High Deductibles & Co-Pays Make Medical Insurance Moot for Many Workers


Have you ever been in the position of having something that costs you money each month but you can derive no benefit from it? When I was a teenager I had a 1966 Pontiac GTO. It was a gas guzzling babe magnet (much more the former than the latter) and I can definitely remember times I couldn’t afford to put gas in my goat.  A gleaming hunk of sexy muscle car sitting in the driveway and I couldn’t drive it for fear of the embarrassment and humiliation of running out of gas. Ironically, it was often my car payment and auto insurance premium that left me penniless and petro-less!


Now days I have a similar, albeit much less sexy problem that can’t be solved with a few gallons of gas.


First, a little background. I live in the Los Angeles area and I work as a technician servicing and repairing commercial kitchen equipment. I make about twenty bucks an hour or roughly $3,400 per month before taxes. Rent takes about half of my take-home pay and the rest goes to extravagances like food, utilities, cell phone, internet, car payment, car insurance and gas. So…...while I end up broke at the end of every month I should be grateful to have a really bitchen, employer subsidized health insurance plan that only costs me about $200 per month.


So what am I bellyaching about? Actually, I can’t afford to get a bellyache unless I can diagnose and treat it myself. I sure as hell can’t go to my doctor or an urgent care. The fly in the overpriced ointment is my $5000 annual deductible. The first 5 grand of medical expenses each year must come straight out of my pocket. In other words, I could spend over $400 a month on doctor visits before my insurance would kick in.


I don’t think I’m all that unique. I’m pretty sure a lot of people are in the same sinking boat with me. I’m a pretty healthy guy and I normally go to a doctor or dentist once or twice a year. For someone like me, health insurance does absolutely no good unless I have a catastrophic sickness or injury to gobble up that deductible. Otherwise, I’m paying for all of my medical care out of my own pitifully shallow pockets. Here are a couple examples from last year:


I hurt my back on the job. I didn’t know any better so I went to my normal doctor. The appointment lasted less than 5 minutes. They took my vitals and put me in a room. The doctor came in and I told her I hurt my back on the job. She said she doesn’t handle workers comp and I must go to another doctor that does. I said thanks anyway and walked out. I got a bill for the better part of $100 for that little meet and greet!


I went to a urologist for some lower abdominal pain I was experiencing (I thought it might be kidney stones which I’ve had in the past). I was examined and given an ultrasound. The doctor tried to talk me into getting surgery for a very minor hernia that gives me no trouble. I declined the surgery (couldn’t afford it since it would have been 100% on my dime) and was rewarded with a $600 bill for the office visit and no diagnosis for the chief complaint that brought me there in the first place.


I decided to go to a Gastroenterologist to get to the bottom of my persistent little pain. Again I was examined and sent for an ultrasound. I made an appointment for a follow up visit so the doctor could evaluate my results and tell me what’s up with my gut. I never went to that follow up appointment. Since I couldn’t pay the almost $800 bill for the first visit, the doctor decided she wanted cash on the barrel-head for any future services. So now I get hounded by a collection agency, my credit rating took it in the shorts and I still have this dog-on nagging bellyache.


I hear a lot of debate about health insurance. About Obama-Care (which my plan is not a part of), single-payer and socialized medicine. I don’t pretend to understand it all but I know this: I’m a healthy, hardworking 58-year-old American. I have a good job with a large multi-national corporation, make arguably decent money and have what is considered a good health insurance plan. And yet, I can’t afford to go to a doctor for routine, non-catastrophic medical care.


Is it just me or is there something tragically wrong with this picture?  The sad part is I would probably be better off being medically indigent and just dropping in at my local emergency room for every little ache or pain that comes along. I would never do that since I know many ER’s are already abused, over-burdened and can’t remain economically viable if forced to treat all indigent patients.


Health care is not a privilege, it’s a basic human right and until our government figures that out a lot of us will just have to live with pain or try to self-diagnose and self-medicate. Oh well, at least we have the internet for free medical advice.

Published by Bill Hoover