Insured but Under-Treating: The Un-Affordability of Health Care
Folks, the crap has hit the whirly thing with the blades. I’m carrying so much medical and dental debt now that I have to cut back on or do without a lot of the care I need from now on.
My current debt situation is not the result of bad money management. It is something many people are experiencing as a privilege of American citizenship: price increases and a stagnant income. Financial en-strap-ment is a plebeian honor bestowed on healthy and chronically ill people alike. Ain’t equality grand?
It is my privilege this year, for example, to pay an increase of 12 dollars per month for Medicare premiums plus a higher yearly deductible, increased drug co-pays, and increased medical co-insurance for tests and procedures, out of an ever-shrinking Social Security Disability income and limited earned income. What’s more, my local hospital system will not give me financial assistance based on my marginal-but-not-pathetic income. So I pay them ten dollars per month. I will incur more debt eventually to add to that already four-digit outstanding balance. My only revenge is that I’ll croak before I pay it all off. Hah.
Dental care and car repairs make up the bulk of my debt. Without insurance, dental restorations and root canals cost the equivalent of a 1960 starter home. With insurance, I save about 200 dollars. Is it worth paying the premiums? Not to me, not with the lame coverage dental insurance provides.
I know this is a familiar scenario for many of you. And like me, I know you’ve observed chronically ill folks resort to fund-raising to pay for a treatment not covered by their insurance. I’ve watched other poor people pitch in 5 or 10 dollars to help—and I’ve been one of them. Somehow we know better than to petition the billionaires huddled in DC to—oh, I can’t bear to go on with that idea. There are limits to my tolerance for farce, for goodness’ sake. Why, back in 2009 when the stimulus package was disbursed, mine was the lone, shrill, dissenting voice that suggested giving every adult in the US a cool two million bucks instead. Just once in our lives, let us all win the lottery. Then sit back and watch the economy get stimulated. We’d have gone one better and given the economy multiple orgasms. But no. Giving huge sums to the plebes who are too small to succeed would have been folly—so off it went to banks that are too big to fail. What is the lesson learned? Keep buying lottery tickets. My chances of winning the mega-bucks are better than seeing a health care industry overhaul.
So what should we do?
Fact: We need regular medical care. Fact: We’ll likely develop co-morbidities and require additional tests, appointments and meds. Fact: The costs of all those things will increase on a regular basis. Fact: Our incomes will not. Solution: Under-treat your health.* Where to begin?
*(Disclaimer—I do not recommend that anybody shirk on their health care. That would be reckless and irresponsible of me. Although the under-treatment plan I’m listing for myself is what I’m really doing, I’m not suggesting you should do what I’m doing.)
Here’s the health under-treatment plan I’ve begun to follow:
- Eat less. As a single person, I can save as much as one hundred dollars a month on grocery bills. I’ll have to find another stress outlet other than stuffing my pie hole with inexpensive starchy stuff. I’m overweight and getting bigger. Getting smaller is supposed to be better for my health. Here’s my chance to test that hypothesis.
- Reduce the number of neurology appointments by half. Easy to do as long as my MS is stable. Annual savings of approx. $110.
- No more MRIs. Ever. Well, not routine MS-related MRIs, anyway. I pay $332 per MRI—and for what? I’ve been stable for so long that at this point, an MRI would only be an FYI. Without new symptoms, an increased lesion load wouldn’t mean a thing to me.
- Reduce the number of dental cleanings from two to one per year. Annual savings of about $150.
- Forego getting more dental crowns. MS-related TMJ and bruxism have ground down most of my teeth to the dentin and have required crowns. The natural teeth look like hell but are healthy for now. The old crowns are beginning to fail. Dentist told me only the front-most molars are necessary for chewing—so I won’t replace the back crowns when they fail. The front teeth look horrid but are healthy—so I don’t smile a big smile anymore. I can’t afford it.
- No more supplement purchases. I already take 13 prescription meds. I can’t afford to keep buying probiotics (they didn’t help anyway), vitamins, krill oil, etc. It doesn’t matter if I’m getting a benefit from these things, they’re too expensive. Gotta draw the line somewhere.
- No more physical therapy, speech therapy, and other assorted doctor-referred therapies. The co-insurance is too expensive. Period. Get free info on the internet instead.
I’ll be tweaking more expenses besides as the year drags on. I hope you don’t have to resort to Draconian cost-cutting measures to keep your MS head above water. But if you do, know that you’re not alone.