Healthcare/Medical 2015/One Woman’s Opinion
by – Sheri de Grom

Continuing rise of health care cost - Getty image.

Continuing rise of health care cost – Getty image.

Statistics regarding our U.S. healthcare system are often alarming and baffling at the same time. Numbers I’ve discovered while researching one topic or another include the following:

  • We’ve created a healthcare system in the U.S. in which 1.5 million people work in the health-insurance industry while less than half as many doctors provide the actual care.
  • America’s total health care bill for 2014 was $3 trillion. That’s more than the next 10 biggest spenders combined: Japan, Germany, France, China, the U.K., Italy, Canada, Brazil, Spain and Australia.
Getty Image

Getty Image

  • We spend $17 billion a year on artificial knees and hips, which is 55% more than Hollywood takes in at the box office. All the extra money the U.S. spends often produces substandard care or worse.
  • There are 31.5 MRI machines per 1 million people in the U.S. but just 5.9 per 1 million in the U.K.
  • We spend another $85.9 billion trying to treat back pain, which is as much as we spend on all of our country’s state, city, county and town police forces. Experts say that as much as half of that is unnecessary.
Getty Image

Getty Image

All of these high-tech advances: pacemakers, MRIs, 3-D mammograms, have produced an ironically upside-down healthcare marketplace. It is the only industry in which technological advances have increased costs instead of lowering them.

Healthcare is so hard to fix because it’s our largest industry, employing a sixth of the country’s workforce. Additionally, it’s the average American’s largest single expense, whether paid out of our pocket or through taxes and insurance premiums.

I’m always surprised when I check the numbers and learn the healthcare industry outspends all other interest groups for lobbying. Who would have thought healthcare lobbying would outspend the #2 Beltway Bandit by 4 to 1? Healthcare spends $4 to every $1 the military-industrial complex spends.

It doesn’t matter which population our congress serves. When our chronically dysfunctional politicians decided they wanted to mess with our healthcare, we knew we could bring them to their knees.

Getty image

Getty image

Obamacare gave millions of Americans access to affordable healthcare, or at least protection against being unable to pay for a catastrophic illness or being bankrupted by bills.

But, I ask, what about those of us that had our retirement accounts [accounts not belonging to the government but to the individual] robbed to make subsidies available for those who could not afford to buy insurance?

I’m not happy about this. Not for one minute. Would you want your personal 401k dipped into for a stranger to have insurance?

I’m not in favor of paying subsidies to anyone. I worked hard for my retirement and didn’t receive set-aside monies for my education. There’s been nothing privileged about my education or career success. I worked full-time while earning my college degrees plus took care of a family.

Each time Congress has been unable to fund a program in the last six years, they’ve looked to the federal employee or retired federal employee Getty imageand retired military to make the sacrifice. I don’t have a warm fuzzy when I know others are receiving subsidies for health insurance and my retirement funds are making it possible for them to live a life I don’t have the luxury to live.

The monies being taken are not from social security or medicare. They are not taken from any federal revenue sourced program. These accounts belong to individuals and no one else. We’ve saved monthly from our salaries to secure a safer retirement.

This is one woman’s opinion, but please, if you read this and you’re receiving a subsidy for insurance under Obamacare, think about the fact that I’ve worked 40 years while you are at home with your children or perhaps following another path more to your liking. I’ll be 70 next year and excuse me if I sound harsh when I say to you, pay your own way. I’ve paid for mine, more than once.

As always, thank you for reading with me. I appreciate you and wish you only the best life has to offer.

