[Cancer]
[cancer] The high cost of disability and dying
I’ve been working through a lot of details with my employer about late life and terminal issues. As I (most likely) get increasingly sick, at some point, I may go back on Short Term Disability (STD) for a while. (This is what I did for last month’s surgery.) Somewhere in my terminal stages, I’ll go on Long Term Disability (LTD).
On STD, I am still an employee. My benefits still apply, most specifically health insurance. My income is reduced by a third, but I believe that reduced income is paid pre-tax, so it’s not quite as painful as it could be. This is a benefit managed by a third party provider, but my understanding is that it is funded by my employer.
On LTD, I am no longer an employee. Instead I am living on an insurance benefit provided by a third party insurance company through my employer, the premiums for which I pay as pre-tax dollars. Because I am no longer an employee on LTD, my insurance lapses unless I elect to carry it through COBRA.
To belabor the obvious, if I go on LTD because I have terminal cancer, letting insurance lapse would be about the most bone-headed move I could possibly make. Yesterday I found out the COBRA costs for coverage for me, ![[info]](http://l-stat.livejournal.com/img/userinfo.gif?v=1){kind=small}
the_child
That’s huge rise in monthly expenses at a time when my income will have been substantially reduced. On the same LTD plan which reduce my paid benefit by the amount I might collect from any other LTD plan, such as the private plan I’ve paid into for the past thirteen years.
Think about that for a minute.
Our system of disability and late life care is profoundly cruel, punitive, inhumane and illogical. The whole point of putting the LTD benefit at only a percentage of my salary is that sick people are somehow assumed to need less money. At the same time, I’ll be putting out $1,800 per month for health insurance (about four times more than my employee-paid contribution currently coming out of my paycheck) and hundreds more per month for co-pays and out of pockets.
What never-been-sick idiot thought this up?
This system puts me and my family under intense financial stress at a time when we can least afford either the direct costs or the associated emotional strains.
This is insane. Is this how you want the end of your life to go? Unraveling financially no matter how hard you’ve worked, how good a job you’ve done?
Tell me again how we have the best healthcare system in the world? It couldn’t be better designed to drive a dying person into bankruptcy and premature death if that had been the primary objective.
This is not how a just, humane and moral society should treat its sickest members.
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Posted: 5:52 am Thu February 21 2013 |
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Wow, that’s disgusting. How do they expect people to cope if they are earning less money? Especially when it’s a tough time to go through anyway, now it’s another problem to deal with. It’s huge companies and capitalism like this that makes me feel sick.
And also slightly glad that I live in the UK where healthcare is free. :/
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While I agree with all you said here, Jay, bear in mind that the “please die early” feature of our medical insurance system is exactly what conservatives want. If you are sick and near the end of your life, they don’t want society to support you.
Well said.
The first time Rachel had her cancer, she had to be hospitalized to receive chemo. That meant 5-7 days in the hospital, then 2-3 weeks recovery. Her insurance paid a portion of the first 5 days of any hospital visit. Great insurance if you only go to the hospital once every 20 years. Terrible if you have to go in once a month for a year!
It’s an insane system. I lost my job for 3 months a few years ago and the cost of Cobra to cover my family was just prohibitive. I have no idea how you are supposed to find that kind of money when you are unemployed. It’s totally nuts that you pay into a system for years and when you need it most is most likely when you can no longer work – and they pull your coverage. It makes no sense at all.
COBRA is rarely a good option, financially, and when the ACA kicks in full force next year, it will be even less so. I suspect that you will be able to cover your family more inexpensively through the insurance exchange once your pre-existing condition can’t be factored in, so COBRA would only need to get you to 2014 (which I’m hopeful you’ll still be working until and it won’t be necessary at all).
We have generally good medicine. What we have is a horrifically screwed-up medical payment system.
Thanks for this, it tells me some things I needed to know. (My workplace is telling me that unless I recover 100% use of my right arm after a rather spectacular break, I won’t be able to return to work. They’ve sent me some (unrequested) LTD papers to fill out. It may be time to spend a few hundred bucks to consult my attorney.
Good luck!
I have a conservative ex-friend who is a doctor. He told me people were poor because they made dumb choices about how to spend their money. Guess who I think is dumb? What a waste of a Harvard education there.
Jay, have you thought about Social Security Disability? It seems a logical next step.
Once you qualify for SSDI you are also eligible for Medicare.
It might behoove you to head down to the Social Security office and start talking to them. The office is at Northeast Hancock one block west of MLK.
You probably won’t qualify now but, you might be able to set things in motion.
Rick, Medicare does not kick in for Social Security disability recipients for a year. Also, full coverage on Medicare for SSDI recipients requires copayments; less than what Jay is talking about but still.
Oh, and by the way, we have one of the most insane health care delivery systems in the world.
As I think I mentioned in response to a different post about the same topic, LTD insurance is designed around the assumption that you will eventually be able to return to work. It isn’t intended to be long-term care insurance. If it’s provided by an employer, it’s also intended to provide the most benefit for the least cost. Sadly this does nothing for employees who are incapable of working.
As Rick York mentioned, it might be a good time to check out SSDI. It won’t help that much with your income – they do ridiculously seem to assume sick people don’t need as much money as healthy people – but it is a vible option. Just be aware that if you receive both SSDI and LTD, most LTD plans will deduct the amount of your SS benefit from you LTD benefit. There is usually a minimum benefit, though, so the deduction shouldn’t reduce your LTD benefit to zero.
It is very sad and frustrating that the insurance industry makes so little accomodation for the terminally ill. Once you stop being a productive member of society you count for nothing, no matter how productive you were prior to that point.
The issue with SSDI is that it doesn’t cover my daughter or her mother, just me. Which causes a whole raft of other problems.
That is more than insane.
This is a horrible policy. People on longterm disability for by definition sick enough to be unable to work and therefore unable to get insurance through their former employer. So if anybody should qualify for Medicare/Medicaid or whatever those public health insurance programs in the US are called, it’s people on longterm disability.
Sorry you’re going through this, Jay. I’d thought that the Obama healthcare reform had taken care of unfair policies like that.
I’m curious: do you know if any legislators ever read your posts? Ones like this should be forwarded to our reps. Or, is there a better way for us to push for change re: the insurance / disability issues that you are facing? Sadly, you are hardly alone — but are far more articulate than most people are, especially when under such duress. IMHO, your posts on topics like these should be required reading for legislators. Note I didn’t say “insurers”, because that is not where any needed change or justice will come from.
I can’t stop thinking about this. I’m going to ask my employer why we have to deduct everything from the LTD benefit of a totally disabled or terminally ill person. I just want to see what they’ll say. I’m sure the response will be something about not increasing our expenses. I think my employer is ethical and reasonably compassionate (for an insurance company), but it is so driven by profit that sometimes I am ashamed t work there. It isn’t just healthcare insurance that needs an overhaul.