Thursday, November 16, 2017

Financial Cancer - Obamacare's Downside


Most people aren't directly touched by Obamacare.  They get their health insurance through their employer, Cobra, Medicare or for veterans Tricare.  Health insurance is mandatory now.  The only health insurance that my wife can purchase is Obamacare on the Federal Exchange and at $1378 per month for their Silver plan it's unaffordable.  There's no competition, take it but under IRS penalty you'd better not leave it.  This is not a political fight for us, it's fixed income survival.  Unchecked Obamacare will kill us.  Best case: Obamacare cripples us.

Figuring 15% to 50% a year in premium increases we could be out a quarter of a million dollars (possibly more) by the time my wife becomes Medicare eligible in 8 years.  And that's just for the mandatory insurance.  Because Obamacare includes big deductibles as standard equipment actual health care for most things not catastrophic is an additional cost. I try to realize that Obamacare is working for some people but that's only at the expense of others. There are winners and losers with every government program and in this one we're big losers. I'm angry at the democrats for creating this nightmare for us and I'm angry at the republicans for teasing repeatedly that they'll modify or gut it and then not doing squat. Here's my Senator John McCain when he was running for reelection last summer:


Maverick my ass.  He told us what we wanted to hear.  Once he was reelected (I regret my vote for him) all of that was forgotten.  I want Obamacare done away with, it sits over our heads like a sharp sword.  I feel like a chump because I carefully planned and saved for retirement and in doing so set us up for this while others who pissed their money away are getting cheap or free rides.  We're the broken eggs in someone else's omelette.

The Feds pay during Obamacare open enrollment time for something called Navigators.  We made an appointment at the local hospital to see one and during our meeting quickly established what I already knew, their expensive threadbare and mandatory insurance was absolutely unaffordable.  She told us that it was mandatory, I refused and only half in jest I invited her to visit me in Leavenworth.  Not because I hate the government but because their health insurance in addition to my Medicare plus supplements would exceed $20,000 for 2018 and will only go up.  She said that she understood and told us that most people who come in for these meetings who don't get a subsidized ride leave angry and without buying insurance on the federal marketplace.  The upshot is that 2 weeks after the meeting with the navigator where we turned down their insurance we got a bill for $1140 from Blue Cross of AZ for a month of Obamacare.  I guess it really is mandatory.  I refuse to pay.  Leavenworth here we come!

So what about that subsidy that we don't qualify for?  Maybe we're rich and deserve to pay full freight.  Hey man, no tax cuts or subsidies for the rich!  Here's how the subsidy works for 2 people.  The eligibility is figured using your gross income, the figure before all the common deductions for stock losses, mortgage interest, medical bills, personal exemption and state and local taxes etc.  Have a gross income of $65,000 or less a year?  Good news, you get a giant subsidy!  Have a million dollars in the bank?  You still get the subsidy.  Have a gross income of $65,001?  Nothing in the bank?  No subsidy for you!  That's it, $65k gross is the subsidy limit for 2018, that's why exceeding it is referred to as going over the subsidy cliff.  Because of my pension and the bull stock market we're just slightly on the wrong side of the subsidy cliff.  I'd rather be rich but over the course of 8 years this is guaranteed to make us poor, to possibly force us out of our home and to leave us with nothing but Social Security and cat food.  

Not buying insurance on their marketplace opens us up to a fine of 2.5% of our income from the IRS.  But there are ways around that.  I have to submit paperwork to the IRS documenting that their insurance will cost us in excess of $6000.  We've also joined the Christian Healthcare Ministries, by doing so we should get a religious exemption.  Thank you Jesus.

OK, so now what?  I had a 3 hour phone conversation with an old friend, he's retired and plays with the tax code and Obamacare just for kicks.  He told me that due to quirks in Obamacare's ham handed regulations and the way AZ handles them Arizona is probably the worst state for Obamacare.  He told me that in AZ there were no alternatives to the Federal Health Insurance Marketplace.

