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Could You Afford an $1875 COBRA Payment Every Month?

You read that right – an $1875 COBRA payment – every month. That’s our new reality. Think you can afford it? I don’t know if we can either, at least not without making major sacrifices.

I don’t want to beat this to the point where it turns into blatant whining – though my guess is that just about anyone would whine about it – but it’s a first-hand and very real account of what’s wrong with the entire health care system.

Our Health Insurance Situation – an $1875 COBRA Payment

For the past 2.5 years my family has been taking advantage of a part-time job with health insurance. In our household finances, I pay the majority of the bills, while my wife maintains a job that provides the health insurance for our family. Our two adult kids also contribute their pro rata shares of her payroll contribution.

The arrangement has worked well for us, since her employer paid 60% of the premium, which amounted to over $21,000 last year. The arrangement originally began with a 20 hour a week position, that eventually increased to 30 hours.

However last month my wife lost that job. I won’t go into the details as to how that happened, since the reasons for a job loss are often convoluted. As well, it’s not really the subject of this article.

The main point is to illustrate how absurdly expensive health insurance has become. An $1875 COBRA payment will ultimately cost $22,500 on an annual basis. That’s only until the new year, when it will do what all health insurance premiums do, which is the “payment change” that goes in only one direction – up.

I should also point out that it could’ve been a good bit higher. In order to keep the payment “affordable” (absurd concept, I know), we dropped the dental and vision coverage. That made it…well, let’s just settle on that it makes the premium less unaffordable, and leave it at that.

The Health Insurance System has Become an Unmitigated Disaster

Could You Afford an $1875 COBRA Payment Every Month?
Could You Afford an $1875 COBRA Payment Every Month?
$22,500 per year – plus whatever it will be next year. I don’t know, maybe it’ll be $24,000. Maybe will be $25,000. What I do know – what we all know – is that it will only get worse. We’ve been conditioned to it. It’s like living with a slow-acting disease that we’re helpless to control, even though we know that it will one day claim our lives. We just hope to “get by” a little bit longer.

That’s the pattern with healthcare and health insurance. Health care is already consuming an absurd 18.2% of the national economy. Even though that’s about twice the percentage that healthcare is eating up the economies of other rich countries, the mentality in this country only seems to be that we need to find ways to throw more money at the problem.

Perish the thought that anybody should actually think about finding constructive ways to seriously reduce the cost of this runaway expense. We’ll keep letting this balloon get bigger and fatter, until it reaches the point where an average premium for a family of four approach $30,000 per year.

Personally, I don’t think it’ll get that far. I think the whole thing will blow up before it gets to that point. I think were close to that now. Much closer than anyone suspects.

The Options that Aren’t…

You’re probably wondering why we didn’t try the ridiculously named Affordable Care Act health insurance exchanges. That’s a fair question.

The answer is…we did.

But that was even worse. We priced coverage on our state health insurance exchange, and found coverage that’s even more expensive than the COBRA.

It was $1,722 per month, and that only covered my wife and I. It would’ve been well over $2,000 per month if we added our two kids. I don’t know – I’m guessing something closer to $2,500.

I do know that my 26-year-old nephew tried to get coverage on the exchange in Pennsylvania, and his premium was $600 per month. For one person. Like us, he passed on the coverage. Fortunately, he did land a job with coverage a few months later.

You can do that sort of thing when you’re younger I suppose, go without coverage and take a chance that nothing will happen. But in a family of four, with two of us over 50, that’s not a reasonable option. Back in April I had an emergency appendectomy, that cost somewhere north of $28,000. Just one uncovered episode like that, and you have serious problems. And in today’s healthcare universe, $28,000 is practically pocket change.

Our Future with Health Insurance

I don’t want to shed too many tears over this situation. In reality, ours is not as bad as it is for some people. We can at least afford to make an $1875 COBRA payment…barely…at least for a few months.

But if it goes on for too long, we may have to make some tough choices. We may even have to consider going without health insurance coverage. There are times when it makes complete sense. Like when you can’t afford the premiums.

I don’t know – maybe we’ll try to balance it out, by going six months on, six months off. At least until my wife finds another job situation that offers health insurance.

