more we take control of our own HEALTH instead of relying on western medicine to treat our illnesses, the more likely we are to live the life we are meant to live. It's kind of a crap shoot anyway as I cared for patients who never smoked a day in their lives who died of lung cancer and also for patients who smoked constantly and had only hemorrhoids as their big surgical need.

When we told our children of our plan to live and work here on The Poor Farm until the day we croak, one of our sons said to us, "Well, you don't want to just die outside chopping wood when you're 80 do you?"

Yes we do, we answered. Yes, we do.

30 comments:

  1. No you don't. You want to do it when you're 90. :)
    Donna, I agree with everything you've said here. I've worked in nursing homes and the blunt truth is that the #1 cause of death is living. Everything else is just a crapshoot. You've given me a lot to think about.

    ReplyDelete
    Replies
    1. Sebelum saya ceritrakan kisah hudupku terlebih dahulu .saya hanya ingin berbagi ceritah dengan kalian semua para penggilah togel, awalnya itu saya hanya kuli bagunan,punya anak dua,dan istri saya hanya penjual syayur keliling dikampung kami , ekonomi kami sangat pas-pasan, hutan tambah numpuk, anak saya juga butuh biaya sekolah,hidup ini bener-bener susah.Tapi akhirnya ada teman saya yang bilang bila mau merubah nasib Seperti Saya coba hubungi nomor hp AKI ALIH katanya dia bisa membantu orang yang lagi susah. jadi saya lansung hubungi dan saya menceritakan semuanya, tentang keluarga kami akhirnya saya di kasih angka ghaib [4d,] sudah 3x putaran tembus,dengan adanya AKI ALIH saya sekeluarga bersukur semua utang saya lunas bahkan sekarang saya sudah buka usaha. silahkan anda buktikan sendiri insya allah anda tidak akan kecewa dari angka ghaib AKI ALIH bagi yang berminat hubungi AKI ALIH di nomor ini: : (((_082 313 669 888_)))atau silahkan dan saya sudah buktikan sendiri angka ghaib hasil ritual dari beliau Ternyata Bener Terbukti Hasilnya terima kasih. Sebelum saya ceritrakan kisah hudupku terlebih dahulu. saya hanya ingin berbagi ceritah dengan kalian semua para penggilah togel, awalnya itu saya hanya kuli bagunan,punya anak dua,dan istri saya hanya penjual syayur keliling dikampung kami , ekonomi kami sangat pas-pasan, hutan tambah numpuk, anak saya juga butuh biaya sekolah,hidup ini bener-bener susah.Tapi akhirnya ada teman saya yang bilang bila mau merubah nasib Seperti Saya coba hubungi nomor hp AKI ALIH katanya dia bisa membantu orang yang lagi susah. jadi saya lansung hubungi dan saya menceritakan semuanya, tentang keluarga kami akhirnya saya di kasih angka ghaib [4d,] sudah 3x putaran tembus,dengan adanya AKI ALIH saya sekeluarga bersukur semua utang saya lunas bahkan sekarang saya sudah buka usaha. silahkan anda buktikan sendiri insya allah anda tidak akan kecewa dari angka ghaib AKI ALIH bagi yang berminat hubungi AKI ALIH di nomor ini: (((_082 313 669 888_)))>
      KLIK DISINI

      Delete
  2. Isn't that how most critters die in nature - doing what they have to do, to live? :)

    ReplyDelete
    Replies
    1. You're not the first to call us animals. Sure you won't be the last. :0

      Delete
    2. Aren't we all animals? ;)

      Delete
  3. You can understand why so many are queuing at England's doors, where all health care is free. Unfortunately it also means that England sees a lot of health tourism, with people arriving from all over the world to 'suddenly' have serious ailments, or babies, etc. The UK still manages a decent free health care system; it's rather surprising that the US can't do the same.

    ReplyDelete
    Replies
    1. I think the US had a decent system in the 80's. Those who could afford healthcare bought the plans within their means, those who could not were cared for under charity care or Medicaid. Then hospitals, physicians, pharmacies got greedy, billing for anything and everything,and it started to collapse. It will take decades to fix if that is even feasible at this point.

      Delete
  4. Yes, the UK has a wonderful health care system, it's difficult for us to appreciate the need for private health insurance. Although it's not exactly free, it's funded by our National Insurance Contributions deducted from everybodys wages. The slight down-side is the queue for some treatments, which can be jumped by paying private insurance.

    I do agree with your thinking, paying 50 dollars a month is 600 a year, so after 4 years you have 2400 saved for possible medical emergencies which hopefully you'll never need.

    ReplyDelete
    Replies
    1. So my question always is for your country and for the US, if it's funded by those who work to provide care for those who choose not to work (those who milk the Public Aid or Dole system, not the truly disabled) how is that fair? I personally don't believe that health care is a right or the responsibility of our government, since its not mentioned in our constitution. Which is why I so resent being penalized up to $900 per person per year for not having it.

      Delete
    2. I don't know what it's like to live under a constitution. I don't know it's benefits or it's abuses, so I can only explain why we don't tend to view health care as who deserves it. Rather, everyone should have access to it, whether they deserve it or not. If health care isn't accessible to everyone, and if it does discriminate based on income, then it's not going to have enough checks and balances, to keep the system honest.

