Yet, when she died, she was almost completely broke.

This is My Life

A bit of history first. I came from a lower-middle class family. My Dad held various jobs, mostly blue collar unskilled labor positions. My Mom managed the household finances and made sure everyone in the household was taken care of. We never went hungry and always had the clothes and things we needed.  There are times growing up that I still don’t know how we managed to keep afloat, but we did. My mom was a whiz with day-to-day finances. At the same time, she had absolutely NO concept of investments, retirement funding, IRA’s, mutual funds, or any number of fairly common financial items that most families take for granted today. She assumed that the government would take care of her when she got older, and that Social Security would provide whatever she needed.

If only that were true.

About 10 years ago, long after she had divorced, and long after I had entered and left the military and had gotten married myself, she started having financial problems. She didn’t have any income other than her Social Security, and her bills were steadily going up. She was lucky enough to qualify for an apartment in a retirement complex (not a rest home, as it didn’t supply any personal assistance) so her rent was low and steady. Her needs weren’t too great at that time. By that time, I had worked my way up in my career to a level where I could have had her move in with me without any problems.

She’d have none of it. She was independent, and that’s the way she wanted to stay! There was no way she could be talked into moving in with us. She was going to stay independent until the day she died. At the same time though, her medical expenses kept creeping up and up, and were costing her a larger percentage of her fixed income each month. We offered to help her pay for the medicine, but again, her pride intervened and we were flatly refused.

At least she allowed us to look into various social service programs for her. If you’ve never been unlucky enough to qualify for food stamps, Medicare/Medicaid, WIC, and other assistance programs, I sincerely hope that you never have to. But if you do qualify, DON’T HESITATE TO GET WHAT YOU’RE ENTITLED TO. My mother, it turned out, was eligible for a number of different aid programs. As she was nearly unable to get out and around, I was the one that went in her place to fill out all the forms, talk with all the social workers, and basically do everything I could to get her whatever aid and help she was qualified for. I’m immensely grateful to the social workers who helped me out, but at the same time, sitting for hours in the waiting areas was a desperately depressing experience. Surrounded by people that were down on their luck, and doing everything they could just to get by, it was a very sobering and humbling experience.

So, What Have We Learned?

I realized quite a few things during this period of my relationship with my mother. We had slowly started exchanging our roles as Parent and Child. I became the Parent, watching over my mother, the Child.

I also realized that when you have very little left in your life in the way of material items, you can still have your pride. My mother was a strong-willed and proud person. By the time I started taking up more and more of the duties of supporting her, that was pretty much all she had left. I took VERY special care to try to preserve that pride. She wouldn’t move in with me, because she though of it as losing her independence, so I did everything humanly possible to make sure she was able to remain independent, while still being taken care of.

I realized that even though our roles had changed, our love for each other was just as strong as ever. It’s that bond that helped her through the illnesses, the surgeries, and many of the bad times she had. She depended on me, and I was going to do whatever was necessary to take care of her.

My final realization is that discussing your parent’s finances with them is HARD. It’s a sensitive subject, particularly with someone who you look up to and admire. But you have to get past the admiration and down to reality to do anyone any good. We had a series of long, hard discussions about her finances. She finally started taking my advice (and consequently, some of my money) and once we broke the initial ice, things continued to get easier.

The one point that she was adamantly against was moving into a ‘real’ retirement home. A home with nurses and assisted living facilities and all the rest. She wanted to remain independent for as long as possible.

The Final Goodbye

My mother had been in and out of hospitals for years, but in 2000, she went into the hospital with a particularly bad case of what turned out to be a respiratory infection. Also by that time, she had deteriorated in health to the point where she clearly could no longer live by herself.

I had to make the hardest decision then. It was finally time to make arrangements for her to be moved to a retirement home. My wife and I got handfuls of brochures from the hospital, and visited a number of homes, hoping to find one that my mother would be happy in. We finally settled on one near another of my mother’s friends, with big rooms, nice nurses, and a beautiful garden in the back patio area.

My Mom passed away that evening.

Later on, after the sadness had subsided some, I realized that she had gotten her wish. She had stayed independent and proud all the way to the end. She had lived her life how she wanted to, and I had succeeded in helping her do that.

Things could have been different. I could have forced changes on her, like going into the retirement home earlier. It might have made a difference. But then again, it might not have.

I’ve never doubted my decision to help her live the life she wanted.