(If you’re wondering why I keep saying “I don’t know”, it’s because I really don’t know. When it comes to health insurance, there’s nothing but a series of bad choices.)

And there again, we’re better off than most people are. My wife has been working two part-time jobs for the past two and half years. She has a second (now only) job working in a jewelry store. They’re increasing her hours, and since it’s a national chain with health insurance coverage, there’s an excellent chance of her getting enough hours to qualify for the plan. In fact, that’s the plan. They’re working with her to move her into that situation.

It won’t be immediate, so we’ll have to muddle through, one month at a time. I feel blessed to have that option sitting out there. In my experience, God has been very good to to me and my family. In our worst moments, He’s always provided a way. I’ve come to rely on that, and I’m counting on it once again.

Where is All of This Going?

My wife and I and our family will get through this, as we always have. But we have options, or at least we’re working to create some. It really makes me sad for the millions of families and individuals who don’t have any options at all.

Unfortunately, I don’t see any of this having a happy ending on a national level. We’re already in the midst of a full-blown healthcare crisis, and there is neither the political will, nor any public consensus, as to what to do about it. Our only “strategy” – as individuals, and as a nation – is to just sit around and wait until this thing finally and formally does actually blow up.

That’s not really a strategy, of course, but it’s all we can do given that there’s no clear path forward.

During the election, Donald Trump predicted that it (Obamacare) would blow up in two or three years. Whether you love him or hate him, Trump was right on the money with that prediction. I’ve heard it said and written elsewhere, many times.

But given the national belief in magic, we continue to tool along, as if we have other options. At a minimum, we think that we can close our eyes and whistle past the graveyard. But this time we may not make it past that graveyard. It’ll pull us in, and force us to give the current rendition of the American healthcare system a decent and final burial.

The only question is, what will take it’s place?

I’m guessing fear and panic for starters. All crashes tend to be worse than anyone imagines. And a healthcare crash will be no different. The only problem with this crash is that lives will literally hang in the balance.

We have a chance to fix that now. Or at least we once did. But there’s no will to do it. Only a desire and a fantasy that we can have all the healthcare we want, and not have to pay for it. Since that’s what people want to believe, the only possible outcome is disaster. It will wake us from our complacency, cost a bunch of deserving politicians their jobs (thankfully), and give us something that could actually work in the real world that we inhabit.

In the meantime, as I’ve already noted, all the choices before us are bad.

What do you think? Am I exaggerating this problem, based on personal circumstances? Or does it truly point to something much bigger, something system-wide? And if you don’t think so, how much longer do you think this can go on? How much higher can health insurance premiums go before they’re too high?

( Photo by sheilapic76 )

26 Responses to Could You Afford an $1875 COBRA Payment Every Month?

  1. I’ve found it interesting that before the election the public hated Obamacare, but suddenly after Trump was elected, suddenly the media kept talking about how NO ONE wanted it to go away. Ahh, those rascally media types. And single payor is not the answer unless as a nation we want to pay over 70% in income taxes like the highly touted Norway’s system costs. And the perils of having the government in charge of whether you get care or not has been revealed by the recent example of the baby in Britain who’s family wants him to get medical treatment but the government says he must die, even if they have the money to pay for it themselves. As I look back, I’m beginning to think the pre-Obamacare days were better. When the SCOTUS upholds a mandatory cost by calling it a tax instead of a fine, what does one do? All I can think of for my personal situation is to pray that my husband’s insurance which he has been able to keep into retirement is not changed. Best of luck to you on your own situation.

  2. Hi Kathy – I’ve noticed the same thing. There’s a pattern here. Anytime any element of the status quo is threatened, the mainstream media circle the wagons and report how doom and gloom will follow if any changes are made. The whole healthcare system is a gravy train that no one wants to disturb, even if it’s only obvious that it can’t continue.

    I’m guessing that the rank-and-file in the mainstream media have cozy health insurance deals, so they think there’s no problem. And anyone who does complain is just another “deplorable” who supports fascist ideas that will starve children and throw grandma out of her house.

