In my 4 years as a blogger, I’ve never done what I’m doing right now. I never read a post (by someone I’m a subscriber to…or otherwise, come to think of it) and got so enraged that I dropped everything to post a response right now. There is nothing more important to me in this moment in time than to respond to “How to Make Health Insurance a Bad Bet” on Zen Habits. You can find the post here. Please read it through (skimming is fine – the jist is very easy to get), and come back over.
Just in case you didn’t see it, here’s my absolute favorite/most enraging part:
“What you’re really throwing away: For my family, a high-deductible insurance policy can cost $4,000-5,000 a year (about $350-400 a month). For a smaller family, it would be less. A lower-deductible insurance policy costs a lot more. Assuming a monthly payment of $380 and an annual return rate of 8%, if you invest that instead of spend it on insurance, you’d have $250,000 in 20 years. More, if you adjust the payments upward for inflation. That’s a big amount to gamble on something where you have less than 1% chance of using.(…)
As you get into your 50s, your odds go up, and into your 60s, they go up a lot. Most people who have heart attacks or cancer are in their 60s or older. Same thing for frailty, Alzheimers, hip fractures, etc. As you get older, it gets very likely you’ll need expensive health insurance. But I’m 39, and my family is younger than that, so we’re not in serious danger at the moment.”
Now, Leo Babuta is one of those Big Bloggers with a huge subscriber base, and when I think of all the young, self-improvement-prioritizers, mostly (aspiring) entrepreneurs reading this, and having them cancel their insurance and – as Leo suggests – “build up savings/investment of at least a few thousand(…)for unexpected medical needs”….I start shaking.
I’d be lying to say that this post didn’t hit home in a very personal way for me. Like, a super very personal way. All my usual readers know that I was diagnosed with Stage Two breast cancer on Nov 25, 2011 at the age of 33. You can read what the last year’s been like for me here if you’re new around these parts, but the main points are that I did not carry the gene (despite a family history of cancer for every one of my relatives over the age of 70), I was down/upgraded to Stage One, I went through 2 lumpectomies + 4 rounds of chemo + a bilateral mastectomy and reconstruction, and I was finally declared cancer-free on June 5th of this year.
I thank my lucky stars each and every day that I’m a heterosexual, married woman and that I’ve been on my husband’s (stellar) health insurance since I quit my corporate job in March of 2010. This year alone, I paid $4,649.49 (yes, I added up all my receipts) for tons of co-pays, insane amounts of medicine, an office visit for an out-of-network doctor, a trial to allow me to keep my hair (didn’t work, but I still had to pay for it), a service that keeps my embryos frozen (’cause chemo puts me into early menopause, and as a 33 year old without kids, my husband and I didn’t want this option taken away from us), and 1 night in a private room in the hospital. Most of the large expenses were choices on my end: to try to keep my hair, to get a private hospital room, etc. I look at that figure and breathe a sigh of relief each and every day. Despite the cancer, I consider myself a lucky lady in every other regard.
Now, I can’t get the exact figures of what I would have had to pay sans insurance for all of my appointments, medications, and treatments, but I think you can get a taste of it based on the receipts I have that told me what I should have paid. Here they be:
- The pills that cost me $10 every time are listed on the receipt as costing $59.17, $105.25, $32.59, $45.99, $67.49, $77.49….so let’s say 3-11 times what I pay for them, and I have at least 20 receipts from Walgreens for this year alone. Let’s say, on average, I would’ve paid $1,000 for my pills and instead I paid $100.
- My plastic surgeon’s office visits + my breast reconstruction surgery cost $20,750. I paid $25. And keep in mind that this doesn’t include the fee from the breast surgeon…she performs the first part of the surgery, and the plastic surgeon only does the reconstruction piece. I would think the entire surgery + office visits would be close to $50,000. I paid $50.
- My husband had to inject me with a syringe after each one of my chemo treatments, which costs $3,821.25. Times four (one for each round of chemo). My cost? $20 each. $100 total.
- Four visits to my oncologist’s office: $1,100. My cost? $100.
Do we get where I’m going here? Do I need to figure out the other charges and then put them up against what my husband and I were paying for our insurance every month and show how I saved hundreds of thousands of dollars while only shelling out a few thousand? I don’t think I do. I’m sure you get the point. The $250,000 that Leo said you could save (in 20 years!) by investing your $380/month instead of spending it on insurance could be gone in a matter of weeks. Welcome to bankruptcy, or worse.
I know this is getting long, but my point isn’t done being made. Leo wrote that:
“So what if you get into a bad accident or get some unexpected disease? Isn’t this invitation for bankruptcy? Well, how often has this happened to you? In my 39 years, it’s never happened, and most people I know haven’t faced this either. Again, let’s use rational arguments instead of fear.”
