The D Word

The patient has NOT fulfilled his deductible.

Those are the words that appear at the bottom of the explanation of benefits from my insurance provider. Over top of that is a graph that shows how much the insurance paid for my surgery. The answer? Predictably zero. Zero dollars. Nada. Zip. Zilch. Nil.

I pay my insurance like anyone else... about $600.00 a month, or $7,200 per year. And on top of that, I have a $2,000 deductible for each of us, (Em and me). So, that means, in simple terms that in order for my insurance to really "pay" for anything, I have to spend $7,200 first. Except prescriptions, I don't pay a lot for those.

Now, at the ripe old age of 37, I have never, ever spent $7,000 on medical anything. I know I am only a few tests and a polyp or a tumor away from that number, which is pretty small in the face of a hospitalization. But, really?

For my recent surgery, I had a doctor's consult which cost me money, an MRI which cost me a lot of money, another test which cost me money and a surgery which cost me a lot of  money. When all is said and done, it all combines to cost me less than $2,000. But the insurance still didn't pick any of that up because of my "deductible".

Well, so should I just "deduct" insurance out of my life?

Because of the aforementioned and unavoidable tumor or polyp or car accident. I scarcely know anyone who gets out of life alive without some sort of hospitalization. Which assumes some sort of hospital bill. There are no small hospital bills.

And when it comes down to it, I can pay the $2,000 without selling off the family silver or hawking Grandma's mink, (back then fur wasn't murder, it was cold outside). But what about all the people that are low/no income earners who will soon be forced by the universal health care plan to have insurance?

I am not asking because I am espousing a particular view... I'm asking because no one seems to know, or want to tell me what happens to those people. And anyone who claims to know has a different answer from the last person who claimed to know.

From what I gather:

A. Great, now I have insurance and I can finally get all that work done I need... Holy shit! What's a deductible? I can't pay that! What a scam. Well, they'll have to send it to collections and take me to court and garnish my wage so I will have to get some sort of assistance  because now I can't afford to eat.

B. Great, now I have insurance premiums that come out of my check so I am taking home less money. And to top it off, I still can't afford to go see a doctor because of the deductible, so I guess I'll just have to pay and not receive any services in return.

C. I ain't buyin' no 'surance from no gubment. This is 'Merica! And I'm 'Merican! Then, I guess according to the plan (at least from what I have heard) is that Jimmy Rick Joe Bobby will have to pay higher taxes because he didn't buy insurance of one form or another. Wow... that doesn't seem 'Merican, either. But again, and I don't know if this is fact so don't go getting your britches all in a hitch, the IRS doesn't think it can constitutionally enforce that levy!

D. Nosotros no hablan Inglés, y aunque yo nací en los Estados Unidos, mis padres son ilegales. Así que me temo que el gobierno va a utilizar este programa para encontrarnos y separar a nuestra familia.
Por lo tanto, mis padres están abandonando sus puestos de trabajo y tomar los nombres de mis tíos para que podamos solicitar prestaciones por desempleo. No confiamos en el gobierno y la Piensan que están tratando de dividir y deportar a nosotros. 
(We do not speak English, and although I was born in the United States, my parents are illegal. So I'm afraid the government will use this program to find and remove our family.
So my parents are leaving their jobs to take the name of my uncle so that they can apply for unemployment and food stamps. We do not trust the government and think they are trying to divide and deport us.  )

E. I'm an insurance company executive. I am so glad the government made everyone in America have insurance, because we want everyone to be healthy and live forever... so they can buy more insurance! And because those suckers pay us whatever we charge for anything, because, and I'm letting you in on a little secret here, the government... Doesn't know anything about insurance! Whooo, dog... these are good times, indeed. Good, good times.
And since every consumer is beholden to our industry, we have more latitude than ever to charge whatever the hell we want to and no one can do a thing about it! We all cry about how it cost us so much money to insure the previously uninsured and someone has to pay. Hey, I guess it's you!

F. My name is Bill Uebbing, I am a Business Development Manager for a mid-sized building services company that operates in 8 states and has about 1200 employees. We are in a cutthroat industry where every cent counts. The only reason people use a contract company like us is because we can do a better job for less money than if they tried to do it themselves.
The problem is, companies have been squeezing us for 10 years. We are doing jobs now for less than we did then. And the companies still want us to give more.
What happens when we have to provide insurance to all 1200 employees? We will certainly have to raise our prices. This will cause the financial and economical advantage of having a contractor to virtually disappear causing businesses to look at us as a middle man.
Once the economic advantages are gone, many companies will "in source" their services because it will become cheaper for those people to be company employees.
My living will dry up and I will be unemployed. I will lose my house, I will have my cars repossessed. I, once a member of the working middle class, the class that supports the backbone of this country, will be poor.


I guess I don't know the facts on health care or Obamacare or whatever you call it, but I do think I know this much... the government doesn't, shouldnt, cannot care about you in that much depth unless you are shooting someone, being shot at by someone or planning to do either of those things.

Why should they even try?