Monday, March 22, 2010

On Health Care

It's no secret that I'm against the Health Care Reform Act that passed through the House yesterday evening. I think the title Health Care Reform is a misnomer, because it does nothing to reform health care. Let me say this with as much clarity as words allow:

Our HEALTH CARE SYSTEM will not change. Only who pays for it. We'll still be getting the EXACT SAME health CARE that we receive now.

So, this bill should be called the Health Insurance Reform Act, because the basic premise is that it will open the doors for more Americans to have access to health INSURANCE.

Earlier this year, the company Deus Ex Machina works for went through a change in ownership. He is one of the key personnel in the company, and the old owners knew that if the new company was going to be a success, they needed to make sure that he was still there. So, he didn't get laid off with the rest of the company. Instead, his pay was reduced by two-thirds, and his benefits were cut entirely. No health insurance.

I was a little freaked out, at first, and so I started looking into private coverage for our family as a self-employed business owner. There are only two companies that offer private insurance in the state of Maine at a cost of between $700 and $1200 per month for catastrophic coverage. This was a bare-bones policy with no bells or whistles for five, relatively healthy, non-smokers with no pre-existing medical conditions that would cover us in the event that one of us developed some serious medical condition. The plan covered some basic routine care (with a 20% co-pay), like annual check-ups, but if we needed physical therapy or other alternative/preventative care, we would have had to pay for it out-of-pocket, while still paying insurance premiums and co-pays.

At the time, we decided to find a doctor who would accept cash payments, and we did. We found a medical co-operative with several different types of physicians, including a few who are trained and practice alternative healing techniques. They do not accept insurance. Pateints pay the bill and then have the option of submitting the bill to the insurance company.

In practicing this way, the co-operative is able to keep their costs down to something that is more affordable for the average person/family. In addition, they have a more holistic approach to medicine. Their pre-patient questionnaire is six pages long and covers everything from dietary habits to one's satisfaction with one's life. They understand that our body is a completely integrated system, and sometimes what might seem like a problem that's isolated to a shoulder, is actually caused by bad shoes. It's all interrelated, and once the doctor has done the initial evaluation, he/she will refer the patient to another person on staff, if it seems like he/she needs another consult.

Benjamin Franklin said, "An ounce of prevention is worth a pound of cure." Our current medical model forgets that sage advice. We don't really engage in preventative medicine or care. Most of our medicine is based on catastrophic care. After the problem, which could have been prevented with some lifestyle changes, becomes a serious health issue, then, we treat it with medication and surgery and comprehensive care, but we do very little to keep it from happening in the first place. I don't believe this bill will change that.

According to what I read in the Health Care bill, the government will subsidize out-of-pocket expenses for medical care after the first $12000 per year. This amount is for expenses above what the insurance company pays, but does not include premiums or deductibles. So, from what I understand, if the bill passes through the Senate, and if my husband's company chooses not to provide us insurance (again), we will be forced to pay between $8400 and $14,400 per year just to have insurance coverage, and then, I have to pay the first $10,000 to $12,000 of medical expenses before the government will even kick in their two cents. That's almost $30,000 out of my pocket, before I even get any help from the government.

If I had $30,000 sitting around to pay my medical bills, I wouldn't need insurance. Right?

It could well be that I am misunderstanding what the bill will do. Perhaps the insurance companies will be compelled to offer me a lower premium per year. Perhaps this bill will force more insurance companies to offer private policies to Mainers, and with more competition, we'll have more choices.

The fact is that Mainers who do not have private insurance and fall below a certain income level already have government-sponsored insurance, which pays medical expenses at a better rate than the catastrophic insurance plan that people like Deus Ex Machina and I will be forced to carry.

The whole issue is very frustrating for me, because as I understand it, I'm going to be forced to pay for insurance premiums at a cost of more than my mortgage - and that bill will never be paid off. It will be a debt that will carry over month-after-month, year-after-year, and we will never be able to consider quitting our jobs and living self-sufficiently, because the cost of private health insurance would be prohibitive and to be eligible for employer-sponsored health insurance, one has to have a job.

The very bottom line for me is that Deus Ex Machina and I have been working and struggling for the past four years to reduce ... reduce our consumption with the ultimate goal of being able to reduce our income, and thus gaining financial freedom. We'd hoped to be able to pay off our mortgage, reduce our consumption of things like electricity to what we could produce ourselves, and earn money in the informal economy to pay for incidentals.

With this new legislation, we may not be given the opportunity to realize that goal. We may not have the choice of working or not, because we'll have to pay insurance premiums for the rest of our lives.

Thanks to this new Health Care Reform Act, we're good and stuck - wage slaves so that we could be in compliance with the law.

Or, we could engage in Civil Disobedience, and refuse to have health insurance ... which would carry a financial penalty, which if we refused to or were unable to pay could result in the loss of our property.

I feel very stiffled here between this rock and hard place.

Update: One of the big draws of the Health Care Reform for a lot of people was the assumption that access to insurance would equal access to quality care. This may not be the case, as a recent article in the Wall Street Journal points out: with thirty-two million new patients, getting in to see the doctor may become more difficult.

So, we're paying more money and getting less care than we were getting before. Where's the reform?

This calculator will show you what you might be paying for health care under the reform. For us, it's no better than what I found when we tried to purchase private health insurance last summer.


  1. Yes, Wendy, our personal conundrum is that we are shooting for an abundant lifestyle OUR way, which would mean below what others think of as a poverty-level cash income but absolutely no debt or overhead and with most of our own needs met by ourselves, our own hands. We simply plan to work our way out of dependence, and what is "normal" to most folks as far as car payments, health insurance costs, mortgage payments, we factored in the equation at such a reduced rate (our own choice) that it's almost laughable to others. In fact they'd probably pity us or think we just aren't progressive citizens and all that. But we want to mind our own business and live for free as much as possible, with our work being upkeep. Prevention figures in higher than any other health matter now to us. It's something no dollar figure can account for. Jack's a VA vet, and I'm 15 years younger than he is, and neither of us wants unusual measures for major illness. I need a minimal healthcare, or else to gain control of my issues myself without it and that means without trips to the doc, unless out of pocket cash. We even want to be buried on our own property (looking into how that's done) at the end of life. But I tell you what...nobody but nobody has the right to impose the dollar amounts mandatory insurance MUST cost. It's not in our budget, not for now and not for the longterm, and I don't believe in killing ourselves for something not self-sustaining. I'm waiting for the day they start putting liens on property for those who refuse imposed healthcare if it comes to that. That's why we have to fight like the dickens to try to keep it from happening. Thanks as always for the great post!

  2. Ugh. I have NO CLUE what this stupid bill is about. I did at one time, but they kept dicking around making it "better" and now I've lost track.

    I personally see it as a bandaid.

    Yeah, lets make sure everyone has health insurance (and where's the money going to come from to police the people who choose not to get it and break the law?). Never mind worrying about getting uninsured people jobs that provide health insurance. Why fix the big picture? God bless America.

  3. my guess is that it is collapsing anyway, and that this may very well speed that up a little. Health care was and is a sham anyway. But I think that if we are poor enough, we shan't have to worry about this mandate stuff.

  4. I agree - this is just a few more cards to an already gigantic house of cards. Assuming it does get underway since there are all sorts of legal challenges on the way from states due to unfunded mandates. Nothing to do but keep an eye on the news, vote, and keep prepping.