And why is a government run medical insurance program bad again?

When I was in seventh grade, back in the late seventies, most of my weekends were spent at the roller rink with all the other kids my age. Ah, memories; the disco, the couples-only skate, the bad music and the bad lights. I loved it, and I was a pretty good skater most of the time, even managing to skate backwards well enough to be on the floor during the backwards-only skate.

But one lovely Saturday I was skating when an employee of the rink flew by me, fast, and he knocked my skate with his and I went flying. I thrust out my left arm to catch myself, but I was moving too hard and too fast and just like that--snap--both of the bones in my arm broke clean through.

It's funny how much I remember from that day. I remember the shock on the face of the guy who knocked me over. I remember my arm looking oddly like a floppy "z" because the hand and wrist just kind of hung there like meat off the end of my arm. I remember someone putting ice on it, and then asking them to take it off because it was too cold, and then asking them to put it back on again because looking at my broken z-shaped arm made me want to throw up.

I don't remember the ride to the hospital, but I do remember the huge Navajo nurse that hovered around me like a protective bear and how he soothed me when I saw the size of the needle they were going to put in my arm to numb it up for manipulation. I remember watching sweat running down his face as he and the doctor bent and twisted my arm back and forth until with a huge "SNAP!" the bones realigned. I even remember the happy and surprised looks on both the doctor's and the nurse's faces when they felt my arm and realized it was back in place (they really thought I'd need surgery). I remember the smell of the plaster as they put on my cast, and I remember feeling sad that I had to have a clunky white cast and I couldn't have the much cooler, brand new pink fiberglass cast.

Why couldn't I have the fiberglass? Because we didn't have insurance.

When my mom picked me up at the roller rink, her face was a study in fear. She was afraid for me and my broken arm and suffering from that horrible, helpless feeling that a mother has when her child is hurt (a feeling I understand much better now), but she was also afraid because it was clear how badly my arm was injured, and that meant hospitals, doctors, and bills bills bills.

Eventually, due to shitty record keeping and bullying bill collectors my mom ended up having to pay cash out-of-pocket for my broken arm TWICE. Unlike most insurance companies, my mom didn't have an entire department of accountants scanning invoices for double charges and billing mistakes, and she certainly didn't have a lawyer to go to her defense and keep her from paying twice. She was young, scared, and she just did the best she could.

Luckily, things are somewhat better now for poor families than they were for me and my mom. Most states now offer some sort of low-income health care benefits for children, and are actually doing a pretty good job of educating families about the availability of such programs (according to this study, only 9% of families were still unaware of the options).

But there are still big ol' holes in the system. In my state, the state-run insurance program for children is actually open to ALL uninsured children, regardless of income (those with a higher income pay a small monthly premium). But in order to qualify, the child has to have NO INSURANCE. So when we tried to sign Tori up to the state plan (at a savings of over $250 a month for the exact same plan), we were denied because we are unwilling to allow her current insurance to lapse first.

As you may of heard, President "I'm totally profile as long as the children haven't been born yet" Bush has been hoping to actually widen that gap, requiring children to remain uninsured for an entire YEAR before they qualify for these programs. He is so insistent, in fact, that he is willing to veto the current funding bill in its entirety to prove his point--leaving many states forced to cancel the program for thousands of children.

Back in 1979, my broken arm cost my mother about $1,000 (the first and second times). While my mother worked hard to keep us off welfare and stopped relying even on the meager help that food stamps provided, she still did not earn near enough to give us medical insurance. Even without my breaking any bones, I was not a cheap kid medically--I had pretty severe asthma and allergies, and was in and out of emergency rooms with asthma attacks (of course, without insurance, we were unable to work with a doctor to manage my care to decrease the frequency of attacks). Adding another $1,000 in bills to our budget nearly broke us. I shudder to think about the things my mother had to give up to pay it off--TWICE (that twice thing really galls me, can you tell?).

Does President Bush have any idea what can happen to a family whose child has no health insurance in a year? What about a child with a chronic illness, or one that requires surgery, or one who has an accident like my broken arm? You know what happens? Bankruptcy. Eviction. At the very least, a ruined credit rating--preventing the parents from buying a home, a car, or any other piece of the American dream.

I remember that fear on my mother's face all too well. It left me with scars; for years, even though I had insurance from my jobs, I waited until I was deathly ill to see a doctor. Basic health care management was beyond my comprehension until I was in my late twenties. Because I don't want Tori to ever worry in that way, Charlie and I spend about a quarter of our monthly income on medical insurance for our family, nearly $1,200 a month (more--much more--than our mortgage).

Hillary Clinton attempted to change the health care climate when her husband was president, and we all remember how well that was received. But, brave woman that she is, she is still trying to do something about it. Her new health care proposal is similar to the Massachusetts plan (in a wonderful touch of campaign irony, Mitt Romney supported the plan when he was Governor of Massachusetts, but is railing against Hillary's plan), and would help families like mine find a level of health care coverage that would be affordable and provide the coverage we need.

I know all the arguments against state-subsidized health care, and some are valid. But the problem remains that health care costs are not only bankrupting families, they are driving companies out of business--look at what is happening with the United Auto Workers and General Motors right now. Maybe if GM didn't have to worry about the constantly increasing cost of health care (at my last job, the cost to my employers went up over 25% in two years) they might re-open some factories instead of closing them all down. Who knows?

With some sort of health care support from the government--in whatever form it takes--companies will be able to hire more workers, everyone will be healthier thanks to better managed care (thus driving down the overall costs of health care), and no more mothers will have to have terror strike through their hearts each time their child is knocked down at the roller rink. Seriously, people--why don't we care enough about our children--and hell, our adults--to do this?

Comments

[Sarah]

1.