Want some rational arguments, Leo? Use me and my breast cancer diagnosis at 33 (and yes, doctors described me as “young, thin and healthy” even after the cancer diagnosis). Use my client and friend Steffanie, a young woman in her 30s who had to have brain surgery last year (no, she didn’t have any of the Risks you talk about) that would’ve cost her $30K (and $5K/mo for medication) at a minimum. Use the 872 members in my Young Survival Coalition Facebook group, all of us diagnosed under the age of 35. Use a close friend’s sister-in-law, a woman in her 30s or 40s (I’m not sure of her exact age) who suffered a brain aneurysm just last week. Talk to Matthew Zachary who founded Stupid Cancer, an organization that works for the 72,000 (!!!!) young adults ages 15-39 who are diagnosed with cancer every year. And then? Talk to my friend and former client Lisa, a 34 year old who was diagnosed with Stage IV cancer just months after she lost her young husband to cystic fibrosis. Actually, you can’t talk to Lisa. She passed away three months ago. I think of her every day.
Yes, we should all do what we can to make ourselves healthier. Exercise, eating few-to-no processed foods, not smoking, etc should be done by everyone (unsure where/how to start? Get this book STAT – the content inside isn’t as close to eye roll inducing as the name suggests). I agree. But just because you don’t smoke, have protected sex, never drive, and are under the age of 50 doesn’t mean that your health insurance is a “bad bet.” On the contrary indeed. Of course, everyone should pick the plan/deductible they feel comfortable with – and hopefully Obamacare will pass and us entrepreneurs won’t have outrageous costs for ourselves & our families anymore – and there’s no need to pick the most expensive if you know you’re relatively “young, thin and healthy.” Because, Leo? Anything can happen to anyone at any time at any age, no matter how many miles they run or green smoothies they consume every day.
And one more thing. It’s a bit of a petty point but I can’t not say it. Your post is extremely condescending to myself and everyone I mentioned above – those whose own actions did absolutely nothing to bring on their diseases. I had someone tell me that she thought cancer was brought on by stress….which implies that the patient brought the cancer on themselves. It’s preposterous. And so is your “advice.”
I would like to highly encourage you to take down your post, or at least update it with some of the facts, stories, and figures I’ve given you here. I invite you, Leo, to post your thoughts in the comments or send me an email at michelle(at)whenigrowupcoach(dot)com. Given your large audience base, I hope you take this responsibility seriously. As a young (thin and healthy) breast cancer survivor, I know I do.
P.S. Leo, I just noticed that you said we should have “regular screenings for cancer”. The only such “screening” I know of is a genetic test that insurance won’t pay for unless you prove that there’s cause to give it to you (meaning you have a strong, early family history or you’ve been diagnosed yourself). I was told that it would be $8,000 out of pocket if I was rejected by insurance. Thankfully, I wasn’t – but I know others who have been. Do you mean a mammogram, or a biopsy? Please let me know if you know of any other “cancer screenings” that I’m unaware of and don’t cost thousands out of pocket.
NOVEMBER 9th UPDATE:
While I did not get a personal response from Leo, I was just alerted that he added an update to his post. He wrote:
“I’ve gotten a lot of negative feedback on this post. I’m OK with that, as I don’t expect everyone to agree with me and actually appreciate opposing viewpoints. It’s caused me to reconsider my recommendations in this post, so I’ll clarify my position here: I don’t recommend that most people forgo health insurance. This is what I believe is best for me and my family, and I offer this post as an alternative to the mainstream view. I hope you’ll give these ideas some thought, but don’t make decisions based on one person’s example. These issues are too important to just go with what I’m doing.”
While I wish that he would have rewrote the post so that this was expressed at the beginning of the article and that his accusatory tone would have softened to more of an opinion (as well as including points made above and in the comments: having the cost of his family’s medical care fall on other people; the cost of “mundane” things like having babies and the sudden onset of asthma; the mental toll a bankruptcy-causing illness can take; the cost of needing ongoing medication; etc. The brilliance in these comments has not gone unnoticed, and I appreciate everyone who rose up with me this week). I’m glad he at least added this “disclaimer”. I don’t know what other negative feedback he’s received, but I have a feeling he’s heard all of us loud and clear. Now let’s hope that impressionable entrepreneurs can separate what he’s doing with what’s best for them.
If you’re interested in hearing more about my self-employment/cancer/insurance roller-coaster this year, a video interview I did with Laura Simms on Oct 31st was posted yesterday. Good timing, huh? Click here in case you need more proof on the importance of being insured as an entrepreneur and/or you want to know how my cancer affected my workload, my self-care and my healthy habits – it’s all there.