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I would like to note that when I signed on today I discovered that MOGASP has indeed resumed its moderation duties and cleared a backlog of posts along with giving responses to them. I'm noting this here because I take censorship issues very seriously. I have no qualms about calling blogmasters on such behavior but am also quite willing to apologize in instances where such censorship calls were made prematurely. Michael J. McFadden Author of "Dissecting Antismokers' Brains"

So, for the first time since I was born 55 years ago, in March 2009 I found myself in a hospital and in the emergency room no less. I am what one might refer to as a “light user” of medical services choosing more holistic approaches to health – vitamins, exercise and such - than the heavy handedness of doctors and their prescriptions though I always have maintained health insurance. My diagnosis was one many women of a certain age hear these days – I had a gallbladder in need of being removed soon. Thus began my brief and recent journey into the wide maw of the health care system. Luckily, and I do mean luckily, I have health insurance through COBRA from a previous employer with a monthly premium of $350. As a self-employed business writer, I am forced back into the employer/employee work world about once every 12-18 months remaining long enough to access health insurance and fulfill contractual obligations. It makes for a spotty resume but there are many of us out there who are primarily self-employed that find this to be the best method of accessing reasonably priced health insurance with adequate if not great benefit terms. I will not go into the gyrations a COBRA participant who is self-employed must go through to deduct monthly COBRA payments as business expenses (current rules award this deduction to our previous employers) – suffice it to say it may be possible to get this deduction but IRS rules governing this are unfair by my estimation. I know at my ripe age of 55 the option to duck in and out of employment is becoming increasingly limited – and I see looming before me a serious decision to buy individual prepaid health (that’s what insurance really is now days) or risk going without coverage. While working as an administrator for my previous employer, a moderately sized non-profit organization, I was flat out told it would not be hiring anyone over 50 ever again and employees over 50 were going to be released as business allowed. This was because older employees caused the overall group rate for health insurance to be higher than it would be if only younger folks were employed. Prejudicial – yes, illegal – maybe, reality – absolutely. It might be interesting to find out just how many highly skilled persons over age 50 are routinely dumped from the traditional workplace because of the burden their ages place upon the business reality of their employers. What a racket: the insurance companies manage to remove through their aggressive group rating tactics the very people who have “banked” health care premiums over the years at the very time they need coverage the most (ages 50 through 65). Then, because of the “politics” of attaining private policies, these same insurance companies wash their hands of this same age cohort through denials, pre-existing condition clauses, and pricing far and above what a “newly self-employed” person can afford. The unfortunate reality is to pay huge monthly premiums ($500/month for high deductible insurance if you can get it) or go bare and potentially risk your retirement savings, your home or even bankruptcy. Back to my gallbladder … As I recall, here’s the progress of what happened to me, an otherwise completely healthy individual, during the six week process to get my gallbladder successfully removed: emergency room visit, CT scan, sonogram, blood work, visit with primary care physician, more blood work, visit with surgeon, another visit with surgeon, more blood work, more blood work, chest x-ray, consult with hospital physician assistant, laparoscopic removal of my gallbladder, overnight stay in the hospital with good care and drugs, and finally a follow-up visit with the surgeon. Mind you – gallbladder surgery is considered now a routine outpatient surgery though I was waylaid for over a day in the hospital so I could have intravenous antibiotics administered. Want to know the charges? How much was billed: $44,716.80 How much insurance paid: 17,540.99 How much I paid: 3,249.97 Funny money billed that no one pays: 29,092.91 First – what’s with that $29,092.91 in funny money charges? I have no reasonable answer to this question; however, a neighbor who works in health insurance says it inflates hospital, doctors, and other providers “losses” and works as an income tax write-off against what otherwise would be enormous profits. So why do not-for-profit hospitals such as the one where I received care need such tax write-offs? I can’t answer that either. Also, you will see that I paid over $3,000 out of pocket for this ordeal in addition to insurance that costs $350 per month - I am (barely) able to afford this but what an extreme burden this must be for others. By my former employer’s estimation – my current health insurance plan is considered a “rich” one covering more than other comparably priced plans. During the exact same six week time period when I was going through my gallbladder ordeal, a family friend without health insurance (but more income than mine) had a health crisis resulting in surgery and a three day hospital stay. He walked out of the hospital with a medical bill of $34,000. Within the week, the hospital called and offered to cut his bill in half to $17,000 if he was willing to place this charge on a credit card or pay in cash that day. He declined this option. Next a hospital social worker called to help my friend find another way of getting this bill paid. Believe it or not, this family friend with a household income of over $100,000 per year was granted temporary Medicaid benefits dating back to the week prior to his surgery and hospital stay. All said, his financial responsibility ended up being about $7,000 – just about what mine was if you take into account a year’s worth of insurance premiums plus my out of pocket expenses. Now, here’s a kicker – I could have had gallbladder surgery with all of its moving parts done at a highly reputable private clinic in Mexico just south of the border for a maximum of $6,000 including transportation and hotel! I finish with a story of the miracle of socialized medicine in the US – Medicare. My husband reached the magic age of 65 a couple of years ago. Last year, he underwent heart catheterization that resulted in three stents being placed in arteries near his heart. This life saving, minimally invasive procedure saves multiple lives each year and helps many avoid heart by-pass surgery. I was astounded when we received a simple bill – the cost of the procedure and overnight stay in ICU was $102,000, Medicare was billed $12,500, and we were responsible for $250. We carry no Medicare supplemental insurance – $250 was the true charge to us through a Medicare advantage plan that costs $90 per month deducted from my husband’s social security check. But again we have funny money totaling $89,250 – what’s with that? My conclusions? The current US health care system is grossly unfair to those of us who pony up premiums on a monthly basis. In the end, if you are sick access to care as well as the expense (if you're a good negotiator) is about the same for those who have health insurance as for those who don’t. Health insurance needs to become just that again rather than pre-paid plans that try to take your money and push you out the door before any claims are made. I also am rather glad my gallbladder ordeal happened while I still am covered by my previous employer’s group plan – I really hope its cost of business is increased just a little by my illness as devilish as that may sound. Medicare is a miracle of how socialized medicine can work in the US. Senior citizens who protest health care system reform – are, well, stupid and hypocritical. They readily accept the largess of Medicare (and Social Security for that matter) and work to deny similar access for the balance of the US population. I for one believe the US would be better off with a single payer system with the large insurance companies working as administrators similar to how they work with Medicare in delivering its successful advantage plans. Large insurers can offer supplemental insurance plans for those wanting greater benefits. Without clear reform to the health care system that reduce monthly insurance premiums while increasing access for all, I believe the US will see extreme consequence as the baby boom enters its retirement years. Many will have limited their health care because of under insurance or no insurance reaching Medicare age in poor health. Others, who have been denied insurance for pre-existing conditions, will be forced to spend retirement savings accessing health care that will increase substantially the need for other social services in coming years. As for me if there is no reform, I have concluded I will not spend more than $350 per month for health insurance – I am at my limit now. My COBRA runs out next April and I look to face difficult options that may force me for the first time in my responsible adult life to not have health insurance. I don’t particularly like the idea of not being able to “pay my way.” As a result, I am exploring moving to Mexico, which offers expatriated Americans a lower cost of living inclusive of access to affordable out-of-pocket health care as well as low-cost access to its government health care system ($300 per year) if you're a resident. As a freelance writer, I can work remotely from Mexico. If we’re close enough to the border, we can border jump for my husband to access Medicare. However, it would be better if our leaders just do the right thing and approve health care reform NOW.