It's complicated, and that's a problem. In the years before my dad died, his biggest medical expense was the drugs he needed to stay alive. The inhalers he needed to control his COPD (and continue to breathe) were so expensive that the two of us together could barely swing the cost. And that was with Medicare part D, which is supposed to pay for some drugs and lower the price of some others.

We switched to a Medicare advantage plan and managed to get the drug cost lowered substantially, though it was still very burdensome. We also noticed a drop in some co-pays for regular doctor's appointments. And that came without a significant premium. I think it was something like $20 a month, which was way more than offset by the lower drug prices we were getting.

Of course none of that was easy, we had to have an independent insurance agent over to the house to help us figure out the costs and benefits of a bunch of different plans. I spent like 2 hours with him at the kitchen table with a notepad and a calculator.

He had to make several phone calls, because even he couldn't understand the wording of some of the insurance plans.

In the end, we ended up saving a lot of money, but it was really difficult. The complexity of the "system" is insane.

And the year after that we had to do it all over again, because plans change, fine print changes, etc. If you're not aggressively proactive, you can end up slapped with shocking expenses after it's too late to do anything about it.

A Medicare advantage plan can absolutely be the wrong answer for some people. But in some situations, like ours, it was very helpful.

So my question is this, how the hell did we get in this kind of a situation where it's so difficult to figure out how to pay for healthcare? Where people get scammed because understanding the system is beyond the ken of mere mortals?

I think we all know the answer to that. A bunch of fat cats are getting much fatter.