Categories
Living in Society

The Health Care Abomination that is America

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Dec. 15 is the deadline to sign up on the ACA marketplace for health insurance effective Jan 1, 2025.

When I left the company and career of 25 years, securing health insurance was an issue. That was July 2009. There were no easy options, so I stayed on COBRA coverage.

The Consolidated Omnibus Budget Reconciliation Act (COBRA) gives workers and their families who lose their health benefits the right to choose to continue group health benefits provided by their group health plan for limited periods of time under certain circumstances such as voluntary or involuntary job loss, reduction in the hours worked, transition between jobs, death, divorce, and other life events. Qualified individuals may be required to pay the entire premium for coverage up to 102% of the cost to the plan. (U.S. Department of Labor website).

COBRA was expensive, so I looked around. I found the Iowa Farm Bureau offered a health insurance plan which was less expensive with reasonable coverage. More than farmers bought their plan, and so did my spouse and I. It wasn’t the best policy, yet it was good enough and met our needs.

The Patient Protection and Affordable Care Act (ACA) was signed into law on March 23, 2010. When the ACA marketplaces were organized, I completed an online form and found that with subsidies, I was eligible at a lower cost than we were paying the Farm Bureau. I signed up for a plan and stayed with the ACA until I was eligible for Medicare.

Today, with Medicare supplemental insurance costs, our health insurance bill for two people is about $935 per month, not including dental or vision coverage. I looked at buying a plan for dental, yet the cost of paying regular care out of pocket was less expensive. The same with vision. Eye treatment related to a health condition was covered under the health plan. The cost for this is slightly less than what I was paying for COBRA in 2009.

The poverty guideline for a household of two is $21,150, according to the U.S. Department of Health and Human Services. Our income is more than that, yet many struggle to bring that much home. Health insurance on such income? Without government help people can’t afford it.

All of this serves as a long build up to the significance of today.

I previously wrote the following about deadlines to sign up for health insurance on the ACA marketplace:

To be covered Jan. 1 you have to be enrolled by Dec. 15 and have paid your first premium. At this late date, I doubt Congress is going to act on the subsidies. In fact, last week, the U.S. Senate rejected extension of ACA subsidies proposed by both Democrats and President Trump. Here is from the website:

December 15: Last day to enroll in or change plans for coverage to start January 1. January 1: Coverage starts for those who enroll in or change plans by December 15 and pay their first premium. Open enrollment continues until Jan. 15 but there would be a lapse in coverage if you wait until then.

For people who don’t have health insurance now, the Dec. 15 deadline is meaningless. Even the Jan. 15 deadline can be difficult without the means to pay for a policy. There is a lot more to say on this topic, yet Tick! Tock! Life is going by at the speed of an eighteen wheeler with the hammer down.

I agree with U.S. Senator Bernie Sanders it is time to guarantee healthcare for all in the United States.

According to the most recent data, the United States spends $14,570 per person on healthcare compared with just $5,640 in Japan, $6,023 in the United Kingdom, $6,931 in Australia, $7,013 in Canada and $7,136 in France. And yet, despite our huge expenditures, we remain the only major country on Earth not to guarantee healthcare to all people as a human right. (It’s time for the US to guarantee healthcare for all, U.S. Senator Bernie Sanders, The Guardian, April 29, 2025).

President Obama was handicapped by the influence of insurance companies while he negotiated the ACA. It is remarkable any healthcare bill at all was enacted into law. Step-by-step, Republicans are stripping away the meat of the ACA, and will continue until all that is left is its bones, which they will grind up for fertilizer. Eliminating the ACA subsidies is just one part of a long plan to remove all the good things the ACA accomplishes.

If you look at my personal journey on retirement health insurance, it was only with Medicare that my worries about how I would pay a medical claim were addressed. Before that, my privileged status as a white male who was able to find a job with health insurance enabled me to find care. The care was never what I wanted, but I didn’t go broke because we had bills after our child was born in a hospital, or a major surgery.