At the site Givewell.com you can now give pre-paid Visa card specifically to handle those pesky Medical Expenses. Yep, a gift card for Medical Expenses.

From the site;

The Gift Card is a more personal and secure gift than cash. You choose the amount you want to place on the card, anything from as little as $25 up to as much as $5,000, and the recipient chooses the health related expenses he or she wants to use it for — however there’s no rule that says you can’t make suggestions!

The card costs $4.95 plus shipping and handling and can be sent to you or straight to the recipient.

At first I thought, "What a neat idea!". Being able to help your loved-ones out with their medical bills in a way that isn’t QUITE as invasive as hiring a private detective to go through their mailboxes for doctor’s bills.

Their Heart’s in the Right Place

I like the concept, and as far as gift cards go, this is better than others. Still, I’m wondering if this business model is going to fly very long.

On the Pro Side – Gift cards are an easy way to give someone some money with a ‘little’ control over what they do with it. If you don’t want Grannie buying food, but instead using your Christmas gift money for healthcare, this is the ideal solution. Just giving someone money for a gift also has that "I didn’t go shopping for you, so here’s some money instead" stigma, that gift cards seem to barely avoid.

This is also a way to give someone a LARGE amount of money (Don’t know off the top of my head where the gift tax limits kick in) you can give up to $5000 at one go if you like. If you wanted to be devious, it might be a good way to get that boob job for the mistress without leaving a paper trail for the wife to discover. (Ahem, IF you were to do that sort of thing, which I’m sure none of MY readers would do.)

On the Con Side – Health insurance is a complicated subject as-is, without mixing in different sources of payment that can ALSO have issues. Again, we have the sensitivity to such a gift by family members. Most people have a ‘thing’ about other’s paying their bills. This could be taken in the wrong way, that they think you believe they aren’t/can’t pay their own way, which can cause some scuffle. Beware!

The Reviews are In

Overall, I’d give this idea a C+, depending on long-term sustainability. I think there’s still a lot of ’selling’ that is going to have to be done culturally to get away from the idea it’s BAD to help friends/family pay their bills. The whole pride issue seems almost insurmountable.

Other than that, it’s a convenient way to contribute towards keeping your loved ones around and healthy as long as possible.

What do you think about the Health/Medical Expenses gift card? Leave us a message and let us know!

I and my family have lived without medical care on and off in years past, sometimes due to job (or lack thereof), sometimes due to the cost of the healthcare itself. In either case, We’ve had enough money to pay for doctor’s visits, emergency care, and other non-catastrophic incidents out of our emergency fund. Even with that, the attitude I and my wife have continually received from all the doctor’s offices, hospitals, and other health organizations was that even though we could pay immediately, and up-front, that we were somehow deadbeats and were treated like we should be on welfare or some other government assistance program. It’s gone so far as one doctor refusing to see my wife because she didn’t have health insurance, even if we could pay IN CASH, THAT DAY for the service!

Why is Health Insurance REQUIRED

I’m not saying private health insurance isn’t a necessity, quite the contrary nowadays. But like car insurance, more and more people (and legislators) are looking at this from the point of view that it should be REQUIRED BY LAW to have private health insurance, rather than optional.  I believe this is more a push by the insurance companies to increase their revenue streams than any real interest in helping the country. Whatever the reason, there are multiple reasons why an estimated 47 million people DON’T have insurance today.

Health care costs have SOARED out of control, and over the past 7-8 years particularly. 

Some Health Care Statistics

National Health Care Spending

• Health care spending is 4.3 times the amount spent on national defense.
• Although nearly 47 million Americans are uninsured, the United States spends more on health care than other industrialized nations, and those countries provide health insurance to all their citizens.
• Health care spending accounted for 10.9 percent of the GDP in Switzerland, 10.7 percent in Germany, 9.7 percent in Canada and 9.5 percent in France, according to the Organization for Economic Cooperation and Development.

