Luck be a lady

In recent weeks, I’ve noticed unprecedented public outrage directed at insurer AIG. I get that people are angry about how a group of morally bankrupt executives are rewarding themselves at taxpayer expense after selling the world economy down the river. AIG was just one participant in this race to the bottom, but I think there is a special hatred for the company because it is the most visible symbol of what has really been destroying the American economy for years: health insurance.

In the event you fall off a cruise ship
In the event you fall off a cruise ship

“Insurance of any kind is a con game where you are forced to bet against yourself, knowing that you are going to lose money.” — Richard Hailey.

What AIG has done here is just the coup de grace of what all insurers do. They take your money, invest it for a huge return, all the while using their political influence to drive up medical costs and leaving you footing the bill. This is how insurance companies became so rich in the first place, it’s just that this time, people have noticed because the insatiable greed of AIG executives has made them complicit in the unraveling of the entire world financial system.

Forget for a moment, terrorism, illegal immigration, internet porn or high fructose corn syrup. It’s health insurance that is the biggest threat to the welfare of the American people. If you’re reading this thinking that Barclay’s usual metaphysical musings have taken a decidedly political and conspiratorial turn, you’re right. I’m not trying to be Michael Moore, but Unbounded Life is all about personal freedom; to consciously choose how we live and take ownership for our quality of life. Health insurance the the antithesis of this: it is surrendering responsibility for our quality of life to corporations driven solely by profit.

Most Americans are victims of insurance fraud. Fraud, as in, being duped by unscrupulous business people who have taken your money under the false pretense of providing you with something that in the end, turns out to be almost worthless. Health insurance, in the words of Cosmo Kramer, is “the biggest scam perpetrated on the American public since one-hour Martinizing.” I say this for two reasons: health insurance doesn’t insure your health; it’s a payment system for medical treatment. It doesn’t really insure anything, since you’re never guaranteed coverage, even for catastrophic events. Second, it’s the insurance company lobbyists that have successfully forced up medical costs to many times the rate of inflation each year, and made insurance mandatory in most states, forcing you or your employer to pay huge premiums, to the point of bankrupting thousands businesses, families and making American manufacturing globally uncompetitive.

Insurers are able to leverage huge discounts from doctors to provide services at or below cost. They then arbitrage the difference between what the doctor charges you and what they actually pay the doctor. They take this difference and invest it (along with your premium) for big returns, while you still pay out of pocket, and receive pennies on the dollar of your investment.

So what, we still have to have insurance, right? What if I get cancer or am in an accident? Insurance is a sucker’s bet because of the extremely low probability of these things happening to you or your family, especially before you’re 60 years old. According to the CDC, the leading causes of mortality in the U.S. are heart disease, cancer, stroke, lung disease, accidents and diabetes. Your chance of dying from the first two are less than 1 in 500 (and though I’m no actuary, I know that the odds are infinitesimally small that either of these will kill you in your prime of life). For the next three (lung disease, stroke and accidents), the chances are less than .5/1,000 and if you didn’t smoke, the first two would drop to .25/1,000 and dying of an accident tops out at .20/1,000. This is, according to NOAA, the same probability as being struck by lighting (1 in 5,000).

You’re essentially paying for insurance that would cover you (minus the $5,000 deductible and 20% co-payment) in the event that you are struck by lightning.

So if you were a gambling sort of person, would you consistently bet, month after month, year after year on winning a game where your odds are so poor? That’s the game you’re playing, with the insurance companies enjoying a huge house edge with a very small pay out percentage. Not only that, but you have to pay to play, with annual average out of pocket expenses for 50% of families exceeding $2,000.

It costs employers on average $10,728 to insure a family of four, with the annual premium for single coverage at $4,704, both rising at double the rate of inflation. At this point, you may be looking at your insurance premiums as sunk costs, and figure you’d lose more by stopping coverage now. But what if you could start investing the premium yourself and choose health care facilities that cost 70-80% less than you’re paying now? This is the path I have chosen and I want to share the results with you.

To begin with: I am my own health care provider. I am my own HMO. I am my own Primary Care Physician.

I have not carried insurance for over 20 years. I have chosen to opt out of the health insurance racket by investing in my health, rather than let ethically challenged companies take my money to invest under the guise of “peace of mind” and giving me a pittance in return. Because I don’t carry insurance, I have been able to invest what I would normally have been paying to insurance companies. Over the last 20 years, had my insurance come through an employer, the annual premium to insure my family would still have cost me $37,140 according to the Kaiser Family Foundation. But because I have been working for myself, I would have had to pony up nearly $60,000 just to cover myself, and $180k to include my family.

So having invested the equivalent of my annual premium each year at a conservative rate of 5% compounded interest over 20 years, I now have $174,000 to cover that lightning strike. This amount will balloon to just under a million dollars by the time I am eligible for Medicare. Had I bought a second home in 1988 at a median value of $112k, even with the downturn, it would be worth $266 now, a difference of $154k, the full cash value of which I could now recoup, had I rented out that house. What I’m saying is that if we look at the many investment choices we have, as well as alternative care, we can beat the insurance companies at their own game.

If we do not delegate our health care to anyone, we have a stronger sense of ownership for our health and we take better care of ourselves. We also educate ourselves and learn how to live well. One thing that I have discovered from being an expat in Asia, is that Thailand has world-class health care facilities, with better service at a fraction of the price. So at least once a year, I do full blood work and a general physical here in Chiang Mai, for about $45. Yes, dollars.

Hospitals like Bumrungrad in Bangkok and Ram Hospital in Chiang Mai have become big medical tourism destinations. With English speaking staff and a number of western educated specialists, I’ve found the level of care here far better than in the U.S. Concerned they don’t have the machine that goes, “bing!”? Here in Chiangmai, Ram Hospital is a distant 3rd or 4th choice of international patients in Thailand (Bangkok Bumrungrad had 400,000 foreign visits last year). Yet Ram features the latest MRI, 64 slice CT Scan, 4D Ultrasound, Cerebral Angiogram, Gamma knife, Cardiac Stents and PTCA. For cancer therapy, they use the same chemicals, same diagnostics and protocols. The hospital has it’s own accommodation and limousine service.

The cost for total knee replacement surgery at Chiang Mai Ram is 336,000 baht ($9,400). Total hip replacement in the U.S. will cost you on average $38,000. Here in Thailand, around $9,000. The average price for a coronary bypass in the U.S. is $110,000. In Thailand, $12,000. A coronary angioplasty here costs 25% of the U.S. and a year of chemotherapy will set you back $9,000. Prescription drugs are freely available over the counter at a small fraction of U.S. prices. Thinking about gender reassignment surgery? You’ll find the world’s finest clinic right here.

Freedom is all about choice. Health insurance companies and the U.S. medical establishment gives us the illusion of choice, where we are actually hostage to them, and are deluded into thinking that we never have to worry about our health as long as we buy in to their system. Call me irresponsible, but I recognize that the health insurance game is a scam and by opting out, I’ve given myself the freedom of real choice – taking full ownership for my family’s health as well as mine, and investing in our independence from a corrupt and broken system.