In addition to the loss of treatment for chronic conditions or accidents, the horror of having your child uninsured for an entire year is completely lost on Georgie. He must not be able to comprehend the double whammy of both having no money to pay for all of the services that make up a single medical treatment (i.e. doctors visit+tests+plus medicaiton+follow up), as well as the problems that arise when you have a 'pre-existing condition' and start health insurance. Even if the program had a clause for dealing with that, it sets a terrible precident.

[Pronoia]

2.

Part of what galls me about things like this is the presumption that poor people are all out to scam the system. Therefore, we have to do everything we can to make sure they're REALLY poor and helpless and whatever.

I call serious bullshit. I won't deny that there are people scamming the system, but if we're talking numbers, I'm guessing there are far more fancy rich people scamming the system than there are poor people, and rich people scamming costs a hell of a lot more as well.

As if a healthy populace doesn't benefit all of us!

[anonymousey]

3.

The insurance thing is a real touchy subject for me. I have a good job and have the option for insurance, but I just cannot afford it. I tore a ligament in my knee last year and I cried harder at the thought of having to go to the hospital then at the actual injury. I still don't have the money (or insurance I suppose) to have the surgery to fix my knee. I also pay for my twice-monthly B12 shots out of pocket. Thank god they're not that expensive.

It's not just babies that are suffering for their parents lack of insurance. Us twenty-somethings are suffering too. Some months I still have to make a choice between food and car insurance. I worry constantly about getting sick or getting hurt. I stopped taking antidepressants because I couldn't afford them anymore. I'm way less active because that torn ligament scared me so badly. A lot of my friends are the same way. They either don't have the money for insurance or don't have the option through their jobs.

It's hard trying to get by, now.

xoxo

[Kayla]

4.

We too spend about a quarter of our income on health insurance, and my husband makes $32k a year. While that's a lot cheaper than yours, it really adds up for us. We live in a part of the country (Mississippi) with a fairly low cost of living, but a lot of people don't realize that while housing costs and such may fall into place with the income levels, things priced fairly nationally do not. I pay the same for a box of Cheerios at Target as my friends in Arizona. Gas costs approximately the same. A box of Pampers is the same price. So we settle for these lower wages, have cheaper housing (our 4 bedroom rental house for me, my husband, our son, and my 21 year old brother is $1150 a month...) but still pay ridiculous amounts for insurance. This is through my husband's employer, and we're still paying that much for a policy with a $200 ER co-pay and $5000 deductible. Oi. I'm looking into the state funded health insurance program for our son.. but like you I don't know about letting his coverage lapse. It's just a clusterf*ck that no one seems to have a solution for.

[ellen]

5.

i don't know what the solution is but we can't go on this way. I would've had a different take on this 10 - or even 5 - years ago. But we also pay $1000 a month for health insurance (DH self employed).

My nephew just had the same arm break as you but needed surgery. My sister never thought to call the ins. co. (it was Labor Day)...now they won't pay. $10,000. She simply cannot pay it. She can't. I don't know what is going to happen.

[Calliope]

6.

It's also really hard to be a woman without a paying job (taking care of Grandmother doesn't pay!) and be denied over and over and over and over again for individual health care due to a higher than anorexic BMI or fertility treatments.

Without anyone regulating the insurance companies they have all of the power. So gals like me have nightmares and panic attacks about not having proper insurance.

Luckily I found a program that acts as a limited liability health plan, but it still kills me that I can't get insurance.

My state has a program for pregnant women to get care so I am hoping I can go that route if I ever do get pregnant.

[Amy]

7.

Duh. This administration only cares about you before you're born or after you're brain dead.

[Maura]

8.

The problem with this country is not the health care system. The problem is the for-profit insurance system.

When nearly 33% of all "health care" dollars actually go to insurance administration and profits, you know there's a serious problem.

When I lived in Ireland I felt much freer than I do here in many ways. And one of the ways in which I am decidedly not free right now is my fear of getting sick without health insurance.

If folks here haven't seen "Sicko", please do, because it shows clearly that even HAVING insurance in this country doesn't guarantee you anything when it comes to actual CARE.

[Alex]

9.

I totally agree with everything you've written.

Here is a modest tip that may help a few people, possibly including you, Charlie, and Tori (if you have group coverage). If a person has group coverage, such as through an employer, and it lapses, one then has 3 months to activate COBRA coverage, or not. If activated, it takes effect retroactively.

So, if you could, say, drop Tori from your coverage effective January 1, 2008, you could do that. As long as you then got her insured through the state program no later than April 1, 2008, she would never be without coverage. Because if something were to happen and she needed medical care on, say, January 2 (before you had gotten her enrolled in the state plan), you could activate the COBRA coverage retroactively.

Of course, COBRA coverage is not cheap, so this isn't an entirely risk-free strategy, but the risk is financial and quantifiable rather than medical and potentially infinite.

Yeah. We paid for COBRA coverage for my DSD after she aged out of our coverage but before she found work at a cost of $500/month. Ridiculous. And because she lived in a different state from the one we (and her policy) do, she couldn't even get good care (out-of-network...). But because she has a chronic, albeit manageable, health condition, she couldn't purchase (not couldn't AFFORD, couldn't PURCHASE at any price) a private policy. Thank g-d -- oh, no, wait, thank Bill Clinton -- for COBRA.

I remember how people railed against Hilary's (original) proposed plan saying it would lead to rationing. As opposed to what we have now? Hello?

[Debbie in the UK]

10.

It is reading posts like that which makes me so fucking glad to live in the UK where we have National Health. I also have private insurance covered by my employer (only for non emergency stuff)but shit, when I see how much you are paying it makes me feel so sick. It is so awful!!

Love

Debbie

[Stacey]

11.

