Health Insurance -- Hard Pill to Swallow

     I never noticed what health care cost back when I was working during the 1970s, '80s, '90s and into the 2000s. My company took a few dollars out of my paycheck. The amount went up a little bit, from year to year, but not as much as my salary -- and besides, it was a minor blip in my financial picture.

     Then I got laid off. I went on COBRA and had to pay the whole bill. I was absolutely stunned at how much health insurance costs.

     I did some research and found I could do better than my old company, which offered what we now call a Cadillac plan (but from what I hear from old colleagues, it doesn't anymore). I got a little better deal through my professional association; but it was still breathtakingly expensive.

     My insurance bill went down after my kids transferred onto their own plans. But now, in the last couple of years, it's started shooting up again. By 16% last year. And a proposed 20% to 40% for this year.

     As I outlined in a previous post, Affordable Health Care for Early Retirees, I haven't been blaming my insurance company for high insurance costs. I figured if medical insurance was a profitable business, I'd be getting solicitations by mail and phone and Internet to sign up with Prudential or Aetna or Allstate. After all, various companies are always trying to sell me life insurance or auto insurance or home insurance. If they're not trying to sell me health insurance, it must not be very profitable.

     In fact, it's hard to get health insurance. You have to have connections in order to get medical insurance. Like they're doing you a favor.

     And besides, I've seen what doctors and hospitals try to bill people for their services -- from my daughter who recently went to a clinic for a sore throat and was billed $383 for a five-minute visit, to my friend who got a pacemaker, stayed in the hospital overnight and went home with a bill approaching $100,000!

     The insurance paid . . . not all of it, but most of it, by far. How can that be a bad deal?

     I do not claim to be an expert on medical financing. But in my admittedly unscientific poll last week, the majority of responders did blame the greedy insurance companies for high medical insurance premiums. And a couple of them must know, since they used to work for insurance companies.

     Some 42% of the votes said greedy insurance companies were primarily responsible for the high cost of medical insurance. Just 23% blamed the high cost of medicine. About 12% blamed overuse of the medical system by well-insured people. Only a couple of people blamed Obama.

     Dr. Kathy McCoy at Living Fully in Midlife and Beyond said, "My feeling -- as a retired healthcare professional -- is that the biggest problem in escalating healthcare costs is the unfettered greed of the big insurance companies. I hated dealing with them when I was in practice because they would refer a patient to me and then I would have to fight for (at times) up to a year to get paid. But I most hated hearing stories about people who had faithfully paid premiums being dropped the moment they really needed care or being denied coverage due to pre-existing conditions."

     June of Aging Gratefully said, "I worked in the insurance industry. It was property and casualty insurance, not health insurance, but in some ways there isn't much difference. Greedy insurance companies are The Bad Guys in this situation."

     Still, I think Dianne from Schmidleysscribblings has a point when she says, "We need to look at our own contribution to the mess . . . Health insurance costs will continue to rise as long as those who can use the system whenever they can. Everytime an effort is made to rein in costs by advising that perhaps some tests are not necessary, such as mammograms, the outcry is so loud, the insurers, regulators and doctors back off."

    Plus, I know plenty of people who run to the doctor with the slightest ache or pain. It only costs them the $20 copay. So why not? It probably does run up costs for everyone -- but is it really significant?

     It's a complicated issue, and even the experts haven't been able to solve it. But still, I'm looking at that letter from my insurance company, and I'm beginning to wonder . . . 20 to 40%? Really?

     Probably the reason hardly anyone blamed Obama for rising medical insurance costs is because not much of the Affordable Care Act has come into effect yet. So the impact is yet to come. Obamacare does an admirable job of extending access to health care for many Americans, including us early retirees. That's certainly a good thing. But anyone suggesting that Obamacare is going to lower medical costs is drinking the Kool-Aid.

     Annie Lowrey of the New York Times reported on an Oregon study showing that uninsured people who gain health insurance "feel healthier, happier, and more financially stable." But it also concluded that despite some savings from better practices, such as keeping people out of emergency rooms, the insured spent about 25% more on health care. The conclusion: "Expanded coverage brings large benefits to many people, but it is also more likely to increase a stretched federal government's long-tern budget responsibilities."

      Better health for more people. But at greater cost, at a time when it's hard to argue that we can easily afford it. Two sides to the same coin. No wonder Obamacare has been controversial.

     Now this past weekend the New York Times in "Doctor Shortage Likely to Worsen with Health Law" revealed that experts project, even without the healthcare law, by 2025 the shortfall of doctors in America will exceed 100,000. Factoring in additional medical coverage from Obamacare, the shortfall will be over 125,000.

     That can't be good. Gee, I wonder what my insurance increase will be for next year?
    

How Do We Reconnect with Family?

     My older sister came to visit for a few days. She's six years older than I am. As children, we slept in bedrooms right across the hall from each other, but we barely knew each other. Yet, somehow, now that we're older and live a thousand miles apart, we've become closer.

     When we were growing up, well, frankly, she didn't have much to do with me. She had her own friends and her own interests. By the time I got to elementary school, she was already in junior high school. By the time I got to high school, she had gone off to college.

