"Under the Affordable Health Care Act, I have the option, as a relatively productive member of the American workforce, to keep the insurance plan I already own."
I've been "grandfathered" in. Whoo-Hoo! Way to keep that promise fearless leaders!
But there's a catch. To keep the plan that our family has, the rates will increase 23% on August 1st. Whoa, wait a second. That's like saying I can keep a deep thigh bruise if I agree to sprain an ankle too.
A 23% increase? That translates to approximately $235 more per month for "the plan I already have." The plan I already have is over a $1000 per month for a family of four. That's right, $12,000 per year in health care costs, not counting a $20 co-pay every visit, plus a $2500 out of pocket deductible.
Let's be honest -- it's a really crappy plan. So, what are the options?
#1 Change doctors. We could drop out of the network of doctors we're in and erase the August increase on its way, plus move about 15% in the other direction for a net savings of $150 /month. That wouldn't be terrible, that is if we didn't have doctors we like, who know our history, who are able to see us in a decent amount of time, and who have decent track records.
But wait... even that has stipulations.
#2 Changing doctors includes a change in co-pays, or +15 dollars per visit. It also ups lab testing +20 dollars per test. If just half my family goes to the doctor in a given month and has a blood test, then we're only saving $75 per month. If a blood test and a urine sample or a throat culture is needed, the savings are cut even further. Emergency visits, ambulance rides, and other procedures are all higher.
Still, $75 is $75 right? I mean, that's quite a savings for totally uprooting your health care network (sarcasm intended). A savings of $900 per year, maybe a little more, could put my wife and children into the hands of a brand new set of physicians that we don't know, that may be many more miles from our home than our current physicians,
#3 We change doctors, we change co-pays, but wait... I forgot about the deductible increases. The deductible on the new plans jumps to $3500 out of pocket. There goes the savings... in fact, we are back into the increase range. So now we're actually paying the system to uproot our family health care history.
There is another option ... we could pull our family out of insurance altogether. I mean, if we're already going to have to pay $30 per visit anyway, why not negotiate a cash price with our doctors? Even if they charge $80 for a routine visit, our family of four could go to the doctor 12 times per month before crossing the $1,000 we pay in insurance. Even if we each went to the doctor once per month each, we'd have about $700 laying around to pay for lab work or the occasional fractured bone.
But what if something bad happens?
Enter the HSA arrangement, which was of course McCain's plan to begin with. A single-payer system was the way to go anyway, so both McCain and Obama had it wrong. You don't fix an insurance problem by selling people more insurance. But I digress.
#4 An HSA would save us approximately $475 per month, doctors stay the same, co-pays stay the same, labs increase, and the deductible moves to $5300 max out of pocket per person, or $10,000 max per family. The money saved basically equals the amount any one of us would have to pay out in a major medical situation. If two of us are sick or injured, it becomes yet another increase.
Then there's the $6,000 (maximum) tax write-off that comes directly off the bottom line by saving that $475 per month. Not too shabby!
It's still a roll of the dice though. A good year will net significant savings which could be used to meet the higher deductibles in the bad years. It's a dice roll that I would have gladly made at 30 or 35 years old. In fact, if I had done so 15 years ago, given the fact that I've had little to no problems (knock on wood) over the last 15 years, I would have generated well over $100,000 increase to my net worth. Enough to pay for one and a half heart transplants outright, max-out-of-pocket not even considered. Enough to seriously stimulate the local and national economy if millions like me had followed suit.
(Do you see why HSA's and single payer systems were the way to go? It might have worked at 30, but it's risky at 45 or 50 years old...)
#5 Oh, but wait -- I am forgetting something!! I could lower my family income and qualify for reduced payments. Here's how it would work for my family -- I could move to part time and lower my income by about 1/2. Doing this would put my family into some significant health care "savings" at the expense of all you other hard working suckers.
Under this possibility, my health care would again drop by around $450+ dollars per month.... for the exact same coverage, me keeping my doctors and everything! I would get two weeks off every month, or 25 extra weeks of fun and family time every year!
My income would drop considerably (but so does my insurance!). Even so, I certain I could make that up by fencing stolen goods or selling drugs. Extortion, prostitution, fraud, illegal gun sales, bank robbery, kidnapping, selling cocaine, cooking meth, or maybe working odd jobs "under the table" to keep from reporting income ... there are a host of ways for me to enjoy my "time off." I might even be able to use my cheaper insurance plan to stock up on quite a few prescriptions of Hydrocodone at $10 per bottle, maximizing my "non-taxable" income!!!
Heck, I've got plenty of time of my hands now to get creative and I am certain that I'm smarter than the average criminal. Tax evasion is big business. Idle hands are the devil's playground for sure.
Bottom line is a lesson from the Tao te Ching:
"The more laws you have, the less virtuous people will be."
The incentive should be toward work, not away from it. Then again, the new law doesn't do much to motivate businesses to even hire... so it's a problem working on the American public from two directions.
It's a real mess ladies and gents. America already spends more on health care per capita than any other nation in the world. When will we wake up and see that the problem isn't one more money can fix, but rather the fact that no one in this country gets what they pay for?