I grew up with Union Insurance. My father worked for AT&T and we had excellent health care. My sister fell and became paralyzed at 20. She spent 8 months in the hospital and the first bill we got from the hospital was over 500k. My parents we are able to sleep at night because they knew that my fathers insurance would cover it. They covered all of us children till we were 23 or until we finished college. If a child had a pre-existing condition like paralysis or muscular dystrophy. They would cover that child till they were married. My sister was 30 when she finally went off my parents insurance. No one supports union workers any more but in the North, and those jobs are becoming harder and harder to get. I pay 150 a month for my husband to be covered under my insurance, he also has disability insurance from the Army. He was injured in Iraq, and if he is sick we have to wait almost a month to see a doctor. Hence, why I pay for him to have insurance under my company. We have held off having children because of the cost of health care.

I think we should have national heath care. I know everyone is apposed to it, but if you are an American you should be able to see a doctor and not worry how you are going to pay for it.

[Cat, Galloping]

12.

you know, i work for one of the largest companies in the world-- with lots of bargaining power. and i buy the most comprehensive coverage they offer (a LOT less out of my pocket than someone who has to buy independently).

i recently had simple outpatient surgery for a hernia. my fabulous surgeon waived all the fees not covered by my insurance. and STILL, the hospital and anesthesia and lab bills approach $1K. amazing to me that such a simple surgery with ample healthcare coverage can cost so much freakin' money. there is *definitely* a problem with healthcare in this country. for the record, i'm pretty sure the problem is with the insurance companies, not the cost of care.

[Jo-Ann]

13.

I am giving you an online equivalent of a standing ovation.

E has ok insurance from his job for all of us. We have to pay almost 800 a month to keep us all in insurance. (They cover just him) The increase last year was so steep that his whole raise went to cover the increase of his insurance and his pay actually decreased!!

I had no health insurance for years and it was scary. I can remember doing very stupid things to get care when needed.

GO CECILY

[Katie W]

14.

To echo what Debbie said, the UK may have things that are wrong about it, but every time I read an american blog post about health care I thank the stars for the NHS.
A healthcare system where everyone gets treatment free of charge, and where prescriptions cost a maximum of £6.50($13), and are free if you are on benefits.
Yes it costs me in tax, but it's an infinitely fairer system.

[RainbowW]

15.

if you live in an industrialized nation that isn't the united states and you get sick, you may wait a long time for basic health care. you may even not be thrilled with its quality.

if you live in the united states and you get sick, you die.

what's hard about that for people to understand?

[Diana]

16.

Well, I live in the same state as this blog's wonderful author, and I went a full year without health insurance when I was 20-21 years old. My husband and myself were uninsured, and his daughter (age 3 at the time) as well. The same medical coverage for children was available but at the time it was only for low income families. Unfortunately, we did not qualify, though we were right on the border. For me, the only solution was to work for the state government. My job previously paid well enough but I would have lost a very large portion of my paychecks to health insurance once it was available to me. Even when I started working for the state, I immediately had access to health insurance for myself, but not for my family, and no rx, dental, or vision until I had been there 6 months. I would love to seek out employment elsewhere, but I would not be able to make it those 6 months while I waited for insurance to kick in at a new job. Really--I hear people with the state complaining because our new contract will have insurance go up (to 3% of our incomes instead of the current 1%) and I shake my head because they have no idea what it's like outside of the government bubble.

[The Editter]

17.

Accident and Emergency care is free in New Zealand too. I didn't know this till my appendix burst, and it took me until a couple of days into my 10-day hospital stay to work up the courage to ask how much this might cost me. Nothing, they said. Whew, cos I had no insurance. I do now, so I haven't had to wait on the public waiting list for free non-A&E surgery. We still all grumble about the health system though!

[Donnie and Jason Surla]

18.

When I first got my teaching job, my husband was out of work. I paid $700 a month out of pocket to insure the both of us.. and that was WITH my school district kicking in $400 (which is pitiful, but I digress).

Our "ability" to consider conceiving a second child will depend in large part on whether we can afford the insurance. Sad.

You've given me a lot to think about. I do envy people whose gov't offers free health care, but I've also found that if anyone in these countries makes any money at all, they prefer private care, leading me to think that the public version is far inferior.

Still, poor health care is a dang sight better than NO health care. At 22, uninsured, I developed pneumonia. When I had lost 20 lbs and could not get out of bed (dehydration), my mother carried me to the ER.

$1600 later, I had a chest x-ray, a prescription for antibiotics, and two bags of IV fluids. It sucked all around.

So I guess what I'm saying is that I think that gov't should offer some sort of health care, especially for the blue collars and the needy.

But even above that, I'd LOVE to see insurance companies rehauled. Can we get some politicians who have enough intergrity for that? It's sickening what they're charging middle class America to keep our kids, and ourselves, healthy.
-D.

[victoria]

19.

as a Canadian resident with both Universal health care and a comprehensive health plan that covers dental, paramedical (chiropractic, massage etc) and all prescriptions that is totally paid for by my husbands (large) company, I am utterly shocked at the state of health care in the US. I have read many stories of people going bankrupt to get treatment for cancer. I hope that this issue becomes a major part of your elections next year, and that help comes to all of your citizens who so desperately need it. Cecily, this post is absolutely fantastic, and I look forward to your new direction.

[Holly]

20.

Wow. It doesn't matter how many times I hear about the nature of the US health care system, I still can't believe it ever got to this point.
I live in Australia and I never even think about health care and cost being connected. If I was diagnosed with cancer, I would be terrified for my life, not for my financial wellbeing. I don't even know if there would be any cost to me personally to be treated for cancer. I just can't imagine it.
There is an out-of-pocket cost for doctor visits. I went last week and I paid $54 at the desk but I believe I receive a refund of about $30 from the Medicare program (which is for everyone, not just for low income earners).
It just blows my mind that anyone anywhere has to spend more on providing a safety net to prevent huge medical bills than they do to put a roof over their head.
And Americans say they live in the best country on Earth?

