Is the new bill a good thing?  I have no idea.  How can you form an opinion on a bill that is over 2000 pages long?  How can you form an opinion on something that has so much mis-information floating around that it is impossible to tell fact from fiction?

My mother and I have this discussion every time we talk.  She is against health care reform.   The reasons that she cites are the exact ones that are supposedly debunked in the Top Five Lies About Obama’s Health Care Reform.  This Newsweek article explains the top 5 objections to the Health Care Reform bill.   If you believe that the bill will offer free coverage to illegal immigrants or cut benefits to the elderly, you should read this article.

On the flip side, CNN Money has an article on The 5 Key Freedoms You Will Lose.  They write that you will eventually lose the right to choose your own coverage or to choose your own doctor.   These are important choices that everyone should be able to make.

So which side is right?  Is Health Care Reform inherently evil or the best thing since sliced bread?  I don’t think that the average American can possibly make an informed decision on that.  The debate is presented by lawyers and politicians who are paid to read the 2000 page bill that has been written in legalese and then interpret it in the way that is most beneficial to their side.   I could sit down and read the bill and know as little when I finished as when I started.

What are the needs of people like me who cannot afford to pay the high costs of health insurance?     I have found various estimates on the average cost of health insurance that range from $4000 per year to $7000 per year.  This ranges from 40% of my income to 70% of my annual income.  It’s not much of a choice.  When I last checked into insurance, the monthly cost was approximately $300 per month and I am a healthy woman in her 50s.  I don’t have any pre existing conditions.  I don’t have diabetes, I have never had cancer, my heart is in great condition and while I am slightly overweight, my cholesteral is within normal limits.  I have never had high blood pressure.   My total health care costs over the last 5 years equal less than $500 and that includes doctors visits and prescriptions.

While I still view health insurance as a necessary evil, I can’t afford to pay more monthly for insurance than I would for a year of expenses.  I would like to have a basic plan for major medical that would cover my hospital bills in the event of an emergency.   I honestly don’t care if I can pick my own doctor or hospital.   I don’t expect Cadillac service on a Yugo budget but I would be happy with some affordable options for hospitalization coverage.

I realize that this article has had more questions than answers.  I think that is the general state of the health care debate now.  I seriously doubt that anyone including the Congress has a clue about the impact of the WHOLE bill.   And I think that because of the complexity of the situation, we should stop and quit trying to rush the solution.  The health care system needs reform but I believe we should be approaching it in smaller,  less complex steps instead of sweeping reform that is bound to fail.

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With my father’s illness, it has become apparent that it’s not enough.  The one thing that they weren’t really prepared for was one of them having to have long term care.  Medicare  and insurance only pay for a limited number of days in a nursing facility.  It’s not something that any of us want to think about needing but AARP says that 69% of men and 79% of women over the age of 65 will need long term care.

Cost of Long Term Care

My father was admitted into a small nursing home affiliated with the hospital.  The cost per day is $132 or almost $4000 per month for a semi private room.  This is more than both his retirement and his social security combined.  It’s a nice nursing home but it’s not the Ritz.  Even if my mother could afford to pay it, the cost would leave her unable to pay the monthly bills at home.

Medicare and Health Insurance

Medicare and regular health insurance pay for only 20 days of long term care in a nursing home IF the patient was hospitalized for at least 3 days prior to admission.  This pays for a semi private room, regular nursing care, meals, rehabilitative services, drugs and medical supplies.

My father has a terminal illness and alzheimer’s.  He has been getting progressively weaker and has trouble getting up and maintaining his balance.  My mother is not able to lift him to help him out of bed so while he does not need round the clock medical care, he does need round the clock assistance.

Nursing Home Alternatives

Their choices are somewhat limited.  They can pay someone to come into their home to assist my father.  Right now, they may only need someone during the day to get him up.  Eventually, they will need round the clock care though. This should be less expensive than the nursing home for the moment.

The family can take care of him.  Our family is rather scattered.  My sister is the closest but she could not physically take care of him.   I am the logical choice but I am 7 hours away and have responsibilities at home that make it difficult to stay in Georgia.  I will probably be making arrangements to do just that though.

Long Term Care Insurance

For those of us who are approaching retirement age,  we may want to consider long term care insurance.  According to this website the cost of long term care insurance for a 50 year old is $564 per year, for a 65  year old the annual cost would be $1337 and for a 75 year old the annual cost would be $5330.  Deductibles and benefits can vary with each policy and affect the cost.  The premium amount should not change once you have enrolled in coverage so look at the long term cost before you purchase a policy.  Pay particular attention to the deductible amount as this can be as much as 90 days before coverage begins.

This is going to be a difficult decision for  our family.  Has anyone had any experience with long term care?  How did you cope with it?  Do you have long term care insurance?

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by S.C. Axman

I don’t have health insurance.  It is a constant worry that one of us will get hurt or ill and we will not be able to get treatment.  I have looked into different individual plans but haven’t been able to find one that we can afford yet.  I am not advocating being uninsured but to help the millions of people who are uninsured.

