Co-Pays, Deductibles, Out of Pocket Expenses, and Me

[Tom Rinaldo]

As a self employed person who had private insurance and dropped it a few years back, let me simply share this with you. As I kept getting older and my premiums kept increasing, I couldn't afford what it cost me to keep my health care insurance. Before I took the final step of dropping that insurance, I progressively watered down my own coverage; opting for ever higher deductibles, dropping prescription drug benefits etc. all in an effort to contain the rising costs that I just couldn't afford.

It reached the point where I realized that the odds favored me being better off using all of that money that I was giving my insurance company each month to pay for my out of pocket medical expenses as they came up, instead of not being able to pay for them at all after spending huge sums on my insurance. In short I could no longer afford to pay for ANY medical care because of the amount of money it was costing me to retain medical insurance. There was nothing left in my pockets to pay for out of pocket expenses. My health insurance had drained me of my ability to seek and obtain medical care.

In the business world the choice I made might be called opting to be self insured. Instead of paying out huge sums of money to a profit making institution each month so that they could in theory pay my medical bill later when I got them, I "saved" that money myself for that later "rainy day". Except of course I didn't get to save anything - I actually needed that money to live on. But Instead of spending $600 on insurance every month, now at least I was able to squeeze out enough cash to see a Doctor from time to time, get an occasional test taken, and eat healthier foods etc.

If disaster strikes I'm screwed, but I was pretty much screwed anyway since I couldn't come up with the thousands of dollars needed each year to keep a policy that leaves me having to spend thousands of dollars I don't have on top of that in the event of any serious problems. At least now I can afford to cover routine medical expenses while I pray I remain basically healthy until I qualify for Medicare. In my case that might happen soon enough for me to avoid being hit with heavy federal tax penalties for my inability to afford buying health insurance. So it could be worse.