[Jess]

21.

This is a fabulous post. We're insured through my husband's work, but every year it seems we pay more and more out of pocket. My husband works in insurance. The amount of money many companies have in reserves and assets (even those that are supposed to be not for profit) compared to what they'll pay/cover/charge is mind numbing. It's just wrong.

[Mel]

22.

I worked in customer service at an insurance company with the CHAMPUS contract (insurance for military dependents) and that convinced me that I would never want the government in charge of my health care coverage.

[Dea]

23.

As I've stated here many many times I'm a Canadian living in California, and health care was one of the issues that freaked me out when we moved here. I heard the rumours about how the system works down here and how it's not an automatic right, like it is at home. Then when I had to pay my first co-pay I nearly choked. The thought of paying for medical care is wrong wrong wrong.
Sigh, socialism is the way to go. I wish more people could agree with me.

24.

Saying Hillary's plan is like the Massachusetts plan is not exactly a vote of confidence. The Massachusetts plan is *very* Romney. You don't create universal care by making it illegal not to have insurance. The Massachusetts plan might help your middle-class family, but it doesn't do much for those straddling the poverty line.

[Lauren]

25.

hmn, Im glad that I live in Australia.

I have never really understood the U.S. system, so thanks for shedding some light on it.

Here - you are covered publically for free (which is what we have) or you can pay to be covered by insurance and be a private patient.

but over there, it sounds like if you are in the middle income levels, you have to pay as much as those who have the higher income levels! What the?!?

[Charlie]

26.

Well said.

You already know my feelings, but I'll restate them here for the benefit of your readers.

Pharmaceutical companies are like big kids who've proven time and again they can't play with their toys responsibly. So it is time to de-privatize the industry. But what about R&D, you ask? Well, maybe without the profit motive as the chief driving force, we can concentrate on drugs for the sickest patients rather than on reinventing nose spray and aspirin for the hundredth time. And do we REALLY need a drug that may result in a 4-hour erection? Really?

Second, limit punitive damages in medical lawsuits. Sometimes we don't like the outcomes of medical procedures. But it's not always the fault of the doctor or the hospital. So let's put a limit on damages that go beyond lost wages and medical bills. Yes, I know tort reform was part of the conservative platform....the only part I support.

[thrice]

27.

In general, people in the US don't pay attention to health care costs, until it affects them personally. How many people who have corporate insurance, really understand how much health insurance actually costs? On top of their ignorance, they complain that they now have to contribute $100 or $200 a month. Everyone needs to wake up to the cost.

[revdrmom]

28.

Preach it, sister!!

And the Massachusetts plan, as good as it is, is still no panacea. There are still many people who cannot afford the coverage they have to buy.

I may be totally out of the mainstream, but I don't think healthcare should be for profit and I don't think insurance companies should be competing for that profit. It is a sick system. We need a single payer system or some sort of socialized medicine that is accessible to EVERYONE without breaking the budget. People in the richest country in the world should not have to choose between paying for health care or paying for food and housing. Nor should they have to go without healthcare, as many do.

[revdrmom]

29.

And amen to what Charlie said, too!

[thrice]

30.

Charlie, With all due respect I don't think that you are looking at the whole picture of medical negligence. I was diagnosed with heart failure after the birth of my twins. Had received the standard treatment, I would have had a 90% chance for a full recovery. I was not and I spiraled down into severe heart failure. I have permanent heart damage and an ICD because of two doctor's negligence.

Would you tell me what damages should be limited to? Dude they messed up my heart. I'll never be able to mother the way I want to, not to mention, because I was so sick they robbed me of mothering my children when they were young.

[Beth]

31.

And this is why I was so poor when my son (now 18) was little --- I could afford to pay out of pocket for an HMO for the two of us (back then, $600/mo) because I had a really well-paying job as a nanny (which also, importantly, allowed my son and I to be together). However. Nobody -- and I mean nobody -- would agree to cover him as he'd nearly died of meningitis at 8wks and had residual health issues. So I quite my job and went on welfare. Having MA meant I couldn't earn more than $556/mo or they'd cut his coverage. (Nowadays folks can get state MA and earn four times that without getting kicked off -- but there are many other serious flaws in the system. Here's just one: state MA covers dental. But there are no dentists in my cousin's county -- for example -- that take MA. And, if you've got MA, no dentist is allowed to take your cash for services so ... No dental care).

Way to go with helping the poor and chronically ill live decent lives ...

[Meira]

32.

Bravo!

(Although the title struck me a little funny -- for some reason, I began reading thinking that you were going to lay out a case opposing national health care.)

[Lys]

33.

As a Canadian the American health care sytem is shocking to me. I live in Alberta where you pay 88 dollars a months for health care no matter how large your family is. In the rest of Canada you pay nothing! We pay slightly higher taxes but is is well worth it! While we have problems in our system (long wait times, etc) I cannot imagine what it is like to be scared to take your kid to the hospital or to be bankrupt over medical bills.
It is terrible people in the 'greatest country in the world' have to go through that.

[Kelly]

34.

Thanks for posting about this Cecily. For those who need prescription drugs and don't have coverage or have limited coverage, both W*l-M*rt and T*rget offer $4 prescriptions. Ask your doctor to check their lists of $4 drugs (its available on line) and pick the cheapest alternative if appropriate.

[CharmingDriver]

35.

Having been raised as a dependent of my father's government-sponsored system of "health care" (he was career military), I can't get behind socialized medical care.

Having had super-terrific-great-fantastic insurance when our son was born (and died) and still fighting a year later over almost one million dollars in expenses billed to us personally, I know something has to change within the insurance industry.

