After days of unceasing worry about how to deal with health insurance that will suddenly start costing an additional $5,000 a year because Congress has taken the cheaper product I preferred off the market, I achieved some clarity last night. First, at some price, it makes more sense for me to bank the premiums and save them each year against a medical catastrophe. We must just have reached that price. In the past, I always defined "medical catastrophe" as expensive medical treatments that would be needed for years and years, possibly for the rest of our lives, which might well be decades. Now, a medical catastrophe is only what we may be faced with for a year of treatment, after which we can sign back up, assuming Obamacare is not repealed--and when are entitlements ever repealed?
If by some miracle it is repealed, and we couldn't get reinsured, well, we'd have to join the ever-growing ranks of people traveling to Mexico, Costa Rica, or Asia for some treatments. Anyway, who says the expensive medical treatments are ever going to make sense just because they exist? We'll always have the choice of dying in whatever comfort can be achieved with some morphine. Morphine will always be available one way or the other, if only on the black market. I'm amazed by what my friends at church routinely bring back from periodic trips over the border to the south. We're not quite as trapped as I frantically imagined. It's only in very recent years that people thought there was some alternative to facing illness and death with as much simple dignity and comfort as possible, especially once they'd reached middle age. Maybe the alternative is simply more illusory than I always assumed.
I've also been giving a lot of thought to how to avoid, at all costs, dying in a hospital or nursing home. I've seen how that works too many times now. It came to me: I don't have to. Morphine again. I've seen at least two people now review their medical situations dispassionately and say, no, thanks, not for me. It's not something to save up for or insure against the expense of. It's something to be declined, like an invitation to be tortured to death over a period of months or years. Thanks, but no!
In the light of these realizations, when Congress destroys my health insurance next year, maybe I'm not facing a $5,000 annual increase in living expenses. Maybe I'm about to cut $5,000 out of my living expenses instead, by going bare. (Sure, there will be a fine, but if I had enough income to care, I probably could shrug off the doubled premiums. What's more, I never overpay my taxes and therefore never ask for a refund.) Maybe, for people not working full-time for an employer who provides (and can obtain) what HHS thinks is proper insurance, insurance is simply a thing of the past. Maybe for us, it's a strictly cash-basis medical system from now on.
I haven't decided for sure to go bare. It's possible I can eat the problem as long as the current estimate of our future premiums holds true. But I don't believe it will; we're in a death spiral on enrollment and premiums. Something will have to give. The premiums will have to go up even further. To the extent that the public is clamoring for a change, they're appalled that deductibles are so high, not that they can't buy higher ones. If they get their way, I still won't be able to buy the high deductible I want, and premiums will go up to compensate for the lower deductibles. There have to be an awful lot of people like me who are just now realizing that going bare is now a one-year risk calculation. It's got to fly apart.
Many people have advised me to shoot for some of the wonderful new subsidies they'll be handing out if they ever get the website working. Having assets rather than income to live on, I probably could qualify for subsidies until they get smarter about the needs-based restrictions. I'm of two painfully divided minds. On the one hand, it feels like giving in to a particularly filthy shakedown: we double your costs and then get you dependent on a subsidy to make it humanly possible to pay the new bill. On top of that, it feels not only humiliating but wrong, like taking money out of the collection plate at church. On the other hand, if my church were taken over by smiling, caring thugs who robbed me as I came in the door, maybe I'd feel differently about robbing the collection plate on the way back out.
I feel the social contract has been broken. I have to rethink how I will live with these people. My final moment of clarity last night was this: these idiots should not have the power to cause me to live one more moment in fury and anxiety. I have a good life. I'll keep living it until they come down the driveway, armed, to roust me. If I get sick, I get sick. If the system is going to crash and burn, I'm in as good a position as anyone to make the best of it. After that, I got a good night's sleep.
17 comments:
For what it is worth in such an intimate decision, I think you've thought wisely about all this. As a nation we've gone exactly the wrong way on insurance: we've decided to treat it as a kind of universal need, when in fact not everyone needs to insure themselves at all.
I did without for many years as a young man, and may well again when I am no longer needed as father and husband. My plan wasn't morphine but perhaps hiking the mountains in Alaska until, some night, it just got too cold. Something like that.
One should think about how to die well. It is an important part of life.
The stupidity of Obamacare is mind-boggling. I'm sorry you're having to go through all this. My turn is probably coming up, but not for a while.
Or, maybe it was designed to fail.
Gads -- I just realized that was the same article you linked to before in "It can't fail".
And what the heck. What's the point of worrying about medical expenses destroying our life savings when the bigger risk probably is currency collapse or outright confiscation? I can't control any of this. Time to stop worrying and be happy.
Thanks for this , Texan- your assessment is in close concurrence with my own, and more thoroughly thought through. (not to twist any tongues!)
