Tag Archives: health

My Health Insurance Story

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If the AHCA passes, something like this could happen to you.

I’ve been self-employed since 1990. When I left my last full-time job — which did include health care benefits — I bought my own health insurance coverage. I was 29 at the time, a non-smoker, and in good health. But health insurance was something I thought everyone needed to have, so I signed up with one program or another — I honestly can’t remember any details — and stayed insured for years.

Understand that I seldom needed insurance coverage. Again, I was in good health. If I caught a cold, I went to the doctor. If my insurance covered the visit and medicine, fine. If it didn’t, I paid and didn’t complain. When I had some problems with my knee and needed several tests, some physical therapy, and finally some arthroscopic surgery to repair a torn meniscus, I ponied up the $1,000 deductible before finally getting some benefits to cover most of the other costs. I’m not rich and I’m not poor but I was usually able to afford any kind of medical attention I needed.

Each year, my insurance rates went up and I paid the new premium. It wasn’t a big deal; I made more money every year and I saw the increased expense as part of my cost of living increase. Occasionally, I’d shop around for a new policy and get one that was a little less costly. That would creep up over the years and I’d change again.

The biggest mistake I ever made

I’m not exaggerating when I say that getting on my future wasband’s health insurance was the biggest mistake I ever made in my life. Why? Because when was I diagnosed not long afterwards with a tumor that needed removal and possible cancer treatments afterwards, he told me that I might not be covered if the insurance company found out we weren’t married. Terrified of bankruptcy from medical expenses for surgery and cancer treatments, I agreed to marry him. After all, we’d been together for 23 years and “engaged” for most of that time. We’d obviously stay together forever.

I turned out to be wrong about that. But the insurance was the root of my mistake; if I hadn’t gotten on his health insurance plan, I never would have married him. It would have been a hell of a lot easier to get him out of my life when he decided he wanted a mommy more than a wife and took up with a desperate old whore he met online only six years later. (Read a few of the early posts tagged divorce if you want the details of his betrayal.)

And no, there was no cancer.

In the early 2000s, my future wasband took a job in the Phoenix area with a company that offered very good health insurance plan. Around the same time, I got a sizable increase in my health insurance premium. He told me I could get on his insurance and it would be cheaper and better. Even though we weren’t married, I assumed he knew what he was talking about when he made the offer, so I dropped my insurance and got on his.

Sometime after we married, when I was still on his insurance, I started having digestive issues. I went to a gastroenterologist connected to Wickenburg Hospital — which I will never do again — and told her about my symptoms, including pain in my upper abdomen. She translated that as chest pains and decided that I needed to get an EKG. When that showed no problem, she sent me for a stress test. When that showed no problem, she sent me for another test. When that showed no problem, she finally gave up trying to diagnose me with heart problems. She was never able to resolve the digestive issues I had. Neither was another doctor I went to see. I wrote about this in a 2010 blog post titled “Getting Quality Health Care: Apparently Impossible.”

My wasband lost the job with the great insurance got another one with good insurance. I stuck with his new plan. Then he lost that job and was unemployed for a while. He got us on Cobra, which he paid for with our joint checking account. Except he didn’t pay on time. He missed a payment and they cancelled our coverage.

He got in touch with them right away and made the payment. It was only five days late. They reinstated him immediately. But they looked at my medical records, saw the heart tests, and refused to cover me because I had a “pre-existing condition.”

Except I didn’t have the condition they claimed I had. I had never had that condition. All tests had proved negative. My heart was fine.

It took six months of fighting with Blue Cross to get insurance coverage again. For the entire time, I was completely exposed to financial loss: if I was hit with a major health problem, the cost of medical attention could easily bankrupt me. Actually, I guess it could bankrupt us — I don’t think my idiot wasband realized how exposed he was, too.

I finally got coverage under my own name, separate from my wasband, by signing papers saying I’d never put in a claim for heart-related issues. I had no trouble with that because I had a healthy heart.

And, as you might imagine, I learned my lesson and kept my insurance separate from my wasband’s no matter how good his next employer’s plan was. I simply couldn’t trust him with something that important. (That probably helped confirm my financial independence from him in divorce court a few years later.)

I have been on one health insurance plan or another since that “pre-existing condition” scare all those years ago. The Affordable Care Act (ACA or ObamaCare) made it easy to find insurance that met my requirements. Again, I’m generally healthy and I make a decent living. I have insurance primarily to prevent bankruptcy in the event of a major illness. I have assets to protect, including my home, my business assets, and my retirement funds. I’ve worked too hard my whole life to put them at risk.