Having been treated, as was my son, with the exact same protocol for MRSA that has been used for over 30 years (you can't make sexy ads for antibiotics) because there is no interest in R&D for that illness, I know something has to shift in the pharmaceutical industry.

What the answer is, I have no idea. But what we're doing sure as shit isn't working.

[Regina]

36.

I agree with Charlie about drugs being too expensive in the US. When I was on a study abroad in Tanzania, I got sick with some intestinal bugs (yes, actual bugs!) and had a bad reaction to the malaria prophilactic I was prescribed in the US before leaving. The doctor's visit cost the equivalent of 10 USD. I did not even bother trying to use my travellers insurance, because the headache would have cost me more than that! The doctor gave me perscriptions for 4 different medications, includding a new malaria drug. The total pharmacy bill was the equivalent of 40 dollars. My insurance at the time (through my parents, as I was still in school and not yet 23) charged a flat fee of 20 dollars per prescription.

Now, clarly many Tanzanians can't afford to pay those kind of prices for health care. But just the fact that medications ARE available in the world for so little money, makes me mad that it costs so much to get perscriptions here. And don't even get me started about how the erection-pill is covered, but the birth-control pill ISN'T.

[Ann]

37.

Awesome post. I totally agree with Pronoia's point -

"As if a healthy populace doesn't benefit all of us!"

That's the thing about public health - it's really not just for the people who use it, it's for ALL of us. Preventive medicine, if available, cuts the cost of disease immensely. And if people had insurance and didn't have to use the ER as their primary health care, then a lot less money would be spent from the taxpayers' pockets.

And yet, certain people seem to think we should make it really hard and inconvenient to get coverage. Why? We're only hurting ourselves, if you recognize that we're all in this as a country together... I think the rich folks sometimes want to believe they can just forget the rest of the country. It's a selfish mentality: I got mine - the rest of you can go fuck yourselves.

Or so it seems to my sleep-deprived brain.

[Hoping]

38.

When my little brother died when I was 9, I remember the bills stacking up and up and the collections calls and everything, until one day a foundation sent a letter saying they had paid for it all. I remember the looks on my parents faces too, it was awful to watch try and figure it out.

I am a military wife and we are covered through TRICARE, to have my son the bill exceeded 20,000 (c Section) and I paid $100 all together, we have no monthly premiums and to get a prescription the other week I paid $3. We are lucky and we know it, the military is taking care of us in this aspect but we won't always be in teh service, and what then? hurt to think about it.

you are right on here Cecily, keep writing, you never whose attention you will grab.

[Meg]

39.

Fabulous post. Thank you.

[Janice]

40.

I know all to well how lack of insurance can affect you... I paid for an emergency knee surgery for my son without insurance. I was a stay at home Mom at the time, my husband was layed off and our insurance lapsed before the insurance with his new job kicked in. Of course it would be just that time that my son received an injury while playing football with his buddies on a weekend. The fact that my husband had begun the new lower paying job prevented us from getting any assistance with the bills because he "made too much". I went to work and payed the bill off in installments. Those who try are punished, and those who don't get the rewards... sorry but it's bullshit.

[Michele Lane]

41.

to us.. pretty much ANY kind of affordable insurance would be great.. try getting medicaid in the south.. WITHOUT your name being Loqueesha. HA. I have a great story about it.

[Jeannie]

42.

I also live in Canada, and have both the universal coverage for medically necessary stuff and insurance through my employer for all the extras (private rooms in hospitals, massage and physical therapy, travel insurance, as well as coverage for my son and husband, although he has his own), and the US health care system scares me.

A few months back, my son got very ill -- he's only 18 months -- with a kidney infection. All he had was a fever. I took him to the clinic just to get him checked out, because we thought it was just a mild virus, and thank God I did, because we caught the infection only just before it went septic. I am very lucky -- I have insurance, but even if I didn't, the visit would have been free, because we live here. I can't imagine how awful it could have been if we didn't go, and he'd gotten much sicker. As it was, he has kidney scarring; had it been worse, he could have had much worse. And from what I hear, that's what happens in the states to poor families.

Canadians may complain about wait times, but I can also say this: when I contracted shingles at eight months pregnant, I got in to see a dermatologist, ophthalmologist AND obstetrician all within 24 hours. If it's an emergency, you get seen -- that's been my experience so far.

And to be honest, I'd take wait times over paying for care, and risking bankruptcy or bad health because of lack of insurance. It's horrifying to me that in such a rich country, there are children without health care. I'm sorry to criticize as an outsider, but wow ... it's hard to see how successful you all are in so many ways, and how much you fall down on this one.

[Abigail]

43.

(re post preceding mine - wha? huh? la la la ignoring)

Between the health care issue and global warming I feel like we're on a runaway train heading for a cliff.

I argue about this with my Republican father all the time. He says "but with government care, people will have to wait a long time and can't chose their doctors!" Oh how I laugh. Even for people with insurance, it is like that right now, except we're all paying a lot of money for the crap service we're getting. The free market /profit motive is not conducive to sane, compassionate health care. Period. End of discussion. Time to have a lively debate about how to institute a single payer system, because the "should we" part of the discussion is over.

[Abigail]

44.

When I said "post preceding mine" I meant Michelle's, not Jeannie's. Love Jeannie's! Go Jeannie! Go Canada!

Even my Republican father has changed his tune a bit since my brother fell ill while attending school in the U.K. and received stellar care.

[kathleen999]

45.

Amen...our health insurance went up to $1350 for two adults and two children. We had to switch to a plan that doesn't allow out of network. That reduced the insurance to $1050. Our rent is 1140. We are paying almost as much for insurance as rent. this is nuts.