About Sheri de Grom

Retired Fed/JAG, 5 yrs. on Capitol Hill. Former book buyer for B and N. Concerned citizen of military drawdown. Currently involved in mental healthcare reform, health care strategist and actively pursuing legislative change wherein dual retirees are exempt from enrolling in Medicare at their own discretion without losing tertiary healthcare benefits. Monitor and comment on Federal Register proposed legislation involving Mental Health, Veterans Affairs, Health and Human Services, Medicare and rural libraries. Licensed OSHA Inspector to include Super Fund sites. Full time caregive to Vietnam era veteran. Conceptualized, investigated possible alternatives, authored, lobbied for, and successfully implemented Title X, Section 1095 (known as the Third Party Collection Program of Federal Insurance).
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  1. markanthonymartinjr says:

    I was diagnosed of COPD in July 2014. I was on Albuterol Nebs and levalbuterol to ease the situation as i constantly go out of breath when talking or when walking, I was adviced for Lung Volume reduction surgery (LVRS) because my both upper lobes of the lungs were affected, i was making preparation for this surgery when a friend of mine told me about a traditional herbal doctor called doctor Abumere who prepares herbal medicine to cure all kind of diseases including COPD disease, When i contacted Dr Abumere his email and bought the herbal medicine I received the herbal medicine through courier service in 3days, when i received this herbal medicine i used it as prescribed and was totally cured of COPD within 18-20 days of usage, contact Dr Abumere via his email: abumereherbalcentre@gmail.com…..

    • Mark Anthony – I wanted to pull your message over to our main discussion with the thought that others might find your thoughts helpful. My husband has 37 chronic diagnoses including most of his major organs.
      We have used alternative medicines in the past, sometimes with success and sometimes not. At the present time, he’s so very ill in so many different chronic elements affecting many different parts of his body that we feel we must stay within the guidelines of his medical team.
      Thank you for stopping by to read with me and for leaving a comment. Sheri

  2. Gallivanta says:

    Hmmm…..the healthcare system in the US is, despite your best efforts to educate me, a strange mystery to me. Many years ago we had free healthcare and free education in New Zealand. Today we pay for some of these costs. I am happy to pay taxes to permit this system to continue but I would find it odd if my retirement savings were dipped into to provide for society’s healthcare costs. I have private health insurance which is quite expensive by NZ standards but the insurance provider is a not for profit organization and is the largest health insurance provider in NZ.

    • How nice to see you and thanks for your generous comment. So many of us in the U.S. are angry with what’s happening to our healthcare. The system seems to change at the whims of our President and the administrative changes of Health & Human Services (agency that controls Medicare and Medicaid).
      Much of our turmoil is the lack of control over the number of individuals who’ve managed to get free care on the backs of the rest of us. More and more people are gaming the system and that’s going to work only so long.
      I watch while refugees escape Syria and pray for their safe passage and see in horror the razor wire fences being put up to keep them out of Hungary. While I understand Hungary is afraid of what will happen to their country if the refugees should stay in their country. It’s my understanding they are seeking asylum in Germany and Germany has agreed to accept upwards of [is it 80,000 or 800,000 – my mind went blank on the number I heard].
      The point I’m trying to make is that we’ve allowed so many to cross our Mexico borders and not only have they bankrupt our education system, they’ve extended medical care beyond capacity and have paid nothing for the care. They are rarely incarcerated for the crimes they commit and when they are, we don’t deport them but pay for housing them in prisons here. Whey they [felons and worse] are released, they are released back on the neighboring streets of America. We cannot live this way and I predict we may face our own civil way if something is not done soon.
      I’ve become a 24/7 hour caregiver as a result of Tom’s misdiagnoses from Sept 2014 through March 2015 and still on my toes every moment. I have 9 medical calls to make on his own behalf today alone. I’m not about to stop seeking the best medicare care ever for Tom. The medical profession did their best to kill him this past two years and if I hadn’t been there at his side, they would have likely succeeded.
      The good news I have to share with you is that when temperatures cool off some, I hope to work in my garden for extended hours preparing flower beds for fall planting of flower beds with wildflowers and at least 2 trees. I’m the most at peace, digging in my garden and not only having conversations with my blogging friends but Jesus is so easy to talk with when we are in the garden.
      Thanks for being here, Ann. I will get over to your house soon. I’ve been lagging behind with all this medical stuff going on and Tom’s care is much more complicated by now. heri