     She tells me she used to babysit for me and my other sister (and by her account, we were both a pain in the neck!), but I don't remember that. I just remember her as this older girl with long dark hair and a big white smile, who loved Joan Baez and thought she was a Beatnik (even though we grew up in a lily white suburb).

     Our family of six usually did have dinner together -- the one time of day when everyone got together. But even then, she sat across the table, and down one. We never talked directly to each other, one on one. We never played together; never did anything together except on the rare occasion of a family outing -- which usually meant driving up to my grandmother's house for a holiday.

     By the time I graduated from high school, my sister was living in a New York City tenement and working and going to graduate school. Then she got married and moved to Virginia, then Tennessee. She got divorced and moved to Florida, where she eventually remarried and where she's now been living for the past 30 years. During this period, I'd see her about once every two or three years, for Christmas or a birthday at our parents' house.

     My parents eventually retired to Florida. I would occasionally go down to visit them, but still I hardly ever saw my sister. She lived in northern Florida; my folks had moved to South Florida; and we rarely visited my parents at the same time.

     My mom died in 2000. My dad was all alone, and before long he got sick. Coincidentally, about that same time, I was laid off from my job. So I now had time to go visit my dad in Florida and help him out. Every time I went to see him, my sister and her husband were there, taking care of his affairs, arranging medical tests and office visits, offering support and comfort. While I was there, my dad worried that he was a burden on us, didn't want to be a big problem in our lives. He insisted my sister take a break and go shopping; he arranged for my brother-in-law and I go play golf together.

     My dad was 90 by then, and he didn't last long. But during those few months, I spent more time with my sister than I had in all the time growing up as a child. I'd barely met her first husband, but spent a fair amount of time with her second husband. Later, when I drove down to Florida to help dispose of my parents' effects, and cart home a few family mementos, I stayed overnight with my sister on the way to my parents' house, and then again on the way home.

My older sister, in the middle, circa 1962

     After I left fulltime work, I started going down to Florida for a couple of weeks in the winter. I'd stay with my sister for a few nights. We'd go out to dinner, walk the beach, talk about our family, and her husband and I would play golf. She in turn began to make summer trips up north. She's stayed at our house a couple of times; and once, she came to visit for a few days when we rented a place on Cape Cod.

     In short, we've become the friends as older adults that we never were as children. Recently, she even friended me on Facebook!

     I wouldn't say we're close; she still lives a thousand miles away and has her own life, as I have mine. But it's nice to reconnect with your family, after all these years.

     And I wonder, is this typical, have others had the same experience . . . of losing touch, then reconnecting? 

Can You Explain It?

     I just don't understand politics . . . or people, for that matter. Or, B argues, much of anything else either. Which is why I hope you'll take my poll, to the right.

     But, be that as it may, consider:

     We all know it's the Democrats, or people in the Blue states, who support Barack Obama and his health care plan. And people in the Red states are opposed.

     Why are people against the health care plan? In part because it requires people to buy health insurance. It forces people to take responsibility for their own medical bills and pay their own way. But wait a second! That's a Republican principle; it's the conservatives who preach individual responsibility, personal autonomy, self-reliance and the importance of paying your own way. The Democrats are the ones who want to get other people to pay for their problems. This is ass backwards!

     The other reason people oppose the health care law is they're afraid it will cost them more, as the government raises taxes to pay for insuring all those uninsured people. (Check out 5 Obamacare "Myths" that Are Partly True.)

     In fact, those people are correct. The new health-care plan will levy a tax on people who sell their primary residence. But only for people who make over $200,000 a year ($250,000 if you're married), who also make a profit of over $250,000 on the sale of their house (or $500,000 if you're married). The tax will be 3.8% of the profit above the limit.

     Where do people sell their houses for a $250,000 or $500,000 profit? Not in Red states like Mississippi or South Carolina, that's for sure. It's in Blue states like New York and California. 

     There will also be a 3.8% surtax on investment income, again for people making over $200,000 a year, or $250,000 if you're married. And an additional medicare tax of 0.9% -- again, on people making over $200,000 a year.

     The new taxes are levied on people making over $200,000 a year. Where do these people live? They live in New York, Connecticut and New Jersey. They live in Washington, DC, and the Maryland suburbs. They live in Illinois and California. These are all Blue states, where the vast majority of people support Obamacare. These people are in favor of taxing themselves for the Affordable Health Care Act.

     Meanwhile, people in the Red states are against taxing other people for the health plan.

     Like I said, I don't understand.

     But here's another thing I don't understand. According to latest figures I've seen from the federal government, inflation in our economy is currently running at less than 2%.

     But I just got a notification from my health insurance provider. They're applying to my state insurance commission for rate increases for next year, ranging from 22.6% to 40.1%, depending on whether it's an individual or family plan and on other variables. For me, the increase would be either 22.6% or 35.6%. I can't tell, because I'm not exactly sure which category I fit into, and I don't know where to locate the fine print to figure it out. And besides, what difference does it make anyway? There's nothing I can do about it; I'm completely at the mercy of the insurance company.

