Obamacare: You’ll Stop Complaining When You Need It (IMAGES)


I have written a lot about Obamacare over the past two years or so, and I have decided that it is time to share some personal thoughts about it with readers. A couple of months ago I was reading a lot of stories about premium increases for 2015, and some of the continued whining about people “losing” their insurance policies, winding up with large out of pocket expenses, having to change doctors, etc. While I have sympathy for some of the stories I have read, on balance this law is helping many more people than it is hurting. Since I am in a group policy, my story isn’t directly about Obamacare. It’s about the high cost of getting really sick, and why everyone needs good quality health insurance.

I didn’t expect to get cancer. There is little history of cancer on either side of my family. Our family issue is heart disease, and I have been convinced for years that I would die of a heart attack. So you can imagine my surprise when, in January 2013, my doctor told me that the mole he removed from my back was melanoma.

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If you have never been really sick before, you may have no idea of how quickly expenses can pile up. Fortunately for me, I have insurance. I have damned good insurance, so the expenses that my illness created were largely taken care of. But, if you don’t have health insurance, or if you have a policy that doesn’t cover major illnesses, getting seriously ill can dig you a financial hole that you will likely never climb out of.

As I share the expenses that, fortunately for me, have been paid by my insurance company, keep this in mind: melanoma is, among serious illnesses, a fairly inexpensive disease. I know people who have had other cancers, and those who have had heart, or brain, disorders, whose bills have been two, three, or more times what mine has been so far. So, if you think you could not afford to pay the bill for melanoma, there’s no way you could pay a bill for an illness that keeps you in intensive care or cardiac care for several weeks. In most places, that bill will easily be over a million dollars.

Round 1: The expenses begin, and I am thankful for insurance.

After my pathology report came back, my doctor referred me to a surgical oncologist. After reviewing my records, she scheduled me for a PET scan, to see if the cancer was anywhere else in my body. That scan was clean, so she scheduled me for surgery, to remove the remainder of the tumor, and to do a sentinel lymph node biopsy, to see if there was cancer in my lymph nodes.

I had my first surgery on February 13, 2013. That concluded what I call “round one” of my treatment. The total cost paid by my insurance for all the tests, medications, surgery, etc? $19,707.89. Not cheap, but not that expensive. Still, without insurance, it would have taken me several years to pay off. But I was only getting started.

Round 2: One month later, more surgery, more charges, I am more thankful for insurance.

The pathology report on my lymph node biopsy found that one of the nodes had microscopic cancer cells in it. That meant my surgeon had to schedule more surgery, to remove all of the lymph nodes in my left armpit area. That surgery, known as a left axillary radical lymph node dissection, was completed on March 13, 2013. My insurance picked up most of the cost, to the tune of another $18,602.14.

Following that surgery, my surgical oncologist passed me on to a medical oncologist. The medical oncologist sent me for MRI’s of my head and body. Add another $2,164.92 to the amount my insurance covered.

At that point, my insurance had paid for $40,474.95 of my medical expenses. Still, not a terrible total. But, keep in mind that the average American only made $51,017 for the entire year, in 2013.

My oncologist then recommended that I see a melanoma expert at Johns Hopkins. That doctor recommended that I begin treatment with a drug called Sylatron. Sylatron is designed to prevent melanoma from coming back, once it has been treated. It is a long term treatment, that you have to take weekly, for months. My insurance paid for the first eight doses, at a cost of $26,000. Fortunately for my insurance company, but unfortunately for me, the first dose made me so sick that I couldn’t continue taking it.

Round 3: Without insurance, my choices likely would have been to bankrupt my family, or die.

I was cancer free for almost a year and a half. In August, 2014, I noticed several lumps under my skin, near where the original melanoma was. At a regular appointment, I showed them to my surgeon. She sent me for another PET scan, and the verdict came back: more cancer. I had a third surgery on September 10, 2014. The total of all tests, procedures, etc, related to that surgery came to $29,023.96.

After I recovered from that surgery, it was back to the medical oncologist for a third PET scan, and another charge of $2329.62. So, from the day my family doctor told me that I had melanoma, my insurance had paid $97,828.53 for my medical expenses. But I hadn’t seen the biggest single charge yet.

The third PET scan revealed more possible cancer under my skin, as well as a spot on one lung. I saw the melanoma doctor at Johns Hopkins another time. He and my regular oncologist agreed that I should begin treatment with a drug called Yervoy. The expenses related to Yervoy, again, all paid by my insurance? $147,449.37.

Why you need to pay for your insurance, and be glad you have it.

As of today, my insurance company has paid almost $250,000 towards my cancer treatment. So, if you are complaining about your $500 a month policy, just stop. If you had no insurance, it would take you almost 42 years to pay off a $250,000 medical bill, at the rate of $500 a month. And that is assuming that you wouldn’t have any other medical expenses along the way. Remember, compared to some, my medical bills have been cheap. Even at $1000 a month, you couldn’t pay off a $1 million medical bill in your lifetime, unless you are planning on living to be very old.

Nobody likes insurance. Nobody likes paying for something that you may never get anything out of. I have said for years that insurance is like betting against yourself, and hoping that you lose. But, until we get universal health care in the United States, we all need it.

If you get hit with a huge hospital bill, and you don’t have insurance, you get treated, anyway. You might want to act noble, and say, “It was my choice, so just let me die.” But I’ll guarantee that if you are faced with the possibility of dying, you won’t say that. When uninsured patients wind up with huge bills that they can’t pay, who picks up the slack? Everyone with insurance. That’s why medical costs had been shooting up, every year, before Obamacare. Now, the rate of increase in costs has slowed dramatically.

Oh, and if you are one of those who is complaining about losing his inexpensive insurance policy? You probably lost it because it didn’t meet the standards of the new law. Which means that it was probably worthless when it came to coverage of major illnesses, anyway. Consumer Reports did a study in 2012 that found that those policies with low premiums were, in some cases, worse than having no insurance at all.

So, my advice to you is simple. Quit complaining about Obamacare. Find a policy that works for you on your state’s, or the federal exchange. Hope you never get really sick. But, if you do, know that you will have what I have right now: peace of mind. I don’t know what my outcome will be yet. But I know this — should I succumb to melanoma, my family won’t have to pay my medical bills for years after I am gone.

Here are a few sample charges, showing how my insurance has kept my family from having to pay a huge medical bill. (Click on the images to see them full size.)

Charges for pre-surgical testing

These charges came from my PET scan

Partial list of hospital charges for surgery

Charges related to medications used in my first surgery

Partial list of hospital charges for surgery

Various charges from my first surgery

Operating room charges

Operating room charges

 

Operating room charges

Operating room charges

Partial list of hospital charges for surgery

Charges for my overnight stay after surgery #2

Partial list of hospital charges for surgery

More charges from my second surgery

Charges for my therapy with Yervoy. The first charge in this group is for 4 infusions of the drug.

Charges for my therapy with Yervoy. The first charge in this group is for 4 infusions of the drug.

Image courtesy The Daily Mirror

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