U.S. healthcare - complex, expensive and for many, unavailable

I'm scheduled to go back to work next week. Yay! My problems are solved. Well, not really. In the United States, healthcare is typically paid by an employer. Unfortunately, I am finding that insurance, being tied to employment, is an incredibly bad system. This is especially true of some employers who offer either no insurance or insurance that is so bad it covers practically nothing (which is the case of my present employer).

Here was my introduction to healthcare problems in the U.S. I had been an employee at the same place for 10 years. So, I didn't appreciate how the system had deteriorated. When I was let go from my employer, I was offered the option of COBRA coverage. Only $540 a month. What a bargain (sarcasm). Taking on a new bill in spite of having no clear source of income struck me as being really ironic. So, I did what millions of working people in the U.S. do every day. I decided to go without any kind of insurance coverage.

That didn't mean I stopped taking care of myself. Since I have severe allergies, I was in a program of getting injections to try to build a tolerance to a whole bunch of allergens by getting progressively stronger injections of what I am allergic to. This process takes many years and I was not quite half way through it. Since I felt I could not afford insurance, I worked out a cash deal with my doctor to continue my weekly allergy injections for $20 a visit ($80/mo). The injections aren't too expensive. However, when I need to get a replacement dose mixed, it's thousands of dollars to do so.

During my period of unemployment, I applied for a temporary insurance plan offered by New York State (in partnership with a private insurance company). I didn't get it. Believe it or not, my unemployment insurance payments made me exceed the income limit! What amazed me was this. Even if I did get the plan they can legally deny paying for allergy injections for 12 months along with any other pharmaceuticals due to being preexisting conditions! Further, they can do it till 2014!


During the process, I filled out numerous web forms that are designed to penalize those who work for a living and don't have multiple children. I was at a disadvantage for qualifying for insurance since I'm not disabled nor am I mentally retarded other than having the feeling that working for a living is for suckers. Good news though. I'm apparently healthy enough to almost consistently get this response.

It looks like these people in your home make too much money or do not meet other program requirements for public health insurance.

So, it appears as though I need to fit into the "other program requirements" category before qualifying for healthcare. Fortunately, I think I found a plan. At $360 a month, it's like renting an additional apartment to live in. However, at least the plan is not income based. The effect being, that it won't soak me for everything I have due to the fact I'm still healthy enough to work for a living. It also has the additional benefit of not being tied to my employer. So, I can switch employers at will without totally redoing my insurance each time. (At least, that's my hope).

As expensive as the plan is, there are several conditions before I can join. First, I need to live in New York State and have a pre-existing medical condition. I suppose it's fortunate that I have a non-lethal but annoying condition that is on the list of ailments. My condition requires medicine and supplies but I've been paying cash for them. So far, I survived the 6 month waiting period. In spite of now being almost out of medicine, I anticipate being able to survive in a semi-miserable state until I am able to get medication at subsidized prices. One thing I though was odd in the application process was that I was either required to be an undocumented alien or a citizen with a valid U.S. passport. I happen to have a passport but it's rather unusual for anybody other than Homeland Security to ask for that level of ID. The application process got even more interesting at the end. It required me to fax my medical records and passport to an unlisted phone number. That requirement was a challenge for me since I don't have a regular phone line. However, I had a PC and scanner and there are still Internet fax services available. After sending off all the paperwork to a phone number with shockingly confidential information on it, there is then a period of absolutely no feedback. So, I can only conclude that I've either sent off my life's information to a healthcare provider or the mafia. Judging from how the application process went, I'm thinking that it may have been both.

I called later to see if they received my information. They did. However, I was informed that I need to wait until my application is reviewed to qualify for the plan. I have no doubt this review is to establish my financial health rather than my physical health since the whole point of the plan is to address people who have pre-existing medical conditions. Hopefully, getting this plan might allow me to avoid the fate of so many people as they go broke when they get hurt and then loose everything they have to medical bills. So, this was as much about insuring my financial health as well as my physical health too.


In my web travels, I ran across a different kind of insurance. It was for "hunger insurance" This unreasonable and expensive policy is being offered due to recent projections of food shortages. However, what was interesting was doing a word replace of "HUNGER INSURANCE" with "HEALTH INSURANCE" made it into a striking resemblance of the health insurance system we have now. Coincidence? Oh, I don't think so!

