A sneak peek at intelligent healthcare reform

Posted on 06/18/2017 in misc

Lewis Peak 1

My imaginary Internet friend Paul McAleer wrote a blog post about the pain of simple health care tasks like using your FSA account. Been there, done that, have the scars from bashing my head against my desk. However, it sparked a connection in my brain. Due the the high cost of healthcare in the US, I've had a sneak peak at an intelligently functioning socialized healthcare system, at least from the consumer point of view. It's not all rainbows and unicorns, but it's close.

My wife was diagnosed with breast cancer last September. Two lumpectomies in a period of a month got us to the insurance annual out-of-pocket maximum for her. So for the last 2 months of last year, none of her treatments cost us a dime beyond our premium. We were on COBRA at the time as I had lost my job 24 hours prior to her breast cancer diagnosis, and I was working as a contractor.

As a side note, if you ever want to really stress test your life, try losing your job, and finding out your wife has cancer, in a 24 hour period.

So, I guess with all the other stress in our lives late last year, the operational benefits of hitting the out of pocket maximum didn't really register. I certainly appreciated not writing checks for healthcare for two months, but with so much else to worry about, the lowering of healthcare stress went over my head.

Fast forward to 2017...my wife has completed radiation, her latest mammogram was clear, and we are into the long term prevent re-occurrence phase of cancer treatment. The company I was contracting for made me a real employee, so I have employer subsidized health insurance again. The health plan is a very top of the line plan, with a monthly premium that made me cry when I first saw it. However a side benefit of that monthly premium is the lowest out-out -pocket caps I've ever seen on an insurance plan. It took us two months to max out my wife's out-of-pocket expenses for the year. So for the rest of the year she simply goes to the doctor for all her various cancer and related appointments, and we never think about the bill. We will owe nothing, so I don't even look at the EOB's when I get an email telling me one has been created. I don't spend time trying to convince the FSA processor that the charge from a doctor's office to the debit card they gave me for that very purpose really is a medical procedure, and not me laundering my beer purchases through a doctor's billing service, or whatever it is they are worried about, since I don't think I've ever had a FSA claim go through without extra work on my part.

So Paul's post, and my realization that I'm not doing that crap for the rest of the year really hit home. From an operational point of view for my family, my wife has socialized healthcare for the rest of the year. If she needs to go to a doctor, she goes to a doctor. It isn't going to cost us a dime over what we are already obligated to pay via premiums. And more importantly for me, as we are not in a position where a $40 copay causes financial stress, I'm not going to be spending hours on the phone trying to understand healthcare bills and what the insurance company is or isn't paying. As Paul commented on Twitter, hitting the out-of-pocket max is kind of like magic. Everything just gets paid for the rest of that year. I don't even know how to put a financial cost to the elimination of that stress, but it is not insignificant. I can imagine how much it would be worth to people that do stress over skipping a couple of meals to pay for a doctor's appointment.

I hadn't really thought about this prior to Paul's blog post, but I wonder how much the stress of paying for medical care in the US contributes to the cost of health care in the US? I suspect the misery of getting this stuff payed for creates sickness. The US healthcare system literally is making us all sicker. I wonder if anybody has tried to study that? I think eliminating healthcare insecurity has to be worth billions to the economy just in recovered productivity. Not worrying about medical bills for my wife for the rest of this year has to be worth 6-12 hours of recovered time for me. Now multiply that by hundreds of millions of people. We are talking serious money here, before we even consider all the non-financial aspects of a healthier population.

Also, Carefirst's PR people were monitoring my blog a couple of years ago when I was having a row with them, and blogging about it. If they're still reading, I'm not on Carefirst so you guys are clean ;) Seriously, I don't really have any specific complaints about the insurance companies I've been dealing with through the cancer stuff. For the most part it's all been pretty normal. The issue is normal in US healthcare billing is such a low bar, because the process is so freaking painful.

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