    I wonder how they’ll report this once the healthcare system blows up for lack of additional funding. Maybe if they lose their coverage they’ll begin to realize that their might be a problem. Maybe a few politicians too, but then they’re on another planet and have no clue what the rest of us are dealing with. Inaction seems to be the surest path to re-election. As I wrote in the post, I don’t see this having a happy ending. I’ll stand by that.

  3. I find it extremely surprising that your nephew’s premiums are that high. I’m in PA, have a pretty good Gold plan, and insure two adults for that amount. And we have a negative thing going for us on that questionnaire at the beginning. I believe you as different regions will have different insurers. I’m just truly surprised.

    COBRA cost that much before the ACA. Been there. It’s really a crappy option, and I always chose to go without back then because it wasn’t really a choice. Sounds like you’re in a similar boat. Have you looked into healthcare ministries? Since you’re religious, it may be a good alternative.

    The ACA needs to be worked on. If you don’t work on it, yes, it’s going to implode. It’s a self-fulfilling prophecy. But the AHCA or whatever the heck they’re calling it now is going to make things worse for at least tens of millions of people. Why not tweak the system we already have that has gotten so many people coverage? (Myself included. Couldn’t have even gotten the plan we’re on now prior to ACA.)

  4. That ACA premium is what my nephew said it would cost. I was surprised as well, but then again not at least based on what I’d seen. We looked into a plan for my daughter here in NH, and it was well over $300 just for a bronze plan. As to the health sharing ministries, a good friend of mine who works in healthcare administration and is also a Christian, has warned me about those ministries. They’re not really insurance, and they work on excluding you based on previous health histories. My wife and I are both considered “damaged goods” from a health insurance perspective, and would likely be excluded.

    I agree that COBRA has never been a good option, but it’s now reached the point where private coverage is considerably more expensive than COBRA. That speaks volumes about the dysfunctional path healthcare is on. I also agree on tweaking ACA, but there’d have to be some big time tweaks. Not going to happen as long as politicians understand the unwritten political rule that you don’t disturb the system or you lose your seat. Our political system is now driven completely by fear mongering. Advance significant change, and your opponents will have you starving children, throwing grandma on the street, destroying the environment, supporting global warming, and maybe even a terrorist sympathizer. No one wants to go there. Political Correctness has succeeded in paralyzing democracy.

  5. Femme, COBRA did not cost that much before the ACA…I know because my family had to use COBRA twice in the 3 years leading up to the ramming in…er, passing of the ACA. We paid around $500 a month for a family of four. After that had run iut, we paid about the same for a private policy until we were once again able to have employer sponsored health coverage. Now, if my husband lost his health coverage for some reason, it would take much of my salary to insure us through my employer. This can’t continue…those who are middle and upper middle class cannot sustain these costs. We will become a third world nation in terms of the health of our citizens.

  6. Hi Becky – You’re so right! Right now I feel as if we’ve become a third world family! Imagine you’re tooling along with your budget, then not only do you lose the cash flow from a job, but you also have to absorb a nearly $2,000 a month payment to boot. E tu Brute! (The famous last words uttered by Julius Caesar from Shakespeare, as his best friend Brutus took him out with the final stab.) I’m not exaggerating when I say that this isn’t the America I grew up in. I hope I’m not the only one who realizes this, and that we’re fast headed down the wrong path.

  7. Jeeeeez Louiiiiise! I remember hearing COBRA was expensive, but I had no idea *how* expensive it was. That’s absolutely outrageous. I wish I had a better answer to this whole mess except … damn, we’ve screwed ourselves so bad.

  8. “…we’ve screwed ourselves so bad” – truest words ever spoken. In order to give ourselves the best healthcare possible, we created health insurance. But that’s been feeding a bubble in healthcare costs, just as student loan debt has fueled a bubble in college costs, and mortgages have created a bubble in housing. After decades of enabling everyone to “afford” healthcare, college and housing, we have a price structure so high that no one can afford any of it, at least without insurance and loans. I suspect healthcare now costs the average household more today than it did back in the 1950s and 60s before everyone had health insurance. There won’t be an easy or painless way to untangle this mess. I’ve been pretty pessimistic about the health insurance situation for a lot of years now, and even I can’t believe how bad this has gotten. Now you have to choose between healthcare and housing. And the government is effectively criminalizing people who don’t have it by making them pay a tax penalty.

