Insight: Affordable? Not so much — This individual is paying the price for Obamacare
by Darin Sims
Special to The Star
Dec 22, 2013 | 11532 views |  0 comments | 67 67 recommendations | email to a friend | print
Photo: Special to The Star
Photo: Special to The Star
I did not win the genetic lottery.

I have a chronic lower-back condition that my orthopedic specialist informs me is genetic in nature. My spine, he observes, is that of an 80-year old.

The problem first became apparent in my early 20s and has been a daily feature since. My doctor at the time suggested I lose 15 pounds. It was important to keep my weight down and my core strong, or I would end up on disability and perhaps in a wheelchair.

His words hit the mark and I took control of my health by losing 35 pounds and starting a daily regimen of core-strengthening and dietary changes, which continues to this day. I am now 49 years old and a disciple of a healthy diet and lifestyle.

The list of medications I take consists of two ibuprofen once every week or two. I visit my spine doctor once every couple of years when I experience a flare in pain, and my injections cost my insurance between $1,200 and $2,000.

Aside from a couple of miscellaneous visits for health care here and there, the cost of my health care to my insurance company is minimal.

My wife follows the same diet and fitness regimen as me, so her health care costs are also minimal. Our diet and lifestyle choices allowed us to purchase an individual insurance policy 15 years ago when we started a business and became self-employed. Since we made good diet and lifestyle choices, our premiums were relatively low.

I appreciate having some control over the cost of my insurance and feel strongly that costs associated with behavior is a very important component of minimizing expenses. Money is universally understood and can provide a very powerful incentive.

If you have followed the rollout of health-care reform, you might guess how I will be impacted and therefore how I and others with individual insurance plans feel about the new law.

If you guessed that I am unhappy, you are correct. I am not surprised that my insurance will cost more. I knew better than to believe the lofty promises of better coverage for lower cost that were made in order to build public support for the law. If you provide more of something for more people, it will cost more (period!).

I did, however, believe that I could keep my plan if I liked it. I can’t say I was in love with my plan — I was paying for something I didn’t use much, but compared to the new plan I would be forced into, I was in insurance nirvana.

My old plan cost $768 per month for a family of three with a deductible of $500 each, and although it covers all the things I need it to cover, my president informs me that it is “substandard.”

My new plan will cost me right at $1,000 per month, a 30 percent increase. This is a significant increase, but I consider it tolerable in order that others can gain access to insurance who otherwise could not (such as those with pre-existing conditions not in their control, for example).

My deductible, however, has increased 400 percent, from $500 to $2,000 per person. So unless something big happens, I am paying my insurance company a minimum of $14,000 and up to $18,000 before it is on the hook for any of my costs.

In short, I will pay for someone else (or several someone elses) to become insured and, barring catastrophe, will essentially forego my own coverage. This is unfair.

As the law was rolled out, I learned that I was in the crosshairs of the creators of the law since the beginning. In order to make it work, the law’s designers had to have those healthy, low-cost people on the individual market subsidizing the others to make it work. The Obama administration granted politically well-connected groups, such as trade unions and certain businesses, allowances on the law's mandates. The individual? No such luck — there is no lobby for the individual.

The broader implications of the law are huge. In order for me to subsidize someone else’s health care, I will have to reduce spending somewhere else, and since I don’t have additional thousands of dollars just lying around, that somewhere else will primarily be my retirement account. This will delay my retirement and ultimately reduce the funds I have available to spend during retirement.

If one projects this nasty little feature over an entire class of people (the middle class, by the way), the impact on our economy is enormous. The only hope I have is that enough people are adversely affected by the law to force our elected officials to scrap it or repair it. That and a strong message vote in 2014 and 2016.

The Affordable Care Act? Affordable to some, perhaps, but not to this particular “individual.”

Darin Sims holds a master’s of business administration and is part-owner of a local small business.
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