11. Health Care ꟷ The Wolf Is (and Has Been) at Our Door
- T Michael White MD FACP
- Oct 26, 2025
- 4 min read
ABC-STEEEP
Affordable Basic Compassionate
Safe Timely Efficient Effective Equitable
Patient-Centered Care
Letters to the File
T Michael White MD FACP
******
11. Health Care ꟷ The Wolf Is (and Has Been) at Our Door
“It is hard to imagine a more stupid or more dangerous way of making decisions than by putting those decisions in the hands of people who pay no price for being wrong.”
Thomas Sowell
The WhiteHouse on the Belleair Bluff
Friday, October 24, 2025
Dr. Mike,
A letter to the file…
New York Times news flash ꟷ “Marjorie Taylor-Greene, the right-wing congresswoman
from Georgia, said she supported an extension (of Obamacare subsidies) after learning that
prices for her adult children would double without them.”
For several years, you have been hard at pointing out that our fine United States’ health
care (non) system is problematic. Today, with the potential for removal of Obamacare
subsidies, the headlines now scream that our United States health care (non) system is a hot
mess. Although you appreciate partners in the fray, without satisfaction, you must remind that
reports that a health care wolf is at our door is old news. A ravenous, menacing pack has been
camped out there for at least a decade.
To make your point (and hoping some may now be listening), please explore several
current examples (the www.healthcare.gov.calculator will be helpful):
Medicare Couple: a Florida couple are homeowners, empty nesters, live modestly, have
sound habits, comfortable savings and enjoy good age-related health. They have earned and wisely aged into a 5-Star Medicare Advantage Plan. Their predictable annual expenses (per individual): Premium: $134/month; Deductible $0; Co-insurances: Emergency Room $225; Hospitalization $200/day X 6-day max; Annual Out-of-Pocket Maximum ($3900) (Translation: couple pays $3.2K/year to have insurance begin immediately, have a robust prescription plan and be protected from catastrophic expense at $4K/individual/year ꟷ except for the age requirement, life is great).
Employed Age 60 Couple: At age 60, this Florida couple is very much like their older
neighbors. He is well-employed with an income of ~$200,000. Regarding his Employer-
sponsored Plan: Premium $315/month; Deductible:$0; Co-insurance: Emergency Room $350; Hospitalization $2500; Out-of-Pocket Maximum: $8000. (Translation: couple pays $4K/year to have insurance begin immediately; have a robust prescription drug plan and to be protected from catastrophic expense at $4K/individual/year ꟷ while employed, life is great)
Unemployed Age 60 Couple: At age 60, this Florida couple is very much like their older
neighbors except due to corporate down-sizing, he has been laid off, and he has lost his
employer-sponsored health insurance. His income has been ~$200,000 (he is unsure of his
income going forward). They have modest savings. Seeking to purchase health insurance, he investigates www.healthcare.gov. In round figures, they are eligible for:
Bronze Plan: Premium $920/month ($1615/month without subsidy);
Deductible:$15,000; Co-insurance (after deductible) Emergency Room 50%;
Hospitalization 50%; Out-of-Pocket Maximum: $18,400
Silver Plan: Premium 1400/month ($2100/month without subsidy)
Deductible:$10,000; Co-insurance (after deductible) Emergency Room 40%;
Hospitalization 40%; Out-of-Pocket Maximum: $16,000
(Translation: they will struggle to pay a premium of ~ $15K/year and if illness/accident
intervene, they will be immediately overwhelmed by deductibles, unable to afford premiums and become uninsured. Food and housing securities will be jeopardized --- this cannot be happening).
Young Physician age 31: Dr. Mike, this may sound familiar, so get out a hanky. At age
31, the young doctor (family of four) has completed his training and plans to move to rural
Florida to practice internal medicine. Having lived in poverty through college, medical school and residency/fellowship, he anticipates working hard and realizing an income of $150,000 (a king’s ransom). His health care insurance numbers: Bronze Plan: Premium ($700/month; $1100 without subsidy); Deductible $15,000; Co-insurance (after deductible) Emergency Room 50%; Hospitalization 50%; Out-of-Pocket Maximum: $18,400 (Translation: Premiums of $8.5K/$13K and massive Deductible $15K make his independent rural practice dream unaffordable. Rather than go uninsured, he signs on to work for a hospital system offering employer-sponsored health care.)
Young couple age 28 with two kids: two high school sweethearts and two kids are
making their way day to day in Florida. They both work two jobs (<30/hours per week so their employers need not offer health insurance). They clear about $80,000. Until age 26, they were covered by their parents’ health insurance plans. They have no savings. Truth be told, despite their best efforts, they live paycheck to paycheck and do not sense they have food, education, health, housing, job, transportation security. After investigating purchasing health care, if there is a subsidy, their premium will be $0 with a massive ($11K) deductible. If there is no subsidy, their premium will be $1,150/month ($14K/year) with a massive ($11K) deductible. (Translation: with subsidy they will accept coverage and hope for the best. Without subsidy, they will be forced to be uninsured. In either case, significant illness or accident will lead to debt and put food, housing and other securities in jeopardy).
Dr. Mike, this has been a long slog. Back to Congresswoman Taylor-Greene ꟷ let us
hope she alerts her Representative Peers, her Senate Colleagues and her President to that
which she now knows: 1) United States health care is a non-system hot mess that, for the
moment, cares for only a fortunate few (and that number is dwindling); and 2) national
infrastructure is required to provide our fine citizens universal access to ABC-STEEEP
(affordable, basic, compassionate, safe, timely, efficient, effective, patient-centered care). (710
words)
******
Respectfully submitted with fondest personal regards,
Dr. Mike
You may leave an anonymous comment without username and email ꟷ please do. Please share your wisdom, insights and perceptions (your reality) about what I have right, wrong and/or omitted. I will be delighted to hear from you as this draft and subsequent chapters will be significantly enhanced.
Dr. Mike
Letters to the File
Introduction to ABC-STEEEP ꟷ Letters to the File
About Dr. Mike
My Perfect Health Care ꟷ An Uncomfortable Paradox
From the Watershed into Universal Access to ABCSTEEEP
Privilege = Responsibility ꟷ Sounding Our National Health Care Alarm
Quality United States Health Care Defined ꟷ ABCSTEEEP
United States Health Care ꟷ Sounding a Three-Alarm Fire
Health Care ꟷ Recruiting Devine Intervention
Health Care as a Right ꟷ The Fundamental American Misperception
See, Say and Do Something: The Doctor Is In ꟷ $0.00
Health Care ꟷ The Wolf Is (and Has Been) at Our Door
(more to follow)
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