61 Comments on Is this another rule I should break?

Rachael on Fri, 29th Jan 2010 9:06 am


I would SO opt out of this one. And if you’re concerned, then yes, set up your own Health Savings Account or whatever. Because if you’re going to give away $800 a month toward your continued good health (in case of need), then shouldn’t you HAVE it in case you do have a problem?

I mean, if you put $800 into an account every month for just-in-cases, then in three months if you suddenly need a doctor visit, you’ve already got a $2400 savings account to draw from. I think that’s pretty much a win.

Shane on Fri, 29th Jan 2010 9:17 am


Johnny, sorry to hear that. Even after all your Copyblogger posts, I didn’t know you were diabetic.

I’d say save up like 10 grand each year for catastrophic events. You’re 33 so hopefully you won’t have any for the next 7 years. At that time, you’ll have at least 77Gs to deal with the situation. This fund becomes your insurance plan. The money you will spend out of pocket to cover everything you need will be “your own” premium payments to yourself. I say this because you seem to be successfully persuing your dreams of working for yourself on your own terms. If you chances for success on your own were not good, I’d say bend over and take your medicine as you have been doing.

Also on the diabetes front, may I suggest a book by a doctor who has been treating (and curing) his patients of diabetes? Some may scoff at it’s premise, but after actually reading the book, I’m certain it has merit.
Check out “Eat Right for Your Blood Type”

Hope that helps. It is just my own two cents though.

Bradley on Fri, 29th Jan 2010 9:27 am


johnny,

while i have never had the same issues as you, there was a time in the past when i went without insurance. twice actually. the regular stuff, going in for a cold or something like that, didn’t scare me. what scared me was, what if i got cancer or was in a major accident?

luckily nothing like that happened, but it was always in the back of my head. the first time i worked a somewhat dangerous job, and was cycling (road and mtn) regularly. so there was potential that i might have to be hospitalized.

luckily, right now i have insurance. of course, i am a 8-5 working stiff. however, i am in the works of changing that. so… would i go without insurance againg? yes. is it risky? of course. the worst part now is that i have a lot more responsibilities now than i had when i was without insurance in the past. so if i chose to do it again, it would have to be a last ditch choice.

so i guess my answer is: maybe, but i don’t know. how is that for sitting the fence??

Shane on Fri, 29th Jan 2010 9:41 am


ps. Johnny. Here’s the amazon page for his book that specifically mentions diabetes : http://www.amazon.ca/product-reviews/0399151028/ref=cm_cr_dp_all_helpful?ie=UTF8&coliid=&showViewpoints=1&colid=&sortBy=bySubmissionDateDescending

I don’t have diabetes, but I have been following his book for blood type O people. I can say I feel better and trimmed down. That’s all I can say is what “I” know. Read the reviews, good and bad, talk to your doctor and make up your own mind. I’d hate for you to try something I recommended and not have it work, but you asked so this is all I know to tell you.

Regards

Jeff on Fri, 29th Jan 2010 9:48 am


Oof…this is an absolutely brutal conundrum, and I still have absolutely no idea how I’ll handle it once I’m self-employed full-time.

I WILL say it’s why every entrepreneur and freelancer I know was praying that the US would get single-payer or public-option healthcare, but I just don’t see that happening.

You’re right that it’s criminal and offensive in every way, and that the profit off of fear and suffering, but it’s not just that you can’t stomach the risk – the reality is that major accidents, injuries and illnesses have become SO costly in our inflated healthcare system that almost no one could afford those procedures out of pocket.

Sorry to hear that, dude. I know it really really sucks having an ongoing condition like that.

Jordan Cooper on Fri, 29th Jan 2010 9:51 am


Johnny, your analogy in comparing insurance to betting against the house is inherently flawed. It’s only so because your life is at risk.

If you’re facing a situation of almost certain death that insurance would cover, then there is technically no optimal price you can’t afford to pay. (infinity)

As an example, if I were to offer you $100 million to for one trigger pull in Russian roulette with a six-chamber shotgun, should you take it? 5/6 of the time, you get the money. 1/6 of the time, you die.

If you answered yes, then consider the same expected value probability wise – you’re telling me that for $200 million, you’d pull the trigger twice. For $300 million, three times. Then you’re saying for $600 million, you’d kill yourself.

Do you now understand the fallibility of the analogy now?

SarahSki on Fri, 29th Jan 2010 10:03 am


I was without insurance for about a year while I was unemployed and my husband and I weren’t married yet. I was worried sick the entire time that something would happen to me.

…and it never happened.

Now I’m insured through my husband’s job, and we pay about $300 a month for insurance, for the two of us, that doesn’t get used. $3600 a year, for “just in case”.

I don’t envy you, but man, I understand. Insurance rates are ridiculous and capitalize on our fear. Nothing should run that way.

Dave Guilford on Fri, 29th Jan 2010 10:04 am


Johnny,

I used to own a heath insurance agency, so I know what I’m talking about. You essentially have two alternatives.

The first has already been mentioned, and that is a health savings account (HSA or MSA). You’ll have a really high deductible (though, realistically, not higher than the $5,000 deductible you have now) and you’ll be responsible for all your out of pocket medical expenses including your maintenance meds up to the deductible, but the monthly premiums should be quite a bit lower. On top of that, this type of insurance has certain tax advantages that also work in your favor as a freelancer.

The second alternative (and one I wouldn’t recommend) is to go to straight accident coverage. This type of coverage is very cheap and there is no underwriting for pre-existing conditions. That is because the only thing it covers is when you get hurt in an accident (broken arm, car accident, cut your wrists shaving, etc…).

Now statistically, the average American is far more likely to have a catastrophic accident than a catastrophic medical event. However, you are not the average American and diabetes is a serious condition. That’s why I definitely recommend the HSA over an accident-only plan.

Dan Cosgrove on Fri, 29th Jan 2010 11:08 am


You could put that $800 a month into a savings account as an emergency fund. Then, if anything happens, you’ve got that money (almost $10,000 a year).

The only problem is the temptation to use it on non-emergencies.