  9. A very key problem that’s rarely talked about is the absurd level of responsibility for our own health that we’ve entrusted to the medical system. We have this highly “medicalized” view of health when much of it is really simple and very affordable. It really is. And we now have the internet so why is it so difficult to seize the opportunity to learn for yourself about eating and our food supply, stress, fitness, environmental toxins, etc, etc. Yes I know there are emergencies and tragic stories but that’s not what’s bankrupting us. Our personal story is – after paying $560/month last year for Ambetter insurance — we found that several health providers simply sneered at it. What complete ARROGANCE that the government considers this legit (legislators are healthcare elites) and the medical industry views an outlay of $560/month as poorly insured! So my husband and I opted out of conventional insurance. We’re 58 and we with Liberty Healthshare Ministries. Yes, it’s a risk … they actually want you to price shop and are not going to cover minor stuff. But we just want catastrophic at this point. We’ve tossed pharmaceuticals in the garbage, lost weight, gotten stress under control, stopped eating so much meat and daily – in large part because we have taken learning about health into our own hands.

  10. Let me also clarify – $560/month for my 57 yo husband. I went to Liberty at the end of 2015 when Aetna pulled out of Texas and the Blue Cross premium for me alone jumped to over $1,000/mos with $7500 deductible and terrible network. NO WAY!

  11. Hi JWB – Your experience with Blue Cross is closer to the norm. I looked for a policy just for me, and it was $861 with a $1500 deductible. That’s not terrible, but it doubles with my wife. We can’t use the healthsharing ministries due to pre-existing conditions. Some will exclude pre-existing for a year, but then you have to have double coverage for that year. I think they work better if you’re young and healthy. But when you’re over 50 and have hypertension, diabetes, etc, they don’t work nearly as well.

    BTW – an insurance broker told me that a $7500 deductible is like effectively having no health insurance at all. You’ll pay the $12,000 a year for premiums, but most years you’ll never get a benefit.

  12. Not sure how to comment in line–maybe because I’m in mobile. Maybe it was because of my pre existing condition (don’t think so) or maybe because of where I live or my employer’s plan, but my COBRA, for me alone, was north of $1k/month. I’m glad yours was cheaper!

    That’s good to know about ministries. I obviously don’t utilize one, but good info to pass on.

    I’m not sure political correctness it’s the problem here. I haven’t heard any in the legislative branch say that the ACA is perfect or doesn’t need adjusting, but am open to hearing about who does so I can voice with my vote. Middle class, too, here. I have heard a lot of people say scrapping the whole thing is the solution, though, and I do disagree. Premiums have to be lowered, but seriously lowering funding for Medicaid and giving HSA owners and others a tax break while my self employment taxes go up isn’t a solution I can get behind. Medicaid covers disabled children of all income levels in states that use the Katie Beckett allowance, and I do think the coverage for lower income families is a good thing holistically.

    I’d like to see premiums lowered through amendments to the current legislation, and have been reading a lot lately about addressing the actual cost of care rather than just insurance premiums. From my cursory research, there’s a lot of interesting stuff being talked about. Hopefully we can all get unpolarized enough to come to the table to discuss. I really believe if more people voted in primaries we wouldn’t see as many legislative representatives at each extreme.

  13. Hi Femme – In order for premiums to be lowered, we’d have to get legislation to lower provider charges. Not sure how that works, or if it can. The problem, fundamentally, is a national mindset that we must spend “whatever is needed” to get the “best healthcare”. While we can all support that thinking philosophically, we also need to realize that this can’t happen without trade-offs. No one will support those trade-offs, certainly not politicians.

    I think this will end with some sort of rationing, while acknowledging that rationing is considered to be an unacceptable outcome. But I don’t think it will be legislated in, so there won’t be a debate on the topic. I think it will come about through crisis. As premiums continue to spiral higher, more people will drop coverage, or move over to Medicaid. The providers will be forced to go to cash payments, and that’s where the rationing will happen – involuntarily.