It is easy to say there should be, as Senator Sanders says, Medicare for all. Getting that done in the United States is nearly impossible with the influence of special interests and their money in Washington, D.C. This is what makes healthcare an abomination in America. I know we can be better than this.

Categories
Work Life

Late Fall Near the Lake

The Carter Family
The Carter Family

The good news about finishing three full weeks at the home, farm and auto supply store is the company offers health insurance that meets the Internal Revenue Service “minimum value standard” for less money than coverage available through the government’s health insurance marketplace or elsewhere.

The bad news is all of the pay from this full-time job will fund health care insurance, co-pays and deductibles for our family if we seek any care. If we don’t need health care once the coverage goes into effect Feb. 1 that will leave us roughly $150 take home pay per week. We’ll need more than that to pay the rest of our expenses.

Ada Blenkhorn and J. Howard Entwistle wrote the song “Keep on the Sunny Side” in 1899:

There’s a dark and a troubled side of life;
There’s a bright and a sunny side, too;
Tho’ we meet with the darkness and strife,
The sunny side we also may view.

Most people know the version Mother Maybelle Carter sang on the 1972 record album Will the Circle Be Unbroken produced by William E. McEuan. I favor the original A.P. Carter version which hearkens back to our family roots in Southwestern Virginia. Dig deep enough and you’ll find we’re shirt tail relatives on the Addington side, which is Mother Maybelle’s maiden name.

Not only may we view the sunny side, keeping there will be the only thing that gives us hope. This first job sets a foundation upon which to build the rest of my worklife.

What else?

In the works are spring at the Community Supported Agriculture project, summer editing at Blog for Iowa, and fall weekends at the apple orchard. These were all discussed during my interview with the home, farm and auto supply company, so getting time off shouldn’t be a problem.

Seed CataloguesThe most excitement I felt in a while was finding the Seed Savers Exchange 2016 seed catalog in the mailbox yesterday.

Someone gave me a packet of their scarlet kale seeds last year and it was a great addition to the garden. Too bad all of my customers are used to getting kale for free, or it could be a source of some income.

It is conceivable I could generate a thousand or so dollars from the garden this year by expanding the planting area and selling excess. Circumstances may have me doing that.

It is a reasonably warm fall day near the lake — a time for hope and getting lost in seed catalogs.

Categories
Living in Society Social Commentary

Blogging the ACA

Garden Planning
Garden Planning

When I had my first colonoscopy there was no President Obama, no Patient Protection and Affordable Care Act, I hadn’t begun blogging, and I was on my employer’s health insurance plan.

The company I worked for would have liked nothing better than to present a cash payment to employees in lieu of paying their 65 percent share of health insurance. However, people they asked wouldn’t go for it.

My second procedure is scheduled Friday and I’m curious to see how it will be paid for by the health insurance plan purchased through the ACA marketplace for some $14,400 annually.

The ACA requires health insurance providers to cover recommended preventive services without any patient cost-sharing such as co-pays and deductibles. A colonoscopy is one of these services.

Information is seeping out through administrative cracks in the health care system. It began with a voicemail from the doctor’s office. My insurance company wouldn’t pay for the sodium sulfate, potassium sulfate and magnesium sulfate solution called a “bowel prep kit.” The kit came with two 6-ounce bottles of the solution and a handy plastic measuring cup. I asked our local pharmacist if I could buy it directly as I remembered it was inexpensive. With a $10 off manufacturer’s coupon it would have been $110, making it worth the trip to the clinic in the county seat to pick up a physician’s sample of the brew.

What I am finding in my limited personal health care is the ACA is peeling off add-on procedures that used to be covered by health insurance. No add-ons to physicals, colonoscopies, and other preventive procedures, at least in my experience.

I don’t know, but the change has to have affected gross margin for these businesses and reduced the cost of health care. Whether savings will be passed on in terms of premium reductions remains to be seen, but I doubt it.

While I didn’t receive a bill for my last physical examination, the hospital sent me a bill for lab tests, which I paid. We’ll see if there are any more cracks in the system after my procedure. If there are, I’ll be posting again.