     And by the way, this increase is on top of a 15.9% increase that took effect for this year.

     I know that medical costs are rising. But not by 20 or 30%. So why the outsized increases in premiums? According to the notice, they "reflect increases in the cost of individual medical services and the increased use of those services." Plus, there's an additional 1.5% increase added "due to the addition of new women's preventive services benefits required by the federal health care reform law," and another 0.6% added "due to the addition of new benefits for autism spectrum disorder required by state law."

     Now I know many of you are on Medicare, and likely don't care about private insurance increases. I myself am looking forward to getting on Medicare before too long -- but it won't be before these increases, and probably some other ones as well. (And after I get on Medicare, what's next? Looking forward to an early death to avoid those unaffordable medical expenses?)

     So you tell me. What's going on? And who's to blame for these ridiculous increases? Go to the poll and tell me what you think.

Summer Blogging Boomer Carnival

     I just watched a PBS documentary on Ansel Adams (1902-1984), who took the famous photographs of Yosemite and other natural wonders. He reported that when he stood in the midst of nature, positioning his camera among the tall mountains and the beneath the spreading sky, it made him feel very small -- and yet, at the same time, not at all insignificant.

     A similar note is struck by Laura Lee at The Midlife Crisis Queen in the Mid-summer Blogging Boomer Carnival, Garden Edition. She also offers links to other sites and sensibilities, including -- for those who are interested -- a link to Vaboomer and her tricks and tips for using Twitter.

     Go enjoy!

   

A Meating of the Minds

     The child is the father of the man, according to William Wordsworth. It was my daughter who got me to be a vegetarian.

     Well, not quite. But close.

     My daughter gave up meat when she was in high school. At first she just stopped eating things that looked like they came from an animal -- a pork chop or a chicken leg. They grossed her out. She still ate hamburgers and other super-processed foods from fast food restaurants. But eventually she gave up meat entirely. I remember the last item of meat on her personal menu was chicken McNuggets from McDonald's. They looked nothing like any animal -- just an oblong piece of food you dip in some tasty sauce.

So cute!

     But finally she gave up McNuggets as well. "I don't eat anything that has to die," became her motto. She still ate cheese and milk and eggs. (Okay, the eggs are questionable, but I'm not judging, I'm just reporting.)

     The last two years of high school, and throughout college, she was a strict vegetarian. She ate lots of pasta and tofu and other soy products. And whenever she came home, she was never shy about lecturing us on the cruel conditions at slaughterhouses and the health hazards of ingesting animal products.

     She finally got to me. I started noticing bits of gristle and bone in my hamburgers, and when I did, they didn't seem so appetizing. A pork chop started looking way too much like an animal's rib, and a steak, to my mind, became nothing but a hunk of flesh wrapped around a bone.

     But I couldn't go all the way. I love fish -- swordfish and salmon and shrimp and scallops. They taste good and are light and full of protein. And most of all, they don't remind me of a barnyard.

     I also decided that chicken would be okay, and turkey. So I gave up red meat. And you know what? It didn't seem like a sacrifice at all. Not to me anyway.

     B, my significant other, complained at first about how this cramped her style in the kitchen. Plus, her kids live on hot dogs and hamburgers. But I didn't mind if she cooked up a ham or a meatloaf. I just ate the potatoes and the veggies and the bread. Spaghetti? No problem. She makes the tomato sauce and the meatballs, and serves the meatballs on the side. And when we have a cookout, I just throw a turkey burger on the grill next to the regular hamburgers. A turkey burger is just as good. And besides, when you get finished adding on the cheese and the lettuce and tomato and ketchup and pickles, who can tell the difference anyway?

No thanks

     I've been on my no-red-meat diet for about five years now. I've lost a few pounds (not many, because I haven't cut back on desserts) and my cholesterol is down by about 15 points. Nothing major, but every little bit helps.

     I don't stand on any high moral ground about my semi-vegetarian life. I figure, something's got to die in order for people to eat. That's the way the world works. But I do occasionally think about those poor cows being led down the chute, and then the guillotine drops, the knees buckle, the animals drop to the ground and bleed out. And then the butchers start hacking away at the meat and bone and sinew of the animals, and if something drops onto the floor, they just pick it up, spit on it to clean it off, and throw it back into the hopper. And if they nick themselves in the process and a little of their own blood gets in there as well -- aah, nobody will notice.

     I've just decided that red meat is kind of disgusting. It's not for me. You guys . . . you go ahead, cut the meat, gnaw at the bone, lick up the blood . . . I mean the juice on your plate.

     I don't mind. But for me, please pass the potatoes.

     Meanwhile, my daughter is now grown up, and she no longer subjects us to her self-righteous lectures about meat when she comes over for dinner. Indeed, she's softened her vegetarian stance -- I've seen her nibble on a piece of fish or take a bite of beef.

     Last time she was here she drove me over to the mall. There, on the floor of the back seat of her car, was an empty cardboard carton from McDonald's. You guessed it. McNuggets.