What Does a Good Health-Care System Look Like?

I make a good living. I should have a larger retirement portfolio than I do, as my husband and I keep our living expenses within bounds, and I am a moderately successful self-employed professional. However, every few years, or sometimes a few years in a row, I find our household being bankrupted by the medical-industrial complex.  

This year has been uniquely devastating. My husband is a 75-year-old bone-cancer survivor. Two years of radical chemotherapy left him with a suppressed immune system, which means for most of the pandemic we’ve been hiding from people the way Gremlins hide from sunlight.

A few years ago he had a two-year bout of C. diff, for which the drugs cost thousands. He finally beat it.

A long-term result of the C. diff left him with bacteria in his teeth and gums, which resulted in him needing $25,000 worth of dental work. He lost his upper teeth, now has upper dentures, and had serious gum work done on all his bottom teeth. Medicare covered a tiny bit of this. Dental work is not considered worthy of proper insurance in this country. And without the dental care he would have developed sepsis and died.

This cost was on top of his Medicare deduction from his Social Security and his $471-per-month drug-plan copay.

We’ve had some truly INCOMPETENT primary-care physicians over the years.  We found a great doctor in 2006. He was an independent. Didn’t take insurance. Fee for service. Had studied at Loma Linda hospital. Great credentials. Finally a great primary-care physician. His wife, a Harvard-trained attorney who had retired from the law, ran his practice. Well, with the COVID pandemic, his wife burned out on medical administration, partly from all of the death they had to deal with. And she had a few COVID deaths in her own family. With his wife retiring from medical administration, he joined a boutique primary-care practice starting January 1, 2022. He’s no longer fee-for-service.  He went concierge. He takes insurance now. But the annual “concierge fee” for 2022 was $3,000 per patient per year. It is going up to $4,000 per patient for 2023.

Then there are MY medical costs. My insurance is $1,189 per month for second-from-top-level insurance. It goes up 14 percent next year. I have arthritic knees from being a 10-to-15-mile-a-week runner from my late teens to early 30s. At 6 foot 1, I am a knee-replacement candidate. Prednisone made me put on weight, and I was already heavy, so I had to get off of it. Humira had all the effects of a sugar pill. I am immune to the benefit. So my arthritis doctor prescribed a biologic drug infusion.

Those treatments, of which I had three, had a copay of $1,468 each. And to boot, they did absolutely nothing! I was fired by my arthritis doctor when I told him that it was professionally irresponsible of him and his staff to prescribe such an expensive treatment without first notifying me of the cost. They felt that it wasn’t their job.

Next year I will have the knee replacement. I am living on pain meds and toradol (an injectable anti-inflammatory) and can’t wait until 65 when Medicare picks up the full tab. The out-of-pocket cap on my health insurance is $8,800. I’ll hit that. And I have a tooth that’s going and needs to be replaced with an implant. That’s another $4,000 next year.  

There is a silver lining in all of this. My husband is a French citizen. He has family all over that country. Lovely people. In 2024 we are selling our home and moving to the southwest of France. As it turns out, with the world having gone virtual during the pandemic, I can service my clients from anywhere. And as it is, over a third of my practice is out of the region where I live. With the equity in our home, we can buy a lovely home in the Dordogne with cash left over. Our taxes will go up only slightly. Our medical costs will plummet by more than two-thirds, and that‘s if we opt for top-tier health care. I really do love this country. I just can’t afford the medical care here anymore.