      While the government is having to pay taxes into Medical care, and wants to win the next election cycle - it becomes a vested interest to create legislations on the medical industry, to prevent extortion. The wrought you spoke about Doctor's who charge for patients they didn't see, that was picked up by our government. Actually, it was picked up by the media first. But once it became common knowledge, the government introduced legislations to prevent that from happening again. I'm sure it still happens, but not as much. As taking money from tax payers illegitimately, now comes with financial penalties if discovered.

      I don't believe our system is perfect, but as to what is fair, we pay according to our income. So some Australians pay more than others. I think it also has a cap on how much can be taken too.

      If you are paying for health care you may not use, pressure your congressman for checks and balances on the industry. Just like any financial stakeholder would do on Wall street. They pressure the board, to deliver better ways to do business, than leaking money. Now that you're paying into it, you're a financial stakeholder. So it has it's perks. :)

      Delete
  5. Not a bad way to go, I think!! Better to die outside chopping wood than end your life waiting in line for help!!!
    Here in Canada, we have a version of National Health Care. It's supposed to mean we all get Care regardless of income or ability to pay. Having a baby or emergency surgery won't bankrupt you here because most of it's covered. It also means you wait in line for Treatment because Trauma or Critical injuries come first. Treatment varies from Province to Province, town to town. Often, it means the injury or illness that could've been fixed if treated immediately becomes a permanent handicap because it took 18 months to see the Specialist. It means people die while waiting for the appointment to get in line for treatment. It means there are no Family doctors when yours retires because the new ones prefer to work in a clinic where they have evenings & weekends off. Walk-In clinics are becoming the norm in Canada. You walk in & take a number. You see a different Doctor each time & they will only treat ONE problem per visit. No one knows you or your history. And more people are using the Emergency room for complex primary care. I always wonder how the famous seem to jump all the lines - you never hear of a Hockey or Football player waiting for surgery!! But the rest of us do it all the time. MSP also doesn't cover glasses or dental or hearing aides. It doesn't cover ambulances or drugs or user fees either. If you're a low income worker, don't get Cancer because you won't be able to afford the treatment even with a National health plan in Canada. We have good care in place but the best way to get it is through an Emergency room via ambulance.

    ReplyDelete
    Replies
    1. I remember hearing in the summer of 2015 how a specialist left the Galway Ireland area and because they had no replacement, appointments made for her were being put back up to two years! Like you said, by the time these folks were seen, they were beyond any simple treatments. Here in the US people think universal health care is the answer to everything, rather than taking any kind of accountability for their own well being.

      Delete
  6. Wow, very interesting post - I didn't realise people in 1st world countries have to think about this as I live in England. Everyone pays into the system if they work, and its free at source for everyone whether they work or not. Personally I can get a doctors appointment if I ring before 11am, and have been seen recently very quickly with eye problems, at the local hospital (within 30mins). My mother has a heart condition, and has lots of tablets but is really active and healthy, Ive had two emergency caesarians, my hubby recently had an accident and has had 4 new teeth put in - I do not know what I would do if i lived in America. Re the Canadian systems waiting times - our hospitals seem to work hard to get the waiting lists down and its in their targets, although trauma comes first and waiting lists get longer over winter I think our biggest problem is health tourism, but hospitals are starting to ask for passports now. Surely someone could come up with a basic health care system for the USA which everyone pays a small amount into each month when they are working and then everyone gets basic health care? It really isn't communism - just treating everyone as you would be treated.

    ReplyDelete
    Replies
    1. Well, if you lived here, you would get treated. ER's are not allowed by law to turn anyone away, but you would get billed for services. Most hospitals will take payments for emergency care but scheduled surgeries would not happen without a substantial down payment, UNLESS you were seen in a mission based hospital where they have charity care programs to pay for care not covered by insurance, AFTER you apply for Medicaid, UNLESS you are not a US citizen then you can't get Medicaid, unless of course you lie about your illegal status then you might slip through the cracks. See? it's simple.

      Delete
  7. The health care we get in the UK is very good and we of course take it pretty much for granted, as you do. It is fashionable to moan about it but anyone I have known in an emergency situation has always been well looked after and received exceptional care. As Cro above mentions, we have health tourists who come over here for "free" health care and although they should be billed for it we have just learned that the Health Service has not been sending the bills out, as if they are incapable of raising an invoice. The worst side of our system is too many managers who have no common sense and no idea how to run a business. Good luck to you and your decision. Personally I keep well away from doctors unless I really need one and if I was in your shoes would probably do the same as are choosing to do.

    ReplyDelete
    Replies
    1. You are right Rachel about managers in healthcare not having any business sense. Fortunately when I was a director of home health and hospice I answered to the Chief Financial Officer on all budget and billing issues. Now with so much of healthcare in the US being run out of corporate offices miles and miles away from point of care, this type of solid oversight has disappeared and thus abuse of the system became easy. Recently in the Chicago area, a hospice manager managed to collect $9 million in illegal reimbursements from Medicare and Medicaid by instructing her staff how to document on patents that did not even exist! She rewarded them with trinkets like new cars. What a peach.