Jess on Fri, 29th Jan 2010 11:14 am


First off, you’re self-employed so you write it off anyway.

Second, fear is something every human experiences and I believe it was given to us for good reason. Although not a fail-safe method, it tells us when we’re about to do something dangerous.

I’m with Jordan. Until this whole healthcare mess is sorted out (maybe never), I’d stay on it. You have no idea what will happen, but one little incident could clear out your entire savings account and put you in even greater debt than the real estate fiasco.

Quite frankly, it’s because people go without insurance that healthcare costs are so high. You can opt out and hope you have no accidents or strange health problems, but I’d like to think you know better than to wage a bet on any given outcome.

Call an agent who specializes in health insurance (with Dave’s comment, it seems like you may already know some). Consult with a professional who knows your options and stays on top of important changes in the industry. When it comes to your health, quality of life and your family’s security, I’d trust no one other than a true expert in the matter, regardless of the cost.

Kathleen K. O'Connor on Fri, 29th Jan 2010 11:42 am


I was just going to chime in and say that getting the HSA would be worth it. You can put the $800/month there instead. I had to get emergency surgery last year, totally unexpectedly, so I was very grateful to be insured at the time. But I could have paid for the surgery myself if I had been putting the same amount away in a HSA.

Worse comes to worst, you can be a “medical tourist” and go to a cheaper country to get treatment if you can’t afford it in the US with your savings. A lot of people go to top-rate facilities in places like India and Thailand to receive treatment for a fraction of what it would cost in the US. I remember when I went to a border town in Mexico, there were tons of dentists. I assume people cross the border to get their teeth fixed since it’s much cheaper. And it’s not like the shady doctor on the Simpsons, I promise. You can really find great healthcare in these countries! It’s all private, of course.

It baffles me that the richest, most powerful country in the world has one of the shittiest healthcare systems in the world. Okay, so it’s not baffling; it’s greed. I am so glad that I am a dual citizen. No matter how sick I get, I can always go to Japan and get national health insurance.

Bradley on Fri, 29th Jan 2010 11:47 am


@Kathleen O’Connor…

interesting you mention japan. my dad has traveled there several time with work. he has kidney stones often, and had them when he was in japan once. he got much better treatment for a fraction of the cost, compared to the USA. his insurance covered none of it, but it turned out to be less than he would typically have to pony-up in co-pays and what not.

Dave Doolin on Fri, 29th Jan 2010 12:30 pm


You should stay insured.

Seriously.

If you go off coverage, you are going to be stunned at how hard it is to get a policy.

Yes, the game is rigged.

Yes, we’re in a MASSIVE health care bubble.

Yes, the middle class is going to reduced to penury over this issue.

But there’s no help for it. Until everyone else in the country is in your position, everyone else is going to play along.

It can’t last forever. We have what, 35 million uninsured now? As this number grows, and it will, change will become inevitable.

Look, it’s like this, *everyone* knows the current situation is unsustainable. But TPTB are either colossally stupid, or they are trying to suck as much cash out of us as they can before the whole system implodes.

Like real estate imploded.

Like the education-industrial complex *must* implode. (I often regret the years I spent obtaining my Phd. What a waste.)

As long as you stay in the boat with everyone else, you have a chance to be “rescued” with everyone else.

Example: I didn’t buy any real estate. I thought it was stupid risky. I waited until the market crashed. But it didn’t crash. The Feds stepped in and propped it up. Now, with prices propped up at insane levels, I’m being bled dry of rent, while I know people who lived for months and years in fantastic condos, by simply not paying their mortgage… and getting bailed out. Sucks for me.

Health care is going to end up the same way. What’s happening sucks, but there’s no way out.

And you know, don’t count on getting a “real job.” With rates skyrocketing, employers have trouble hiring… the overhead is getting out of control… becoming increasingly difficult to afford employees.

Its madness, and I have hard time seeing it ressolved equitably.

Genuine Chris Johnson on Fri, 29th Jan 2010 12:37 pm


Have life insurance to cover it, but otherwise double down on being a millionaire.

Claire on Fri, 29th Jan 2010 12:44 pm


Hi Johnny: First…I’m very sorry to hear about your insurance situation.

Second, since the carriers are probably different in your state compared to mine, all I tell you is that I know there are some(?) or a few(?) companies that will offer health insurance to small biz owners as a group, essentially putting all their subscribers in a group.

I haven’t had to research that option myself, but wanted to mention it in case the research you already did left out that option.

Really hope you find a good solution…one that works for you. All the best, Johnny.

Pace Smith on Fri, 29th Jan 2010 1:09 pm


Two things to consider.

1. Since you don’t watch the news, you may not know this, but one of the health care bills being bandied about the Senate would make it MANDATORY for every American to purchase health insurance, out of their own pocket. Who knows whether this is going to become law or not, but if it does, and you opted out of health insurance beforehand, you may become well and truly hosed by the system.

I know, I don’t watch the news either, but a little bird told me about this one. (:

2. There is a kind of insurance called, I forget, “catastrophic” or something, that just covers the really bad stuff and doesn’t cover anything else. I don’t remember the details, but that word might help you find out more about your options.

*hugs* (:
-Pace

Mike Stankavich on Fri, 29th Jan 2010 1:14 pm


Johnny, what a mess! Here’s an alternative that you may not have considered. Have you looked into joining some sort of professional organization that offers group coverage to get you away from those insanely high individual rates? I thought I recalled some sort of software professional association that used to pitch me, but I couldn’t find any details. I did find National Association for the Self Employed http://www.nase.org/Membership/MembershipLevels/GoldMembership.aspx that says they offer group plans. Couldn’t hurt to call them to see if their deal is better than what you’re getting.

Drew @ Cook Like Your Grandmother on Fri, 29th Jan 2010 2:37 pm


This could get real political real fast, but here goes.

You’re not interested in day-to-day coverage. You’re paying that out of pocket already. You’re interested in the catastrophic coverage if you should need it. And if you do, they’re going to fight you tooth and nail trying to deny it anyway.