We need national health care and we also need to close the loopholes that allow people to fly here from other countries, have their kids here and have it all paid for by Medicaid. Our babysitters daughter has just done this for the second time. And both kids are now citizens, of course. There needs to be a better system, one that takes care of Americans and doesn't allow people to leave home and have their medical care done on other people's backs.

[Tonya]

46.

I believe that any given uninsured person pays through the nose for medical service-- to the tune of several times the amount a person with coverage has to. I see the medical bills we've (I've) racked up these past few years, and it never fails to astound me how little insurance companies actually pay providers. Between that & disallowing certain charges (or limiting coverage amounts), they have a stranglehold on consumers.
I believe anyone who's uninsured is paying through the nose to support a currently corrupt system. They don't get any sort of discount, and they get screwed.

And of COURSE W doesn't care if kids have to wait a year before getting covered. He's so rich that no one he knows personally would ever be affected by such a provision. WTF should he care? {grrr}

[Veevs]

47.

My god, I am never going to live in a country without a govt-funded medical structure. The Austrlaian government is doing its best to decimate Medicare, but it's still there and still saving millions of people billions of dollars. Higher tax rates are a small price to pay for equality in health care.

[4katnap]

48.

I pay $1000/mo for health care for 3 people. I had my gallbladder removed recently. the bill before insurance was $13,000. I paid $125 and the insurance company paid about $1000. THe hospital wrote off the rest. Tell me why my surgery would have cost me $13Kw/o insurance and the HMO only paid $1K.

I say give Georgie boy a budgethe can't overspend w/o going to jail, and a choice between housing his family and health care. Then let some one get sick or injured and see what if his beliefs change.

[Stephanie]

49.

A lot of people with employer paid healthcare are concerned that their care would go down under a national system, so they're against. I do think of it as a little of the "I've got mine" syndrome. I'd rather "give up" some of my mythical care to get everyone covered. Care in other systems may not be "top of the line"-another frequent comaplaint-but I don't every want to feel as desperate as I did when my godsons were sick and had no insurance. Ten years later, and remembering those days still makes me cold to the bone.
Some people don't get it, you know? But those of us who've been there...we know how important it is.

[Elizabeth]

50.

Haven't read comments, but what really gets me is the hypocrisy of the anti-gov't-healthcare crowd. Supposedly they are all about unfettered capitalism. But capitalism is HINDERED when businesses are responsible for healthcare costs...a sort of historical accident that now seems "normal", but is really pretty absurd in our current economic reality - especially considering that most workers will change jobs many, many times. It makes no sense from a purely capitalist perspective to tie a worker's health insurance to their job. It prevents the free movement of workers from job to job, as many workers stay in jobs they don't want in order to retain their healthcare coverage, and companies must spend way more than they should to attract the best workers, because of ever-rising healthcare costs. NO ONE WINS with this arrangement.
The irony is, single-payer health insurance does NOT mean socialized medicine, or a National Health Service like the UK has, where the gov't runs the clinics, and the care does leave much to be desired in many ways. Single-payer just means that the whole damn country becomes a risk pool, and you have ONE system for insurance, that everyone gets covered by, instead of the many different companies and plans that now bog down our healthcare system because of the sheer administrative burden of dealing with them. Under single-payer, we'd have the same doctors, and clinics, and hospitals, and most people would have MORE choices, not fewer. It would be simpler, not harder. Cheaper, not more expensive. More efficient, not more complicated. Better for business, not socialism.

WHY is this so hard to understand?? The only people losing under single-payer are the insurance companies.

[Elizabeth]

51.

That last sentence should properly read, "the only losers are the insurance companies"...because companies aren't people, right? Except they seem to have more rights than actual people, under the current administration.

[Elizabeth]

52.

That last sentence should properly read, "the only losers are the insurance companies"...because companies aren't people, right? Except they seem to have more rights than actual people, under the current administration.

[Chris]

53.

As a former employee of an insurance company, thank you for a terrific post! When I got pregnant with my daughter 4 years ago I was so happy to be leaving that industry and swore I would never go back. We are definitely in crisis mode in the US and something needs to be done.

[akeeyu]

54.

People who don't want socialized medicine say the quality of care would suffer, but QUALITY of care is kind of trivial when the issue for so many is the EXISTANCE of care.

It's kind of like saying "But if we do bla, everyone will have to eat cereal for breakfast every morning!" I understand that this is a step down for those already eating three course breakfasts lovingly prepared by a private chef, but for the people in this country without anything, cereal would be a huge step up.

[akeeyu]

55.

...and considering that one of the things driving up health care costs in this country currently is the non-payment of huge medical bills (usually crisis care) by the uninsured, I find the argument that covering everyone would make everybody's costs go up kind of implausible and stupid.

The flip side of that is, if taxes went up but I was able to change jobs without losing my health care, I would call that WORTH IT.

[ls]

56.

Actually, Idiot (GW) doesn't care becasue he has never once in his incredibly privileged life actually had to worry about anything like bills. My daughter is on Medicaid, I pay for catastrophic insurance for myself, and buy my expensive migraine drugs from India. I haven't had a check up in 4 years, and probably won't in the near future. Taxes don't need to even go up...they just need to be re-prioritized from the military, from corporate tax breaks and the mismanaged mess in Iraq and out country would have the money it needs for a long time.

[Wendy]

57.

I'm just curious. The government doesn't seem to be doing such a great job on many fronts, and you want them to take over health care? What is that going to look like?

[Christina]

58.

The subject of health care is the pony that loves to be trotted out come election time.

Has anyone noticed that nothing has been done about in since hmmm '92 when Mr. Clinton first started talking about it.(or maybe when I first started paying attention) That has been what, fifteen years now.

Reform! REFORM! is the cry from the streets.
REFORM REFORM is the cry from the podium
REFORM REFORM is the cry from the polls

crickets after election is won.