    This isn’t what I want to happen, but what has to happen if there isn’t a cohesive legislative solution. And I don’t think that will happen, because it will require politicians to come forward and admit to the people of America that the healthcare gravy train is over. They won’t do that, they’ll continue to send the “everything is fine” signals, and tell us we just have to tweak the current system. Then things will play out the way things do when chaos rules the day.

    As a nation, we have a choice – we always do. But only up to a point. When we keep kicking the can down the road, to avoid making difficult choices, the choices become more constrained and more painful. I certainly don’t have a crystal ball, but I think this is more than a reasonable outcome, though admittedly not a pleasant one.

  14. I guess I just fundamentally have been getting a different conclusion from watching the same events unfold. I have seen politicians acknowledge the need for change and negotiation, and I’m getting that you haven’t. I don’t know that either one of us is wrong. We may just have been exposed to different things. I tend to be more optimistic that if we can take some of the vitriol out of this convo, cooler heads will prevail and politicians from both sides of the aisle will be able to work together to find a solution that actually helps the American people–if we demand it. If we can’t do that on healthcare, and allow it to devolve into the apocalyptic scenario described, we have major societal issues beyond just health insurance premiums. And yours are unaffordable. Shoot, I even tend to think mine are an undue burden. As someone else with a pre-existing condition, I empathize with you and hope we as an American people are able to work together to hold our politicians accountable towards working together to avoid a disaster rather than sitting staunchly in their opinions to prove either extreme ideology is “right” or “better” to the point of collapse. I’m not ready to give up yet.
    (I also think the middle class is disappearing to complex factors including but not only related to health care, and downward mobility is a problem for everyone–even if they individually find themselves on the “up.”)

  15. I wish I shared your optimism about the political system. I tend to be optimistic about people and about myself, as individuals. That is, I truly believe that each of us can improve our circumstances, even in the midst of national troubles. I believe in the sovereignty and unfailing love and provision of God, the ingenuity of the human mind, and the unfailing desire of the human spirit to thrive despite prevailing trends.

    But on a big picture level, the one controlled by the political establishment, I see only fear mongering and paralysis, accompanied by a lack of public consensus. Collectively, at least at the national level, we seem utterly incapable of fixing even minor problems. We’re terrified of making a mistake, and the result is perpetual inaction. As well, a public conditioned to getting benefits from the government at every turn has become incapable of unifying around workable solutions. It’s as if long ago we sold our birthright for a bowl of stew (biblical reference). All of our national problems revolve around a national attitude of “make sure I get mine”. Until politicians have the confidence to fix what’s broken – by coming forward and telling us “we can fix this, but you’ll all have to give up X” – we’re effectively leaderless.

    I hope your outlook is the one that prevails Femme, but I just don’t see it. I suspect I’m a good bit older than you, so I have a different take.

  16. Sorry to hear about your difficult situation.
    I am part of the protected class – i.e. a state government employee – but even we have seen increased costs over the last several years. Almost embarrassed to say that 10 years ago, my oldest daughter’s 2-month stay in the NICU was fully paid for by the taxpayers of our state. So, now we have much higher monthly outlays (still nothing compared to your $1875) as well as copays and deductibles to meet. But I think that is more of the key- the so-called protected and intelligentsia have to have some kind-of skin in the game in order for real change to be made. We have to be made to see how much things cost and use our (still small) political power to make some changes. Unfortunately, being a government employee can at times be a glorified welfare state on the left side of the aisle where the solution is usually more spending (see Illinois). No one seems to believe that there might not actually be an unlimited supply of money at the end of the rainbow.
    And the current health care debate/reform really does nothing to arrest costs. That $20 aspirin is still going to cost $20. And as you say, it really takes courage to even do just a little bit. You can see who is going to benefit from the health care bill by looking at the stock prices of the health care companies that have been skyrocketing over the last several months.
    So, this has been a bit rambling, but I am coming around to your bent that the health care system has to spectacularly collapse and hopefully take down the stock market, housing, and college bubbles with it.

  17. Interesting that you mention Illinois. I’ve been following that situation even though I don’t live there. I see it as a foretaste of bigger and wider problems. Right now it’s being seen and reported as an “Illinois problem”, but I remember well that the mortgage meltdown was originally reported as a “subprime problem” that wouldn’t affect the general mortgage market. Ah…no. What’s been happening in Illinois has been happening in most states to different degrees.

