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is only what we may be faced with for a year of treatment, after which we can sign back up, assuming Obamacare is not repealed--and when are entitlements ever repealed?
If by some miracle it is repealed, and we couldn't get reinsured, well, we'd have to join the ever-growing ranks of people traveling to Mexico, Costa Rica, or Asia for some treatments.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.