Compare the scenarios:

A) You *have* coverage and suddenly need a foot transplant. They deny it, you sue, they stall, you go bankrupt trying to fight them in court … Eight years later you’re sitting (on half a chair) in the gallery at a State of the Union address as an example of why we need to pass healthcare reform.

B) You *don’t* have coverage and you need a foot transplant. You go to the emergency room where they’re not allowed to turn away indigent patients. You get on the foot transplant list.

Four years later they call to say an NFL place-kicker has just died in a freak PAT accident and his foot is a match. They hold a benefit blog-in on Copyblogger, where they auction off topless consulting … over the phone … with Michael Martine. It raises enough for the transplant and, with the added spring in your step, you score a 6 on the Crossfit test.

—

I don’t know about you, but I know which option *I’d* go with.

Catherine Caine on Fri, 29th Jan 2010 3:18 pm


I can’t tell you what to do here. I’m just going to sit in the corner and be very, very grateful that I’m an Australian.

Johnny on Fri, 29th Jan 2010 3:40 pm


Thanks for the ideas, everyone… I’m here lurking and reading; keep ‘em coming!

Drew: I LOL’d.

Avonelle Lovhaug on Fri, 29th Jan 2010 3:46 pm


I’m no insurance expert, but before you drop your plan, make sure you check one other thing:

Find out if the costs you are paying for your regular monthly insulin are not lower because you have insurance.

Here’s what I mean: I used to have a plan where I paid for everything out of pocket until I reached something like $5,000 for the year (which I never got to). Then, it was an 80/20 thing.

But one year we got close to the limit, when my son developed a weird movement tic that they suspected was a brain tumor. (It wasn’t, and it turned out to be no big deal.) He had a lot of tests (two MRIs, EEGs, etc) to try to figure this out. I knew I would have to pay for all of this stuff out of pocket, unless it went over my limit.

It turned out that we never hit the limit because the doctors charged us the the rate our insurers get, not the rate they charge someone with no insurance. So, their typical MRI rate might be $1,500, but they charged us $950.

Your situation might be different – again, I’m no expet. But make sure you find out what you will be charged for those costs if you have NO insurance, just in case.

Darcy on Fri, 29th Jan 2010 5:05 pm


I have been uninsured most of my adult life out of conscious choice, not ignorance. It’s less lack of funds and more lack of making exorbitantly priced health insurance a priority. Freelance jobs, part-time jobs, attempts at self-employment and now a non-traditional living arrangement (not being married to my sweetie, and the stupid fucking state Ohio making domestic partnerships illegal for people working at state-funded institutions like the one where said sweetie works) have meant I’d have to self-insure to the tune of those astronomical numbers you mentioned, and I’m not willing to do it. I don’t like Western/allopathic medicine anyhow and prefer alternative methods (chiropractic, acupuncture, homeopathy) that insurance does a bad job of covering, so I pay out of pocket for what I need/want and don’t have coverage in case of a catastrophe. I don’t have kids, though, so if something to happens to me, I’m not going to orphan anyone, so you’re in a bit of a different situation. I say drop it, but it’s easy for me to say that. Your points are all very valid and you have a more complicated situation than I do.

My last GP told me that she herself was uninsured, because paying for insurance to her felt like gambling that she’d have a catastrophic situation in which she’d need the insurance. She didn’t want to put that kind of energy out into the universe. That’s kind of my feeling about it, too.

Challenging decision, wishing you good luck with making the right call for you.

Greg Payette on Fri, 29th Jan 2010 5:44 pm


I have a friend (old guy) who built a house in Nova Scotia out of scraps and old windows way back in the day. Goes there to get away.

But somehow he says he gets health coverage in Canada. Not that he’s going to go up there when he needs a stitch or two. But from what he said, if he has cancer or something f’d like that he’s driving north and getting taken care of.

I can’t confirm the facts. But it’s a good story.

So, you might want to look at building a house in Nova Scotia. Land is cheap.

And even if you don’t get the coverage, your wife and kids will have a place to vacation.

Michael Martine on Fri, 29th Jan 2010 7:31 pm


I don’t think my moobs are that moob-a-licious over the phone to raise that much money, so I guess you’re screwed buddy.

I’m with Chris J. on the millionaire thing. Or, consider moving to Canada, eh?

Keith on Fri, 29th Jan 2010 9:08 pm


Johnny,

Bottom line: If you have the discipline to stick the money in the bank, drop the damn plan. You’re being gouged. We all are. If you *don’t* have the discipline, and fear that one day while feeling particularly healthy you may pick up that 65″ Trinitron while on a diaper run at Costco, then keep the insurance.

Being of sound mind and perfect, flawless health, and my own biz, I had a cheap $600/month plan for years, $5,000 deductible. One serious event: rushed to the hospital for an emergency appendectomy with complications. Hospital bills @$4,500 — all out of my pocket. After that, I dropped the damn plan–opened a savings account.

My Health Bank Account grew to be fat and healthy and all was dreamy until we moved to Boston: Here, it’s the law: carry insurance, or it’s jail, buddy. You don’t want/need it? Tough. You think MA has bad insurance products? Tough. Pay up. So, we how have even higher monthly payments and high deductibles with the shittiest insurance I’ve ever seen. After living here and watching this State mess it up, I don’t know how the US can be moving towards a centralized system. But I digress.

I digress more: the person who suggested that people opting out of the system is the reason costs are so high is mistaken. Costs are high because the freakin’ government can’t keep their mitts out of health care — get us lawsuit tort reform and maybe we can start talkin’ seriously about health care reform . . .

Keith on Fri, 29th Jan 2010 9:33 pm


P.S. Oh yeah, I second the guy who mentioned “Eat Right 4 Your Type” as a great diet, followed it for years. Dr. Hyman is another doc (here in Boston) who’s world famous working with Diabetics in his clinic — he suggests a diet very much like Dr. D’Adamo’s Type O Diet — check him out here: http://www.ultrawellness.com/blog/diabetes

Catherine Azzarello on Fri, 29th Jan 2010 9:39 pm


Damn! Nothing but expletives for insurance companies come to mind.