    I give you credit for admitting to what you see as an “insider”. What you’re seeing is a big part of the problem, and something that doesn’t get discussed (special treatment for government workers). A few years ago I was talking to one of my cousins who’s a fireman. He was complaining that the city wanted them to begin paying $5 copayments for doctor visits, and the department was up in arms over it. We were already paying like $50. I respect what he does for a living, but do the public employees have to get a (much) better deal than the taxpayers who are paying for that deal? That guarantees the imbalance will continue. There are too many protected classes and niches in our society and it isn’t helping.

    My own feeling is that collapse is going to happen due to inertia. If something this big is spinning out of control, and nothing is done to correct it, the end result will be a disaster. You don’t need to be a fortune teller or a prophet to see it coming. Everyone wants to pretend that it will “all work out” as long as we continue doing what we’ve always done. I’ve heard this referred to as normalcy bias, and it’s just a mindset that has nothing to do with reality.

    Wikipedia describes normalcy bias this way, and I think it totally describes the American mindset across the board, including with healthcare:

    “The normalcy bias, or normality bias, is a mental state people enter when facing a disaster. It causes people to underestimate both the possibility of a disaster and its possible effects, because it causes people to have a bias to believe that things will always function the way things normally function. This may result in situations where people fail to adequately prepare and, on a larger scale, the failure of governments to include the populace in its disaster preparations…The assumption that is made in the case of the normalcy bias is that since one has never personally experienced a disaster, one never will. It can result in the inability of people to cope with a disaster once it occurs. People with a normalcy bias have difficulties reacting to something they have not experienced before. They also tend to interpret warnings in the most optimistic way possible, seizing on any ambiguities to infer a less serious situation. Normalcy bias is essentially a “desire for the status quo.”

    This is why I can’t agree with some who feel this will somehow work out. If we can step outside of our comfort zones and dare to see the darker side of what’s happening, we might be able to reverse disaster. But if we face it with denial, we’re just inviting a bad outcome. So we have this healthcare bubble that no one dare’s label as such.

  18. The people I know who live in Europe and Canada like their systems far more than anyone I talk to here in the good old USA. If you think their taxes are too high, do a fair comparison and add all your medical costs as well as your insurance premiums, co-pays and deductibles etc to that tax percentage you think is lower here. When you recalculate you might find we pay far more than they do. The “death panels” are right here in our country, pricing you out of life saving medical care now. The only health concern here is the health of company profits in the medical and insurance industries. How many of the rich executives making obscene salaries in those industries have taken pay cuts because “times are so tough”. However, executives here have no problem cutting YOUR pay and benefits and then having the nerve to tell you to pay for all or most your health care and finance your own retirement too.

  19. Hi Daniel – I think you may be on to something with that analysis. The only reason healthcare is tolerated by the population here is because it’s largely hidden out of sight. For example, about 40% of the US is on either Medicare or Medicaid. Another 20-something million (plus their families) work for some level of government and enjoy plans that are superior to what people employed in the private sector have. And as for the private sector, employers typically subsidize 50% or more of the premium as an employee benefit. But if you’re self-employed or employed without coverage you feel the full weight of the real cost of healthcare.

    In the end, since more than 18% of the economy is consumed by healthcare expenses, it acts as a tax on everyone. But if you aren’t actually making the payments (other than the reduced premiums being taken out of your paycheck) you really don’t see what’s happening. As a result, you may believe that the system is relatively fair here.

    The problem is that healthcare is the biggest single industry in the US, and the largest growth industry at that. It’s a major profit machine for the people at the top. And given the ad revenue that it generates for the media, they will speak no evil of it. And here we are.

  20. I’ve been reading Charles’s blog for many years, and have even contributed there. I recommend it strongly for everyone – he’s downright brilliant. Though the fact that he’s talking about this topic is coincidental. He talks about the healthcare problem often, and I agree with his positions fully. There’s a lot of people on the web talking about these problems, but since most people mostly follow the mainstream media, they tend to be “surprised” at the depth of the observations and opinions they find on blogs. I think that those of us on blogs are a lot closer to what’s really happening, not the least of which since we report firsthand experience, as I’ve done with this article.

