It all comes down to the mathematics.
Like everything I spend on life; eating, the roof over my head and transportation, they each are determined by what I can afford and what I consider to be important in my life. The finite limit on my monthly expenses is the money I generate each month. Thus, the only thing I have control over is how much I spend. Freedom should allow me to determine what I value more and thus it should allow me to choose what I spend my money on.
This is the arithmetic of my health.
In my particular case, my penalty for not carrying health insurance for 2015 was $1,394. (A quick note: my wife and child are covered by my wife’s work place)
In 2015, I spent a total of $348.96 in medicine and a doctor’s visit for flu-like symptoms. My medical expenses average for the last three years is about $300.00 annually. Yes, I track how I spend my money each year, even how much gasoline I put in my car each week, so you can rest assured that these numbers are pretty accurate for my case.
Taking the penalty and adding my medical expenses for the year gives us a total of $1,742.96 for 2015.
Now let’s look at the alternative. I do not qualify for federal subsidies and as a self-employed individual I cannot offset the cost of my health insurance premiums with employer contributions. Therefore, the “silver plan” would cost me about $476 a month. That comes out to $5,712 a year for the health insurance premiums. The “bronze” plan would cost me about $410 a month, or $4,920 annually.
It is also important to note that all of the health insurance plans require you to pay out of pocket expenses that are in addition to the monthly premiums. The out of pocket expenses can go as high as $6,000 annually, depending on the plan. Therefore, it is very likely that the $348.96 I paid in 2015 would have been required anyway. But, let’s forget the out of pocket expenses for the moment and focus on the arithmetic of the penalty versus the premiums.
The Obama Care Arithmetic
In my case, I have two choices, pay $1,742.96 or pay $4,920 annually.
I am sure you can see that not having health insurance is the most cost effective solution for me. It saves me $3,177.04 annually, or $264.75 a month.
I am sure some of you are thinking about the political rhetoric behind the affordable health care act and asking yourselves, but what will I do if I come down with a serious health problem or I am seriously injured.
It is a fair question that deserves an answer.
Like all responsible adults I make life-style decisions every day. My wife will attest that I am the worst eater because I prefer donuts and red meat over vegetables. However, I may not eat as healthy as I can but I do watch my weight, a never ending battle, and I try to take care of myself.
In regards to serious accidents, I have control over certain daily decisions that may impact what serious injuries I may suffer. For example, do I get drunk in public – no. Or, do I jump out of airplanes, I used to – not anymore. Of course, there are those events that I have no control over. For example, car accidents. As a responsible adult, I carry automobile insurance. If we were all responsible, everyone would carry automobile insurance. However, the reality is that not everyone is a responsible adult. That is why I also carry uninsured motorist coverage. In a car accident, my automobile insurance covers the lifesaving measures that I may need. Notice that I used the word “lifesaving”. I’ll get into that later in this post.
For those of you thinking about pointing out that automobile insurance is a government imposed requirement you must remember that the cost of paying for automobile insurance versus the cost of tickets makes carrying automobile insurance the best option. Not so for health insurance.
For now, in the instances where I may suffer a serious injury, either my automobile insurance will cover it or not. If, the individual that caused my injuries is uninsured or unable to pay for my medical care then I have to pay for my own medical bills. Not fair but it is a part of life. It is also a life-style decision. I have access to savings and credit through making wise decisions in my life. If need be, I can rely on them. However, either comes out of my pocket, so my first question when a doctor makes a suggestion about a specialist is, is it really necessary. That is followed with, explain to me what the repercussions are if I do not spend the money on what the doctor is suggesting. As with all decisions in life, I make the final decision on whether I cannot afford it and whether the expense is worth it to me. And yes, I have made these types of decisions before.
The complexity of life makes all decisions complex and there may by an instance when I may not be able to make coherent decisions because of my injuries. I have thought about that and have made the decision on how to deal with those situations as well. But first, as they are related, let me address the issue of severe illnesses.
There are serious illnesses that cannot be predicted and therefore I must make decisions on how to deal with them. This is where I radically diverge from the thought that medicine is about quality of life instead of emergency life-saving medicine that most of you have been led to believe.
In my opinion, medicine has evolved into a money-making operation where medical decisions are made based upon making money instead of life-saving medicine. For example, cosmetics has now become a standard of care in most medical decisions. Not too many years ago, if a child broke an arm, it was a quick x-ray and then a cast. Today, an orthopedic surgeon must be consulted before the bone is mended. Likewise, specialists are now recommended for concussions at the playground or sprained ankles that require consulting specialists and multiple visits to the doctor.
The conspiracy theorist in me believes it is about generating more revenues for the medical profession while others argue that it is about offering the best medicine possible. However, the reality that many have forgotten is that we should be responsible for deciding what we can afford and what we cannot afford. It is about making life decisions.
In my planning, I prefer to spend the $264.75 I save each month on taking quick weekend trips to the beach with my family or going to the movies and dinner, instead of on health insurance.
This now brings us to the issue of unplanned severe illnesses or injuries that are catastrophic. To address these, I have been clear with my family about my wishes. Additionally, I carry a directive with me that states that I do not want extraordinary healthcare or life saving measures, in other words, a DNR. I try to be careful with what I do each day. Even then, there is the uncertainty about life where I may find myself having to deal with an unplanned and catastrophic injury or illness. That is life.
Like everything else, I must deal with it within my own resources and not depend on others to give me the solution. I believe that I deserve a Porsche, yet I cannot afford one, so I drive a Nissan Juke. Likewise, I deserve the best that medicine has to offer but I cannot afford the Cadillac of healthcare and thus I plan for the life-sustaining healthcare, not the cosmetic medicine that focuses on whether a scar will be visible that is practiced today.
In a perfect world, the basic-life saving emergency medicine would be free for all. That would be life-sustaining emergency medicine that would deal with the emergency without the need for medical specialists to be on call. In this type of medicine, a broken bone would be x-rayed and a cast put on it. If the patient wanted an orthopedic surgeon to review it, then they would pay for it with their own insurance or from their own wallet. In other words, emergency medicine would deal with the immediate problem and it would be up to the patient to make the decision to spend their own money to deal with the consequences of the injury or the illness.
As governments would have to fund basic life-saving medical treatment then there would be a tax involved. However, in a perfect world that tax would be $50 or less a month. Unfortunately, there are those irresponsible people that would abuse the system and go to the emergency room to deal with flus, colds or the results of life choices they made on what they ate or consumed.
Obviously, this does not answer the issue of what to do with a severe illness. As cold as it may sound, ultimately it comes down to your individual choices in life. If you want to prolong your life for as long as possible then you make the choices each day on how to do that as well as you pay insurance premiums that guarantee you the best medicine the world has to offer.
In my case, I roll the dice and I have decided that what I can afford is to live life to the best of my ability today and hope for the best. In case that does not work out, then I have made the choice that extraordinary life-saving measures is not what I can afford and thus I do not expect to receive it.
Unfortunately, the Affordable Healthcare Act has reduced what I can afford each month without giving me anything in return. It is the result of a government imposing moral values on a society. The end result is that it does not do that nor does it make my medical choices any better, it just takes away $145.25 from me each month, although I am a responsible individual. In other ways, I am paying almost $150 a month more for those that choose to be irresponsible with their lives. I pay so that others can continue to rely on the government to be responsible for them.