Susan's Scoop

Healthcare, UGH.

I feel like that title generally sums up the healthcare system here in the United States, which is painfully broken. Somehow the US spends almost twice as much per person on healthcare annually compared to other wealthy nations, yet we have very little to show for it.

I took both of my kids to the dentist this week for their regular cleanings (no fillings, no x-rays) and it was almost $400. We don’t have dental insurance, so as a ‘self-pay’ client we have to make up the shortfall from significantly discounted payouts from insured patients.

Since my husband and I aren’t working W2 jobs, our health insurance comes from the ACA Marketplace - and next year those insurance premiums are expected to rise an average of 18%(!!!). This is being attributed to inflation, rising labor costs, tariffs, and increasing use of expensive diabetes/weight loss drugs.

On top of that, the new tax bill eliminates the expanded ACA tax credits, reinstating the 400% FPL income cliff. (If you make greater than 400% of the Federal Poverty Level you will now be eligible for ZERO subsidies, versus the gradual phase-out in place now.) And, starting next year, if your income comes in higher than you estimated on your ACA application, you will have to pay back the full excess subsidy – there will no longer be a repayment cap.

So essentially here in the US we have:

· Employees often chained to jobs solely to obtain health insurance

· An expensive dysfunctional marketplace system for the self-employed

· A Medicaid system that now has strict work requirements, leaving many with no options

All for a higher monetary cost than the nations that provide socialized healthcare to all of their citizens!

So yes, we’re all trying to function in a very broken system. But I have found a few cost-saving healthcare hacks that I thought I would share; I’m not affiliated with any of these, but have found them useful:

1) MDSave: This website allows you to compare prices of procedures from different providers. As an example, I ran MRIs in my city (Austin, TX) – that exact same procedure varies from $400 to $1000 based on the provider!

2) Dentalplans.com: This is not dental insurance, but it allows you to buy a ‘dental plan’ that qualifies you for the negotiated insurance rates. It seems weird (and is another good example of how broken the system is), but it can actually save you thousands on dental care and even braces.

3) UltaLab: This is one of my favorite hacks for lab work. Instead of going through the doctor’s office and getting billed at inflated “insurance rates,” you can order your own tests online, pay upfront, and go to a local lab for a fraction of the cost. Many basic blood panels cost $25–$30 instead of $100+.

4) GoodRx: Even though we have prescription insurance through our ACA plan, we still use GoodRx for some of our drugs because the coupon price is cheaper than the insurance copay!

The truth is, we can’t control how much ACA premiums rise or what Congress does, but we can control how prepared we are. Whether it’s negotiating bills, using discount plans, or getting smarter about where we get care, small steps can add up to big savings over the year. The more proactive you are now, the less likely you’ll be caught off guard when those higher healthcare expenses hit - and that’s one of the best ways to protect both your health and your wallet.

What I'm Reading

📕 Mary Had Schizophrenia—Then Suddenly She Didn’t (New Yorker Article)

This article blew my mind! It turns out that some people with schizophrenia and other mental disorders have seen their symptoms disappear completely after getting (unrelated) immunotherapy for cancer; it seems that their mental illness may have been caused by an autoimmune issue the whole time. I’ve long suspected that MANY illnesses are actually linked to autoimmune conditions, and now it looks like the science is finally starting to confirm it.

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