  3. inesephoto says:

    Sheri, I don’t know what to tell… Waiting almost a year for an MRI scan is a shame in the 21st century. Even when I used to have a very good insurance I still had to wait a couple of weeks for a scan. I’d rather we had some extra “unnecessary” equipment here.
    Medical procedures are so overpriced, yet, expecting you to share your personal 401k with a stranger is immoral. Let’s hope for the better…

    • Inese – Thanks for dropping by. I’m not sure why I gave the impression that we waited a yr. for an MRI. We have more MRI machines per population than anywhere else in the world and normally can get an appt within a week or 2. Emergency MRIs at trauma units are available almost immediately. I’ve often wondered if medical procedures weren’t priced as high as they are, if they were priced at the actual cost plus actual overhead, would the insurance companies negotiate them down so far the hospitals and other providers would go broke.
      It seems I spend at least 2 to 3 hours a day comparing explanation of benefits with bills we received to make sure everything balances out correctly. Providers such as lab analysis and x-rays are often completed by outside sources and thus are billed separately from the original appointment. For whatever reason, all insurance information is never forwarded and I have to make the necessary phone calls to insure they are paid correctly. Life was much easier before Medicare and Obamacare entered into the equation.
      I hope your summer is going great.

  4. Hi Sheri, I don’t know enough to make a really informed comment, but it does seem wrong to use funding from individuals’ retirement funds. The only real similarity I can think of here is that as a public sector worker my pension entitlements are being eroded (i.e. I have to wait longer and get less – this is a pension scheme that I pay into but also has contributions from the employer, which in this case is local government, so it’s a national scheme) to help cover the wider deficit and the fact that we have an increasing ageing population.

    • Andrea – Thank you so much for stopping in and reading with me. I always appreciate your taking the time out of your day to read and comment. I can relate to your pension structure becoming less value because in a sense, your government is using it to balance out the deficit brought on by the ageing population and other factors.
      In my opinion, the retirement plans of individuals should never be eroded to offset the spending required to run today’s business. It might mean we have to have higher taxation but then at least it would be a little more equitable because everyone would have to help raise the money to make up for the increasing deficit.
      The ageing population seems to be taking a larger bite of the healthcare budget than expected wherever I read.
      The Thrift Savings Plan of Federal Employees in the US are tied to the stock market and even the safest fund [the G Fund] is falling now due to the stock market plunge.

  5. My husband and I aren’t even hoping for SS benefits at this point. We know all too well that those benefits aren’t something that we can really count on any longer. We are instead, trying our best to invest money in mutual funds so that we know that we will at least have something when we retire. If they keep cutting military benefits, we won’t have much there either when my husband retires in 4 years. Trying to make the best out of the situation. Thanks for sharing your thoughts. Your posts are not only thought provoking, but educational as well. We just have to turn this country around somehow. Not sure what it will take and no matter who is leading, things just seem to get worse rather than better.

    • Michelle – I agree, we have a long uphill battle ahead of us. We are going to have to treat each issue with care and hold true to our core beliefs. I hope as your husband retires [will it be with 20 yrs as a minimum] you will have the option for Tricare. It isn’t all is should be but if you can marry it up with another descent insurance plan with an employer, it will give you a good base for healthcare.
      When Tom became so seriously ill, Tricare was what saved us in the co-payment department. All the years with my having my BC/BS Federal and keeping it into retirement, the combination of BC/BS and Tricare provided us everything we needed. At the time Tom and I married he had custody of his 2 young daughters and I put Tom and his daughters on my plan and it was worth it’s weight in gold and still is.
      We all have to pick our fights and figure out where we want to devote our time and energies. While Congress is on break, I plan to hit hard and heavy with each of my representatives and senators. I want them to know one-on-one exactly what it is that I want them to do for me. With elections coming up, hopefully I won’t have to fight as hard:)