1. Tell your health care provider.  In this area, there are doctors and clinics that provide health care on a sliding scale to patients that don’t have insurance.  They can also often help you out with sample medications.
2. Start an Emergency Medical Fund.  You can only open a Health Savings Account (HSA)  if you have a high deductible Insurance plan but there is nothing that says you can’t put money in a savings account for medical expenses.  You can use your regular emergency fund but you have to take into consideration that if you are seriously ill, you will probably not be able to work and you will need your emergency fund to pay for living expenses.
3. Add up last years medical expenses. This will not only help you determine what you need to have in your Emergency Medical Fund but it will also help you determine if paying for an insurance policy would be financially feasible.  If you had medical costs of more than or even close to $150 per month, you might be better off spending that money on a health insurance policy.
4. Check Medical Schools.  If there is a teaching hospital or medical university in your area, they may offer free clinics or sliding scale medical care.
5. Call your local Social Services Office.  While you may not qualify for benefits through them, they can tell you of any free clinics, state programs or lower cost clinics where you can receive treatment.
6. Check with Pharmaceutical Companies.  If you cannot afford your medication, it can be worthwhile to call the manufacturer.  Pharmaceutical companies sometimes will offer reduced rates to people who cannot afford their medications.  You can also ask your pharmacist and doctor.
7. Check High Deductible Health Insurance Plans.  If you have a healthy emergency fund and can pay some of your health care costs (most of the uninsured already are) high deductible plans can be very affordable.
8. Look into Limited Benefit Plans.  There are two types of limited benefit plans and they are very controversial but they may be better than nothing.  The first type is the Discount Card.  This plan offers a discount on services at in-network providers.  The second type is the Mini Med plan.  This plan only pays a set amount for a limited number of benefits.  With either of these plans make sure you understand the small print and how the plan actually works.
9. Major Medical Plans.  These are extremely high deductible plans usually with deductibles of over $10,000 per accident or illness but they are also much lower cost.  It seems like a huge deductible especially per illness but if you look at the costs of having a single accident, it begins to make sense.  My daughter was in an accident 10 years ago and had a skull fracture.  She was medevac’d to the university where she was in a coma for 3 days in the pediatric ICU.   Ten years ago, the bill was over $60,000 for the hospital alone not including the physician’s bill and the helicopter fees.
10. Auto Insurance Medical Payments.  Almost every auto insurance company offers medical payments with their policies. Medical payments is a no fault coverage for the insured and anyone in the car or involved in the accident.    It is not a replacement for health insurance but it is a low cost hedge against the possibilty that you might be hurt in an accident and need medical care.
11. Shop Around. We don’t normally compare prices for our doctors but if you don’t have insurance, it can help.  There can be vast differences in the cost of health care and prescriptions.  Check around and see which end of the scale your doctor is on and the same with pharmacies.  Pharmacies can offer different prices on different types of medication.  Walmart offers $4 prescriptions and Walgreen’s does also.

I hope that these will help a few of you.  I have had to learn them the hard way and it has been a costly process in terms of both my help and my budget.  If you have found additional ways to save, please feel free to chime in with a comment.

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In early 2003, John bent over to pick up a towel off the floor.  When he reached down, he had a knife sharp pain in the middle of his shoulder blades that radiated down his right arm.  Thinking that he had pulled a muscle or had a muscle spasm, he lay down for awhile and applied a heat.

When it didn’t go away, he took the day off work and rested.  Any movement of his head, shoulder or arm, re-awakened the sharp pain to the point of naseau.  Later that day he made an appointment with a chiropracter.  The chiropracter took xrays and found 3 discs in his upper back that had  slipped, resulting in an 8 degree curvature of the spine.  He referred him to a sports medicine chiropractor and then to a neurosurgeon.

The long and short of the medical history is that the neurosurgeon said that it was inoperable as surgery might make it worse and there was a less than 50% chance that it would improve.  He gradually lost feeling in his right hand and lost the ability to look up and focus on anything due to pressure in his spinal cord.

For a construction supervisor, this was a very debilitating injury.  The short term disability company researched his injury and hired a specialist to evaluate his ability to return to work.  When the specialist sent in his report, the company paid him for 3 years of disability.

In the meantime, his insurance benefits had run out and he was unable to pay the high cobra fees to keep insurance.  He applied to Social Security for Disability and Medicaid.  If you research disability claims, you will find that they are almost always denied the first two or three times that you apply.  This is exactly what has happened to John and he found himself living off his ever dwindling resources.

Five years later, he is still battling the disabilty system.  Unable to afford health care, he has no medical documentation after 2005 to prove his claims.  Because Medicaid is only available if you are approved for disability, he is one of thousands of people who have fallen through the cracks in the system.

John is not some bum who has lived his life off the system, he was just like you and I.  He had a good job with a good income and benefits.  He had worked for the same company for 17 years.  He had a home, a nice car, two kids and a good middle class lifestyle.

Now he is caught in a vicious circle.  His resources have dwindled until they are barely able to pay the small mortgage payment on his family home and the electric bills.  He needs medical care and documentation to prove his continuing disability but is unable to afford the high cost of CT scans and MRI’s and the specialists that are needed to diagnose and treat.  Without further documentation it is likely that his disability claim will be denied again.  He has tried to return to work but a day’s normal activity results in weeks of pain.

He is not alone.  According to Tim at My Disability Blog, more than 50,000 people in Michigan alone are waiting on disability claims.  Sixty to Seventy percent of all disability claims are initially denied and have to be appealed numerous times.  The chances of getting disability are not good unless you hire and attorney or disabilty specialist to represent you.

Do you know anyone who has applied for disability?  What did they go through?  Did they ever receive it?  Are you prepared if you are ever disabled?  Do you have long term disability insurance?  Are you sure?  Many people believe that they have it through their employer but these policies are often limited in time and will not support you during the years that it might take to get Social Security disability.

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