Health insurance changes

As the Supreme Court heard oral arguments last week on the national health insurance reform bill, I received a letter I'd been dreading for a few years. My insurance plan is going away. Sandy and I bought into this plan in November 2006 when her Microsoft COBRA ran out, and we'd been grandfathered into it when they stopped offering it to new members a few years ago. Now, no one gets it. It was the best-value individual health care plan I'd seen on the market.

In fact, I'd been surprised that they continued to give us such a good deal as health care costs rose in recent years, but both Sandy and I were grateful to have the broad coverage and out-of-pocket limits it included. We certainly got our money's worth. In addition to our moderate monthly premiums, we each had just a $500 annual deductible and then paid 20% of everything from that point, until we'd spent the $2000 out-of-pocket cap each year. With expensive cancer treatment, we'd paid Sandy's entire $2500 by the end of January last year; everything that followed was essentially free.  In 2009, my diagnostic tests had used up the $2500 for the year before I got to surgery in March, so I paid nothing more for open-heart surgery, ICU care, follow-up echos and cardiology visits, etc. It was a sweet deal.

It's not like I'm losing coverage. They're just moving me to another plan. For slightly lower monthly dues, my annual deductible will be $1000 and my out-of-pocket cap $5000. Some things about the new plan are nicer. For example, office visits will cost just a co-pay even if I haven't used up my deductible yet, and I'll have some coverage for glasses (I last had new frames in 1996). I'm pretty healthy right now, and I tend to lean more heavily on my naturopath, who isn't covered by my insurance, so I don't expect the plan to change much for me.

Sandy worried about money a lot in the last year of her life.
She didn't want to leave me a poor widow, and wouldn't hear
my reassurance that I'd be fine financially. She hated feeling
like she couldn't buy things she wanted, couldn't travel if she
wanted to. But when it was clear she would be dying soon,
she came up with ways to give away all her retirement funds,
puzzling over how to make the math come out right. And
then she looked up at me and said, "Or I could just let
you have your money." (I was listed as the beneficiary
on her accounts.) That satisfied her, but I've given to those
organizations on her behalf, all the same.

I'm just glad they didn't make the change when Sandy was worrying about cashflow. Essentially, Sandy's care would have cost us an additional $3500 last year, an increase we could have afforded, but she would have stressed about it. She was very concerned about money, aware that her disability payments would never increase more than cost-of-living rates. She was looking forward to moving to Medicare after two years on disability, but she'd only been receiving disability payments for eight months when she died.

Mostly, the change brings the national health care debate into sharper focus for me. People who oppose the idea of a single-payer plan say they worry about a lack of choice, that health care will be rationed. But how many of us really have a choice now? If your employer provides your health insurance, you're limited to the plan or plans they've selected — and those can change every year, leaving you searching for new doctors and facilities each time. If you buy your own plan, as I do, you're stuck with the rather limited and discouraging individual market, and still have no control as plans and costs change from year to year. It seems like the people who have the most choice are Medicare patients, as long as doctors are willing to take them. If we were all on Medicare or its equivalent, maybe we'd all have more choice.