But for now, I’d keep the insurance. Why?

Your future uninsurability is guaranteed, once off a plan.
Shit happens to healthy people…appendicitis, compound fractures w/infections, disc problems…cancer.
Even short hospital stays or surgeries add up–fast!
HAVING insurance allows you to switch insurers. Look into each and every group option available: self-employed business groups/credit unions/etc.
It’s a deductible business expense.
Fingers crossed, we’ll get the country moving towards universal coverage of some sort. (I know, I know! Possible pipe dream.)

Tough choice. Crappy options.

I’d be sure to send a link to this blog to my representatives, if I were you. At least make a stink about it with the power brokers!

Good luck!

FYI: Insurers aren’t very gracious w/cancer survivors, either…even after YEARS and great odds. They’re parasites!

Denise Canellos on Sat, 30th Jan 2010 12:10 am


Hi Johnny,

I self insure, too, and it stinks. However, my husband was diagnosed with colon cancer at 38, and if we did not have health insurance my young daughter and I would have been left with medical bills of at least $500,000. The thing is, if you don’t have insurance, hospitals bill you at their regular rate, not the lower negotiated rate that insurance companies pay. So you are doubly screwed.

I know a huge illness like this is rare for a young person, but it is not out of the realm of possibility.

Good luck-
Denise

Ed on Sat, 30th Jan 2010 12:36 am


Johnny,

I’m in a situation similar to yours, but not diabetes.

I think it comes down to a very few options.

1. Keep the current policy and pay the bastards.

2. Drop the policy and get catastrophic health insurance, covers only when you have massive bills, everything else is self-pay.

3. Go with what I think Mike said, NASE.org offers group insurance in some states (I don’t think it’s everywhere), and there are other more local business organizations that you can join and get in on a group policy which hopefully would be cheaper. I’ve been told to investigate places like the good ol’ Chamber of Commerce in your city to see if they offer group plans, or if they know of another business association that does offer them.

Like I said, my case is different, but if it were me, I’m a little too pessimistic to bet that I won’t develop something weird that would bankrupt me and my family without some type of coverage.

Best of luck and let us know what you decide.

Ed on Sat, 30th Jan 2010 12:47 am


P.S. I just found this quote on an article at GetRichSlowly.org:

A state high risk pool or mandated basic plan. (Contact your state department of insurance for details.) Insurers aren’t going to line up to tell you about this, but your state may require them to accept you for a certain health plan. Again, premiums will be high, and benefits may be limited.

The article if you’d like to read the rest of it is at:
http://www.getrichslowly.org/blog/2008/05/14/finding-affordable-health-insurance-when-youre-on-your-own/

Anne on Sat, 30th Jan 2010 1:30 am


I didn’t want to read all the comments above (there were a LOT) to see if anyone had already satisfactorily addressed your problem, and it is all “sol-ved” as Inspector Clousseau would say. So I will just offer my story.

My husband and I have been self-employed forever (it seems) and before that we pretty much never had insurance (as in we had no insurance for us or our children for over 10 years). The reason for that is that my husband is in the construction industry and employersin that industry can’t afford to pay for health insurance (in general) because work comp coverage is so outrageous.

So…I have done the non-insured thing for a long time and we managed just fine. I’m not saying that we never had bills that took forever to pay (those were mostly maternity costs for the births – we had no insurance at all for 3 out of our 4 kids births).

Fifteen years ago we got self-employed coverage with an HSA attached. It is a very high deductible (at least $6000). And yes, the costs keep going up. It costs us about $960 a month to cover my husband, me and our two younger kids (when our older kids graduated from college they had to get their own insurance and got low-cost major medical from the same company as us). We also put $200 a month in the HSA which, I am happy to say, is finally growing nicely since I have dipped into very little in the last two years. You can use the money in the HSA for all kinds of medical bills (including diabetes supplies) plus it is completely deductible. (And you probably already know you also get a deduction for being self-employed and paying for your own insurance.)

I’m guessing you have shopped around but…just in case our insurance is with Golden Rule Insurance. You can get a policy with them with or without an HSA.

My husband gets aggravated too with the cost of the insurance BUT I keep pointing out to him that the insurance is not a complete loss because it provides a PPO component through United Health Care that saves us tons of money on lab work, tests, my mammograms, etc.

We are a little older than you (okay, a lot older?) I am 48 and my husband is 54 so we are in a place where we need regular preventive care (like my yearly mammograms) and my husband has had to have tests for heart issues (that turned out to be nothing, fortunately). So I would say that just over the last two years the insurance has saved us a few thousand in what we would have paid not getting the PPO discounts.

Finally, I am curious why your wife and child are on a different policy. Does she get insurance through work? If not I would look into a family policy through Golden Rule.

It is not necessarily the worst thing in the world to go without insurance esp. if you put the money aside that you would have been paying, into a money market account. You could maybe just get an “accident” policy. And I also don’t think, as you said, that you are uninsurable, should you drop your current policy.

The fact is though, that even if you take great care of yourself, and believe me my husband and I do, there are still things that come up with age and you will probably want to have insurance later. On the other hand, if your business goes the way it looks like it’s going, you could end up with so much money in the bank you wouldn’t have to worry about medical bills.

Just my 2 cents.

Bill Perry on Sat, 30th Jan 2010 1:45 am


JT,
When you say “insulin-dependent”, do you mean Type I or Type II? I can’t ever keep ‘em straight.

I read that the “Zone” diet by Barry Sears is really good for helping diabetics (again, not sure which type) either stay off the insulin or minimize shots needed.

He says it’s something about balancing natural insulin and hormone levels, which is supposed to help promote excellent all-around health anyway.

As far as insurance, I can’t offer any specific advice on it, other than maybe either find something cheaper, if possible, or forget it altogether since you’re already paying the majority of your stuff anyway.

Greg Payette on Sat, 30th Jan 2010 9:05 am


I woke up thinking about this. I posted one option, but then I thought…damn this is pretty serious. For those of us who are working hard to make it on our own, pulling $1000 a month for insurance (regardless of tax deductions) is a big, big chunk of change.

