Last week I ran into a problem with my vision. It wasn't major at the time, but it was worrisome. I had blood in my eye. I called and made an appointment with my optometrist, fully expecting a referral, but the earliest I could be seen was today, Tuesday.
Yesterday, not wanting to wait another thirty hours for the eye appointment I had set up for this afternoon, I called and asked if I could be seen sooner. Nope. Booked solid, but he asked me what was going on. I told him. He said (not quite, but it could well have been), "Great Scott! You have got to see someone right now!!!!" It was pretty much the last bit. The "You have to see someone right now" because he told me to call a retinal specialist immediately.
Long story short, I am not on the verge of losing some or all of my eyesight in my left eye. I do not have a retinal tear (which could affect my sight quite badly) or detachment (which would mean I would be blind if they couldn't fix it). I don't need surgery. I do, however, have a blood speck in my eye - which is what I'm seeing and what led to all of this.
It's an almost tear - a not quite tear where the gel that fills the eye has drawn away from the retina. If it had done so with force, I would have a tear and a blind spot pending repair involving surgery. If the surgery worked, which is not guaranteed.
With all of that though, and all of the expense associated, it got me thinking about Obamacare - the "Affordable" Care Act that was enacted a couple of years ago.
Do you realize that even though I am going to be out-of-pocket about $1,000 for all of this - $300 for the first doctor I saw, plus almost $500 for yesterday's visit to the retinal specialist, plus the charges I'll incur for the follow-up I have scheduled for Thursday, I am still ahead of the game without having health insurance?
If I had signed up through my company in January, I would have paid $500 per month for ten months in premiums. Out-of-pocket $5,000 to date.
Then, because of the $6,000 deductible the policy I considered carries with it, I still would have had to pay from my own account the $1,000 for the services I'll receive related to this.
So, instead of $1,000, my expenses thus far would have been $5,000 in premiums to date (January to October, for this year) plus $1,000 out of pocket for deductible expenses for a total of $6,000. And that's "Affordable".
No, thanks. At an 80% savings, I'll self-insure.
Now, if I did have to have surgery, there would be the question of which is cheaper. According to the nice lady with whom I spoke at the retinal specialist's office yesterday, the expenses for their services for yesterday's visit and the surgery and post-op would be about $2,300 to $2,500. Then there would be the hospital, the anesthesiologist, and nurses and all of that on top of it.
I still think I would have been in the black on that one. Because the premiums for me for one year are $6,000, plus the $6,000 deductible before benefits start opening up, that's a $12,000 window.
Say, $2,500 for the specialist, plus outpatient surgery of $6,000, plus the other expenses. It probably wouldn't have been more than $9,000 or $10,000, total - still under the $12,000 I would pay in premiums and deductible. Then, on top of the $6,000 premiums, if I was still under the $6,000 benefits threshold, I would still be paying the majority of cost for this stuff.
Hmmm. So, $6,000 for premiums plus $6,000 to satisfy the deductible = $12,000 versus $8,000 out-of-pocket. Which do you think is more affordable?
Looking at it from that perspective, the "Affordable Care Act" is anything but.
No, thanks. I'll self-insure and I suggest you think about doing the same.
Yes, there are fines being imposed by the IRS, but they're not as onerous as the premiums and deductibles which, I've heard, have gone up somewhere in the range of 30% to 40% in the past year.
You do know why they made this a mandatory thing, right? It's so you will pay for everyone else who can't afford the Affordable Care Act. They knew it would be too expensive for many. There are almost as many uninsured people now as before the law was passed and enacted. It's just that now, someone like me who cannot afford the $500 premium plus the medical outlay is a criminal. I'm breaking the law. How does that work in a democratric republic such as this country is supposed to be?
Oh well. That's a discussion for another day. In the meantime, stay healthy and have a lovely day!
Best~
Philippa
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Well, Phillipa (if this is your real name), let me know how "self insured" works when you actually have a medical emergency and have an ambulance trip to a hospital, have an emergency surgery for something as simple as a burst appendix or something, and then have to pay out of pocket all the expenses for the ambulance, the hospital, the doctors and surgeons, medications, all of which could easily exceed $30,000 to $40,000 minimum. What will you do then - declare bankruptcy and walk away from the bills, which only shifts YOUR bills to other patients (the hospital/doctors simply pass those bad debts on to others). So before you suggest others "self insure" think about the ramifications of doing so regardless of whether you personally agree or disagree with Obamacare. Oh, in case you hadn't heard, the penalties for not getting insurance are going up next year to check your math - you may not be coming out ahead.
ReplyDeleteThanks for reading and commenting, Anonymous.
ReplyDeleteI don't propose my solution for everyone, not at all. However, I do not like working to support myself and my family, and work to support my neighbor's family, and their neighbor's family and so on.
It's a choice for each person to make and, being someone who respects and appreciates what the Founders envisioned for this country, it bothers me that politicians who swore to uphold and defend that document have done exactly the opposite.
And, for the record, if I was faced with something catastrophic, I would not shirk my responsibility as you tell me I would. Beyond that, why should I pay someone else's bills?