Saturday, March 31, 2018

They said we didn't have much chance of rain today but by mid morning the slight chance became a certainty. So I have stayed inside. I got quite a bit of embroidery done and another two rows of my Catherine's Wheel stash buster lap afghan done. Checked all of the pots upstairs and watered those in need of water. We had planned on going to my brother's for dinner tomorrow (they celebrate Easter) but his son is home with the flu--part of the second wave of the season. Instead I will soak the big hibiscus and trim the rosemary. I plan to use the trimmings to make an alcohol tincture that I can spray on the furniture where the cats are clawing. They will hate me but we really don't want to replace any furniture--yet.

The lead article for this Bloomberg post strikes a chord with us. For several years at least once a year, we have had a discussion concerning health insurance and the price versus the benefits Mom gets. She has Medicare Parts A and B, and health insurance from her deceased husband's last employer which has a drug plan included. For years, looking at the cost of the coverage and the cost of the "services," including the drug plan, the equation came down on the side of keeping the insurance and paying the premium, which had been rising a bit at a time each year. Until a month ago when the equation shifted. She used to pay the monthly premium of about $115 plus the copay on her doctor's visits (every 6 months) plus the part of the cost of her drug (it used to be drugs but she is off all but one which is absolutely necessary) which was about $30 every three months. But CVS bought Aetna and suddenly her drug jumped from $30 to just over $100 because it was reclassified as a Tier 4 when it had been a Tier 3. The drug is a name brand but her doctor gave excellent reasons (when she asked) why a generic (which might be cheaper) simply wouldn't do. So now the equation has changed significantly. It becomes $115/month + doctor's copay + $106 every 3 months. Going without the insurance saves $345 over three months + the copay for office visits (every six months) which will cover the cost of the drugs, whatever Medicare won't pay for the doctor's visits, and the lab tests the doctor orders. What about unexpected illness, injury, whatever? We'll decide that on a case by case basis.

By the way, Bloomberg's editorial position is clear with the following
There’s plenty of evidence that having insurance is a good thing. People with health coverage spend less out of pocket on medical care and are less likely to go bankrupt. They see the doctor more often and get more preventive care. They’re less depressed and tell researchers they feel healthier. Some studies suggest having insurance reduces the likelihood of death.
People may spend less on average out of pocket but only if you don't count the premiums or the deductibles. They may see a doctor more often but I have seen studies that question the value of "preventative" care. The reports of feeling less depressed and healthier are just subjective reports that don't prove anything more than those particular people feel less depressed and healthier. As far as "reducing the likelihood of death" goes--that has a dubious value at our age (Mom at 86, me at 68) because at a certain point the likelihood of death will become the certainty of death. Bloomberg's writer is basically following, uncritically, the insurance industry's talking points.

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