And someone in Johnny’s situation, where these f-bag insurance companies prefer to turn you around and give you there special treatment it’s a sinful situation.

There has to be a fix. You don’t have to be left or right to realize it. What’s it going to be like just 5 years from now if something isn’t “fixed?”

And believe me, I’m not looking for someone to carry my bags. I just want my money to go to something that’s fair for me and my family.

You want to feel ill? Check out the 07 salaries of the health insurance CEOs. They’re not worried about writing a $1000 check each month:

http://www.healthreformwatch.com/2009/05/20/health-insurance-ceos-total-compensation-in-2008/

Ray on Sat, 30th Jan 2010 9:14 am


He’s type 1, insulin dependent. I am type 2 and manage with diet, exercise, and metformin (which prevents my liver from producing as much glucose as it would like). I am insured, but my beloved Roseann is not. I would like to add her to my policy but can’t until we get married, and so I live in fear of her having a medical issue. We are both in our 50’s, so I know it’s just a matter of time. I don’t know what the answer is here, Johnny. It’s one of the most important issues of our time in the U.S. I wish I had an answer for you, man. I understand perfectly the worries and concerns you have. I share them. The worst part is that worrying tends to drive blood glucose numbers up. Talk about your vicious circle. My potential brother in law is uninsured and is basically dying from cirrhosis. He went to the emergency room after his abdomen filled with fluid, and has since been signed up for some public assistance program. There are long waits when he has to see a physician, but he does get treatment. Maybe the answer is to make like an illegal immigrant and drop the insurance and avail yourself of the public assistance measures that are available. You might want to consider putting your savings offshore though, if you know what I mean. Somewhere that doesn’t particularly care to communicate with our government agencies, if you know what I mean. I’m just sayin’…

wtrauth on Sat, 30th Jan 2010 1:13 pm


Dump it. Nine years ago, as luck would have it, I was in a planned 90 day gap between jobs and had a heart attack. I was in the best shape I had been in since basic training. Serious mt. biking three times a week and long aerobic sessions almost daily. I was light an strong with no signs of heart problems. Taking good care of yourself doesn’t save you. It may lower the odds on average, but who is average? Don’t get comfortable because you’re in good shape. I was in great shape.
I had no insurance because of the job gap. I got the health care I needed without havang to pay anything up front or having insurance. Of course they billed me. And of course I took a long time paying them.
Health insurance is the main cause of rising medical costs. teh cossts will continue to rise as long as we continue to pay them. Whether we pay them as individuals or as insurance premiums. It’s basically the same as the mortgage problem. The price doesn’t matter as long as you don’t have to pay it. So it keeps on rising. It will continue to do so until we stop paying. Save the premium money. DON’T

Kelly Diels on Sat, 30th Jan 2010 3:41 pm


holy shit. I had no idea.

I’m Canadian. My mind boggles.

I work in Vancouver. A co-worker works in Bellingham.

I have health insurance because I’m Canadian and that’s just how our government rolls.

She doesn’t. All winter she has been sick and finally ended up with bronchitis. I kept asking her, why don’ t you go to the doctor? Like, seriously, I was mystified.

Finally, she explained: she’s young and broke and can’t afford the deductible.

That’s a mofo crime. I’m outraged.

You know how much I pay per month for health insurance? $112.00. You know what I would pay if I was in any risk categories? $112.00.

And that’s the family plan, for me and my 2 little girls.

You know what the deductible is? Nothing.

This is a really great post. I’m viscerally upset on your behalf. What an impossible bind.

I don’t have a solution, beyond come to Canada. We’re very nice.

Michael Martine on Sat, 30th Jan 2010 6:22 pm


See? What’d I tell ya. Seriously, man, I was about this close once to doing it. The reason I didn’t is because in the future I plan on having either plenty of money and killer attack robots, or we’ll be immortal by then anyway.

You think I’m joking.

Giovanni on Sat, 30th Jan 2010 11:27 pm


Politics and my oneness with the universe aside there’s two reasons to keep a medical plan of some sort; 1, you get the insurance co rate on your out of pocket costs and 2, you may never be able to get it again if you drop it now..

Putting 10k/year into savings sounds like a big number but you could burn through that before a doctor even sees you in an emergency. And forget about a long term stay. You’d probably spend less booking a suite at the Beverly Wilshire and calling Keith Richards for pain management.

The HSA/catastrophic may be one way to go but 86ing it all could be very costly. As others have said group rates are worth checking out but beware of insurance plans masquerading as business organizations. Look for a real organization. http://www.freelancersunion.org has a group plan, I think it’s with Golden Rule too.

chub flounder on Mon, 1st Feb 2010 12:41 am


don’t do it. i don’t know about how HSAs work, but i just don’t play the insurance game. i’m 40 now, i’ve never been insured, and i ain’t about to start. you can get free emergency care at good hospitals, which might ruin your credit, but you’ll still be alive, so it seems like a pretty good deal. btw, i don’t care much about my credit, because i don’t have kids and i don’t have a pressing need to buy things i can’t afford, so maybe that’s not practical for you.

the main reason i’m against insurance is that on top of betting against the house, the house will think of every possible way to fuck you if it looks like you might ever need to cash in your chips. so you’re kinda fucked anyway, but right now you’re paying for “peace of mind” that might not be there when you need it.

don’t rule out medical tourism.

Matthew Needham on Mon, 1st Feb 2010 5:10 pm


Johnny,

Is it possible to go more hybrid in your approach? For example you reduce the level of your cover and save the equivalent of the policy into a savings acount. Each year you adjust the level dependant on the level of risk you want to undertake.

I’m assuming that you have life insurance in favour of your family? (I come from the school of thought that what’s the worst that can happen and plan for tht) so I’d insure myslelf first, before turning ot the individual policy.

Lou Mindar on Mon, 1st Feb 2010 8:38 pm


It’s a difficult decision. However, maybe my experience can be helpful. I was completely healthy about 10-12 years ago, but I was having sinus trouble. I finally opted for surgery, which is pretty routine. However, I ended up getting toxic shock syndrome (from a MRSA staff infection) and spent 6 days in ICU. That’s not cheap. Saving money in an HSA (Health Savings Account) may sound nice, but medical care is so expensive, your savings just won’t go very far.

