I vaguely remember the days of $100 deductibles and $10 co-pays. Now I have a $7500 deductible and a Healthcare Savings Account. Paul Ryan and the Republican Congress think the more we are responsible for our own healthcare costs, the better decisions we will make. That does not factor in folks like us who have chronic medical conditions that require constant care and long-term treatments. Even if I never had to go the hospital or have a single extra trip to the doctor, my standard medications and regular doctors’ visits would be enough to bankrupt me quickly without insurance.

The financial cost cannot be ignored, although it is small compared to the emotional and spiritual costs. But since we live in a world defined by the all-mighty dollar, we have to face it. Chronic illness can bankrupt you faster than anything else…alcoholism, gambling, smoking, hookers…I can entertain myself for hours in a casino with forty dollars, but I cannot get five minutes of an ER doctor’s time without getting a bill for $1400.  And I told him what to do! My poor HSA. card is way more worn out than my credit card. On the bright side, I am maxing out Uncle Sam’s tax benefits!

I hit my out of pocket maximum for the family, for the year, in February last year. In fact, I think it was the first week of February. No matter how much you plan for these expenses, it is impossible to be prepared for such a large cash outlay, just after Christmas, unless you win the lottery. Each year we try to save more, prepare more, but no matter what, it never seems to be enough. I usually spend the first six months of each year juggling medical bills as money goes into the HSA each pay period.

Hospitalizations typically take most of my deductible if they occur early in the year. The good news is the hospitals will allow me to do a payment plan. Unfortunately, for 2016,  my prescriptions ate most of my deductible, and pharmacies do not do payment plans. They want all of their money up front. This means I was out $7,500 by February, but I did not have that much money in my HSA collectively until the end of the year. We ended up putting quite a bit on credit cards until we were able to recoup that money, so I had the privilege of paying interest on my already outrageously overpriced medications.

This idea that I can sit down with my doctor and sprinkle some magical fairy dust and come up with a cheaper treatment plan is beyond ludicrous.

Half of all adults have at least one chronic health condition, per the CDC. One in TEN adults has a rare disease, which affects 25-30 million people. (NIH) Rare disease parents are fortunate if there are medications made to treat their illnesses. Many have to settle for treating the symptoms only. They do not have the option to make different decisions, and this is a large enough portion of the population to make a significant impact on legislation.

The high-deductible, HSA plan is already a massive burden on a measurable percentage of patients. Increasing that burden the way Paul Ryan and the Republicans are discussing could truly be devastating to people who are already drowning in medical costs. Small tax credits and tax savings will not be enough to offset that. This must be taken into consideration when passing a bill to make any changes to the ACA.


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