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I had a little procedure performed on August sixth, a little nonmalignant skin cancer removed from behind my left ear. The procedure went well and other than adding a tiny scar to my decidedly well-worn carcass, barring infection there should be no after effects.

No, I don’t wear sunscreen and yes I should, but that’s not today’s topic. Today I’m going to discuss the cost of medical procedures, staying alive and insurance. Hey! Wake up! I’ll make it fun!

In more ways than we can enumerate I am a child in an old man’s body. I abdicate responsibility for most everything adult to my loving wife, the goddess Durga, and health care is certainly one of those areas. Since our marriage in 1986 my health insurance has been tied to her employment and, like most children with most things that simply “are,” I tend to take it for granted. Pre-surgical discussion concerning the cost of my little basal cell carcinoma was estimated at $3,000. Out of pocket.

We have Aetna insurance and our premium is around $150 a month. We have a $5,000 deductible which means we pay 100% of every medical procedure until we reach $5,000 out of pocket. Aetna has negotiated with many physicians and the rate we pay for visits to the doctor is less than “list price,” but when we see a medical practitioner we pay every penny of the bill: Starting over every year, until we reach $5,000 in medical payments, our “co-pay” is whatever the bill is.

In addition to providing our health care Durga also established an HSA, a Health Savings Account. HSAs make pre-tax dollars available to pay our medical bills. When we divide $5,000 by 52 we wind up contributing $96 weekly to the HSA. Those dollars will cover our out-of-pocket until and if we reach our deductible. Adding the health care premium to the HSA contribution brings our monthly health care costs to about $535, though most of that expense is paid for using money that is NOT taxed. Figuring in the tax benefit I put our equivalent cost down to $115 weekly.

The average US annual family income is $59,000, so $115 a week represents ten percent of family gross income. Ten percent of gross pay for fairly minimal insurance would be a big burden on most families but I am fortunate because not only did my procedure go really well, they only took two layers of skin and therefore I didn’t need a skin graph reducing the bill to about half of the estimate, but, thanks to Durga,  we have a higher than median family income.

Self-care is an important first step in health maintenance but my little basal cell carcinoma procedure helped me understand the financial burden so many US citizens face in their daily struggle to just stay alive while tax breaks are given to those of us fortunate enough to receive benefits that help us thrive.

Oh! Contributing more than one’s annual insurance deductible to an HSA makes a ton of sense, especially as we age, and yes, I’ll try to use sun screen more regularly because self-care is everyone’s personal responsibility.