Timing personal collapse

There are many ways of interpreting when personal collapse happens - and what personal collapse looks like. 

For one particularly good example of what personal collapse looks like, see Paul Krugman's article. 
By security, I mean that you have enough resources and backup that the ordinary emergencies of life won't plunge you into the abyss. This means having decent health insurance, reasonably stable employment and enough financial assets that having to replace your car or your boiler isn't a crisis.
By opportunity I mainly mean being able to get your children a good education and access to job prospects, not feeling that doors are shut because you just can't afford to do the right thing.

As for when it happens, I find that it depends on the definition of collapse.  I did a previous posting on this topic a while back.  http://lifeafterpeakoil.blogspot.com/2012/06/apocalypse-when.html

When developing a response plan to economic collapse, one useful thought experiment would be to imagine if a person was to lose their primary means of making a living due to some economic upheaval. What is a good plan for that?  For me, this became more than just an academic topic.  A few years ago, through a comedy of circumstances, I found myself suddenly unemployed.   Expenditures such as mortgage, taxes and utilities were about as expected - and unemployment insurance (plus what I had saved previously) would cover those expenses for at least a year or possibly more.  I had also been preparing for some sort of financial disruption due to peak oil for several years earlier.  So, I had more than enough of some items like food and gardening supplies.  I even had a bicycle, good shoes and warm clothes.  Most important, I lived in a city which made most every need or want within walking distance.  At the time, the weather was mild, going into summer.  So, my home heating costs were low and my pedestrian transportation option made my gasoline expenditure almost vanish!  However, I found I would quickly run short of other resources.  One commodity that I found depleted much more rapidly than I predicted was cash!  It turns out that I had underestimated my monetary expenditures - specifically for insurance.  The big three were for auto, home and medical.

In the case of medical, it was in the period where Obamacare was being implemented.  The insurance bills were a useless but massive monthly bleed-out of money that gave me nothing but a checkup visit.  The sliding scale of medical plans only looked at past income, not present income.  So, the sliding scale fees worked against me.  To the graphs, I was still a fat wealthy moneybag ready to be harvested.  Each month brought a healthcare bill of several hundred dollars that ate up a significant chunk of my unemployment checks.  In addition, I had an over-priced prescription that I felt I should maintain - that is until I saw the price of it increase from $35 a month to $1000 a month(because my insurance plan no longer covered it), then $2000 a month (the price I would pay if I had no insurance at all). Needless to say, I was in no position to pay the last two prices.  Fortunately, my doctor found a substitute medication.  It didn't work as well, but it at least allowed me to go back to work.  Now that I'm back to work, it is my employer is paying the ruinous sums of money to the insurance cartel. It's not that my healthcare problem is solved, but it does give some time for me to think about how to respond to the healthcare extortion system when the day comes that I can no longer work.

The whole exercise taught me some lessons. First, I learned that change of this kind can sometimes bring some unexpected benefits. Due to walking, biking and lack of daily stress, I lost some weight and gained some stamina.  So, my overall health improved.  Second, I learned that preparing for one kind of emergency (oil crash) that didn't happen gave me many of the same resources that were needed during another crisis that did happen (Job loss).  Not only did I have enough resources to get through the storm, but I also had access to low cost transport to a new job.  This was due to my decision (driven by preparing for peak-oil) that made me decide to buy a house near a bus line.

How to financially survive a visit to an ER in the United States

I have a saying that has been proven to be true. "Catch someone at the wrong moment and they will appear to be an idiot."  Fortunately, this condition is rarely incurable.  It can be treated with training. That is, for specific situations, the proper response to given stimuli can be made to be almost automatic.  It's done for many situations from learning how to fight to learning how to perform first aid. Although its impossible to train for every situation there are several situations every American citizen should be prepared for.

When it comes to dealing with hospitals and ER (emergency room) treatment, disputing anything seems futile.  They seem to be massive organizations that have enough lawyers to crush most anyone.  Plus, a victim is close to the perfect customer.  The "customer"  usually doesn't know what is needed, has no idea what the costs are and may be in no condition to think rationally. 