I even broached the subject of divorce with my wife.  If we were no longer married she could get any job and get a big subsidy and our retirement funds would remain intact.  We'd see a lawyer first so that nothing would change other than the ripping up of the marriage certificate.  I've read of couples in our situation who have done this.  She wouldn't hear of it.  She is once again looking for work.  It's slim employment pickens here but supposedly the economy is better now and if she hits the jackpot and gets a job with employer health insurance we can forestall the erosion of retirement assets.  Meanwhile, she's making challah at $6 a loaf.  Obamacare Silver goes for $1378 a month here so that means that for 2018 the break even point is 230 challahs per month.

A neighbor my wife's age who just quit her job and is facing the same problem as we are called and said that she had answered some junk mail from a salesman who said that he had a way around Obamacare.  The salesman was to come to their house to make his pitch, wanna come over and listen?  I listened.  It's flimsy and legal for them to sell but possibly illegal for us to buy.  It's from a company I've never heard of that's owned by Kemper Insurance.  They use the Christian Healthcare Ministries as a fig leaf of legality.  Thank you Jesus, after a second meeting I bought the questionable insurance because it was a little more than 1/3 the price of Obamacare silver and I felt like I had my back to the wall.

I'm afraid of testing this insurance (it kicks in Dec 1).  I'm afraid of the IRS.  I'm afraid that the Republicans won't repeal or gut this financial cancer upon us and I'm afraid that the Democrats will again scream that to alter it in the slightest is heartless, cruel and will mean that innocent people will die.  They're both full of crap. We're just collateral damage.

Wednesday, April 20, 2016

Truckin'

Here's our ABF/UPack trailer, right on schedule.  In the morning we load.







Saturday, April 02, 2016

Moving Day Fast Approaches

Pictures Updated 4/13/2016
Welcome to Chaos Manor!
Everything Must Go!









Wednesday, March 23, 2016

And Now a Word From My Oncologist

This letter recently arrived in the US Mail.  Considering all of the radiation side effects I've had since the seed implant procedure on 2/29 I wonder if I'll receive another letter when the radiation declines by the first half life.


Wednesday, March 09, 2016

Brachytherapy After Ten Days

I've been home from surgery for a week and recovery hasn't been as uneventful as the pre-surgery handout from my urologist promised.

So now I've met the O/R and know that I never want to go back.  I found an O/R to be quite an assembly line.  When I was doing all of my paperwork in the waiting room prior to the big event there was a woman with a cane bitching to staff and anybody who would listen about her eye and what some distant relative nurse she found on Facebook told her to tell the doctors that they must do.  When I regained consciousness after my procedure one of the first things I heard was the same woman, only a partition curtain away, telling the doctors in the O/R what some distant relative nurse she found on Facebook told her that they must do.  I met the urologist and oncologist who worked on me prior to my going into the O/R but I haven't seen them since.  

I've seen what the Foley catheter looks like installed on/in me and unfortunately it's something that can't ever be unseen, it looked like someone had successfully grafted my Johnson to a garden hose connector ("connection adapter", shown below minus the internal parts that snake into the bladder), plumbing fit for Frankenstein.  I knew beforehand that the Foley catheter was going to be part of the show and I chose willful ignorance prior to the procedure and being whacked out on anesthesia during since there was no way I could prevent its use.  I knew that such a device existed but had never seen one because I don't hang out in hospitals or look at kinky plumbing prØn.  
Once implanted and radioactive I was uncoupled from the hospital's electronics and plumbing I was placed into a wheelchair and sent out of the hospital with a single pain pill, a handout describing what I should do to for a successful recovery and a post card where I could rate my experience and express my customer service concerns to the hospital.  All of the hospital staff that I interacted with were courteous, pleasant and polite but there was no box that I could check that said, "please don't attach hospital equipment to my wiener", so I threw the postcard away.  

