My cancer/Obamacare story
I worked over 20 years at a job that had a good benefits package. Ms. Scrutinizer was covered as well under my health/dental/vision plan. She had similar coverage through her trade union, but only when she was working. There were long stretches when construction was down and she was laid off. Her union coverage would cease. We never used the COBRA option because she was still covered under my plan. We were lucky to be healthy and except for routine physicals rarely visited the doctor. I estimate conservatively that our total coverage cost over $300,000. Probably 80% of that wasn't "used" by us but that is how insurance works. Plus, we often had double coverage when so many people had no coverage. Stupid and wasteful.
Then in August 2015 I became eligible for Medicare and I retired. Ms. Scrutinizer was on her union plan so we didn't use the COBRA ($1600/month) option on my plan. If the ACA hadn't been in effect, we may have considered that. But we didn't have to. The ACA gave us more freedom and choices. Then she got laid off with her coverage ending December 31, 2015. We knew it was coming so we went on the marketplace and signed her up for a silver plan. $2500 deductible and total out of pocket of $6850/year. $400/month. She expected to go back to work by summer and we expected we would be required to repay the $400/month subsidy since our income would be much higher than when we applied. No problem. The plan and premiums should be pegged to means.
She had been bothered by pains and discomfort for months but the doctor couldn't find the cause. All blood work came back normal. An MRI of her back revealed possible arthritis. Physical therapy and different medications weren't working. Finally she had a CT scan in April 2016 and they found stage 4 pancreatic cancer. Inoperable. Given six months if she did no treatment.
She decided to try the chemotherapy suggested by the oncologist hoping it would buy her a few more months. Cost $10,000 per week. After a couple months, they did another CT scan and the tumor was no smaller. Decided to try radiation coupled with a different chemo drug. She was scheduled for 28 doses. $2500 per treatment. After 21, she was so miserable and weak (down to 80 pounds) and in lots of pain that she called it off. Went onto hospice care so she could die with some dignity and autonomy at home. She was the most fearless person I ever met. We had been married for 30 years. Her death was long but we mostly had the pain under control. Watching her physical and mental condition deteriorate was agonizing for me and family and friends. I still cry often. Grief is a long process. It may never end for me.
She passed away in the spring. One good thing about a terminal diagnosis is that you can help plan your funeral. She opted for a natural burial. No embalming. No casket. Her family and friends created a burial shroud. Her brothers constructed a shrouding board. We filled the grave ourselves after the graveside ceremony.
In summary, from 1994-2015, two insurance companies took in over $300,000 and paid out $60,000. From 2015-2017, a different insurance company took in $7,000 and paid out well over $100,000. Without the ACA, all the cancer treatment would have been disallowed as a pre-existing condition. We would have made the same treatment decisions but it would have used up much of our savings. For many families, this would wipe them out. Bankrupt and homeless. An inheritance tax of 100%.
I learned a lot about how progressive the ACA was. You could be way behind on premium payments but you could not be dropped summarily. Premiums, subsidies, co-pays, max out-of-pocket were all dependent on your income. That's as it should be instead of being dependent on how sick or old you are.
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story. More Congress members need to hear this. May only the good memories of your life together stay with you and comfort you. 