To keep my premiums as low as possible, I have a very high deductible: $5,000. I take advantage of a health savings account if I can. (My new plan does not allow additional savings but I can still use the balance from my old plan.) It’s nice to have annual check-ups and special tests like mammograms covered by insurance without having to worry about the deductible. Coverage under ACA helps people who can’t afford doctor’s visits at all to make at least make one visit a year which can, hopefully, find any problems before they become serious.

I’m not at all happy with the provisions of the Paul Ryan American Health Care Act (AHCA or TrumpCare) in part because it will allow insurers to deny coverage or greatly raise rates for people with pre-existing conditions.

Will it affect me? Will I be denied coverage? Or charged some outrageous rate for premiums? Just because I had a few heart tests ten years ago? Tests that proved I had a healthy heart?

And will some test or problem you’ve had in the past prevent you from getting coverage?

And what about well-care visits? Maternity coverage? Contraception? Mental health care? Any number of items on the list of required coverages from the ACA?

(Don’t worry boys, I’m sure you’ll still be able to get your little blue pills. Republicans wouldn’t dare threaten a man’s sex life.)

With only 17% approval rating from the people, Republicans could pass the bill later today anyway. They don’t care about the people who voted them in. They care about the lobbyists and rich donors who pay for their campaigns. The people most likely to benefit from this plan.

So I guess time will tell how it affects you.

Learning about Milk Fat

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I learned something new today, thanks to a debate with a friend.

The other day, a friend and I were discussing milk.

I told her I preferred 2% milk but was trying to get to like 1% milk. To me, it was about reducing unnecessary fat and calories in my diet. I’ve been drinking 2% milk for years and actually now prefer its flavor and consistency over whole milk. Whole milk, to me, had become too rich, almost like a light cream. I wanted to start liking 1% milk in an effort to further reduce fat and calories for a healthy diet. I already enjoy fat-free yogurt; indeed, I don’t think I’ve had whole milk yogurt in years, if ever. (Do they even make it? I guess I could make my own.)

My friend was adamantly opposed to reduced fat milk. I gathered from our conversation that she thought they added things to the milk that made it less healthy when they removed the fat. Or that something about the actual process of making reduced fat milk caused it to be less healthy. In any case, she thought reduced fat milk was bad and didn’t want to hear anything else about it.

If there’s one thing I’ve learned, especially in the past three or four years, is that when someone is stuck with an idea in their head it’s no use debating the point. At least not without facts. And although I suspected there was nothing unhealthy about reduced fat milk, I had no evidence to prove my point. So I let the subject drop and we chatted about other things.

But this morning, when I sat down with my coffee and some time to kill before dawn, I set about finding some evidence to support my point of view.

How Reduced Fat Milk is Made

I Googled “How do they make reduced fat milk?” I got a number of search results. The first, from The Kitchn website, had the answer I was looking for: “How is Skim Milk Made?“. Here’s the pertinent info:

So how is skim milk made? Traditionally, the fat was removed naturally from milk due to gravity. If fresh milk is left to sit and settle, the cream — which is where most of the fat is — rises to the top, leaving behind milk with much less fat.

The quicker, modernized way of making low-fat and skim milks is to place the whole milk into a machine called a centrifugal separator, which spins some or all of the fat globules out of the milk. This occurs before the milk is homogenized, a process which reduces all the milk particles to the same size so that natural separation doesn’t occur anymore.

The article goes on to provide some other interesting information about milk and fat free milk. Among that information was a note about additives:

Federal law mandates that most skim milk has to be fortified with vitamin A and sometimes vitamin D. This is due to the fact that even though whole milk naturally has a fair amount of both, the vitamins are fat soluble and thus lost when the milk fat is removed during the skimming process.

Milk solids in the form of dried milk are also added since they contain proteins that help thicken the watery consistency of skim milk.

Not only was this likely the additives that worried my friend, but it also explained how some brands of skim milk were far more palatable than others: they likely added back more dried milk to thicken it up.

2% Milk
The only thing that creeps me out about Shamrock Foods milk is its extraordinarily long shelf life: the quart I bought last week is supposedly good until March. Could it be the plastic packaging?

Now I don’t know if the 2% milk I normally consume has a lot of vitamins or any milk fat added back in. The milk in my camper’s refrigerator now — remember, I’m on the road this winter — is from Shamrock Farms and says it contains “reduced fat milk, Vitamins A & D.” Nothing about milk solids.

