Hey You! Don’t **** With My Unaffordable Healthcare

Healthcare has been essential for me to live a healthy life, the last 46 years as a Type 1 diabetic. ObamaCare has made that and making a living as a self-employed consultant possible. But my gut tells me those eager to Repeal it have little incentive and fewer ideas how to Replace it.

The system has problems but I’ve kept the same doctor across every year of changes. Looking at 58% increases out of pocket for 2017 are terrible, but losing access looks worse.

Not by any means as cheap it was when I was a kid, a gallon of milk cost an average of $3.28 in 2016. That’s relatively affordable.

Let’s say that starting in 2017, the price of milk is jumping to $5.19 per jug. And until you meet your Bovine Deductible, your out of pocket costs will be $9.68 per gallon.

Affordable still?

Don’t worry, I made that up.

But this is true.

In November I learned that my QUOTE/UNQUOTE “Affordable Healthcare” premiums would be going up 58%

In what rational universe is a 58% increase allowed for something labeled “affordable”

What part of affordable do I not understand?

Maybe I should be relieved as the average premium increase in Arizona is 116%.

Focussing on the Elected Ones

It’s just a hunch, but it seems that the people complaining most loudly about repealing ObamaCare are ones who have employer paid health plans. Nice perch.

But heads up politicians — think carefully before ****ing over 20,000,000 voters, or here in Arizona, over 200,000 of them.

I’ve been reading closely the Indivisible Resistance Guide, taking in that ranting in social media accomplishes noting (as does writing pieces like this one). But what I do get is that action needs to be aimed at my Congressional Representative and two state Senators. So once I finish writing this long winded post, copies will be printed and mailed to:

All three Republicans are lined up together as harsh critics of the [Un]Affordable Healthcare Act with same arm waving suggestions for competitive alternatives.

I am going to ask them what they are doing to keep me and 200,000 others in Arizona from losing access to healthcare, affordable and unaffordable.

My letters will be followed by phone calls on this issue to these representatives and in person questions any chance I can to go to where they are publicly speaking.

The irony is that all members of Congress get Obamacare insurance plans purchased through the Marketplace. But get this — Congressman Gosar and Senators McCain and Flake have access to the top gold plans under the lower rates that small businesses pay. And guess what? The US Government (aka from yours and my taxes) pays 72% of their healthcare costs.

What a sweet deal. Where do I get that plan?

Unavailable to me. Or most of the people in Gila County where I live; the majority of people here work for small business or are self employed. Census data from 2015 show that only 42% of the population of Gila County have employer provided insurance and 17% have no insurance.

Data Point? Take Me

While the Republicans gleefully count the days until they can start slashing and looting the Government, 20 million people wonder where the **** they are going to get healthcare after 2017. All we have are campaign promises.

Healthcare is batted around like a beachball, spoken about as if it is a single entity.So as a public service, I am prepared to offer insight into one of those 20,000 million data points.

Yes, me.

The one getting ****ed over this year on premiums and fully expecting to be cut off after 2017.

First of all, as a Type-1 diabetic since I was 7 years old, I would be classified before ObamaCare as from (excuse the poor taste pun) the basket of uninsurables. Skipping health insurance is not even something to consider. But the insurance needs of a person with an ongoing chronic condition is not the same as someone needing “just worst case” scenario.

I have never been hospitalized for any issue related to my diabetes; the last significant treatment I had for laser treatment in my eyes in 1993 which has successfully stopped diabetic retinopathy.

The second key about my data point is that I have been self employed since August 2012 (I am an educational technology consultant); I was able to continue coverage from my last employer under COBRA coverage until February 2013, when I was able to sign up for ObamaCare.

Here’s what I have paid per month for health insurance in that time, all 80/20 plans from Blue Cross Blue Shield (the name and details have changed every year). These rates were somewhat consistent until this year.

What will 2018 bring? Another spike up? Or just an termination of the graph.

What I Spend Money on as a Diabetic

As a diabetic my pancreas does not produce insulin, the hormone that converts the food eaten to energy the body can use. Until 2006 my treatment was multiple daily injections; that was the year I switched to an insulin pump.

Boy was I lucky. My health insurance provided by my employer covered the entire cost. The good old days.

“The $6,000 Man” flickr photo by cogdogblog https://flickr.com/photos/cogdog/4773288007 shared under a Creative Commons (BY) license

When the warranty on that pump expired in 2010, under the insurance of a different employer, for a list price of $6000, with trade in of the old pump, my out of pocket cost was only $300.

The next one I got in 2015 under my ObamaCare insurance; the list price was now almost $10000, the trade-in was a lot less, leaving me with an out of pocket cost of $900.

A new pump will be a financial bite every few years; but there are ongoing costs for the 3 day insulin reservoirs and the tubing/infusion set which connects the pump to my body. The list price for 3 month supply of both items is $1300; with insurance that costs me $42o.

“$500 Worth of Meds? Affordable Health Care?” flickr photo by cogdogblog https://flickr.com/photos/cogdog/24410761961 shared under a Creative Commons (BY) license

A three month supply of insulin, 8 vials, would cost me $500 without insurance (instead I pay $100).

The other key part of managing diabetes is regular blood testing. The scheme here is much like razors; the meters they give away, but they get you on the cost of test strips.