Six more years of healthy living ended when I was diagnosed with throat cancer. I don’t smoke and I don’t drink, but I ended up with cancer anyway. I had the best treatment medical science had to offer because I was insured. I met a guy that was diagnosed with the same type of cancer as me, but was going through a different treatment protocol. I was getting a lot more treatment than him. I finally found out from one of the nurses that he was uninsured, so he was just receiving the bare minimum. He died about three months after I met him.

Six more years passed and I just found out I have cancer again. This time it’s prostate cancer. They caught the cancer early and my prognosis is great. Because I’m insured, I have the luxury of searching out the best treatment available. I don’t have to settle for the lowest level of treatment. Also, although I’m going to end up with a few thousand dollars out of pocket (deductible and co-pay), I’m being charged at the PPO rate because I have insurance. That makes a huge difference.

Health insurance is expensive. There’s no doubt about it. But if you ever need it, it could not only save you money, but potentially save your life. You insure your house and car, doesn’t it make sense to insure your health?

Lou Mindar on Mon, 1st Feb 2010 8:51 pm


Wow, I have more to say about this than I thought I would. First, an HSA is not intended to replace insurance. It’s meant to put money away for deductibles and co-payments.

Second, my health insurance has paid out about $600,000 on my behalf over the past 10 years. I don’t know how much this latest issue is going to cost, but I’m probably going to be up around $750,000. Try saving that much in an HSA.

Third, before these issues came up, I was healthy and active. You never know when a health issue is going to come up. And considering your medical history, regardless of how well you take care of yourself, you’re going to be at a higher risk of health problems than someone without diabetes (Not to mention a higher risk of complications if you do get sick).

Fourth, medical bills are the number one reason people end up filing for bankruptcy. Having insurance doesn’t guarantee you’ll stay financially solvent if you get sick, but it will sure help.

I don’t mean to sound overly preachy. In fact, I’m a little surprised I feel so strongly about this. I just hate to see you drop your insurance to save a few bucks and then have it cost you your entire life savings…or maybe even your life.

Anne on Mon, 1st Feb 2010 11:17 pm


I feel I have to add something because so many of the comments have seemed to discount the value of the HSA although the person admits they don’t know much about it.

The advantage to having an HSA is simple: you are forcing yourself to save money to pay for your out-of-pocket expenses each year. For my family, until the last couple of years I used almost all the money we had put away in our HSA to pay for things like dental appts., orthodontics, or whatever. The last couple of years we have been able to pay for most of our out-of-pocket from our regular budget so we now have several thousand dollars in our HSA. If we ever had a hospitalization, we would owe an amount equivalent to our deductible, and we could then use the money in our HSA, if we chose, to offset that.

In the meantime, we get a tax deduction for the amount we put in, the interest is tax-exempt, and once we hit a certain age (not sure what it is – somewhere around retirement age) we can use the money in the HSA for anything we want (not just medical expenses). It effectively becomes another retirement account.

As you can see, an HSA has many advantages. You can get a major medical with or without an HSA but I feel having one has been a real advantage for us.

Laura Roeder on Tue, 2nd Feb 2010 12:34 pm


This really just comes down to numbers – from what I understand you do NOT have enough in savings to cover a catastrophic event such as cancer and the $800/month that others are telling you to save won’t even come close to enough money. Will you die when you can’t pay the bills? Maybe, maybe not. You might not be able to get treatment at all, or you may have insane medical bills that you just can’t pay. I know that the stress of the later scenario is something you’re actively seeking to get out of right now with your real estate bills.

I am going to play head shrinker on this one – it seems like you don’t want to the insurance not from a logical point of view but because you are pissed that it’s unfair. There are many psychological studies that show that humans HATE to feel cheated, or like someone else has gotten a better deal than us. I think that’s a part of what’s leading you to feel this way.

Lastly, I would play with the idea of not thinking of $800-$1500/month as an outrageous amount of money. If your business made $100k in profit a month, this would be a non-issue wouldn’t it? High medical bills whether you pay them to insurance or out of pocket are part of your reality due to your diabetes, and you need to work those numbers in to how you structure your business. You might need to structure your business so that you can make more than the $15k or $20k a month that others might be thrilled with.

Debra on Tue, 2nd Feb 2010 1:56 pm


Wow, best site I’ve read yet. I’m new at checking out sites to see what’s out there. This was by far the best conversation I’ve lurked onto. I really liked what Laura said, “don’t think of it as a lot of money”.

As for me, I have no insurance, a huge risk I’ve chosen to live with. I have been fortunate to have been healthy all my days, I do listen to my body and what it tells me. A change in this fortune could have me seeing differently. I’ve gone back and forth, being insured, not being insured, being self employed not being self employed. My kids are grown and just starting out on their own, they have their own insurance, so if I die due to loss of insurance coverage, so be it. I too have hated the way insurance companies set up the living in fear method. Although I’ve been told, we the people asked them to do it, back in the days when they started.

I do everything wrong : Johnny B. Truant on Tue, 2nd Feb 2010 3:10 pm


[...] expert, and I certainly never blog about technology tips and hints anymore. Instead, I blog about my shitty insurance plan and how well I did on a fitness [...]

Joe on Tue, 2nd Feb 2010 4:36 pm


Fuck insurance companies for being the greedy bastards they are.
Fuck our government for perpetuating this system for decades.
Fuck Obama and Congress for not fighting hard enough to get real health care reform.
Fuck the oblivious people who go on accepting this bullshit because its not currently affecting them.

I’m sorry, but just as Kelly Diels, I am viscerally upset by this… Every time I read a story like this.

Johnny on Wed, 3rd Feb 2010 5:17 pm


Thanks for all the ideas and support, everyone. We’ve gotten a bunch of new options that we didn’t know we had, and my wife Robin (whose head doesn’t hemmorage when she thinks about insurance) will, I’m sure, figure out a way that will work… well enough.

