Wednesday, July 9, 2014

How To Financially Survive the American Health Care Disaster

This piece is predicated on two things. That you have some disposable income and that you currently do not have health insurance.(and know this- many of you will soon lose it.)

In 2007, I was able to retire early at the ripe old age of 46. It had always been a dream of mine not to spend my entire life toiling away for someone else. In the America of my dreams- life planning, hard work, discipline, determination, denying myself big ticket purchases, and saving- might allow me to pull that off. My American dream was contingent on freedom and the expectation that government or anyone else for that matter, would not be allowed to steal my money.

I'm not talking about an opulent life. I am talking about being able to afford a decent house, a new car, and enough money to travel when I want. Those things are attainable- but you have to live frugally. Frugally does not include paying 500 a month for health insurance coupled with an annual 2000 dollar deductible. That rounds out to something like 700 dollars a month or roughly- what I pay for my current mortgage.

In other words, I did not live my life saving every penny that I could just to turn around and piss it all away because some imperial President and his left wing puppets think they should be allowed to seize my money and redistribute it. There were no reforms, no spending caps, no cost caps. There was no due diligence. Obamacare stands as the worst law of my lifetime. It is the absolute antithesis of freedom. That the Supreme Court allowed this sham to stand is proof positive that we no longer have a Republic- we have a mob run democracy.

Health care costs were already out of control and barely affordable in the early 2000's after Rubin, Congress, and Clinton removed Glass-Steagall in 1999. With the help of a complicit and co-opted Congress, bankers were able to destroy what was left of our economy with the worst lending and accounting standards ever conceived. I use destroy in the past tense- because there have been zero reforms since the 2008 collapse. After the collapse of 2008, healthy and young people lost jobs and healthcare by the millions. I was one of them. Instead of stepping up and punishing those responsible- this government of theirs because it's surely not a government of ours- decided that innocent folks like myself needed some additional financial screwing to help keep the insurance and health care industry afloat.

This is how I've survived. Let me be more specific. This is what I have done to survive in America without health insurance for the past 7 years. I am 53.

The first thing I did was the most obvious and the most difficult- yet I believe that most Americans lack the will to do it. I got healthy.

No more drinking alcohol, smoking cigarettes, or eating that shit that they sell you in the grocery stores. Corn syrup is garbage and they put it in everything. I won't use ethanol in my car because it strips my car of performance and gas mileage and I consider corn syrup- the equivalent of  human ethanol. Your body does not know how to process corn syrup because it does not know what is is. I quit eating a whole host of "cheap carbohydrates" as well. Back in 2007, I was faced with a few looming health issues. Potential diabetes brought about by the shit I was eating and drinking, a complete lack of exercise, and lugging around an extra 80 pounds of fat which was not only hard on my circulatory system- it was creating stress and pain on my knees and ankles and actually preventing me from exercising. So I changed my diet first and quit drinking. As I was losing all of that excess weight, mostly from dietary changes, I introduced a simple exercise plan that included walking 5 miles a day every day of the week. I quit using tobacco. Today I run 2.5 miles a day and I lift weights. I still fight weight gain. I am a member of Planet Fitness which costs me a paltry 10 bucks a month- money well spent.

Once you've done everything you can do to mitigate your own personal health risks- find an independent doctor. Independent doctors are not beholden to giant hospital and health care systems- which means they are not required or encouraged to prescribe unnecessary imaging, tests, and other services unless they need to. One of the greatest health care con jobs in America is the doctor who loves to order un-necessary diagnostic tests because you are insured. Doctors also love to reduce their exposure to malpractice suits with tests which essentially prove nothing and cost thousands.

I am never afraid to weigh my costs against the expected results. If your doctor is somehow offended because you question the need for testing- consider getting a new doctor. I have had two bad experiences, oddly enough both were with female doctors, who were miffed because I questioned the efficacy of what they were trying to accomplish while they were ordering tests which cost me money, serious money. They are so used to burning insurance money that they don't even know what their ordered tests cost anymore, nor do they care. I make a habit of asking- and the truth is- this makes some doctors uncomfortable.

Interview doctors and dentists. Get cash prices and make payment plans. If they don't want to help you- move on. There are still compassionate professionals out there.

Many small and independent labs- and some "doc in the box" type clinics- will provide routine blood work for fractions of the costs of hospitals. I have monthly routine, blood clotting or protime tests. One local hospital charges 100 dollars a month for this testing while my local "doc in the box" arrangement costs me 14 bucks. That's a savings of 1000 dollars a year.

I am currently shopping for a colonscopy- cash price. I  am not afraid to leave our state and get it done outside of Idaho and maybe spend a night in an Oklahoma hotel if need be. The costs of a colonscopy are outrageous and can vary from 1500 to 5000 dollars or more. Getting it done out of state with a cooperative referral is possible with an independent doctor.

Prescriptions. Drug companies are granted 20 year patent protection on drugs they research, develop, and bring to market. Patent protection gives American big pharma a license to steal. Gilead Sciences recently developed a hepatitis C cure which they are selling for 84,000 dollars or 1 thousand dollars per pill over a 12 week period. This is the kind of monopolistic and insane pricing that can only be brought about when desperately ill people need treatment from greedy and protected drug developers. What's a fair price for Gilead's drug? Probably something far less than 84k but it's not like you have any regulatory body checking profit margins once big pharma gets a monopoly license. ww.newsweek.com/insurers-worry-84000-hepatitis-c-drug-sovaldi-could-break-bank-252539

Fortunately the internet has changed the rules of the prescription drug game. Where big pharma once had a captive U.S. audience- many of us have found ways to escape. I routinely use Canadian pharmacies. Would you rather pay 250 bucks for ten tabs of Viagra at a U.S. Walmart or 15 bucks for 10 tabs of Viagra (or its generic equivalent) at Northwest Pharmacy in Canada? 