Employer and Employee Health Insurance Costs

• Premiums for employer-based health insurance rose by 7.7 percent in 2006. Small employers saw their premiums, on average, increase 8.8 percent. Firms with less than 24 workers, experienced an increase of 10.5 percent.
• The annual premium that a health insurer charges an employer for a health plan covering a family of four averaged $11,500 in 2006. Workers contributed nearly $3,000, or 10 percent more than they did in 2005.The annual premiums for family coverage significantly eclipsed the gross earnings for a full-time, minimum-wage worker ($10,712).
• Since 2000, employment-based health insurance premiums have increased 87 percent, compared to cumulative inflation of 18 percent and cumulative wage growth of 20 percent during the same period.
• According to the Kaiser Family Foundation and the Health Research and Educational Trust, premiums for employer-sponsored health insurance in the United States have been rising four times faster on average than workers’ earnings since 2000.
• The average employee contribution to company-provided health insurance has increased more than 143 percent since 2000. Average out-of-pocket costs for deductibles, co-payments for medications, and co-insurance for physician and hospital visits rose 115 percent during the same period.

The Impact of Rising Health Care Costs

• National surveys show that the primary reason people are uninsured is the high cost of health insurance coverage.
• One in four Americans say their family has had a problem paying for medical care during the past year, up 7 percentage points over the past nine years. Nearly 30 percent say someone in their family has delayed medical care in the past year, a new high based on recent polling. Most say the medical condition was at least somewhat serious.
• One half of workers in the lowest-compensation jobs and one-half of workers in mid-range-compensation jobs either had problems with medical bills in a 12-month period or were paying off accrued debt. One-quarter of workers in higher-compensated positions also reported problems with medical bills or were paying off accrued debt.
• If one member of a family is uninsured and has an accident, a hospital stay, or a costly medical treatment, the resulting medical bills can affect the economic stability of the whole family.
• A new survey shows that more than 25 percent said that housing problems resulted from medical debt, including the inability to make rent or mortgage payments and the development of bad credit ratings.
• A survey of Iowa consumers found that in order to cope with rising health insurance costs, 86 percent said they had cut back on how much they could save, and 44 percent said that they have cut back on food and heating expenses. 

From the National Coalition on Healthcare web site

With the costs rising, and the out-of-pocket expenses eating at families even WITH health insurance, what is the average American to do about the situation??

An Extreme Example

One particularly egregious example of the situation cites an increase for entertainment workers in California and New Jersey to more than $44,000/year for family coverage. That’s the median income for the average American, and an average 82% INCREASE from the year before. This is an extreme example, but by no means the only example of rate increases. The breaker for me was when my OWN company sponsored health insurance increased 42% one year (following a 37% increase the year before). That was when I decided I couldn’t afford to pay more for my family’s health insurance than I did for my mortgage.

Is it any wonder that 47 million people in the United States don’t have health insurance today??

So, with all these examples of spiraling health costs, why the attitude??

Is There a Solution in Sight?

Short answer, No.

Little longer answer, Not yet. Maybe.

The American people are at odds with the Insurance industry, Healthcare industry and other Big Business companies that have a vested interest in maintaining the health care industry as status-quo. High costs equate to high profit for many of these companies and they don’t want to see a move towards Universal Health Care (UHC), so they have made it a political and PR issue. Many myths about the ‘evils’ of Socialized Medicine exist (using the word Socialized, is supposed to remind the American public that Socialized = Socialism = Communism = Evil Russian Enemies/bad things/bogeymen).

Universal Health Care, a major issue in the upcoming elections, has been in the works for over a decade now, without being implemented. This is in no small part due to the myths perpetuated by the UHC opponents.

A few of my favorite myths.

Myth: Universal Health Care Would Be Too Expensive – Federal studies by the Congressional Budget Office and the General Accounting office show that single payer universal health care would save 100 to 200 Billion dollars per year despite covering all the uninsured and increasing health care benefits. (*1)

Myth: Universal Health Care is Socialized Medicine – Universal healthcare itself is not socialized medicine, which refers to medicine that is both financed and delivered by the government. In other words, the government pays for and owns the healthcare system. That is the case for so-called “national health services” such as the healthcare systems of the U.K. and Spain, but it is not the case for other health care systems in Japan, Canada, and the rest of Europe. Single-payer systems such as Canada are not socialized medicine in the sense that the mechanisms of delivery are mostly private (i.e. physicians exist mostly in the private sector) (*2).

 Myth:The Problems With The US Health Care System Are Being Solved and Are Best Solved By Private Corporate Managed Care Medicine because they are the most efficient –

• Fact: Private for profit corporation are the least efficient deliverer of health care. They spend between 20 and 30% of premiums on administration and profits. The public sector is the most efficient. Medicare spends 3% on administration.