Ultimately, Laura nailed it. Even if I can afford it fine, my main reaction to all of this is just to be pissed off. I’m not desperate; I’m angry.

chub flounder on Wed, 3rd Feb 2010 9:59 pm


yeah, i kind of agree with laura too.

her comments really opened my eyes to the possibilities of not living like a gypsy, a scabrous barnacle on the bloated underbelly of american society, being one of the petty grifters who are undermining our fabulous medical system by racking up huge ER bills i can’t possibly pay and then daring them to collect from me, since i couldn’t care less about my credit score, since i’m not planning to buy a house any time soon, since i enjoy “throwing my money away on rent,” unlike so many of my friends who are still paying off $400k homes that they bought for $650k in those heady devil-may-care days of the early 21st century.

i hope laura can to show me how to “structure my business” to make more than $20k a month. i’m sure it’s a structural problem, and all i need to do is create a new structure that allows me to make $100k a month. not too difficult!

maybe all the american economy needs, now that i think of it, is some new structure, or maybe even multiple structures; possibly an entire framework. maybe laura, if she’s not too busy being proactive and dialoguing a new paradigm shift, could help obama’s people figure out how to make this country live up to its full potential. i think there’s too many boring old farts in washington, who don’t even know how to twitter their podcast mashups into the blogosphere to reach the young people who really know how to make things happen in this brave new world of intertubes and dolphin-safe cybernets.

P.S. i really hope i’m not out of line here, but the reptilian portion of my brain is wondering if “structure your business” is perhaps a euphemism for “call parents and ask them to give me an advance on my trust fund to build a website so that i can sell my advice on marketing to the companies i’m going to invite to advertise on the site i’m going to build.” not insinuating anything. just asking.

Abby on Thu, 4th Feb 2010 10:26 am


The health insurance mess is caused by government meddling, but unless Obamacare rises from the dead, that meddling is all at the state level. The result is, the availability and cost of insurance varies from state to state. While researching your options, consider whether you are willing to move. (There’s also Canada or other countries, but research wait times for treatment before you move to a country with socialized medicine. And survival rates for cancer. And long-term outcomes for diabetics.)

I share your anger at the insurance racket (and Obamacare would make it worse, not better) – my husband and I are currently uninsured as a direct result of state laws of the same sort proposed by the plan that has most likely just died in Congress. Community pricing and shall-issue laws drove all insurers but Blue Cross/Blue Shield out of the health insurance business in the state we’d bought coverage in, and our plan was cancelled.

The insurance company we applied to turned us down (I think it was Golden Rule – they won’t take you if you have a pre-existing condition). We were able to get student insurance for a few years, but now that I’ve graduated, we are again without insurance, and both self-employed.

We can get it, if we’re willing to pay the price. At worst, our state has a high-risk pool. But every time I shop for insurance I get so pissed I put it aside. We will get something, once I can get past my anger long enough to finish the process.

What makes me most angry is the state laws which restrict the type of plans the insurance companies can offer so I can’t find the type of plan I want to buy (a high-deductible catastrophic plan). (Obamacare would be far more restrictive – see the post above from the person who moved to Massachusetts for a sample.)

That’s not to say we don’t need some fixes to our system, but we don’t need a pile of mandates. What we need is to reduce the cost of providing care, so self-pays (what we now call uninsureds) can afford to pay. Mandating that everyone buy insurance will do nothing to reduce the cost of health care. Putting everyone on a Federal version of Medicaid won’t give us the quality of care we’ve come to expect.

To get back to Johnny – shop around, consider all options, including what it might cost you to pay for everything (both routine and serious conditions), before you drop your coverage.

Michael Martine on Thu, 4th Feb 2010 12:57 pm


You’re all entitled to your opinions, but I’m getting a little tired of folks saying the health care mess is because of the government. I’m not picking on the latest commenter before me, but saying this to all of you who believe this.

To think this is all because of so-called “government meddling” is the grossest oversimplification imaginable. I’m sure it makes you feel all self-righteous and triumphant to say that, but if put even the slightest effort into thinking about the problem instead of echoing phrases out of the Rush Limbaugh talking points book, you will find that idea does not hold up at all.

The reason why there exists the uneasy relationship between private enterprise and government regulation is because private enterprise too often exploits people for profit. In other words, companies deliberately FUCK YOU OVER, and they’ll keep doing it until they’re regulated. In the case of health insurance or any kind of insurance, there is little choice about where to go: all your choices SUCK. They will all screw you over without a moment’s hesitation. It’s built into their bureaucracy. Insurance companies are just a legal form of organized crime, as far as I’m concerned. They’re worse than banks, and there’s no such thing as a good bank, either.

The situation has a complex history, so keep your childish platitudes to yourself. If you really think that healthcare would be fixed if government got out of it, you are unbelievably naive and don’t even know your country’s own history.

Let’s take a look at another favorite wingnut punching bag: unions. Why do unions exist? Because people are lazy? No, it’s because companies were employing child slave labor and literally getting away with murder, exploiting people’s desperation for profit until something stopped them. The only things which put an end to that were unions and government regulation.

For years, the auto industry fought every safety regulation ever proposed. Does that not seem insane? Only recently has safety become a selling point. Without government regulation, this would not have happened. Market forces were not enough to push it through.

These are only just a couple examples, but you get the idea.

You will not find anyone more capitalist than me, but I believe in a capitalism of service, not exploitation. Capitalism does not equal conservatism, and government regulation does not equal socialism.

This kind of simple-minded un-thinking is the kind of idiot shit slung around on news channels and in the public discourse, and it more than anything is helping this country sink down into a pit of its own stupidity.

I’m saying this because I care about raising the level of thinking and discourse. I’m not attacking anyone personally. We can do better than this. It doesn’t take much.

This is Johnny’s LIFE we’re talking about here. More than that, we’re talking about all of our lives, and our children’s lives.

Raise the bar, people.

Kristi on Thu, 4th Feb 2010 5:12 pm


I guess I won on a long shot…

I was healthy until I was diagnosed with a heart defect just before my 30th birthday, while pregnant with my daughter.