But first, if you are in a condition to make a rational choice, some nasty expenses can be avoided before they happen. For example, if you find yourself facing a decision to take an ambulance ride to the ER (emergency room) or to an urgent care center keep these points in mind.

• Consider that ambulance transport is between $400 to $1200 a ride and is not usually covered by insurance.
• If you didn't call the ambulance, you don't need to take it! However, a "responsible person" such as a friend needs to accompany you away from the scene (and they will wait until this person shows up). 
• If you do ride in an ambulance and you are conscious, you can choose your hospital. Although, if you are not in the best state of mind, that might be quite difficult due to shock.  Then again, if you ARE able to make a rational choice, what are you doing in an ambulance?  Regardless, prepare to be fleeced.  There's not much you can do about it except try to leave the hospital as early as you can and have as few billable incidents as possible.  The hospital will help shove you out.  They have a saying, "ship them out sicker and quicker"
• For not so serious conditions an "urgent care" clinic might be a less expensive choice.  Just don't expect off-hour service or quick treatment.  Then again, I've noticed that ER rooms at hospitals are not that fast either.  What seems to be the main advantage of "Urgent care" places is that they are much more receptive to your concerns about exactly how much the treatment will cost. This is due to them frequently wanting up-front payment.

Ok, so you couldn't avoid a trip to the ER.  They stitched you up, put you in a cast, shoved you in a cab and you somehow crawled back in your home to recover.  At some point, you'll think about the the bills.   For normal debt it pays to retire debt as quick as possible to avoid interest and fees. However, hospital debt is rather strange. Ideally, a hospital would wrap all that hospital debt up for you.  Then you pay your percentage of whatever your healthcare plan covers, up to the out-of-pocket maximum.  However, that won't be what happens.

Instead of billing you immediately, the hospital may try to get an agreement with you as quick as possible (even though doing so may breech their contract with their insurance carriers). So, they will rarely contact you directly.  Instead, they may send you a big fat financial aid packet and/or use another organization call you to "ask questions" to see if you "qualify for help".  After a while, you'll  get a series of bills from labs, doctors, anesthesiologists and other specialists.  You'll also get duplicate bills, and invalid bills sometimes appearing MONTHS after treatment. Don't ever over pay anyone cause you'll NEVER get a refund.  So, unless you like needlessly tipping thousands of dollars to these people it's important that you don't pay anything early!  Instead, collect a pile of these bills.  Then, one by one, nicely go through them with your insurance company. I used to think a delay of a month was a long enough time.  However, after waiting a month, then paying all I thought I owed, I found I was getting billed again from the hospital!   Due to that, I recommend (and I'm not kidding about this) at least three months before paying bills. It's stressful, but I assure you it's less stressful than not having any money (or bargaining power) later! 
 
Here are some other tips:

• Did I mention you should not pay anything as long as possible until YOU have the information required to get the maximum amount covered from your insurance company?  You can contact the people billing you to inform them of the delay.   To people billing you, make it clear that the delay isn't your fault but that your insurance company needs to review ALL claims, not just theirs.
• Once you decide to process bills, contact your insurance company and ask them about EVERY bill no matter how small. Even if it needs to be paid, but isn't covered by insurance, at least it may eat away at your deductible.  
• If anyone (but the hospital) says they will send you to a collection agency for non payment, inform them that the bill is being reviewed by your insurance company.  (make sure the insurance company really is reviewing it - ideally, giving you a correspondence number)  If they persist bothering you or threaten you with fees, remind them that charging additional interest or fees by itself may violate your insurance company's agreement with the hospital.  If they persist, offer to report them  to your states insurance fraud hotline.
• Keep in mind, what is casually said over the phone usually applies to you, but unfortunately not to them. So, don't talk to anyone if you can help it. Instead, do it in writing if at all possible.
• At some point, you'll then reach your "out of pocket maximum".  That is, the insurance company will pay 100% of what they cover.  However, you'll probably be responsible for a whole bunch of other stuff not covered - and that might make you go broke.  But hey, suck it up buttercup!  That's what you get for not doing enough to promote no-fault socialized medicine!
  

Hopefully, we'll soon get decent healthcare so you'll never need to go through all this.  However, if that doesn't happen, I hope these tips help.