Scribed In Light

(aka The Stuff No One Bothered to Tell Us Because They Don’t Want You To Know)

Welcome to Day Two of dragging the American healthcare system by its wig. Yesterday we talked about why health insurance has turned into a full-contact sport. Today we’re talking about what actual humans can do besides scream into a throw pillow. Because yes, you do have options. Not perfect ones, but real ones. Shockingly, many don’t require selling a kidney to afford coverage for the other kidney.

Adjusting Your Income in a Legal, Calm-Down-Karen Way

Marketplace tax credits depend on your adjusted income, not the number on your paycheck. After deductions, write-offs, and whatever wizardry your tax person does, your income might fall into a much cheaper category. It’s not cheating. This is exactly how the system is set up. Anyone with fluctuating income can benefit from this.

Bronze Plans Paired With Cash Pay

Bronze plans are high-deductible and low-ish premium. They’re meant for big emergencies. For everyday stuff, you simply pay cash. The wildest part? Cash prices are often cheaper than using insurance anyway. Only in America can two aspirin be forty bucks in the ER but four dollars anywhere else.

Direct Primary Care

Direct primary care (DPC) is the old-school doctor model making a comeback. You pay a monthly membership and get real access: unlimited visits, same-day scheduling, real talk, longer appointments, no insurance middleman. Then you carry a basic emergency plan for big stuff. It feels like medicine before corporate hands got involved.

Medical Cost-Sharing Communities

These are member-based groups that split medical bills. Not insurance. Not perfect. But often far cheaper and more flexible. Some families love it. Others prefer insurance. But it is a valid option mainstream systems don’t advertise.

Off-Exchange Plans

Not every plan is on the marketplace. Some exist quietly off-exchange: short-term plans, regional plans, hybrid plans, catastrophe-only plans. Some are awful, some are gems. When paired with DPC, these can dramatically lower total costs.

High-Deductible Plans with a Health Savings Account

This is the long-game strategy. You choose a high-deductible plan, your premium drops, and you use an HSA. HSA money goes in tax-free, grows tax-free, and is used tax-free. It rolls over every year and can be invested. Years later, this becomes a medical nest egg.

Building a Patchwork Plan

One-size-fits-all is dead. Families now build their own set-ups:
Bronze plus DPC.
Bronze plus HSA.
Catastrophic plan plus cash pay.
Cost-sharing community plus small emergency plan.
Off-exchange plan plus DPC.
This is the new BYOH era — Build Your Own Healthcare.

What You Can Actually Control

You can’t control corporate greed, premium hikes, billing errors, pharmaceutical nonsense, or the codes that turn a forty-dollar visit into a four-hundred-dollar surprise.

But you can control:
The type of plan you choose.
Whether you qualify for tax credits.
How you allocate your medical spending.
Whether you switch to doctor-centered care.
Whether you use alternative models like DPC or cost-sharing.

You’re not powerless. You were simply never handed a clear guide.

Part Two Wrap-Up

This system was never meant to make sense to the average person. Confusion keeps people compliant and overpaying. But once you break it down, you realize you have far more choices than you were ever told.

Knowledge with laughter is medicine.
And we are absolutely in need of serving both today.

Signing off with a hug of humor, a little truth, and the hope that this helps ease even a sliver of the insanity we’re all walking through.

—Tina N. Campbell | Scribed in Light