      • Yes, Brian will be retiring with at least 20 yrs. He could stay in longer depending on what his options are. Since I stay at home now, Tricare has been very helpful. Although many doctors now, won’t accept Tricare and it does get frustrating at times to try and find a doctor that will. I fear that this will only get worse in the future. We still don’t have a single psychiatrist that will accept our insurance and and I had a hard time finding an ob/gyn that would. I am thankful for you Sheri, you never let us down with your willingness to fight for our future. I wish more people cared as much as you do. Have a good week! ~M

        • I know one of the losses to Tricare will be penalties for using an ER when you don’t have a true emergency. Additionally most copays will be higher and many labs will no longer be covered. We also expect many medications will be dropped from the pharmacy formulary. I understand what you are saying about the non-availability of doctors. The same is true for Medicare only it is worse for Tricare. Our pharmacy does a split bill to BC/BS first and then to Tricare. BC/BS pays within the week and it takes Tricare around 5 to 6 months. That doesn’t matter if you are a big box store but the independent pharmacy gets hit hard if they have a lot of customers that are military or retired military. The primary reason doctors will not accept Tricare is they go broke waiting to get paid plus Tricare pays less than everyone else.

          • Thankfully most of our medications are still covered, but I have seen a ton of medications being removed from our coverage plan. Hopefully we won’t need those in the future. I didn’t know it was taking so long for doctors to get paid. I am glad to have a primary care doctor who cares more about his patients than the money. Sometimes I get the feeling that he would treat our family free of charge if it came down to it. He is a big supporter of military families. I don’t know how we would get by without him.

            • Doctors like your primary care physician are rare indeed. It takes me years and years to find doctors I trust and I know have our best interest at heart. It’s interesting to me that I often find some of our best doctors in places other than doctor’s offices. I meet them in bookstores browsing in the same section I’m in or chatting at a coffee house, gallery opening or other such locations. That also gives me the opportunity to have had a somewhat normal conversation before I ever realize they are a physician.

  6. Angie Mc says:

    Sheri, my daughter and I were just talking about a much smaller, but similar, example. Our family has our third child in college. We have paid for it and they have worked or earned their way while many of their peers have their college paid for…by taxpayers dollars. And for some reason, that’s OK. It’s as if taxpayer’s money is magic money that just falls from money trees. It’s painfully frustrating sometimes yet, in the end, we’re proud that we’ve worked so hard to pay our way. You are on the money, Sheri. And I’m just sorry this is all such a mess.

    • Angie – You are spot on. What’s wrong with the old American work ethic wherein if you want something, you work and find a way to achieve your dreams. I currently know of a young woman graduated from college with a BA in film (not easy to find a job with that degree with no experience). Her debt is high and Congress is backing college debt with civil service retirement so that’s a pretty sore topic with me, also. Anyway, this young woman couldn’t make it on her own so she returned to the parental nest for 2 years. She’s been unable to find a job to her ‘liking’ and has decided to seek financing to go on to graduate school. In my day, this is what we called being a professional student.
      I know times have changed but this is also a student who said she didn’t have time to work while going to college. I said nay to that. I worked full-time, raised a family and graduated at the top of my class and then continued straight into the graduate program. I know I’m ranting here but what’s with the kids without a backbone and where are the kids who want to become successful because they know they can get their on their own?
      Bravo for you and Dave instilling in your children that easy street doesn’t exist and when they accomplish their dreams, how sweet it will be.