I had surgery. It went poorly. I had to have another surgery to fix it.

Because I am insured, I had the luxury of seeking the best care. I can’t overemphasize how that gave me a sense of control when I felt very little.

Over three months I had medical bills of almost $250k, the vast majority of which was covered by insurance

People knock insurance, and I get it.. But as I went through that process, I was nothing but grateful.

I won’t represent my situation as likely — I’m the anomaly that puts you in your conundrum. But the thought of not having choice in my doctor and care because I can’t pay and knowing that I was headed for financial ruin… I’ll keep paying my premiums, thanks.

Good luck sorting it out, and let us know if you find a solution that works for you!

Aislyn on Sat, 6th Feb 2010 12:29 am


Dude, even if something did happen they most likely wont even help you.

You should move to Canada. We’ve got you covered up here. Not as warm, sure, but the beer is way better.

Kaushink on Sun, 7th Feb 2010 10:54 pm


I’m in a similar situation. I have mediocre coverage from Mega Ins for about $600 a month, and it keeps going up. As you point out, there are no easy answers. I know there are well-meaning comments here, but stopping the insurance is not a good idea. You will have a very difficult time getting insured again, and if some something happens, you will have to depend on county services. What you and I are really paying for is catastrophic events like finding out we have cancer or need surgery for something. $10k will not cover surgery

If you come up with an answer, please share.

bobby one time on Tue, 9th Feb 2010 1:41 am


You have insurance to protect your assets, not to guarantee medical services. Hospitals (in most states) can not deny you services based on insurance coverage or lack of. Shit, if you get hit by “the bus” or truck, most likely the bus or truck is at fault and your rolling (or wheeling) in the big bucks. Plus you can bump up your medial coverage in your auto or motorcycle policy and poof, you don’t have to worry about those sort of injuries – whether you are at fault or not. Just stay away from rock climbing, serious downhill skiing, the hood, bar fights, cage fighting, etc and keep up with your insulin, exercise and you are fairly set.

There are plenty of people who fit in the gray areas who have smoked for 40 years, are pear shaped and are a few years away from needing a quadzipple bypass where insurance may offer them better care to extend their lives, although many are denied better care anyways. Keep out of overnight hospital stays and even broken arms are not that expensive – relative to your combined annual payments and deductible. When the doctor says, “I think you need to stay for the night” – he means, let’s make some money, just reply with “I’m uninsured and filing Chapter 7.” Nine times out of ten, you’ll be out the door and fast.

What about cancer, what about this or that? If the shit hits the fan, you are not going to be worried about how to pay for it.

Let’s say you do have big medical bills one day. So what? You don’t have to pay. We just believe we have to pay. Nobody puts a gun to your head and says “Pay.” They can’t even take your house, even in bankruptcy as long as you are living in it. They might get a judgment to garnish wages from a 9-5 job you don’t have. Less anything with a title registered in your name and bank accounts with your name stuffed with cash – there is not much to go after. You are just storing that hot tub at your place for your buddy, right? That’s your kids college fund, isn’t it?

Seems you need to restructure your assets legally. There are all sorts of ways. What keeps you from moving your assets into a trust that you control and floating your health expenses out of pocket until either you begin making big bucks and can pick it up again (insurance companies still will want your money if you have not been covered) or pickup national insurance that will be available in less than 10 years?

We are all told we NEED health insurance. We are also told to become doctors and lawyers so we can make big bucks and have the best 9-5 jobs (21st century volunteer slavery). Most people reading your blog know – there is no good 9-5. Furthermore, how many doctors that actually make any real money work only 9-5? So who is giving the advice? Sure back in the 80’s you could get a kick ass HMO that covered everything, your employer picked up the whole tab and all you had to do was initial the paperwork – not any more. Just by the numbers, making the most of a health savings account is a good place to start.

Johnny, your blog rocks. Thanks for posting.

Johnny on Tue, 9th Feb 2010 7:08 am


That’s a reeeeally interesting comment, man. Thanks.

Sandra @ DebutanteClothing on Tue, 16th Feb 2010 9:45 am


Johnny-
I just started reading your blog via the Third Tribe seminar. I had no idea you were Type 1. I am too. Have been for 33 years now – I am now 35. This is a tough situation. I understand the math involved, I just know that the physical and psychological dependence on health insurance has been ingrained in me so profoundly that it it were me, I couldn’t do it. Even with out of pocket expenses, it’s like a safety blanket, even if it’s just psychological.

Good luck with whatever your decision is. I may have to pick your brain about autoimmune disease and working for yourself sometime!

Johnny on Tue, 16th Feb 2010 11:38 am


The annoying thing is the way you’re penalized for having an entrepreneurial spirit and starting your own business. Want to start a business? Can’t… you’re fucked without an employer covering insurance. Ugh.

Still haven’t decided what to do, but will have to in a week or two.

Archan Mehta on Sat, 20th Feb 2010 3:16 pm


Johnny,

Thanks for sharing. This is a great post. Sorry to hear about your pain.

What worked for me was changing my lifestyle choices. I quite smoking.

I started to eat three meals a day. And smaller portion size.

Go for a stroll in the outdoors every single day. Keep your body moving daily.

Drink more water. Take a shower. If you feel hungry, snack. Take a siesta.

Meditate daily. Practice yoga. Eat plenty of fruits and vegetables. Buy a juicer.

Eat lots of yogurt. And drink hot tea/coffee and flush the toxins out of your system.

Make sure to get enough fresh air and sunshine. Hope this helps. Cheers.

Drew @ Cook Like Your Grandmother on Sun, 21st Feb 2010 9:39 am


Archan, all of that sounds like great advice. Except how does it reduce the cost of medical insurance for someone with diabetes?

Johnny on Sun, 21st Feb 2010 10:45 am


So my wife went on one of those cost-comparison insurance sites and signed up and now we’re getting 50 calls a day from insurance companies, and *I* have been tasked with following up with them.

At least the situation got less complicated and more straightforward.

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