[Mel]

59.

GREAT post. And GREAT comments.

As someone who works in the health care system, I'd love to see it available on an equal level for all.

[Ellen]

60.

Great post, great topic - and so alarming to see all the comments. A few of my own:

1) My husband used to work for the Catholic Church. Bit of irony? You can buy a family plan through them, but they won't contribute more to it than the individual plan. At the time (and this was, hmm, five years ago so I know it's much more) that'd mean another $700 a month. No one who works for a church does it for the money, but it's a harsh financial stance nonetheless.

2)When rich people do it, it's called intelligently exploiting a loophole. When poor people do it, it's called scamming the system. The rich are industrious (or their lawyers are, anyway), and the poor are lazy. Love that republican logic!

3) I live in Massachusetts, and what astonishes me about bleepity bleep Mitt Romney's vaunted plan is it's similarity to Clinton's wellfare reform. It's easy to get people off wellfare if you simply stop giving them money. It's easy to get people health care if all you're doing is mandating they buy it whether they can afford it or not. This is why I'm a little worried about Clinton's plan, too; I'm just not sure it helps.

And perhaps this is at the center of the issue. What is a reasonable profit for the insurance companies? (Not that you'd ever get an honest answer on that from the GOP, since the idea of capping anyone's profits is blasphemy to them.) And what does 'afford' mean? Clearly to Bush and his ilk, you can afford health care. It doesn't matter to him that it beggars you to get it. He doesn't think it sufficient that people like the poster above would have to pay as much for housing as they do for health insurance. To him, can't afford it must mean literally that you don't make enough money to cover the premiums - not, in the case of my sister, that it'd take two thirds of her income to meet them.

[Rachel]

61.

forgive me, 'cause i'm all kinds of inarticulate, but:

i swear to god, the american public is too stupid to be embarrassed!

we pay too much for medication, and the choices absolutely suck.

we have to wait for the fda (a poor excuse for a public safety net if there ever was one, and one that can be bought to boot!) to approve that very limited choice of medication, when the rest of the industrialized nations get a cheap rainbow of medication.

we ALLOW jerk-offs in congress to pass laws helping the drug companies, that few of the american people have stock in - but are boarded by many people in congress, by refusing us medicine from canada and mexico and other parts of the world.

shouldn't we be marching in the streets for something better? better education, more job security, better medication and healthcare, for heaven's sake?!

time to get mad people. we've been handed our asses.

i'm sorry, but we, as a nation, did this to ourselves. this is a direct result of assuming that any politician gives a shit about the average american. they are not us, and we made them that way. they will never know hunger. they will never know the literal pain of having little or no insurance.

so, unless you are ready to reform the ways we let ourselves be governed, i don't see how even universal healthcare (something i desperately crave and dream of) will take us out of the turd sea we are swimming in.

your friendly young neighbor in the south who's ready to pay more taxes, get the young'ns better educated, and just plain worried sick over how to take care of her aging parents and god-babies!

many best wishes,
rachel in texas.

keep on steamin' cecily.

[Tory]

62.

Another Canadian here... I just wanted to say thank you Cec, for posting this because it made me rethink my attitude about our health care system, specifically when I bitch about the wait times in emergency.

Thanks to hockey, we've been to the emergency room three times - once for a concussion and twice for stitches. All three times the wait time was 10-12 hours. My brother in law actually gave up his wait after 2 hours and never bothered to get his CAT scan that he was supposed to get for the concussion. My husband went in at 6pm to get his chin stitched up and got home at 7am the next morning (12 hours for 4 stitches).

We all bitched and moaned and whined about how ridiculous the wait times were. But now all I can think is - at least we never had to worry about how we'll ever pay for it all.

Thank you Cecily for the eye-opener.

[Melissa]

63.

The SCHIP conference report is coming to the House floor today and the Senate floor today or tomorrow. HR 976 is a good bill, a compromise.

Lots and lots of people have worked some extremely long hours to put this legislative package together. I want to put my head down and cry that it is going to be vetoed. The Senate has enough votes for an override (a previous vote was 68 in support) but I don't think the House will clear the 2/3 mark.

Beside the year-long waiting period, Bush and CMS are trying to restrict states from enrolling working-poor and moderate income (200-400% of the federal poverty line) by demanding unrealistic enrollment nos (for more, you can see my post at FreeState for a Maryland-centric perspective: http://freestatepolitics.us/showDiary.do?diaryId=532

PA is doing pretty well but many other states are facing a serious shortfall and will stop enrolling kids if the reauthorization isn't passed soon (see http://opencrs.com/rpts/RL32807_20060508.pdf)

Thanks for writing this. I'm sure your blog is reaching many, many people who haven't thought about SCHIP.

[Jenni]

64.

I love the way people complain that the quality of care will decrease. People who say that have obviously not experienced some of the drive through McMedicine my family and I have. And we have AMAZING insurance!

So many doctors are pure profit driven they want you in and out as quickly as possible. You have to really look for a doctor that will care and spend the time with you.

And the other reason so many are against health care for all is because they have health insurance themselves. And they're too idiotic to realise they could just as easily not have it.

[mijk]

65.

thank you for reminding me that I live in paradise in some ways. We pay around 1800 dollars a year per person the children are free for basic insurance. Based on income one can get a compensation. It is illegal to be uninsured though. The thought of being afraid for medical costs because of insurance is so alien for me. But when I do think about it is so scary. Sometimes America from the outside can look like a third world county!

[mijk]

66.

He see I am not the only non us based reader who views at its own medical system with different eyes. I live in the Netherlands..

[liz]

67.

(didn't read all 66 comments, sorry!)
Amen Cecily! This is one major reason companies go off-shore and why other first world nations are able to undercut the US in prices on goods. They pay higher personal and corporate taxes, but overall costs are lower due to lower health-care costs.

