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Monday, July 18th, 2011 01:45 am
I decided I couldn't afford to spend seven hundred and fifty dollars a month for a baseline medical care, and I let the COBRA go. It means I do owe the insurance company about that much for what they paid for while I was making up my mind. But this is the really odd thing. I had been paying about a hundred and fifty dollars a month for medications while I was insured. (the COBRA is just under six hundred dollars a month: that and the medicine cost was how I got to the seven-fifty figure)

This time when I bought the medicines without insurance the pharmacist pulled some kind of discount out of the air and it cost me eighty-three dollars.


I really don't understand why the insurance companies charge such high premiums. "Because they can" is the natural answer, but the thing is, they can't. Not with everybody's wages falling and all the support systems falling out, and housing and fuel and food costs not dropping. For example. I have been making about $1,000-$1,400 a month since I got laid off: and now I am an "independent contractor" which means I'm responsible for my own taxes, etc (in other words, this is going to hurt me again next year, even if I do get a real job again). So $600 a month for insurance plus $150 a month for medicine is simply not happening. I could go on about the rest of my expenses -- they are not generally high, compared to other supposedly "middle-class" people -- well, I'm a professional with certifications, doesn't that make me middle-class? Right? -- but you don't need me to break down all my expenses to see that I'm just not going to make it on $400 a month after medical expenses. That's before we get to the fact that I'm actually supporting two households on this money (no, he can't work his way through: it's illegal. No, he can't get grants: they don't give them to students at foreign schools. Yes, we're taking loans out for him. No, we can't take out enough loans to cover it all)

Discounting the kid in school -- though a lot of families are in the same boat, there, since financial aide has been gutted all over the place -- it's still not enough money. And I have a ridiculously low mortgage, and I lack a lot of other expenses that many have. So the picture emerges: the insurance companies raise their rates, and people can't pay them. Sooner or later they'll discover that they just aren't getting the premiums.

I don't understand how the mandatory incurance coverage will work when it kicks in next year. If individual insurance rates remain the way they are, we'll turn into a country of blatant scofflaws overnight. Supposedly you'll have to pay a fine if you don't have medical insurance. But if we don't have the money, we don't have the money. I can hardly imagine they'll garnish my house over it. Would they?

On another front: I kind of lost today and I kept thinking it was Monday, which would have made things even worse.
Tuesday, July 19th, 2011 12:50 pm (UTC)
My sympathies.

There is supposed to be help for people who can't afford the insurance. Because it is mandatory, people who wouldn't otherwise buy insurance will be in the program, so there will be a larger pool of funds. In principle, individual health insurance could be made much cheaper with the mandate because more people who wouldn't otherwise buy insurance will be paying in. However, anything that would reliably limit insurance company profits was taken out of the final bill. So prices will be raised to soak up as much discretionary income as possible for the majority of participants in the plan. The state regulatory agencies still have authority, and in larger states that may help, but in smaller states, I think matters will be grim. When the mandate kicks in, I think the screams will be audible from Mars.

Then there's the problem of starting to collect the mandate in the middle of a depression. I suppose it is possible that increased spending on health jobs (the health insurance industry is required to spend 85% of the premium money on care) might be stimulative. On the other hand, it seems to me likely that the health insurance industry will find away around that, and sock the money away, just like the banks and manufacturing firms have. The Administration, having fired all its economic advisors (really), apparently believes on no evidence that prosperity is just around the corner and is depending on that hope, and also on IBGYBG--it will be the last two years of Obama's term and past the reelection of every Senator who voted for the PPACA.