I recently paid 75 bucks for a 35 gram tube of steroid cream at a local Walmart. I found a 50 gram tube, same strength, in Canada for 22 bucks. That's a savings of over 200%. 

Several years ago, I had friends who frequently traveled to Mexico to buy prescriptions for 1/20th of the costs they incurred in the United States. These were the same drugs produced by the same manufacturers. In a sense, American consumers and their health insurance plans, have subsidized the costs of drugs all over the world.

Behold the rise of ala carte and cash based surgery clinics. http://www.beckersasc.com/asc-turnarounds-ideas-to-improve-performance/cash-pay-surgery-centers-a-trend-for-the-future.html

When you take responsibility for the costs of your own health care- it's amazing to see how quickly and dramatically the costs can come down. It's almost as though you have to become part risk manager- part insurance adjustor and eliminate all of the waste and fraud yourself.

Despite all of this, I am still faced with two dilemmas. In the event of a catastrophic illness or traumatic injury- I will not be able to pay. Obamacare has never offered a true low priced- catastrophic plan. The other problem of course is the looming and enhanced penalties of 2.5% of your income for failing to obtain insurance in 2015 and beyond. I don't think I'm going to pay the penalties and that's my bottom line. I have already considered consulting with an anti Obamacare attorney that I am familiar with. I am quickly becoming one of those people who is growing weary of federal extortion and over reach. Maybe they will have to build new prisons for all of us health care dodgers and then of course- provide health care once we are all confined.

Finally, we may get a health plan we can afford.



  

 










11 comments:

Compleat Patriot said...

See ya in the pen. We'll sing America the beautiful or something.. I'm done with this outfit, they can throw the key away.

Brian said...

We shall play cribbage and talk about the good ol days.

IRISH said...

You know Brian, You could always track this woman down and save a shitload of cash I'm sure ;)

http://www.dailymail.co.uk/news/article-2677020/Cops-Truckers-duped-woman-impersonating-doctor.html

Jim at Asylum Watch said...

Good on ye, mate! You may still want to consider going a big step further and move south of that border you refered to. For what you're paying on your mortgage, you can lease a fabulous apartment or house. Places like Mexico, Costa Rica, Panama, Equador, and Uraguy offer excellent medical services at very reasonable prices (in dollar terms). Plus, if you know the name of the medicines you need, you can buy them cheap at any farmacy without a doctors prescription.

(You notice I did not recomend the country I live in.)

Adrienne said...

Brian,

We lived for most of our life without insurance. For a few years we had a catastrophic policy and I'm sorry we did it. If we had put that money in the bank we'd have an additional 40K or more in the bank.

Catastrophic illness? Set up a payment plan with the hospital. Hospital bills are unsecured debt. It is unlikely that they would try and get a judgement against you. If they did, all they can do is put a lien on your property.

And.........the only way they have to collect the penalty is to take it out of any refund you may have coming. Make sure you don't have a refund coming (which you should be doing anyway.)

PeterE said...

Did I mention the system is broken? Oh, and here in Australia you can't find high fructose corn syrup in anything. But I wouldn't recommend moving here, we are moving in the same direction you are. Jim at Asylum Watch is on the money (Costa Rica sounds nice), or just move to Canada.

Anonymous said...

Let's all grow beards and raise a barn!

Aren't the AMISH exempt?

Are their religious exemptions?

Anonymous said...

A fellow self-insurer buddy of mine, was having chest pains at 55-ish. He, like me, will only go to the hospital if a DEFCON-4-situation. He went in to the local hospital emergency room, and they wisked him in, and kept him over night. All the testing and overnight stay cost like $6,600. He was charged for a private room, even though he had to sleep in the hallway, as no rooms were available. He's a self-made millionaire, but told him I can't pay this. So he worked out a payment plan, and is paying it off monthly. Just a comment on the insane costs, and a way some others deal with it.
Dental is killing me. Costs are insane! I'm going to get a dental plan. My dentist and doctor give me 10%-off their outrageous fees for paying cash. I hadn't been to my doctor since 2006. And I only went then for a physical I was nagged into getting. I had a mole removed. It was like $200-to cut it off, but the test on it, was like $600? I called and asked the lab at the hospital if this was correct? They said yes, because a cancer specialist had to analyze the results, but if you pay it today, it'll be $475. A phone call saved me $125.

Brian said...

No HFCS? Wow. I have thought about Canada. Just too cold Peter- getting sick of fighting sub zero temps.

Brian said...

I spent 1600 on a root canal/crown last year and I think the dentist cracked my tooth during the procedure. For a year I lived with some intermittent pain and eventually a month ago- he pulled the tooth. My mouth was sore for three weeks. Dental has cost me far more than anything else. Hell, it's not even close.

Anonymous said...

I shopped for my colonoscopy also-found a doc that would do it for $400 and by using his hospital and paying them in advance in cash, that cost was $800-I told the doc my ride had the check and when I woke up, she would give it to him-he waited until I awoke and got his check.

I'm with you on ObamaCare-I have absolutely no intention of providing any medical information to the IRS nor am I paying any fine-I have always paid cash for my medical costs and should I get into a position that requires 100s of 1,000s for some medical procedure to save my life, it's adios earth, I'm off to the next plain.

Your health plan is how I've lived my whole life except I still enjoy a little wine or a cold beer on occasion-I'm 62, in perfect health(knock on wood) hit the gym every morning and have a positive outlook-stick with it dude, it's the only way to go.
MM