So nothing I learned about the production of reduced fat milk has scared me away from drinking it.

Benefits of Whole vs. Reduced Fat Milk

Scrolling down in the same search results, however, brought up links to two different articles in TIME Magazine. I read them both. After all, I wanted to learn the truth — a truth that would either support or even change my own opinions.

  • The Case Against Low-fat Milk Is Stronger Than Ever from April 4, 2016 cites a study of people whose health had been tracked for 15 years. The conclusion was that, if anything, people who consumed whole fat dairy products were less likely to be obese or suffer from type 2 diabetes.
  • Why Full-Fat Dairy May Be Healthier Than Low-Fat from March 5, 2015 cites the results of over 25 studies that concluded that “people who eat full-fat dairy are no more likely to develop cardiovascular disease and type 2 diabetes than people who stick to low-fat dairy. When it comes to weight gain, full-fat dairy may actually be better for you.”

Huh.

Both articles suggested that there might be something special about the fat in dairy that works with our bodies to help them process the foods we eat and help us feel full. Dairy fat could actually be preventing us from eating less healthy sugars and carbs to feel sated. And these articles maintained that it was foolhardy for diets to recommend cutting (or eating) just one kind of nutrient — for example, low fat or fat-free diets — when the body naturally works with all consumed nutrients together.

I understand how these studies could have gotten these results. Back in the late 1970s and early 1980s when the fat-free diet craze was in full swing, stores were full of fat-free processed foods. I know because I still lived at home (or at least visited regularly) and saw that my mother bought them. She, like so many other people, thought that the answer to keeping weight under control was to keep as much fat out of their diets as possible. But rather than do this by eating naturally low fat foods like fruits and vegetables and whole grains, they did it by buying processed foods labeled “fat free.” They then consumed as much as they wanted, not paying attention to the ingredients that made this food taste good despite the lack of fat: mostly sugar. Calorie counts were sky high. It was around this time that I started reading labels and making food choices based on what I read. While I don’t have a perfect diet, I’ve learned to minimize my time in a supermarket’s middle aisles where all the processed foods reside.

The Calorie Argument

Okay, so what about calories? The articles both confirmed that one of the benefits of reduced fat dairy products was the accompanying reduction in calories. So I decided to see just how many calories I was saving by switching between whole, 2%, and 1% milk. (I really detest fat-free milk and generally only have it in lattes because I think it froths better. Fat free yogurt tastes fine to me.)

So I Googled “What is the calorie count for whole, 2%, 1%, and fat free milk?” The PopSugar website had the answer I sought: “Whole vs. Reduced vs. Low-Fat vs. Nonfat Milk.” Here’s the nutritional information that interests me for one 8-ounce cup of milk:

 Whole2%1%Fat-free
Calories15013011090
Total Fat (g / %)8 / 35 / 22.5 / 1~0 / 0

What’s interesting when you read data in the article’s table is that they all the same fiber, carbs, and protein but 1% and fat-free milks actually have more sugar — although admittedly it isn’t much more: 11g vs. 12g.

Now I don’t drink a lot of milk, although I probably do drink more than the average adult. I’ll go through a half gallon in about a week. Every cup of 2% is saving me only 20 calories over whole milk and a switch down to 1% milk would only save another 20 calories. Is it worth it? I don’t think so.

At this point, I sort of regret getting so used to 2% milk.

An Exercise in Critical Thinking

So what did I learn?

In a way, my friend was right: reduced fat milk isn’t any better for you than whole milk. And if she believed that there were additives, she’s right — although I’m not sure those additives make reduced fat milk any less healthy.

But in a way, she was also wrong: reduced fat milk isn’t really bad for you. It just doesn’t give the health benefits we’ve been led to believe.

As for me, I was wrong. There’s no real reason to switch to reduced fat milk. I have no evidence to show her. I have nothing to stand on for pressing my original point of view.

Will I change the way I buy milk? Probably not — at least for now. I really do like 2% milk. I’m used to it. To me, drinking whole milk is almost like drinking cream. I’m not so picky, however, that I’ll turn down whole milk if that’s the only thing available. I’m not worried about 2% milk hurting my health.

But 1% and fat-free milk have definitely become a little bit less attractive. No real calorie benefit and what’s with the added sugar? And what if milk fat really is good for you? Should I really be minimizing it?