      • Angie Mc says:

        Exactly. The life approach you describe isn’t good for anyone. Thank goodness I know many self-sacrificing young adults who are working hard and making life better for themselves and others. Some have overcome difficult obstacles, too. And thank you for the pat on the back, yet I’ve also got to give credit to my children. Interestingly, they like the rebel feel of living life as responsible adults at a young age. How counter-cultural can you get 😉

        • Angie – My hat is off to you and David. It takes strong parenting and being day to day examples for children to develop these values. My hat is off to both of you with the deepest respect.
          I have to ask, did David accept the position with the VA? I’ve been asked to represent the voice of all Veteran Caregivers at the upcoming 2015 Veterans Mental Health Summit. I feel so very honored in representing the voice of so many caregivers worldwide. If you know of anyone that’s a caregiver please feel free to give them my e-mail address. They don’t have to be a veteran caregiver. I want to know all problems encountering caregivers today – especially those like myself that have been doing it for so many years.
          Thanks Angie.

  7. mihrank says:

    Every 15 years or so, proposals to reform the entire U.S. healthcare system seize national attention. The cycle has endured since President Franklin D. Roosevelt considered proposing universal health coverage as part of the Social Security Act. Presidents Truman, Carter, Ford, George H.W. Bush and Clinton all produced proposals for universal coverage. Though different in detail, they shared one key characteristic — failure.

    • Goodmorning, Mihran. You, as always, are absolutely correct. Universal health care meets with failure time and time again. The issue that bothers me the most about the Affordable Healthcare Act is that unless someone comes up with some creative loopholes, we are probably stuck with it. Recent events have shown just how difficult any attempt to use the congressional budget process to repeal or make substantial changes in Obamacare a waste of time. When the Supreme Court ruled in favor of the Obamacare subsidies in King v. Burwell, the only real chance the GOP had in making changes to Obamacare (again, total repeal was never possible). Do you know a way out. It seems the subsidies are the biggest hurdle in moving beyond the Affordable Care Act.
      I read that dreadful 2,000+ page document everyone called Obamacare and shuddered – I wondered how many of the Supreme Court Judges actually read every page with yellow marker in hand fully understanding every element. How could they have? They’ve lived in their chambers and out of society far too long to know what the American people are about.

  8. Very enlightening post, Sheri…thanks for sharing…

  9. Denise Hisey says:

    Sheri, it’s becoming more and more apparent that healthcare is big business and not necessarily about our health. I’m seeing an increase in providers not taking any insurance, and patients paying out of pocket. Surprisingly, patients are actually liking the option. No red tape. Just get the care you need, when you need it and pay a reasonable fee for it. Back to basics I guess you’d say.

    • Hello, Denise. Thanks for stopping by and leaving a comment. Yes, you are so right when you say our healthcare is no longer about our health. When we have corporations such as CVS deciding to take certain medications out of their own formularity because they decided the medications were too expensive, it’s obvious things are out of control. Thankfully, we still have a choice to go elsewhere, but for how long.
      I see in my research the percentage of providers not taking insurance. However, if that were the case for Tom and now myself, we wouldn’t be able to pay for the care we need if we didn’t have insurance.

  10. Sheri thank you for the education. You take a very complex issue and make it clear cut and informative. But…..now what?

    • Colleen – Our healthcare has turned upside down on itself. Patients aren’t receiving care and providers are going bankrupt while the middle man [that person calling all the shots determining what services the patient may have but doesn’t know anything at all about medicine or the situation] is making a fortune. Patient’s have lost control of their own bodies and doctors have little say when it comes to how they care for their patients. Everything is now controlled by a protocol and that protocol is becoming more and more rigid.

      • And it’s a nightmare. My doctor and I often have this discussion. I miss the days when someone who saw me, listened to me, heard my heart, knew my story inside and out, could be the force to advocate for me. Now, people/protocols that have no knowledge of me make decisions. How did we let this happen?

  11. lbeth1950 says:

    Always so glad when I see your posts in my inbox. Always give me something more to think about.

  12. I find it incredibly disheartening when the federal government succeeds in pitting different victimized struggling groups against one another, while the true culprits – the corporate elite -continue to rip all of us off. We’re all victims here and we get nowhere by fighting each other. It’s high time the corporate elite started paying their fair share of the cost of doing business, instead of shifting it onto the taxpayer. Once we end corporate welfare subsidies, there will be more than enough money to go around.

