Killing It In My Sixties

True story – I have an $8,900.00 annual deductible on my health insurance plan. Any service that is not deemed routine or preventive must be paid out of pocket, before my 70% coverage kicks in. To give you an example; last year my doctor referred me for a diagnostic upper endoscopy procedure that required about ten minutes of general anesthesia. It was an outpatient procedure – I was in and out in a matter of 90 minutes – AFTER I paid my $2,800.00 copay.

I had not been told I would owe anything that day, so it came as a complete shock.  But I had my ride to and from arranged, had been without food or liquid for 16 hours, and needed the procedure due to experiencing terrible stomach issues for months.  So – cancelling it didn’t seem reasonable.  Fortunately – the procedure was negative for anything serious, but then bills kept coming.  The copay had just been the beginning.  There were bills for the anesthesiologist, the surgeon, the operating room, and the radiologist.  In total, it cost me $4,700 out of pocket to NOT find out what was wrong with my stomach.

In follow-up, the doctor then wanted to order more tests and refer me to other specialists for further treatment. I politely declined any referral, and have declined every other test, treatment, or appointment since then. The only medical services I will now accept, are my prescriptions, my annual physical exam and covered lab work. These things either cost nothing or a very nominal amount. It is simply not affordable to agree to everything that is recommended by my doctor.

A few years ago, I had my routine mammogram – which is a covered benefit – no out of pocket cost.  Unfortunately the radiologist thought there was a suspicious spot on my films and called me back for a more extensive set of mammograms.  After it was determined that the spot was really there – they ordered an ultrasound – and then an ultrasound-guided needle biopsy.  Thankfully the biopsy was eventually determined to be negative for cancer a week later.  But the bill for all the additional tests? Close to $8,000!

Yes – I was grateful for the good news – but $8,000?!  I have declined to have any more mammograms since then.  I simply cannot afford anything other than a perfect diagnosis.  My doctor doesn’t even argue with me any more.  I told her that even if I did have breast cancer – it would be cheaper to die.  As she reached to make a note in my medical chart, I stopped her and said, “No, I am not a suicide risk or in need of mental health attention – it just doesn’t make sense to pursue or seek unaffordable treatment”. She couldn’t disagree with me.

How did we get to be a nation where medical care is beyond reach as we get older?  A monthly premium of $1,100 provides me the assurance that I can have my prescriptions filled and that if I am in a life-threatening situation – a hospital will take, and treat me.   On a daily basis, I weigh whether or not the $13,200 per year in insurance premiums is worth anything at all?  Doctors won’t take you if you don’t have insurance, and having insurance doesn’t mean it will pay for your treatment.

Medicare does not kick in until the age of 65, which means you must have some source of health insurance up until that age. In researching options, I have found that it comes down to four basic alternatives: 1) Employer-provided coverage, 2) Medicaid/MediCal, 3) Spouse’s insurance, 4) State or Federal-funded healthcare group such as “Covered California”.

So, if you are fortunate enough to still have a job, and ageism in the workplace hasn’t prevented you from being hired – this is your best alternative. Medicaid has a low income threshold, so is not an option for the average middle class person. If you are single – no spouse? No insurance! And options such as Covered California premiums are based on your annual income and often cost-prohibitive.

And don’t even get me started on long-term health care when assisted-living comes into play. I am grateful that both of my parents are able to afford their health care costs and they both have loving partners to care for them as they age. I am happily single but do worry about my future as I age. I absolutely do not want my sons or their spouses to be responsible for taking care of me on any level, in my later years.

I have considered moving to a European country, like Italy, where their universal health care system is classified as the 2nd highest rated in the world. Medical care is top notch and completely affordable to all. Access to prescription medicines is easy and a doctor visit will not put you in the poorhouse. Italian law recognizes health as a fundamental right of every person and anyone present in Italy is entitled to a form of healthcare – citizen or not. What a concept!

I don’t know where the coming years will take me – but I’m praying that God will see to it that I am ushered from this life swiftly and without great expense. Maybe when my time comes – we will have that figured out as a society.