  21. Hi Kevin. I, too, am sorry for your situation, and I hope it resolves soon. You have pointed to some options, though not stellar, are at least something. I watched a documentary recently on Sunday night with Meghan Kelly and then was reading more about it. This may be off-base here, and I’m not fully knowledgeable on the entire subject, but here it is. It has to do with the opioid epidemic we are having in this country and the raping, if you will, of the healthcare system because of it. It was quite disturbing, but the scam is like this…the scammers open these so-called sober homes and claim them to be rehab facilities. No licensing, credentials, nothing. The addicts go there, and their insurance companies are billed these outrageous fees for services not given (labs are involved in the kickbacks), and the insurance pays out. This ties into Obamacare because that insurance is supposedly unlimited for rehab. The disturbing part is that these “people” that own these sober homes, if you can call them that, are still supplying the addicts with the drugs and then consider them to have a relapse and continue to bill. It’s quite an extensive scam. I think this is another reason the insurance premiums are so high. The scammers are being paid tons of money that the taxpayers are paying for through Obamacare. A very unintended consequence of the ACA, but yet another way to steal “legally.” Sort of like the mortgage meltdown, but sadly in this case, the addicts aren’t getting the help they need, and they are dying. Sorry for the long rant, but you can read about it. It’s so sad what’s happening out there. I’ll stop only because I’m so verbose.

  22. Hi Bev – I’m really glad you shared that story. It points to the fact that we’re in a healthcare bubble. All bubbles are characterized by scams. Because the money flows in so freely, it’s easy to take advantage of the system. Right now millions are making a fortune on healthcare one way or another. Worse, a lot of it seems superficially beneficial. Like all these miracle drugs that are being dispensed. A lot of them do nothing at all, and most do only a fraction of what the manufacturer claims. But they’re being dispensed to millions of people who are incurring risks without the promised benefits. Again, in a bubble no one questions it. But it’s a sure sign that the bubble is about to burst. People are being over-charged, and money is being squandered in the name of keeping us healthy. It all sounds so noble, but much of it is either completely or mostly without merit. I suspect this will all work itself out, but not the way most people think. This is an excellent time for us all to become more proactive in taking care of our health. The medical “miracles” may be very hard to come by in a few short years.

  23. Kevin, I’m sorry to hear about your situation. You’re right, of course–the situation with health care in America is obscene.

    My wife and I could not afford the ACA either. I was shocked by what it was going to cost us. The only thing good about the ACA is the coverage for pre-existing conditions. Personally, I think the whole insurance thing is a horror, and support single-payer. I see no other options, honestly. The idea of the “market” doesn’t make me feel good at all. We are heading for a cliff, and Trump keeps lying about how great things are going to be. It’s like no one is taking the plight of regular Americans seriously.

    Good luck to you. We differ politically, but I really love this blog.

  24. Hi John – While I have unfettered confidence that our government has unlimited ability to mess up whatever it touches, I’m coming around to the idea of a single-payer system. The Canadians and Europeans are working with it, and paying only half what we pay on a per capita basis. The complication of course is that we’d be starting with a higher cost structure.

    As well, there’s an American mentality that there’s no limit to what we as a nation can afford, so it’s likely that the price spiral will continue. America’s unique privilege of having the international reserve currency means there’s no effective limit on how much the nation can pay for anything. But even with that advantage, look for taxes to explode in response to the price spiral. We can know this with certainty since 40% of the population is already covered by the government via Medicare (56 million people) and Medicaid (74 million), and prices are rising.

    My guess is that when the government starts cutting payments to a single payer system, we’ll all be required to cover the difference. Enter supplemental coverage (as already exists with Medicare) and cash payments, and it won’t be long before we’re right back to where we are right now.

    It’s hard not to be pessimistic about these things. We’ve got some entrenched patterns and mindsets in the country that need to be addressed, repudiated and reversed before anything can get better. Changing the payment system won’t alter the current grab bag quality of the healthcare system.

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