      Delete
  8. I've used both the UK and the US health care service, and also worked in the US system. Of course I was one of those UK workers who paid for National Health from my weekly pay check deduction. I was fortunate enough to be included on my husband's military insurance, in the US and after we retired continued to do so. I saw much of the abuse of over-billing, prescription abuse, doctor shopping, unnecessary ER visits when I worked in our local hospital, I said thirty years ago the system was broken.
    My granddaughter will soon be graduating with her BSRN nursing degree I hope she will be able to find a job.....
    Happy New Year from our home to yours !
    ~Jo

    ReplyDelete
    Replies
    1. Hi Jo, you sound like you've been where I've been, in the trenches watching a slow collapse. I have the opposite concern for my daughter, daughter-in-law, and niece (all RN's). I am afraid they will be flooded with too many patients to care for since the baby boomers are getting old and sick very quickly and the two generations behind them, have harmed themselves even more. In Illinois the nursing shortage is expected to be huge as it is going to be across the nation. Young folk don't as a rule, want to work as hard as we did for so little.

      http://www.theatlantic.com/health/archive/2016/02/nursing-shortage/459741/

      Delete
    2. Donna thank you for this link, it's such an interesting article, and I have forwarded it on to my granddaughter.
      ~Jo

      Delete
  9. I'd like to see a non-profit health care system that covers all kids in school, run through schools, that covers dental, medical, glasses & hearing. Start with the kids. Cover them totally, no matter their family circumstance. Give the future taxpayers a good start!!

    ReplyDelete
    Replies
    1. I am torn on this approach Sharon. I too believe children should have basic medical care but at what point do they become responsible for themselves? Age 16? 18? In the US many health programs allow parents to keep their children on their policies until age 26, which just enables their self-centered "I deserve everything without ever earning it" attitude. Ironically though, a sexually active 14 year old can have an abortion without her parents knowledge. It's a very whacked system.

      Delete
    2. I'm talking about kids in School!! I believe once you're 19 - 21, you become an Adult legally. And I do believe Uni students have medical/dental care on campus. So, I'm talking about kids - as long as they're in school. You quit, then you better get a job!!

      Delete
  10. There are a lot of good points in your post, Donna. In fact, it made me wonder why I am paying into a Medicare Supplemental program when I have no (known) health issues and take no medications of any type, including OTC varieties.

    ReplyDelete
    Replies
    1. It is of course a risk Beatrice, but a statement about our society in general. Life happens, so do we take our money and enjoy it, do what we choose to do with it, or do we insure against every possible bad outcome that might be lurking out there? It's a very personal choice.

      Delete
  11. I agree with what you said about health insurance over here in USA. Having lived in both the UK and USA, I would go with the UK system. Both of course are abused, but I think Health Ins companies in the USA are milking the public and have seriously thought of dropping out of the whole health care ins thing, especially when I work for a company of 150 employees and even at a group rate the health ins for my husband and I is $750 per month, and for a family is over $1,000 per month, that's ridiculous. So personally I think your approach is sound thinking to get off the treadmill.

    ReplyDelete
    Replies
    1. The more I hear from all of you the more convinced I am that this corrupt health care system is on its way to major collapse. In 1985 I paid $16 a month for fully family coverage, now families her are paying hundreds more. Income has certainly not increased at this rate so why should we believe the costs of healthcare validate these atrocious premiums?

      Delete
  12. Under "affordable health care" our premiums jumped from $400 a month to $1200 a month for just the two of us, and with a higher deductible and fewer services. This is almost half of our average take-home pay. Because this insurance is offered through Dan's work, we don't qualify for the government subsidy. Even if we did, I really don't trust them (your story is a case in point.) We did the math and discovered that the penalty for not having health insurance was much cheaper than the insurance itself, so that's what we opted to do. I've worked in health care too and seen the "don't worry about it, insurance will pay for it" attitude. Like you, we know that if we have to have emergency services we can work it out, otherwise we've had better success with alternative treatments.

    The sad thing about Obamacare is that it took the focus off the rising costs of health care by focusing on the term "affordable." As long as the industry pursues higher and higher profits, the cost will never come down. And anytime government (taxpayer) money is available costs go up even more - we see that in higher education. When the government makes more student money available, they all raise tuition.

    Right after the election I heard interviews on NPR with former supporters of Obamacare who were admitting it was a failure. Also that less people have health insurance now than before it became mandatory. But there's a huge battle brewing over preserving it just because it's "us against them." I hate politics. They can keep it as far as I'm concerned, just stop making it mandatory.

    ReplyDelete
    Replies
    1. Your premium tripled. Tripled. And yet ACA supporters still support it. How can it be "affordable" to spend 50% of your income on health insurance?! More frustrating are recent reports and statistics being released by the CDC claiming the percentage of Americans uninsured has decreased from 16% in 2010 to only 10% in 2016. I have to wonder where they've gotten their info and why the Center For Disease Control is tracking insurance coverage instead of monitoring infectious diseases as assigned?

      Delete