For what we ALREADY pay per capita in health insurance, everybody could be covered better than those of us who have insurance already are. Gah!!!

[Val]

68.

Nice item to start you new and improved blog! I cannot even start on how I hate this whole Insurance BS. I have a great job with great benefits. My BFF however went for several years without health insurance. She was self-employed, but qualified for the state-fund coverage. It was great coverage. Then one month she started to make a tad too much. Boom. No insurance. No $1000 for coverage for herself and kid. I know the fear. She never went to the doctor because she could not afford it. She waited until her sinus infections where so bad there was no way to avoid the doctor. (she got them frequently). She finally, after many years, has coverage through her spouse who finally found a unskilled job that offered health coverage. They both ran to the doctor. Now they are in $2000 debt for the co-pays and deductibles but are happy - the sleep apnea study was $3000 plus the machine (which she's needed for years) is $3000. No more fears that she's going to die in her sleep.

[Spacemom]

69.

I got lost in the comments.

I think we should have a national health care system, BUT we have to be careful. Many cite Canada's system as a good model, but there can be delays (a Canadian man recently crossed over to Buffalo and got an MRI that determined he had a tumor, something that he would have waited for 4 months to get the MRI with the Candian system.. it's long and drawn out)

I agree that the health insurence companies have congress eating out of their hands. I hate that.

When my husband was in grad school, he had a similar situation to your mom's. THey billed him twice. He raised HELL and got the bills dismissed.

[Juanita]

70.

Good old W, trying to screw the average American once again. It is unconceivable to me that any child at all should go without medical care for a day, much less than a year. Besides, in the end it is going to cost the taxpayer that much more when people have to go on welfare because they had to declare bankruptcy because of unpaid medical bills.

[Hetty_Fauxvert]

71.

It's obvious that the way we have things set up now is not working for everyone. However, it is dangerous to be cavalier about wait times when it comes to health. Any system that results in long wait times for treatment or even simply to be be seen is going to result in higher mortality rates. For instance, the UK has a much higher mortality rate from breast cancer than we do in the US, because women wait much longer for treatment after being diagnosed. I could also cite instances in my own family... both my mother and my FIL died from cancers (ovarian and pancreatic, respectively) that they might have had a chance of beating if they had been diagnosed early. My mother messed around too long out of fear of seeing doctors (her own fault) but my FIL couldn't get an appt to see his own doc about his seemingly inconsequential symptoms... and it turned out to be pancreatic cancer. I am wary of any system that potentially INCREASES wait times.

[Kristin]

72.

A YEAR without coverage? Good God.

Cecily, no joke, can you print this out and send it to, like, every Congressperson there is?

Well said.

[maggie]

73.

Great post. Bush makes me twitch.

[AdirondackJen]

74.

I had emergency colo-rectal surgery in April. My non-corporate employer did not even OFFER health insurance -b/c he didn't want to spend the MONEY.

Everything from seeing a general practitioner in order to GET a referral to a surgeon, to the SURGEON'S initial consultation, to the surgery was going to be big bucks, and that was scarier than emergency surgery. Imagine!

After the surgery they couldn't control my pain, but I seriously was more worried about them keeping me overnight in the hospital and what that would cost, over the immense intolerable pain I was in. It was hell to have to weigh the financial benefit of checking out against medical advice (AMA) vs. getting the IV drugs/medical care I knew I really needed. I stayed overnight, but just barely. There was no pill that could touch it, so I stayed. If there was, I would have been home within 5 hours after surgery, to save myself money on the hospital bill. That's sad, to say the least.

BONUS..the procedure required a follow up surgery (in an O.R., not the dr's office) six weeks later. MORE BILLS!!

Here's what gets me...I called on every single bill I received to see if I could get each one reduced, and I DID! What kills me it that the freakin' dr's charge about two to three times what the service is worth, because they anticipate submitting the bill to an insurance company. Whatever the insurance company pays is what they get, and then the dr's write off the rest. This is b/c every insurer pays a different amount for each item, so dr's jack the bills way up to cover all the bases. You never see this part of the system.

Had I not sought a hardship reduction/poor person discount on the first bill, I wouldn't have figured this all out. All this insurance crap was beyond my understanding before this.

Whaddya know. I was able to get every.single.bill. except ONE anesthesia reduced by a MINIMUM of 50%. I got 1/3 off for paying cash w/in 30 days for one of them. Heh.

Small consolation, tho. I'll still be paying this all off in small bites for YEARS to come.

If there was a level playing field, a level income expectation for every procedure a Dr performs, for every doctor across the board, maybe the prices would not have been so high...I don't know. Maybe Canada's social healthcare system would work better? All I know is, having no insurance is SCARY.

I also don't place the blame on the Dr's. They're stuck in the middle of all this and this is the only way they can pay their bills. It's constant paperwork and crap for them too..it's no walk in the park. They're fighting for every penny, and we're fighting not to pay them. And THEN we sue the pants off them. No wonder we have such a hostile relationship with our health care system.

Have since tested into/got a civil service-type job with the State, and we're all insured now. Dental and vision too. Won't ever take it for granted, no sir.

[Aldo]

75.

I don't want to pay for some person's complications from drug and/or alcohol addiction... or any other vice. That is why I don't want government health care.

[anon for this]

76.

I live in a small country where the insurance is state run. You can also have supplemental insurance from private insurance companies.
The insurance costs are +/- 10% of your salary. For this you get all basic stuff free: hospital stay, medicine (but there is a restricted list on that), specialist care, gen.pract. visits, etc. A lot of of people complain here, but on the other hand, if this system doesn't exist, a LOT of people would have major problems paying for their medical bills.