Monday, March 6, 2017
I'm 62, I Have Cancer, I Have Obamacare, And Trump Is President. My Timing Is Great!
(Many readers already know, but now all of you do.)
In early February, I went to see my family doctor with hip and back pain, which had been nagging me for about 6 months. X-rays, CT scans and MRI's showed bone loss in the hip and other areas. I was diagnosed with cancer in the bones of my right hip and spine, and also in one lung. It probably started in the lung and spread from there. I smoked cigarettes for 28 years but quit 16 years ago.
On February 27th, I had tumor removal/hip replacement surgery and am recovering at home. In a couple weeks, I'll begin chemotherapy treatments, of a type and duration still to be determined by my pathology results. There will also be some radiation at some point.
I'm 62 years old, just shy of qualifying for Medicare. I'm self-employed and still working; my wife is not. Our health insurance is a policy obtained on the ACA/Obamacare federal exchange. We qualify for an income-based premium subsidy. We are happy to have Obamacare. It's a definite improvement, and who knows where we'd be without it. So far, our insurance has paid for almost all of my medication and diagnostic testing. But the costs for surgery and treatments will be subject to co-pays and deductibles, etc. Our out-of-pocket costs are unknown, but they'll be substantial. Obamacare is not a free ride, and I am not a mooch.
And yet, as the cherry on top of my shit sunday, Trump and the Congressional Republicans are in a headlong rush to repeal Obamacare and replace it with . . . not much. Basically, roll back the clock and pretend Obamacare never happened. At stake is affordable health coverage for perhaps as many as 30 million people, including your humble correspondent. Timing is everything! I'm covered for this calendar year, but next year, who knows?
Among the many changes designed to kill the ACA, the GOP will eliminate the mandate that everyone carry insurance, and will eliminate the penalty for failure to do so. With the goal of covering as many people as possible, this is actuarily unsound -- it's totally bass-ackwards. The GOP plan will also remove certain taxes on the health industry and high income individuals which help pay for the ACA's expanded coverage. That cooks the goose right there.
The big problem with American health care is our exceptionally high cost for everything, including insurance premiums. But the GOP will get rid of the income-based direct premium subsidy, the mechanism which actually makes obtaining health insurance affordable. Their new idea is year-end tax credits -- not based on income, worth far less than the current subsidy, and available to me only after I've paid the full retail premium for a year. That's a perversion of affordability.
There will be a re-emphasis on tax-advantaged Health Savings Accounts. I've had an HSA before and it's OK for small planned procedures, if you're able to save money and if you're able to wait. But if you're in a low income/high medical bills trick bag, how can you save money? If your need is an emergency, how do you instantly save for that? So what good is it?
Whatever the future holds for me, I'll now go through the rest of my life with "Pre-Existing Conditions" tattooed on my forehead. But not to worry, those compassionate Republicans promise they'll always give me "access" to coverage. I'll just have to pick it up in a "high-risk pool," which is the insurance industry equivalent of a leper colony. Access comes only with unaffordably-high premiums, enormous deductibles, and restrictive policy maximums. That sort of "access" is bullshit.
The premium subsidies are the key to affordability under the Affordable Care Act. There is no real affordability without them. If they go away -- which is what the Republicans want -- the ACA goes away. And where does that leave me? Where does it leave millions of others like me? It seems that Congressional Republicans "replacement" is to advise me to sell my home, liquidate all my assets, and then quickly die with a minimum of fuss.
To have waited so long for any improvement in health care access and affordability, to have finally accomplished some of it with the ACA, to have finally achieved a degree of parity with all those people covered by large employer group plans, to see it all taken away so soon by a spiteful, capricious Republican party is a bitter disappointment. It's unfair and cruel. It is wrong.
I'll copy and paste the text portion of this post and email it to my members of Congress. If you agree with me, please do the same. Especially if you consider yourself to be a Republican or an Independent, and you're finally seeing the light on this important issue, please write your members of Congress and share this story. It'll be a character-builder for ya!