If it makes you feel any better, this stomping of the social contract in the name of "Progress!!!" isn't unique. It's a persistent feature of the project. Ask the people whose land is underneath TVA reservoirs. It didn't matter what they wanted, or that their ancestors' graves were laid there. It didn't matter that they'd be reduced from free farmers on their own land to some other way of life they had reason to hate. Their land was in the way of water and power, and whatever it cost them they'd have to move.
For that matter, ask the Apache. How do you live with these people again? I'm not sure they've figured it out yet.
I appreciate your musings about whether to take a subsidy. My financial situation is such that I can make my income be pretty much whatever I want. I can, for instance, make it just barely high enough to get me above the "throw her into Medicaid" line and end up collecting such a huge subsidy my health insurance will cost me almost nothing. (I don't think they're going to be able to change basing the subsidies on income rather than assets.)
My thoughts on whether to do that have ended up in generally the same territory as yours: if the Feds are going to tell me what to buy, why not use their money to do so? On the other hand, it is - as I said to a friend a few weeks ago - a crummy deal for my fellow citizens who are actually going to be paying my premium, many of whom are probably in worse financial shape than I am.
My decision is complicated by the fact that, unlike you, my premiums will be about the same, although my out-of-pocket expenses will be higher. And the other element is my reluctance to put sensitive information into what may well be an extremely insecure exchange data base.
And brava for this:
these idiots should not have the power to cause me to live one more moment in fury and anxiety.
But I'm still working on the serenity that will permit me to talk to my sister, my nextdoor neighbor, or my oldest friend. :-)
Grim, I do realize I'm not the first person with whom our society has broken the social contract, nor do I imagine I'm taken a licking anything like some of the others. What is unusual, I think, is the upside these clowns have written off. I'm the citizen they should want to have on board. They need a couple like me for every citizen they'd like to buy votes from by handing out expensive freebies.
But they're dead to me.
But I'm still working on the serenity that will permit me to talk to my sister, my nextdoor neighbor, or my oldest friend. :-)
When you get there let me know - and let me know how you got there. :+)
I think you have the right of it, about the subsidies. There's no way to steal it back from the people who stole it. Any attempt will just end in helping them rob someone else.
I didn't mean to imply I think not taking the subsidies is the right thing to do - or even that there is one right thing for everyone (even everyone who hates ObamaCare) to do in this kind of situation. I can see going either way and I think all of us in this situation need to weigh our own situations and our own responsibilities.
I guess I think about the subsidies the way I think about legislative pork. I have no trouble understanding how a Representative can be absolutely opposed to legislative pork and yet make sure his district gets some. Why? Because his constituents are paying the taxes that fund the pork and it's asking an awful lot of people to expect them to pay taxes and see everyone else getting to spend their tax dollars while they get nothing.
I don't know what I'm going to do about health insurance, subsidies, etc. I need to get some final numbers, look at my financial responsibilities, consult with my family, and so on. I can say that having to weigh these kinds of considerations is one more reason I'd like ObamaCare gone.
I suppose that I'm in an odd position because the insurance I've had since 1996 never did cover routine medical things, so I've been paying out-of-pocket for everything, including oral surgery (just call me "Fang"). So that will not change. What changes is how I'm looking over my shoulder wondering "what's next?" And I don't qualify for a subsidy, as best I can determine, because my "household" income exceeds the minimum even though my individual income does not (it's complicated). I'm going to grit my teeth and pay what I can, because I don't want my family stuck if I get run over by a bus, but home-hospice is looking more and more likely if (G-d forbid) I ever develop a serious medical condition.
LittleRed1
Yeah, I've never in my life had insurance that covered regular things. Even in my old law firm, we had high deductibles, which I can remember hitting only once. Over the years I raised my deductible as I became more confident of my ability to pay big medical bills if they should hit, just as I raised my deductibles on things like home and car insurance.
First-dollar insurance is a horrible idea. It's like buying terrible warranties that cost a big fraction of the price of the appliance. Even if it weren't a complete waste of money, it also steadily divorces the recipient from the payor of the medical services, which more than anything else it what's cost the prices so out of whack.
Can't type this morning. . . . Which more than anything else is what's caused the prices to get so out of whack.
Grim, you would enjoy Alaska immensely, I suspect. Off and on over the years I have spent time on the coast fishing, in the Yukon interior, and up on the north Slope- it is a vast, varied and beautiful land. My fathers ashes are scattered across the headwaters of the Kongakut River. It was a favorite place of his.
Texan, yes on this - "these idiots should not have the power to cause me to live one more moment in fury and anxiety."
This is causing a lot of anxiety, and I fear it is going to further polarize our society- we have friends who are ecstatic about their new "free" health care- and I really do not know how much longer I am going to be able to stay friends with people who think it is OK to force other people to work for them.
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