And that’s what critical thinking is all about, folks. Gathering information and forming your own opinions after thinking about what you’ve learned. Even if you begin researching with a preconceived notion, you need to be ready to change your mind when the evidence clearly tells you your notion is wrong. You shouldn’t just look for evidence that supports your view. You should look for evidence that tells the whole story, the true story, or at least the story that properly conducted research and established facts support.

I sure wish more people would learn to think critically in today’s world.

The Odd Thing about My Old Eyes

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Can vision problems reverse themselves with age?

I’ve been nearsighted for most of my life. I began wearing glasses in the fifth grade and switched to contact lenses nearly full time when I was in college.

Over the years, my vision has gotten progressively worse. Each eye exam resulted in a slightly stronger prescription. I was lucky, though. Even though my natural far vision is bad, it’s very correctable. The contact lenses I’ve been wearing for at least 20 years — Acuvue disposable daily lenses — fit me like they were made for my eyes’ size and shape and bring my vision to 20/20 or better.

My near vision, on the other hand, is amazingly good. With glasses and contacts off, I can see nearly microscopic detail of things within 4-5 inches of my face. I can even read the micro text on $100 bills.

Of course, with contacts on, that close vision disappears. And as my far vision prescription got stronger and stronger, my close vision with contacts on got worse and worse.

At first, I combatted the close vision problem by letting my stronger eye do distance and my weaker eye do close vision. The ophthalmologist did this by prescribing a strong lens for my right eye and a much weaker lens for my left one. This worked pretty well, at least for a while. But then I realized that what it was really doing was making both my far vision and near vision less than satisfactory. So I went with contacts for good far vision in both eyes and began using reading glasses for close vision when my contacts were in. My back up eyeglasses were progressive lens bifocals.

Last year, my contact lens prescription was -6.50/-7.00 (right/left). My understanding is that that’s the equivalent to 20/650 and 20/700. Again, with the lenses in, my vision was about 20/20.

This year, however, I began having trouble with my vision. It started in the autumn when allergy (?) issues made it impossible to wear my contacts for more than a day or two. My eyes were itchy and teary. I wore my glasses quite often. I could see okay through them, but not great.

Then I started my drive south for the winter. I was wearing my contacts again and should have been seeing great. But I wasn’t. Everything in the distance was a bit blurry. I was having trouble reading signs. Objects in the distance on the side of the road that I thought were shrubs turned out to be cows. Oops.

What really confused me, though, is that when I wore my sunglasses and looked through the reading lenses at the bottom of the glasses, I could see distance better. That wasn’t right. I should see distance worse. Sure enough, when I put my readers on, I could see distance better than without them.

Eye Prescription
My current eye prescription shows a remarkable improvement in my vision.

So when I got to Arizona, I made an appointment at the same eye center I’d visited the year before, which is the same one I’d used when I lived in Arizona. After the usual eye health check up, I told the doctor what I’d noticed. He didn’t seem terribly surprised. We went through the usual exercise with the machine and eye chart to figure out what my prescription should be. The result: -5.50/-5.75.

My far vision had greatly improved over the past year.

He fetched some sample lenses and I popped in a pair. It was amazing. I could see perfectly again.

But what was even more amazing was that my close vision was also somewhat improved. Although I’d still need readers for small print, I could see good enough for most reading in good light. The doctor confirmed this: instead of +2.50 for readers, I could now use +2.00 readers.

I left the doctor’s office looking around me like a blind person who has just been given sight. I was drinking in everything I saw. The detail amazed me.

Needless to say, it really made my day.

The question both the doctor and I have is why my vision might have improved. He says that vision is often tied in with blood sugar levels and asked if I’d had any blood work done lately. I told him I had, about a month before, and that the doctor had given me a clean bill of health. He said that high sugar levels usually cause vision to get worse, not better. So now I’m wondering if I had high sugar levels last year when tested and they’d come back down gradually since then.

But I have to admit that I honestly don’t care. As long as I can see as clearly as I do now, I’m happy.

On Saturday, I treated myself to a new pair of good quality readers. On Sunday, I ordered two new pairs of bifocals, one of which includes snap-on sunglass lenses. For those interested in saving money on glasses, do check out Zenni Optical; I ordered two pairs of glasses for 1/4 of the price of one pair at Walmart Vision Center. You can’t beat that.

Glasses Order
My eyeglasses order. I decided to treat myself to two pairs: one just for indoors and the other for outdoors/flying. The pair with the snap-on sunglasses is a reorder with my new prescription. For some reason, they automatically applied a 10% discount so even with priority shipping, my order was less than $130.