  13. I agree. It seems that the good ol’ work ethic is losing here to the squeaky wheel. I have a girlfriend who defended the subsidies saying everyone didn’t have the success I did–as though it was bestowed upon me, not created from 12-15 hour workdays. I have another girlfriend who pays about $300 a month for her subsidized plan. Mine’s over $1700 a month.

    The worst thing for me: I can’t buy catastrophic insurance. I MUST have prenatal care, maternity benefits, and that sort, despite that I’m over 60.

    We’ve gone through the looking glass.

  14. I hate when the call SS and Medicare entitlement money. Yes like you I worked 30 years and deserve to get back what I put in plus intrest.

    • Hi Kim, Social Security and Medicare have been robbed so many times, there’s nothing left to take from those funds. Now the congressional bodies are taking money from individual’s private investments wherein the government didn’t participate. The government doesn’t own any portion of these funds nor do other citizens. The funds I’m talking about are private accounts set up where government employees both working and retired and the military, both working and retired, could place tax deferred savings for independent retirement accounts. When congress takes from this money, it’s theft in it’s most simplistic form. Many individuals I know are cleaning out their retirement funds to place it where the government cannot get their hands on it. It’s a sad day when we can no longer trust our own government.

  15. lifelessons says:

    I think the question of where Congress finds funding is a different issue from universal health care. I agree with you that it shouldn’t be taken from Medicare or Social Security. What they need to do is reduce tax benefits for the richest corporations and use this money to fund Obamacare. And, regulate the health care and pharmaceutical companies that are making a killing on our ailments and killing us as a result!! It is cheaper for insurance companies to send their claimants to Mexico for medical care–and to pay airline costs and hotel bills for them and their spouses–than to get the same care in the states. This is ridiculous.

    • With the sequester, every item in our government’s budget must be funded by existing monies. The sequester does not allow borrowing to run programs that have been passed. My blog is not about funding Obamacare by taking money from Medicare or Social Security. Those 2 sources of monies have dried up. What I am addressing is congress’ attempt to drain private accounts belonging to individuals working for the government as civil servants, retired civil servants, active duty military and retired military.
      These accounts are not the regular retirement accounts individuals have worked toward their entire careers. The accounts are personal monies paid into protected accounts for additional savings toward retirement at a tax deferred rate. The only way the money is in any way tied to the government is the individual is or was employed by the government for a minimum of 20 years.

      • lifelessons says:

        And they think they should be able to take this money? Ridiculous. It is happening all over the world–robbing the poor to give to the rich. The reverse Robin Hood System. The point I was making was that if the govmt. needs money, it should reduce tax advantages to the rich. How in the world can they justify just stealing your money? Are they saying it is a loan? Perhaps they could loan the money to the government themselves, out of their savings from pork barrel politics. i wonder if there has ever been a point before when everyone was fed up with politics as usual!!!!

        • I so agree. Not only is it unlawful but beneath practically anything congress has done to decrease morale among federal employees and active duty military as well as retirees. I’m with you in the idea that we need new tax codes. Our country has gotten to the place where the middle class has been eliminated.
          To protect what I had placed in my fund, I’ve pulled mine out and reinvested it. Thankfully I don’t have to pay earned-income on it due to Tom being a veteran and I’m his sole caregiver without the VA contributing anything toward his care. Many are not only pulling their retirements but also cashing in their US Savings Bonds for fear the money won’t be there when the time comes that they want to cash them in.
          It’s a tough world out there.
          Thanks for commenting. I always enjoy being able to have a conversation around a topic with another blogger.

  16. Inese Poga Art plus Life says:

    Thanks Sheri! I think you might find interesting this new blog to which I was trying to move peoples’attention; http://inesepogalifeschool.com/

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