One of the first ways HCR will affect me.

Here's how it's done. Not a new "tax" to pay for healthcare reform, just a slight adjustment.

Starting in 2014, those of us who have employer sponsored health insurance will now get a W-2 for the cost of our benefits (what the employer pays) and we pay income tax on that. This will mean a huge increase in our taxes. Kiss any refunds goodbye, and if you had to pay in the past, there will be more to pay in the future. Don't let anyone tell you this isn't going to cost us. It's just going to cost more for those of us who have the traditional insurance. Those who qualify for the expanded Medicaid will not have to pay more. This isn't just the rich we're talking about here (Robin Hood theory) but the middle and lower working class people trying to stretch the all-too-small dollar. In other words, your tax bill will get bigger, without seeing more wages to compensate, so consider this a loss.

This is just the tip of the iceberg. Obama has also factored in limitations to Flex dollars (pre-tax money you can use for OTC drugs like Tylenol, Advil and cold remedies). The taxes are going up, but he's hoping we won't notice. Free lunch?

Again, I appreciate the concept of universal health care and I truly believe it can be done. If patterned after Japan, Taiwan and other countries it can work but more patchwork will not because there will always be people getting the short end of the stick. The employer pays for insurance but we pay in decreased take-home pay. Employers who don't do this risk penalties. We still have all the red-tape and insurance boondoggle, despite a few protective controls (these are mostly good - at least in theory - we have yet to see them in action). We can't benefit from the universal nature of all benefits being equal, no money exchanging hands, billing departments eliminated and other expensive pieces in this health care mess we're in. We're just getting another patch on another hole, but this does not eliminate the other holes.

What a day!

I have enjoyed amazingly good health all my life. A few surgeries and run-of-the-mill stuff like colds, but overall I can't complain. This is why April was so weird for me.

This month alone - two bouts with serious infection. The first happened at the beginning of April and I had a solid week of fever and chills with unclear diagnosis. Then it went away for a couple of weeks. Hit again this week - same symptoms - fever, body aches, chills, abdominal pain. All together, 3 trips to doctor's offices ($45 copay the first time since they couldn't get me in at a regular clinic d/t Easter weekend, twice this week at $25 copay each). They couldn't get me in today for a CT scan and doc felt I couldn't wait for Monday so the only way to get it done today was to go through the ER, so $150 copay to grace their doors. So today I spent six hours at University Hospital. At least I got a diagnosis and new medications ($200 - yikes!). I figure when all is said and done, this one illness will cost me $1,000 out of pocket even with "good" insurance. Don't get me wrong; I'm glad I have insurance. It's just distressing to see the costs in spite of it!

The good news is they normally make the patient be admitted for IV antibiotics but felt that since I'm a nurse I would be compliant enough to treat myself with oral meds at home and know when to return if needed, so two separate antibiotics, one of them taken 4 times a day. They stressed that this must be followed religiously to avoid inpatient treatment, so I need to remember better than I normally do when it comes to multiple meds each day, but it's worth it to be home (I think). The bad news is that I have to go back to the doctor next week (another $25 copay) for follow up, then a repeat colonoscopy even though it's only been4 years. This is because I also have unexplained anemia and "at my age" this brings up red flags. For that I have another large deductible and then 20% of the total. I've used all my flex dollars until the next fiscal year:( Welcome to the American health care system! The biggest folly here is making you go through the ER to get the scan, adding thousands to the cost for the insurance company besides my extra $150 which should not have been necessary. If they can "get you in" if it's through the ER (and they weren't even busy), they should also be able to get you in through the regular doctor ordering it.

For my soapbox here: why aren't we fixing those kinds of health care dollar wastes? I fear that this requirement that everyone have health insurance will continue to result in high deductibles and out-of-pocket costs while the waste and inefficiency due to the industry and he insurance companies continues. At least they can say we have health insurance I guess. Time will tell.

Furthermore, in January, part of the health care reform means we can't use flex dollars for OTC meds. Don't get me started on the flex thing...It's all a gamble, trying to predict how much money you will need for unreimbursed health care in the coming year. (one year I lost money, this year, being conservative, I lost benefits). If you guess high, you lose because it can't be carried over. If you guess low you lose because you can't enjoy the benefit of pre-tax dollar medical spending for all your medical costs. In the past, if you guessed high you could stock up on Tylenol, etc. at the end. Now that won't be a possibility so we'll have to guess low to be sure. What a system...

Well, now the pain meds have kicked in to I'm heading for dreamland and hopefully a better night than I've had in a while.