One of the scarier things about being self-employed is the necessity to be self-insured.  For all of our adult lives, we've had health care coverage provided by our employer.  In recent years, we contributed to the cost, but it was fairly nominal, and the benefits were comprehensive and very good. After my husband lost his corporate job in July 2009, he started his own business in order to work as a contractor, and we had government subsidized COBRA coverage (thank you federal government for something) until October 2010.  At that point, we had to pay full price to maintain our coverage - $1,192.36 per month - until January 1, 2011, when the COBRA coverage would no longer be available to us at any price.

So last month, we initiated the process of getting independent health care through Blue Cross Blue Shield, the provider we've had for lo these many years.

Welcome to the real world.

Yes, BCBS does often independent health care plans.  Yes, we qualify to convert directly from a group to individual plan.  But none of the plans provide anywhere near the kind of coverage we got in the big company group plan.  The deductibles are triple and quadruple what we've been paying, the out of pocket maximums 10 times what we've had in the past.


The whole thing necessitated a sea change in the way we look at insurance.  The only difference in each of the three individual plans offered by "Big Blue" was the annual deductible.  All other coverages stayed the same - except, of course, for the monthly premium.  For instance (and forgive me for all this detail, but there's really no way to even talk about insurance without going into some amount of excrutiatingly boring detail) we could get a $1500 annual deductible for $1,110/month; a $2500 deductible for $750/month; or a $5000 deductible for $450/month.

Our first thought was "$5000 deductible?? No way!!"  But then we started doing the math.  If we chose the $1500 deductible plan, we'd end up paying Blue an extra $500 per month in premium costs alone.  Over the course of 12 months, we've already paid them $6000.  Why not keep that money in our own pocket until we need to use it?  Maybe we'll continue to be lucky, and our medical costs will be minimal.  But if not, that $5000 will be in our bank account instead of the fat coffers of the insurance company.

Our generation was one of the first that grew up with health care, and we've certainly gotten used to going to doctors whenever we needed to without worrying about how to pay for it.  Luckily, we've never needed to use our benefits for much.  In the past five years, I've probably been in a doctor's office less than a dozen times.  I think one of the problems with insurance is that, over time, it lulls you into a false sense of entitlement.  I know lots and lots of people- particularly elderly people- who dash into the doctor at every little twinge.  If they had to hand over a $100 bill each time they went in, I suspect they might think twice about it.

I'm no fan of  the modern medical profession, and I'm becoming even less a fan of modern medicine in general.  I think our health care is far too specialized, much too focused on invasive and expensive treatments, and entirely too profit oriented.  And I think the health insurance industry is at the root of a lot of those ills.  Nothing about the current health care reforms addresses a major problem in health care - curbing costs.  And I don't think any politician will ever address that issue because they're too indebted to the insurance and pharmaceutical lobbies.

In choosing the highest deductible plan for our individual insurance policy, we felt as if we were taking a tiny bit of power back into our own hands, power that the insurance and medical bureaucracy has been wielding over the little guy for much too long.

And that was good medicine.