My recovery is coming along more slowly than I was led to believe it would.  Other than having prostate cancer I'm in fairly good health so I feel for any guy who isn't in good health and has to withstand this kind of well intentioned abuse.  I quickly came to feel as if someone had repeatedly stomped my genital area with hobnailed boots.  I had to pee frequently but couldn't produce and I found that incredibly frustrating and frightening.  I'd sit like a girl for 20 minutes trying to fight overwhelmingly unpleasant sensations as I tried to start the flow of the river from my yellow headwaters.  Eleanor got used to me closing the bathroom door behind me and having sessions of grunting and loud cursing.  In retirement a man needs to keep his mind working  so I've taken to cursing in Russian (link NSFW!) and да (yes), I'm also teaching myself the Cyrillic alphabet.  ебаTь!

I'm leaving the house on a daily basis now and advance scouting for bathrooms wherever I go because I never know when I'm going to suddenly be in need of relief.  At night I awake and roll out of bed every hour and a half to urinate, or attempt to, and I find this incredibly annoying (although not as annoying as having an advanced cancer).  My hospital handout says that this sleep disturbing side effect of my treatment can linger for months.

Next, many physical journeys by aircraft, automobiles and truck will culminate in the new home that awaits us as I work toward living happily ever after and cancer free.

Monday, February 29, 2016

Achy-Brachytherapy

My cancer now has a 2nd glowing sole print on its ass.  I reported to the hospital bright and early and allowed them to sedate me and then to somehow implant radioactivity on the cancerous areas of my prostate gland.  I say somehow because I encouraged them to use enough anesthesia to bomb me back to the stone age.  I wasn't aware of what they did or how they did it.
Next stop: the O/R where cancer gets the 2nd of a radioactive 1,2 punch
But when they were done I sure knew.  While I was off pounding cold ones with Fred and Barney I had a Foley catheter installed.  Modesty prevents me from relating exactly what that is, where they stuck it or what it looked like when properly installed so click on the link (SFW) and all will be revealed.  When I woke up I was in pain all over.  My throat hurt because they had stuck some kind of breathing apparatus down in there.  My insides hurt where my new radioactive seeds, the ones that I'll take to my grave, now live.  My wiener hurt and my bladder was screaming that I had to pee like it was filled with jellied fire.

Not knowing where I was and not quite conscious I think that I tried to get up with the intention of finding a men's room.  But I still had tubes in me and wired sensors on me, some of which I'm told that I ripped out.  Oh, and the Foley catheter was still properly plumbed.  My struggle is what the nurse told me caused the big blood stain on the bed.   The nurse warned me that when he removed Mr. Foley's catheter it would be painful and boy was he ever right.  I screamed from the intense burning pain in a very personal place where I had never felt pain before.  They sent me home wearing a maxi-pad.

When I got home I motored around my house under my own power.  I'm uncomfortable and when I urinate it burns like I'm peeing Drano but the doctors said that I should feel better in a few days.  I'm carrying enough internal radiation to arouse the TSA or ICE from their slumber but I have a card attesting to my nuclear non-proliferation status to show them at the airport or the Canadian border.  My post-op instructions say to not allow little children to sit on my lap due to radiation and to take it easy for a few weeks.

My urologist says that if the scan I'm to receive shortly shows the seeds taking root in the right place I'm good to go, to move to our new home and to live out the rest of my days happily ever after.

Sunday, February 28, 2016

Prostate Cancer - I get (Preliminary) Results


Just prior to the procedure to seed my prostate gland with radiation I can carry around I received a pre game PSA test.  A score of 4 or lower is considered normal.  I was sent to a urologist with a score of 8, which grew to an 11.

Below is proof that 5 weeks of a daily radiation blast and some hormones get results, I now have the PSA of a normal guy.


In order to keep the PSA of a normal guy I'll need to get some more radiation, this time implanted on the prostate glad itself.  I'm in the on deck circle for that right now.

