I Would Rather Die at Home

A THCB reader in Tennessee writes:

Thanks for listening. I am a single 55 year old male in Tennessee. I’m not offered insurance from my employer. June of 2012 I was diagnosed with Essential Thrombocytosis. A blood disease that messes up your platelets. Took every test they could think of to figure it out. In and out of hospital, adding up debt by the second, I stopped going to doctors, stopped buying meds. I drag myself to work, every day, just to survive. Under Obamacare it will be, for the worst plan, $571.00 a month, with a $ 5100.00 deductible. I can’t afford that. I would rather die in my home as it would be better than being homeless. Is this a joke?

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31 replies »

  1. Sorry to hear that you are down with ET, i also have ET, by the way I would suggest that you do a endoscopy to find out if H. Pylori related Gastritis with Erosion is the cause of it

  2. Please don’t be quiet. And please do let us know when the next lecture …er, rant, is scheduled for.

  3. “it will be impossible for people with no money to pay for that.”

    There’s a subsidy for that.

  4. ObamaCare is really messed up right now, if the had a little compassion over people, they would be fixing al that horrible taxes and insurance plans. It´s obvious that it will be impossible for people with no money to pay for that.

  5. Excellent point. As you say, normally overlooked.

    One of the puzzles presented by ACA was the issue of “double-eligibles” — those who are both poor enough to qualify for Medicaid but also dependent on Medicare. The new rules present yet another layer of complexity to the challenge of how to award benefits (read “private sector providers quarreling over tax dollars”) in the form of premium subsidies, especially for drugs. I have no idea how that cat is being skinned but once again we can see what happens without either single-payer “reimbursement” or true government health care (which makes reimbursements unnecessary). FUBAR doesn’t begin to describe our healthcare system.

  6. Even if the poor gentleman in this post had a subsidy for his entire Bronze plan premium, he would still face the large deductible.

    And therefore be just as broke after the ACA.

    God, how Americans seem to love deductibles. And just when you look favorably on Medicaid, which has no conventional deductibles, you realize the ugly fact noted here —

    that with Medicaid, the deductible is your entire life savings!

    (and even a future inheritance, due to estate recovery rules)

    One might note that in Medicare, no senior citizen has to turn over assets to have his hospital bills paid. That should be our model.

  7. In the absence of a legal mandate or contract of insurance, insurers have no more duty to fund medical expenses than your local grocer.

  8. Bankruptcy would be an exhilarating joy ride for most Medicaid beneficiaries. There is hope of recovery in many cases following bankruptcy but certified Medicaid recipients mostly look forward to a life of destitution and dependency with all their tools of recovery gone forever.

    When my mother was being Medicaid certified the caseworker even asked if her assets included prepaid funeral arrangements. (Georgia allows up to ten thousand dollars — current value — for a prepaid funeral.) I had to furnish a letter from the funeral home stating the current value of her arrangements, not what she and Dad might have paid years ago. I never heard of such a thing, but when I contacted the funeral home they treated the request as a routine matter they deal with all the time.

    Most people trying to weaken or toss away social safety nets are seriously ill-informed about many realities. Our taxes stretch a helluva lot further for welfare than they do for, say, defense contracts or tax credits and carve-outs for big corporations.

  9. BC, true before the ACA. True now with ACA, but less so for those qualifying for subsidy. The ACA will also reduce the disposable income of those not receiving a subsidy – better cancel that trip to Disney.

    Medicaid has stringent asset qualifications, you really do have to be indigent in most states, so Archon should be satisfied with spending down ones own resources before the public will foot the bill.

    Unlike the banks, they got to keep their assets and bonuses when the tax payer bailed them out. If you can fund election campaigns there’s plenty of compassion for you.

  10. The poster did not say if the premium included any subsidies. For those with pre-exist and no subsidies prior to ACA more would be left “destitute. Did the insurance industry have any “compassionate” program for them?

  11. Let’s not tax you and let’s not tax me, let’s tax that man behind that tree.

  12. Sorry to be a wet blanket, but insurance is not the problem. Insurance is nothing more than risk management for how charges are to be paid (or not). The real problem is the amounts being charged, which are more often than not way more than they should be. There are many reasons for high charges, but over-testing and over-treatment are the two biggies — plus the fact that fees and charges for medical care are packed with expenses having little or nothing with medical care.

    The footprint of most health care systems in America is often as big as an industrial park. There are so many clinics, labs, private practices, specialty centers, agencies, imaging centers, retail outlets selling durable equipment and disposables, pharmacies, the list is endless… And that doesn’t take into account the ancillary non-medical businesses from window-cleaning, landscaping and waste removal to uniform sales, food service outlets and parking garages. It takes your breath away to think of it. And every dollar supporting this is in one way or another the cost of health care in America. Every dime feeding this monster begins with a charge for someone’s medical bill.

    Healthcare systems should not be much bigger than a good-sized hospital. And they should be scattered far and wide, like grocery stores, in proximity to the places where health care is needed — NOT in the most affluent parts of the metroplexes where they are now concentrated. A more robust system of community health centers should be part of that picture. (That, too, is part of the vision of ACA. But that will have to wait. Congress is more apt to piss away more on drug testing or another government shutdown than to appropriate anything for better community health.)

