JBB’s Final Thoughts Episode 21: Thanks Obama

JBB’s Final Thoughts Episode 21: Thanks Obama. Adding insult to injury, after getting laid off, I get to explore the wondrous worlds of ACA. Everyone wants to blame the other guy. It’s an ugly mess, but worse than that is whether it’ll become a missed opportunity.

Resources:

Transcript:

JBB’s Final Thoughts, episode 21: Thanks Obama

Joe Bustillos, here.

The last couple months I’ve been fighting a cold that just won’t let go. It’s annoying, not really critical, but it’s also contributed to my long pauses between podcasts, ’cause who the hell wants to hear my sniffling voice and I sure as hell don’t appreciate the endless sneezing attacks possibly caught for posterity as an MP3. No thanks. Along the same line of annoyances… well, actually much worse… I spent a goodly amount of time last month staring at my computer screen trying to navigate ACA. Yeah, adding insult to injury, after being laid off in October, I had to sign up for health insurance. Fuck.

Since beginning my first real full-time job at the phone company in 1979 I never really thought about health care or health insurance. Being young and having no family responsibilities, the cost of health insurance wasn’t something I spent any time worrying about. Then for the next 34-years health insurance was just something that was part of working for the phone company, or pubic school districts or for-profit university. Thank God I had good coverage when I was diagnosed and treated for CIDP from 2012 to 2014 or things would have turned out quite differently. My oldest sister suffered from a similar ailment during the exact same time, and only got authorization for treatment from her health insurance the week after she passed away. Yeah, things could have been very different had I not had coverage.

So, this past October the health insurance went away when the job went away and while I continued to look for a job, I still had to get insurance or else suffer getting a penalty on my Income Tax. I started on the Costco website because they promised to make the process easier but ended up on the healthcare.gov website. I work online. I have a Master’s degree in Online Education. The actual website was pretty straight-forward but it was frustrating trying to understand what all of these plans were really offering. I studied the plans for about a week. I consulted with my girlfriend, who as a small business owner had to figure out how to get coverage for herself and her teenage son. Even with my online savvy and expertise, making a decision on what plan to purchase wouldn’t have been doable without my girlfriend’s input.

NPR has a great interview of journalist Steven Brill, who was investigating ACA when he was diagnosed with a condition that required heart-surgery (Fresh Air 2015). Depending on your political stance, this mess is all because of either the evil health insurance companies or the damn government stepping in where they don’t belong. Brill’s reporting is clear that it isn’t any one player that’s completely responsible. With his own recent personal experiences, I completely identify with the notion that when one is faced with the decision to do an expensive procedure, you don’t care how much it costs, you just want to do whatever it takes to get better. When I was getting my IVIg treatments I was told that the immunoglobulin fluids cost around $10,000 per dosage. Over the course of my treatments I received 88 doses, plus multiple MRIs, a spinal tap, physical therapy, etc., etc., etc. In 2014 I had paid out my deductible before the end of January. I didn’t care how much it costs, just do what it take to get better… and in my case, this was all WITH good health insurance (that had been a part of my employee compensation).

So, now, that I’m not currently covered by a work-based plan, the best I could put together was a health insurance package that was going to cost me $500 per month (or $6,000 per year) that had a $6,000 deductible but would cover 100% emergency room or in-network critical care after the deduction is paid for. I think doctor visits and prescriptions are also covered after the $6,000 deductible is covered; No vision, no dental coverage. There were plans with the traditional 80/20 split for office visits, some not requiring payment of the deductible before kicking in. But I figured that, depending on the circumstances I should be able to cover two office visits per year and my A1C medication, but what would financially kill me is if I ended up with a hospital stay or emergency room care, even 20% of that will quickly get beyond $6,000 without having fixed anything. Basically I got a plan that might keep me from having to spend more than $12,000 if I end up in the hospital. There’s no managed care, doctor visits, health maintenance, nothing… just spending at leasts $6,000 a year so that I won’t go over another $6,000 if the bottom falls out. Having gone through what I’ve gone through with my CIDP and IVIg treatments, it’s better than nothing, but it’s also pretty damn close to nothing.

I completely get that the system works better the more participants it has to contribute to the pool of resources/revenues. I just can’t see someone working minimum wage, which currently in Florida is $8.05 per hour or $16,744 per year (before taxes), plunking down $500 per month for health insurance that does nothing except maybe prevent one from financial ruin in the event of an accident or hospital stay. It just doesn’t make sense. Single moms, college grads with huge student loan debt or high school grads aren’t going to be able to afford $6,000 per year for insurance that does nothing. I never realized how expensive nothing can be until I was faced with the reality of being uninsured, and also being unemployed, getting insurance seems all the more ridiculous. I know that Florida is “special,” with it’s unconvicted-insurance-fraud-governor who chose to not put a cap on what insurance providers can charge. Basically, there’s no incentive for providers to charge any less given that the burden is now on the individual to get coverage. And the obvious solution for me is to get a goddam job that has health coverage. I remain hopeful that the “employment solution” will get me out of this mess, but all of that ignores the fact that good healthcare isn’t something available to all.

Remember, I work on the Internet, and the Internet figured out a long time ago that if you cut-out the middle-man and offer your work for less you can get a bigger return because more people will not think twice to spend some cash for what you have to offer. There are a lot of stories of folks doing really well offering their work on Amazon’s Kindle and on the Apple platforms. I remember when ACA was first talked about, there were notions that individual states would create exchanges so that insurance providers within the state would be greatly encouraged to decrease the cost of policies with the understanding that the providers would benefit from having a huge increase in participants. You know, charge less but generate more revenue because more people can afford to participate. $500 a month, that’s the best they can do? And right now, according to Steven Brill’s research, big phrama holding the reigns and government’s inability or unwillingness to properly regulate the insurance industry are the two chief reasons this current plan doesn’t deliver on its promise. I don’t blame Obama (despite the headline of this post) and I certainly don’t blame the health care professionals who have done their best to see me through some really tough times.

It comes down to our cultural confusion associated with who should get healthcare and even the idea of health care as a business and not a common good. The fear that I hear connected to the idea of removing health care from the for-profit world is that it will eliminate our drive to innovate and work toward all of the great medical technologies that we seem to be enjoying. But the problem is, as a “whoever can afford” mindset, who cares about the innovation if I can’t afford to get the treatment. It’s a very complicated issue, but the IVIg treatments that enabled my recovery were rejected by my sister’s insurance as too experimental when she developed symptoms five-years before it developed again in 2012.

Is it so impossible for us to imagine that everyone should get meaningful health care for a reasonable cost and if we all participate, then the medical professions, the research scientists, and yes, even the investment bankers should be compensated for their efforts. ACA isn’t it, but as long as we continue to NOT see the benefits of everyone getting coverage and see medicine as primarily a money making venture then this opportunity to really do something good with our national wealth is going to be lost and wasted and forgotten over time. I was lucky. My sister was not. It shouldn’t be this way.

Thank you for spending this time with me at JBB’s Final Thoughts, please check out my website at joebustillos.com (spell out)… for more of my musings and thoughts. Catch you later, bye-bye

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