All I Need Now is a Green Light from My Doctors

Assuming that everything goes according to plan with my upcoming brachytherapy here are 2 pictures of our recently completed house along with a still shot from a webcam overlooking the development.


Soon to be finished and furnished

Thursday, February 11, 2016

Graduation From External Radiation





Although I'm still left with the side effects of 5 weeks of radiation Godzilla is safely back in his cage.  Soon I will get internal radiation and then hopefully be on my way to beating cancer and selling our house.

Thursday, January 28, 2016

Leap Year

Leap year comes once but every 4 years and every 4 years I do a double take when I look at a calendar and see February 29th.  I've did a double take after I found out that my next step in prostate cancer treatment, seeding the prostate gland with little bits of a radioactive substance, was scheduled for the morning of February 29th.  

So imagine my surprise when I received an email from the builder of our new house in Arizona saying that they'd like us to come on down for the closing on our house to trade a large sum of cash for title and keys on February 29th. What are the odds?  
By the time you read this I'll be move in ready!
The builder broke ground the day I received my cancer diagnosis.  So in the race to see whether I'd beat cancer first or have to cough up money for a house I can't move into until I beat cancer is over, the house won. Needless to say I can't hand over money in Arizona while I'm sedated and having an invasive medical procedure performed on me in Seattle so my wife called the builder and sweet talked them into a no cost extension, because moving into a new house is a really big deal but becoming cancer free is job #1 prime directive now.  Only after recovery can I seriously think about job #2: paying for the new house, moving to the new house and selling the old house.  New house closing date is now March 15, the oncologist says I should be roadworthy by then.

I'm in the home stretch of daily radiation treatments and can't wait to hit the 5 week finish line.  The most annoying radiation side effect so far has been on my bladder.  Driven crazy by radiation it's in perpetual freakout mode, always alerting me that it's full and ready to burst. "I gotta go!!!!!", Right NOW!  There are no half measures, no stalling, no putting it off for the next rest area on the freeway.  It's always seems like a matter of desperation.  I sometimes awake every hour during the night to stumble to the bathroom and pee and man, is that annoying.  My oncologist says that this should diminish when the daily radiation stops, only to pick up again in March when radiation will be permanently installed in the prostate gland itself.  It should permanently diminish as the radiation half life decays the radiation away, kills the cancer and the seeds become inert.  Those inert seeds will go to the grave with me.

So how is this seed installation done?  What happens after the radioactive seeds are implanted?  If you're curious click here and read,
WHAT TO EXPECT FROM A SEED IMPLANT: THE FIRST TWELVE MONTHS
I received that in the US mail and it was most likely written by my oncologist as his name is first on the masthead. 

I had been under the impression that they would place these radioactive seeds in my prostate gland through my back door just as the urologist previously biopsied it but this isn't so. 

Following anesthesia, thin needles containing radioactive seeds are precisely placed under ultrasound guidance through the skin between the scrotum and rectum and into the prostate.

Yow!  That sounds like a frightening thing to let strangers do in a very tender place.  Anesthesia isn't what I thought it would be either:

The first choice is a spinal anesthetic where a thin needle is inserted in the lower back and a Novocaine-like medication is injected. With spinal anesthesia, patients are temporarily numb from the waist down and will not feel any of the needles being placed. In addition to the spinal anesthetic, patients commonly receive a sedative intravenously so that they are more relaxed and often sleep through the procedure. The spinal anesthesia is the most frequent choice of patients and the one that we usually recommend whenever possible. 

The second choice is a light general anesthetic so the patient is completely “out.” This works well but patients are often groggy for some time after the procedure. The anesthesiologist will review the details including both pros and cons of these two approaches. Sometimes the type of anesthetic is determined by the patient’s overall medical condition; other times it is a choice for the patient to make.

Make mine choice #2, light general anesthetic. I don't want to experience the lower half of my body turn numb while I watch people insert things into me.  I know that this work needs to be done, wake me when it's over.