    Complaining about insurance premiums is a smoke screen to distract from embedded toxic systems already in place. Ike’s military-industrial complex has not only grown, but has been amended by similar tax-money-to-privatization schemes involving prisons, education, medical care and prescription drugs. We can now add insurance premium subsidies to the list of tax money being redirected into the private sector — 80% to health care providers (with their fee for service, unaudited billing) and 20% for the insurance industry for administrative and actuarial tasks.

    Did I forget to mention flat-screen TV’s, concierge food service, marble floors and live plants in hospitals? It’s okay, you know, cuz most of them are “non-profit,” Never mind they have executive compensation packages matching or exceeding those in the for-profit sector. Hospitals are essentially money-laundering centers for a dense community of for-profit businesses clustered around them,

    This kind of argument is really tiresome. The poster is still working, but he may as well go ahead and “spend down” to become a Medicaid beneficiary. It’s a sad story repeated all over the country, and more apt to happen to older, even sicker people who live long enough to graduate to long-term care. If you think being sick is expensive now, wait til you see what happens when Medicare stops paying your room and board after 99 days in long-term care and you get classified “custodial.”

    Keep in touch, Mr. Poster. They won’t let you die. Sooner or later you will become a cash cow, either for a big hospital looking for more “write-offs” to justify horrendous charges, or a skilled nursing facility when you get long-term care. Dying is not as easy as you might think in our system. Dead people are worthless. But lIving, sick people are like uranium ore.

    Sorry, folks. Rant’s over.
    Sometimes I just have to get it off my chest. I’ll be quiet now.

  13. Bob:

    ACA is good in that you can’t be kicked off or denied insurance, but what happens if you can’t afford the insurance due to inability to work brought on by illness?

    I assume if you don’t pay the premium the policy is cancelled. If you don’t pay rent or mortgage you are on a path to eviction. Not everyone has AFLAC or disability.

    To get onto medicaid I’m guessing you have to part with your assets. So in such a scenario can one actually become bankrupt or am I missing something?

  14. And the original poster says your “Affordable” Care Act would leave his family destitute. I respect his decision.

  15. archon41,

    This is true of most govt. spending. People want all sorts of things, but it’s always someone else that’s supposed to pay. Probably the reason why we have $17 trillion in debt.

  16. Yes, and many of those unwilling to pay for it do not realize that in the future, when they get sick and have pre-existing conditions, it will still cover them, unlike most non-group insurance plans now.

    Author: archon41
    Many “support” Obamacare, but it seems that few are willing to pay for it.

  17. Many “support” Obamacare, but it seems that few are willing to pay for it.

  18. Compassion in my book is the feeling that anyone who suffers from a serious illness has enough pain to deal with. I would support full no-deductible insurance for some ailments whether the patient is broke or a multi-millionaire.

    Come to think of it, that is how Medicare works.

    The millionaire does support the program when he/she pays taxes, of course.
    I just do not want them paying at the time of illness.

    Call me a health care socialist, I confess!

    Bob Hertz, The Health Care Crusade

  19. Are we talking about “compassion” for illness or “compassion” for being required to exhaust one’s own resources before qualifying for public assistance?

  20. The French health care system has a list of painful chronic conditions where no deductible or coinsurance applies. I would be fairly sure that this illness would be one of them.

    If our system had an ounce of compassion we would do the same thing.

    We would also need price controls on some of the drugs and procedures, so that insurers are not bankrupted by the charges they must pay in full.

    France has a Pharmacy Price Review Board for drugs, and a national fee schedule for outpatient procedures.

    Another ounce of strength required.

    Neither of which is present in Obamacare.

    Bob Hertz, The Health Care Crusade

  21. “I can’t afford that. I would rather die in my home as it would be better than being homeless.”

    Not trying to be glib but I’d advise getting a SS disability lawyer, that’s the best scam going for the down and out.

    I’m for health care not resulting in bankruptcy, but there’s no full story here about the life this person led and what decisions were made to get here from there. Not enough info.

    Obamacare was never going to pay your rent, no system would do that.

  22. Something wrong with this picture but I’m not informed well enough to comment further.
    I want to read the comments that come in to this post.

  23. I don’t want to wallow in your misfortune (unlike Republican critics of the ACA), but I can’t resist noting that the *old* pre-Obamacare system has bankrupted you, and the new system (Obamacare) has much more chance of helping you. If your income is low, you may well quality for subsidies, assuming your state is not one that eschews such help. I wish you all the best, and hopefully kind people will lessen the financial insult on top of your physical illness.

  24. Oh, NO, NO, NO!!! The Koch Brothers Contingent want to put all of the middle class and below into a spend-down-into-penury means-testing paradigm for SS and Medicare.

    “the government should help people ”


    Recall the loud, derisive, grossly vindictive applause for Ron Paul when he said during a GOP debate that the uninsured should in fact be allowed to die at the ER curbside had they not provided for themselves ahead of time.

    Y’see, Randian hardheartedness is wonderfully fashionable these days. Unless it’s YOU or someone YOU love.

  25. This pricing includes your subsidy? Either way the government should help people who were financially devastated by the OLD system as they try to make the transition to the new one …