“A Good Diabetic Number Too” flickr photo by cogdogblog https://flickr.com/photos/cogdog/24885912065 shared under a Creative Commons (BY) license

My Medtronic insulin pump comes with a Bayer Contour test kit. What helps is that it wirelessly sends my readings to my pump, which then I can dial in how many carbohydrates I will eat at a meal, and the pump calculates a proper dose.

Sadly (or strangely) Blue Cross considers Bayer Contour test strips a Tier 3 item, which means my 3 month supply would cost nearly $300, while One Touch test strips (not compatible with my pump) are covered at Tier 1 and cost $20 for a three month supply. I gave up trying to find out why similar items are priced so radically differently.

Fortunately I found the test trips I needed on Amazon for $65 for a three month supply. So I do an end around my insurance company

The other fun part of the insurance game is that for 2016 Blue Cross Blue Shield had separate $400 deductibles for prescriptions (insulin) and the insulin pump supplies (durable medical equipment). So last January, when I needed both refilled, I had to layout $800 just to reach the deductible. This year the deductibles went up to $450.

The first rounds of supply costs each year is a double dose on top of premiums. So I try to get as much ordered before the end of the year.

What I spent in 2015 on Healthcare

A lot.

  • Medical and Dental Insurance Premiums $7368 (13% of income)
  • Dr office visits and lab work copays $242
  • Prescriptions and supplies not covered by insurance $4197 (7% of income)

Because the year before I decided to roll the dice and skip dental insurance, I had some major work in January 2016 that cost me $3300 (a long story, and an example of the pitfall of trying to go “without” insurance).

My total out of pocket medical costs for 2016 was $14,865 or 25% of my income.

I won’t have that expensive dental wallup this year, but… the 58% jump in insurance is going to be even more than that ($4800).

Because of my income level, I get no tax credit for insurance.

I wonder of my Congressional representatives have to pay a quarter of their income for health care. We cannot even speculate about the incoming President since his finances are buried deep inside the center of the earth.

About My Lavish Lifestyle

“Red Dog Gets to Play” flickr photo by cogdogblog https://flickr.com/photos/cogdog/25543360612 shared under a Creative Commons (BY) license

My luxury ride is a 1998 Ford F-150 with 170,000 miles and dents that may never get fixed. I do not have penthouses or golf course homes; my mansion is a 960 square foot modest house built in 1977, complete with wood paneling. I have nothing gold plated.

My fixed living costs- mortgage and utilities are about $1000 per month. I have $0 debt on credit cards.

I thought maybe I could make up the extra $380 per month for insurance premiums in 2017 by spending less on groceries. My average monthly food budget is $400. Diabetics don’t do well on $20 per month for food.

Or maybe I spend too much on designer clothes? No I spent a whopping $535 on clothes… in the entire year. Mostly jeans and t-shirts.

Here is my biggest expense for 2016:

“Oh, Those Eyes” flickr photo by cogdogblog https://flickr.com/photos/cogdog/27175342084 shared under a Creative Commons (BY) license

I adopted Felix in April from the Payson Arizona Humane Society. The kibbles, vet fees, toys, kennel boarding cost me $2200 in 2016. Plus $1700 to extend my backyard fence.

Yes, that is disgustingly extravagant.

But Felix and I have walked over 5 miles per day since April. In that time I lost 22 pounds, bought those basic jeans in a smaller size, lowered my blood glucose levels, and stopped feeling the pain in my lower back I was feeling last year.

I think that this canine investment has been good for my health. While I won’t get a tax deduction, I get great company

Prepping for The Repeal

I have zero faith that the eagerness of the incoming agenda to dismantle Obamacare will be followed with a replacement- to date the most detail we have heard for a plan is “something different”.

I’m not waiting around for “something else.” I am counting on being cut off from my unaffordable health insurance. It’s virtually impossible for someone with diabetes to get health insurance without the current regulations against cutting off people with prior conditions. I looked into in 2012 and it was not pretty.

Even if “something else” guarantees coverage, they can squeeze you out with insanely high deductibles. Or they can pull an epipen move on insulin making the costs of critical drugs prohibitive.

I will continue to buy my blood test strips from Amazon, where they are cheaper than insurance covered suppliers. From a recent NPR story I discovered Glucomart, a reseller of overstocked or near expiration diabetic supplies. I see I can buy my insulin pump reservoirs and infusion sets for a lot less than what my insurance provides. I am researching the possibilities of buying insulin in another country.

So “affordable” healthcare means finding other sources for critical supplies.

If “something else” turns out to be “de nada” I can do fewer doctor office visits, or take start taking medical trips to Mexico. But I am hosed if I ever need hospitalization.

This is not the route I prefer. I want affordable healthcare; I want to pay for it. Why do we have this inefficient system of “in and out” network, and different pools for individuals, small business, and apparently Congressional representatives and staff? If it were up to me, the “something else” would be a large universal single pool.

I am envious of the subsidized healthcare coverage that you have, Representative Gosar and Senators Flake and McCain. And I am going to be asking you all, a lot, if and why you are going to jump to Repeal and not Replace.

We, the 20,000,000 currently insured, are holding you to the promise to keep us covered. True affordability would be a nice bonus.

Stay tuned. Stay active. Stay asking questions directly to your representatives- not in social media.