We've been here before

When I learned about tiny houses, I thought the concept was great! The idea would be to make a small house out of nice materials rather than a larger house out of not-so-nice materials. The small size would keep initial costs quite low even when high quality materials such as metal roofing were used. The houses would offer privacy, low cost upkeep and small land tax due to their size. Older single people might enjoy this since it would offer something close to carefree living.

However, people do get lonely. So, the next step might be to put these houses into little clusters. Perhaps a few tiny house owners could pool resources for grounds upkeep. The upkeep might start out just for lawn mowing. The program would likely expand to pathways, then parking lots and perhaps a central community building or two. Perhaps "blue boy" systems and composting toilets would be replaced with real water and sewer service hookups. Eventually, community resources might be pooled for roof repairs and painting of privately owned houses too. It would then be only a small leap to solar powered energy systems and community gardens. Once the list of possible shared systems expanded to shared tennis, pool and golf course access, I realized something.

I just re-invented the concept of the condo.

However, unlike a condominium, tiny houses can usually be moved to different locations. In fact, many tiny houses are by nature movable since they are frequently built directly on trailer frames. Due to this, they can have the ability to change their locations very quickly. Another indirect benefit of being on a registered vehicle trailer is that construction is regulated by the DOT rather than building code enforcement and homeowner associations. Still, these agencies sometimes have bans on RVs for extended stays and these probably could be extended to trailer mounted tiny houses.

Assuming tiny houses are legal to park in an area, I imagine a tiny house cluster model would more likely resemble a seasonal camp ground. In the image on the right, just take out the RVs and put in tiny houses. Unlike RVs, tiny houses would likely have enough insulation to be able to be occupied during the winter months. They might even have electric and water/sewer hookups. So, they might become semi-permanent structures. Depending on who is beholding it, such a community would either be a beautiful living arrangement or an eye sore.  Doh!  I just described a higher end trailer park.

As they say, history never repeats. However, at times it sure does echo!

Apocalypse when?

Many people agree that no empire is forever. After all, in a few billion years the sun will eat the earth. Sometime before then, the United States will end. But how?

The effect of world resource depletion on the United States could be compared to a decaying automobile. Without repair, such a thing WILL stop working and usually does suddenly. The term "stops working" could be due to rust finally allowing the uni-body construction to crack in half such as Dimitri Orlov suggests in one of his essays It could also stop working due to lack of a critical part the system needs. That is, the principle of "peak everything", described by Richard Heinburg which covers the lack of availability of parts from ignition computers to gasoline. Using common sense, we know collapse of the United States is inevitable but cannot be precisely predicted.

Here's why. If someone were to look at say the death of a suburban shopping mall this fault is easier to see. When does an old shopping mall collapse? Is it when the mall's owners conclude occupancy is at a level that no longer covers operating costs? Is it when the mall finally closes it's last store? Is it the date when some square footage of roof section falls due to snow load? How about when the remains are finally leveled by a bulldozer to build a new golf course? Depending on how collapse is defined, a "collapse" doesn't happen at a specific time at all! Rather, it's a process consisting of events that can be spread over decades.

So, one might ask,"Will the U.S. achieve somebody's definition of collapse soon?" Absolutely. It's already happened. Just ask somebody who's unemployment has run out. Yet using different metrics, others may say the U.S. is OK or can at least muddle around for another hundred years even if the peak-oil and climate change doomers are correct. Maybe their definition is like mine. As long as the IRS is around, the U.S. still exists.

In my opinion, defining collapse metrics makes the analysis good only for identifying stages. Once the stages are identified, history can then be compared for similar scenarios. However, even if a relatively good historical match can be found little more can be done than setting general strategic direction. Still, analyzing collapse stages might be helpful when deciding on places to live, occupations to pursue and what capital should be built up first (both human and material).

As an example, one action I did in response to Peak Oil and Climate Change was to imagine stages of resource depletion using Dimitri's stages of collapse model. Then I biased that analysis on what I knew of my region's geography and it's history. So, I decided one effective tactic would be to buy a small house with a fixed rate mortgage in a walkable community with enough land for a decent size kitchen garden.  So far, so good.  Even though I'm currently unemployed and prices for all kinds of things are going up, I'm in no immediate danger of starving or being thrown out of my house.