My Medical Insurance is a Second Mortgage

a

I have a high deductible, piece of shi%t insurance plan from Anthem.  Until I pay $6K per person or $12K for the family, they pay nothing.  Nothing!  This costs me $1095 a month.  Here is the best part.  Next year it is going up to $1395 a month.  That’s a 30% increase. What if I don’t pay?  Oh yeah, it’s the law so I have no choice.  This is basically a second mortgage on my house and I will have spent $30K for the year before the insurance company pays a dime.  Want some more?  My son has ulcerative colitis.  Anthem won’t pay for any of his medications.  Not a dime. The generic sulfasalazine wasn’t working so he needed to go on to the next level of meds.  Turns out Anthem has the ability to just say no to anything they want.  Asacol, out of pocket, is $500 a month. I tried to use the pharmaceutical company’s card that guarantees no more than $25 month out of pocket for the medication if you have insurance.  Wouldn’t you know it, Anthem doesn’t care and won’t let the Rx go through. Luckily, he is under control without Asacol right now but that can change at any moment.  So, thank you, President Obama. Thank you, AMA.  Thank you, AAFP.  You created a monster that does nothing other than add a second mortgage to my monthly expenses.

Feel free to spread this around so others can see and share their horror stories.  We need to change the ACA because this travesty isn’t working. Wait, sorry, it is working just fine for Anthem and the other insurance companies.

Douglas Farrago MD

Douglas Farrago MD is a full-time practicing family doc in Forest, Va. He started Forest Direct Primary Care where he takes no insurance and bills patients a monthly fee. He is board certified in the specialty of Family Practice. He is the inventor of a product called the Knee Saver which is currently in the Baseball Hall of Fame. The Knee Saver and its knock-offs are worn by many major league baseball catchers. He is also the inventor of the CryoHelmet used by athletes for head injuries as well as migraine sufferers. Dr. Farrago is the author of four books, two of which are the top two most popular DPC books. From 2001 – 2011, Dr. Farrago was the editor and creator of the Placebo Journal which ran for 10 full years. Described as the Mad Magazine for doctors, he and the Placebo Journal were featured in the Washington Post, US News and World Report, the AP, and the NY Times. Dr. Farrago is also the editor of the blog Authentic Medicine which was born out of concern about where the direction of healthcare is heading and the belief that the wrong people are in charge. This blog has been going daily for more than 15 years Article about Dr. Farrago in Doximity Email Dr. Farrago – [email protected] 

  19 comments for “My Medical Insurance is a Second Mortgage

  1. David Dawson
    October 22, 2015 at 4:48 pm

    Quit paying them. If all their insured quit they maybe they will change their policy.

  2. Linda
    October 22, 2015 at 11:54 am

    Wow. Maybe you could consider shopping the Marketplace again to see if there are better plans available. (Cue laughter.) Now I’m wondering if the price gouging depends on the state or age group. Our state doesn’t have Medicaid expansion or a Marketplace, so my husband (35-44 age bracket) had to get his plan through healthcare.gov. His BCBS policy was less than $250/month with a high deductible, so the price difference is a bit startling.

  3. Philip
    October 22, 2015 at 9:41 am

    Gee, sounds awful, imagine if you had a public hospital system for the catastrophic health issues, yeah I know such a thing must be wrong, what would the UK, Canada, Australia and New Zealand know?

  4. Carol
    October 21, 2015 at 1:05 pm

    I’m torn between “first, kill all the lawyers” ( who help the insurance companies) and just go to the top CEO’s- even “non-profits”- remember, they may be non-profit, but that doesn’t mean they don’t want to make money- just look at their”discretionary ” funds

  5. JRDO
    October 20, 2015 at 12:40 pm

    Anthem is making record profits (http://www.nasdaq.com/symbol/antm/financials?query=income-statement). Pharmaceutical companies are making record profits and some are increasing the prices by 5,000% (http://www.nytimes.com/2015/09/21/business/a-huge-overnight-increase-in-a-drugs-price-raises-protests.html).

    If you want to take the profiteering out of healthcare it seems to me there are two possibilities: 1) improve competition which would mean revamping the drug patent laws and allowing interstate health-insurance competition, and/or 2) instituting price controls.

    Neither of the above options(sadly in my opinion) are addressed by the ACA. On my wish list for the ACA was also a better funding mechanism (I prefer a payroll tax) and malpractice reform.

    I obviously believe the ACA ain’t perfect and I hope it get’s improved, but I for one am not ready to scrap it as I believe the goal of all legal residents having affordable healthcare is one that we can and should do as a country. I am waiting to hear a viable alternative from the naysayers. Direct Primary Care can be a nice part of an alternative, but I don’t believe an unfettered free market will serve the needs of all the legal residents. I think the ACA can be improved as there are multiples models in the world that does healthcare better than the U.S.A. does that we can look to- but I am cynically pessimistic that it will happen anytime soon given the political polarization milieu that we currently are awash in

    • Ben Van Raalte
      October 20, 2015 at 4:27 pm

      A national sales tax not a payroll tax. Like Canada and many other countries. Then all the disability cheats, drug dealers, those working for cash, illegal immigrants, all pay in too. Of they don’t make and spend much, as they claim, they won’t pay very much.