• Fact: The same procedure in the same hospital the year after conversion from not-for profit to for-profit costs in between 20 to 35% more

• Fact: Health care costs in the United States grew more in the United States under managed care in 1990 to 1996 than any other industrialized nation with single payer universal health care

So What Can You Do?

For those without insurance, there are other options, including free clinics, hospitals with ‘required admittance’ statutes, and other avenues out there to get needed healthcare. They’re not easy, and they’re not as publicized, but they are out there. Doing some homework with your phone book may be able to dig up local resources for assistance.

For those with insurance that are just getting by, keep itemizing health expenses (they can be tax deductible) and talk to your employer about cheaper insurance alternatives (like joining a co-op organization for small businesses, or going with HSA plans that can double as an investment).

Stay healthy by taking care of yourself. Even moderate additional exercise can have effects on overall health. Take a walk, play with your kids. Try eating a little less or try to quit smoking.

Until the system gets fixed by our leaders, there’s not that much that individuals can do to change things. Vote for the leaders that have put forth a solution you believe works. Talk to others about their views and try to get others to get involved.

To the health care industry out there.

We know that you have stressful jobs, and you deal with lots of patients without health insurance, but please, PLEASE, the next time you talk to someone without health insurance, TREAT US BETTER! Many of us don’t CHOOSE not to have health insurance, it’s just a financial impossibility to us. Be understanding, it could be you that gets fired and can’t afford health insurance tomorrow.

Do you have viewpoints on Universal Health Care?? What do you think needs to be done? Let Us Know!

Sources

1. Connecticut Coalition for Universal Health Care
2. Universal Health Care Myths 101
3. Single Payer pt 3 – Six Myths As Barriers to Health Care Reform

I’ve been quoted a success rate of 98% for 20-20 vision or better, and I also opted for the life-time guarantee (if I ever need another surgery, say to correct something or my eyesight starts going downhill with age, it’s covered). Not a bad deal.

Financial Deal

Another aspect, since they WANT business quick, they offered a discount to do it now rather than after the first of the year. This is to convince those people with Flex Medical Accounts to take the plunge now rather than in Jan-Feb timeframe. The discount was enough to make up for the tax savings I would have received, so it’s a wash for me.

Additionally I’m using my Trapped HSA Money and a zero-interest for a year medical credit account to cover the remaining. So there’s no out-of-pocket costs for this procedure. Kind of nice around Christmas time.

I’ll blog later on the results and my experience with the company So far though, I’m pretty impressed. Usually surgeries are scary to contemplate, but they’ve done so many of these that they’ve got it down to an easily-repeatable process. Also, the computer laser is going to be doing the vast majority of the actual work, and as a deep technophile, I’m more comfortable with a machine doing ultra fine surgery than I am with a fallible human, not that the doctors aren’t skilled at what they do.

Photo by Kazandrew

I recently changed jobs and the new company doesn’t offer a health insurance that qualifies for my existing HSA (with Aetna). At the same time, I hadn’t contributed over the minimum amount ($2000) to open an investment account with them either. So what’s happening is that I have an amount of money sitting in limbo with Aetna that isn’t earning me hardly anything.

Finding Out the Facts

Doing a quick search on Wikipedia came across the following;

Most HSAs have more than one possible method for withdrawal. The exact method of withdrawal varies from HSA to HSA and can be considered a marketing design issue. Checks and debits do not have to be made payable directly to the provider. However, in the case of an audit, account holders will be expected to provide documentary evidence that the transaction was for a qualified expense in order to avoid making the amount in question subject to income tax plus a 10% tax penalty for early withdrawal.

So this means if I withdraw the money w/o it going to a medical expense, I pay taxes on it (which I don’t particularly mind) AND pay a 10% penalty to the IRS. I didn’t know about the $2000 minimum to open the investment account with Aetna, or I would have dropped enough money in before leaving to make it over the minimum.

Since the family is fairly healthy, I don’t expect needing to use this money for anything health related for awhile. So the part that bothers me is that it’s just sitting there doing nothing!

One of my core beliefs is that your Money should always be working for you. Aside from my emergency fund, I generally have every penny doing something constructive, rather than sitting in someone’s bank just gathering (virtual) dust.

Help Me Readers, You’re My Only Hope

So here’s the request. If ANYONE HAS ANY IDEAS to resolve the sitting around issue, I’m all ears. Let’s hear it from you smart people out there. How do I get this money doing something constructive without incurring the IRS penalty??

Any takers??

Technorati : HSA, Health Savings Account