Monday, January 19, 2015

Rootless: Health Insurance

Last year was the first year for mandatory health insurance enrollment. 

I didn't enroll in the health insurance system in 2014 because:
  • My legal residence is in one state, but my body is often outside that state. I had no idea how to enroll in a plan that would actually be of any use to me should I need it. Over the years, my experience with bureaucracies has shown that they don't know what to do about round pegs in square holes. The consequence is that the round peg is penalized in some way. (Not to mention that the legislators in my home state willfully sacrificed affordable access to their constituents in order to make a political point. They even made it a crime for state employees to give any advice to Missouri residents who had questions about enrolling in the ACA.)
  • I'm very lucky to enjoy good health.
  • It made more economic sense for me to pay the 2014 penalty for non-enrollment than to pay the insurance premiums.  

This year is different because:

The penalty for non-enrollment is significantly higher than it was in 2014, so I might as well get the insurance coverage, although with its ridiculous $6000 deductible, it's about worthless to me except in a catastrophic situation.

In fact, I'm appalled at two things: 1) that I'm paying so much every month for so little; and 2) that taxpayers are paying the extortionate monthly subsidy I qualify for - for this deplorable coverage  - in order to sustain a healthcare system that enriches a lucky few, wreaks financial, physical, and spiritual devastation on so many, and to top it off, is so disparate in its quality of services. These high-deductible plans - with the carriers getting so much money per month from the insured and the federal government - are like a happy financial windfall for them. 

But here is the silver lining: Some of the policies are eligible for health savings accounts. Now there's something I can get behind! The HSA is a pretty little creature:
  • I can put tax-free money into it every year (there is an annual cap);
  • I can use it for any medical or dental expense throughout the year (without paying tax on what I withdraw);
  • Any unused money rolls over to the next year, so as the likelihood of my medical needs increase with my age, I'll have more HSA money at my disposal; 
  • I can put the HSA into an investment account to grow my deposits; 
  • Once in a lifetime, I can roll over an IRA into my HSA; and
  • When I reach a certain age, I can treat my HSA just like an IRA. 

I think health insurance coverage will work for me for 2015, after a fashion. "Work for me" in the sense that I won't be assessed a tax penalty for the 2015 tax year. Unless I miscalculated my prospective income for the year and then I will be punished for same.

Will it work for me after that? Don't know, as I don't know where I'll be after 2015.

Hopefully, the current iteration of so-called "affordable" health care is merely a stepping stone to what we need to do in the USA - have single-payer health care. Medicare and Medicaid are already viable systems, so it's not like we have to invent any new wheels.

A final note: The singling out of smokers for higher premiums in the health care marketplace is discriminatory. Smoking has negative health effects, but no more so than some other behaviors such as driving while impaired, abusing substances (artificial or natural, legal or illegal, prescribed or not prescribed), and so on. There is a relationship between smoking and low socio-economic status. By targeting smokers for higher premiums, we are over-taxing the poor. (Disclosure: I am not a smoker, but I used to be.)

P.S.: I just saw where my insurance carrier has Dr. Oz on its home page. Imagine. Dr. Oz, who dispenses snake oil along with medicine.  Jeez.


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