  6. Ben Van Raalte
    October 20, 2015 at 11:59 am

    Part two
    Last year I fell off my bike. Rib fractures, dropped lung. Chest tube, one day in hospital, saw a nurse 3 times.
    Hospital billed BC $45,000.
    Hospital paid by BC $8000
    cost of chest tube and room 10 years ago would have been $1500.

    Blue Cross told me there was a $45,000 claim (note claim not paid amount) and raised my insurance 25% to $1400 a month for a family of 3.

    so now $17,000 a year plus $5000 deductible
    My hospital administrator CEO promoted his COO to CEO , gave himself a new title of ? super CEO, and increased his salary. He was only making a million a year. His job is to supervise the guy who does his job, and attend meetings 9 to 5.

    • Perry
      October 20, 2015 at 1:05 pm

      Yeah, I love how the amount paid by the insurance company is so much less than billed.
      My wife’s CT was billed at almost $4000, and Anthem paid them $1200. Nice, huh?

  7. Benjamin Van Raalte
    October 20, 2015 at 11:55 am

    Health insurance is a second secret tax on self employed.

    Government workers dont pay it, union workers dont pay it(and note the political issue to now even eliminate the tax on their gold plated plans), retired dont pay it, poor dont pay it, and most large company workers are partially immune.

    If you make 200k, sounds good, right? But thats after 10 years of not making money. Owing $$ student loans.

    Now in addition to taxes you pay 25k in your health care premiums and deductable. Thats another 12% tax.
    Add that at 200k your kids dont get any aid for college. Thats another 10% tax.

    So a self employed physician is now in a tax bracket of 35% plus state 8% plus health 12% plus college costs 10% or 60% tax bracket

    The poor, union, government workers, and million dollar earners all wanted ObamaCare rather than a national sales tax to fund health care like Canada and many other countries. High Earners are still in the 40% bracket because 25k of health costs are only 1% of a 2 million dollar income.
    A National Sales tax would catch the illegal immigrants to pay in, the drug dealers when they spend money, those working under the table, the disabled who work for cash on the side. A prudent physician not spending would pay less. And if you are poor and claim you only make 6000 a year well a 10% sales tax only costs you 600 a year for all your health care.

    The system is going to collapse. And self employed workers who provide most of the job growth in this country are going to disappear.

  8. Pat
    October 20, 2015 at 10:01 am

    I’ve had a similar experience, with premiums doubling in 2 years for … what? Since its passage, I’ve read a number of fellow respondents on this site speak in supportive terms of the ACA. I’ve read the comments from doctors, nurses, health insurance and hospital administrators, and other bleeding heart patients with their own sob stories and fuzzy hopes who were in favor of the ACA, even as a few of us predicted this very disaster.

    So where are all you ACA supporters now?? Why don’t you step forward and own this ?

    Crickets…

    • Randy
      October 20, 2015 at 10:25 am

      Their response would be “you guys can afford it”. But the reality is the only people that had their health care made more affordable by the Affordable Care Act are the ones subsidized by the government.

      • Pat
        October 20, 2015 at 3:08 pm

        And my counter to them would be, “So you thought it was moral and practical to punish the majority to help a minority; so you thought it was okay to help others by using force against your neighbor…”

  9. Perry
    October 20, 2015 at 9:13 am

    Well, therein lies the fallacy of the ACA. Let’s get everybody insured and things will be great—
    NOT!
    The bottom line is, insurance and healthcare are not the same, and no effort has been made to reduce costs not only for insurance (other than getting subsidies if you are eligible) but for meds, imaging, hospitalizations, etc. And you’re right, the insurance companies are loving it.

  10. Randy
    October 20, 2015 at 9:03 am

    My BC/BS plan is going up 30%. Thanks Obama!

  11. Steve O'
    October 20, 2015 at 9:01 am

    Interesting you should mention that – my medical school loans are a second mortgage which I will pay off shortly before I retire.
    If only there were a method of DIRECT PATIENT CARE, where the payments from the patient to the doctor could be negotiated at a mutually satisfactory rate to benefit both….. naw, fuggetaboutit. That’s crazytalk.

  12. Fred Powell
    October 20, 2015 at 7:49 am

    I feel the pain as well. My own personal Anthem policy was 650 per mo, now renewal is 730 per mo. Just for me. Holy crap. And the carve outs for what they dont cover are plenty. No wonder their profits are going through the roof.
    If you need a good app to help find the best price for any rx, try goodrx app. It’s free; punch in zip code and medication………..it gives the best price and then allows you to print a coupon for all the numbers the pharmacist needs to give you that price. I use it several times per day for patients. Just yesterday one pt was paying $300 for his rx, I priced it through this app—$42.

Comments are closed.