Denied
December 10th, 2005We’ve been refused health insurance from the monopoly health care provider in our state. All three of us were refused. Irony 1: This same company who covered my successful cornea transplant in 1998 used this against me and declined coverage. Irony 2: Heather’s post-partum depression being successfully treated was used against her and she was denied. Irony 3: Leta’s two MRIs, which proved she was healthy have been used against her. Denied.
I feared this might happen when I left my day job. But none of us has diabetes. Or cancer. So I naively figured we’d pick up an individual plan at a higher rate than we paid from my previous employer. I figured it might be as high as double or double and a half the amount with a higher deductible. Oh how wrong I was. COBRA was five times what I paid. Five. Per month. We could buy a second home for that amount of money. And furnish it entirely with Sasquatch-related paraphernalia.
I believe the United States is on the brink of a health care something. I read this piece in the Kansas City Star by Paul Krugman (which ran in the New York Times) about how the free market doesn’t work with health care. I couldn’t have stated it better. The “free market” for health insurance is subsidized by tax dollars and is geared to delivering coverage to those who don’t need it most. Insurance companies apparently only insure the healthy. Or those who work for companies with more than 3 employees (and who offer a group plan for employees). They spend great amounts of money and energy weeding out the sick and needy. It’s sheer insanity. I can hear the conservatives cracking their knuckles to comment now. Save it. As a small business person recently self-employed, all the Hannity in the world isn’t going to fix this problem. It’s going to take creativity, genius and sacrifice from every side.
We qualified for a state “high-risk” plan (Irony 4: it’s managed by the same monopoly company that denied us coverage), but the premiums are about three car payments a month. Two if it’s a really nice car. And that is with an enormous deductible. Enormous.
I’ve read where Costco is doing a test of offering it’s members health insurance in certain parts of California which was started this past summer. Since every state has different laws, Costco can’t just roll out a plan for all their members. How crazy is it that a company with millions of private members, who are ripe for health care coverage can’t offer a simple plan across state borders? What if Wal-Mart or Target started offering customers health coverage? I think we’d see some interesting options arise, but I don’t think that is going to solve the crisis.
I’m a believer in universal health care. Especially if the rich pay more. If I make a million bucks a year, I should have a portion of that money go to those who need it more than me, just for the opportunity of making that kind of money. I’d gladly pay it. GLADLY. Whether that’s in the form of a tax or part of my national insurance or whatever you want to call it, it would be wonderful to know that if I didn’t need the coverage, someone who did would get the benefit. I’m afraid I’m in the minority.
The biggest issues facing universal health care in the United States seem to be the powerful insurance lobby (remember the scary ads from the insurance companies in the 90s when Clinton wanted to give a health card to everybody?), the failed notion that free markets and competition will keep prices low and the paranoia that universal health care will somehow be a huge step towards socialism/communism. Add to this the decreasing employer contributions to health care for employees and in the next 5 to 10 yearsof continued inflation of health care costs this country will be in serious shit. I believe that it’s time to put some brain power into solving this issue. There has to be a better way. Creativity, genius and sacrifice.
I plan on writing my local and federal representatives about this situation, but I don’t have a lot of faith that I’ll be heard above the insurance lobby. Individuals who need health care coverage have little recourse. If I’m part of a group, I have guaranteed coverage, but guaranteed at what cost?
So anybody have a great health care plan that takes cornea transplant recipients, depression survivors and very cute toddlers that doesn’t cost three cars a month?
December 11th, 2005 at 1:01 pm
Yes, health care companies are motherfuckers. I used to temp at one every summer.
I currently live in Germany, where everyone is required to have health insurance. Now that does not mean that the government pays for it all, because they don’t. Contrary to what some of my Republican friends think, Germany is not a socialist country. Now the government does subsidize it to keep costs down and does pay for its poorest citizens. That makes it more affordable. My German husband explained the importance of mandated subsidized health care to my Republican father. “Look, people who get sick and have no health insurance go to work and are not productive and get everyone else sick. If they had health insurance then think of all the working hours you could save.” Even my free market loving dad could not argue with that logic.
December 11th, 2005 at 1:38 pm
I’d like to address Elise’s point about Canadian healthcare.
“When I was still living in Canada, I paid the same monthly premium that I do with my current job (yes, there are health care premiums in Canada) plus my total taxation burden was 55% (income taxes + sales taxes). And it took weeks to book an appointment with my doctor, months to see a specialist etc”
Yes, we can pay premiums for drug plans and private hospital rooms etc. But basic healthcare–dr visits, hospitalizations, surgeries, Er visits, diagnostic tests etc. are all covered.
And I heard all about the horrific wait times etc on the news. But when my daughter’s tumour was found–at an ultrasound appointment that came one day after a well baby checkup–our specialist appointment was booked for 8 am the next day. The thing is, there are wait times. But it’s sort of like a neverending triage: Those who need to be seen first, are seen first. Regardless of their ability to pay. As a commited Socialist, I’m really down with that as a policy.
December 11th, 2005 at 3:40 pm
My husband and I have been in your shoes and it sucks. We both worked from home as consultant project managers for a couple of years.
Be careful picking up insurance coverage offered through different associations (NASE, NAFE, Artist Organizations, etcO. We often found ourselves completely unsure of what they were/weren’t going to cover until the bills came.
Finally, my husband took a part-time job at Whole Foods just to get medical insurance coverage (not sure if they still do the part-time coverage thing). Another perk of working there was the 20% discount on groceries. He was definetly pressed for time - but it really ended up being worth it.
Fortunately, I now have a fantastic employer who provides me with decent coverage with only a small contribution on my part.
Good Luck!!
December 11th, 2005 at 4:47 pm
All of the suggestions are good. NASE is slightly better than catastrophic coverage. Kristine is right when she says the coverage is not clear. My boyfriend has it for himself and his grown son (unemployed). They do not cover doctor’s office, but they do cover emergency room visits. So the kid goes to the emergency room rather than the dr. The costs are so much higher, but mostly covered. It’s a racket, but it’s coverage.
December 11th, 2005 at 5:09 pm
By law, COBRA can only be 2% higher than your company’s cost (to cover their admin costs). So when you say COBRA was 5x higher than what you paid before, you mean than what your contribution was, correct?
That’s the shitty thing about working. A lot of us work for the benefits. Employers pay a lot of money to cover employees. Even bad employers.
December 11th, 2005 at 6:51 pm
As an Australian, I have to say it has come as quite a shock to read your story and the comments above. We have universal health care here (medicare). We also have to option to have private insurance which covers all the other stuff like physio and high-cost dentistry. I pay AU$100 p/m for mine as it covers obstetrics, but my other half only pays AU$60 p/m. While some plans don’t cover pre-existing for new clients, people who already have cover can switch between different companies without too much trouble. Medicare here is funded by taxpayers. The levy is normally 1.5% of annual income (though low-income usually pay a reduced amount if any). High-income earners who don’t have private insurance also have to usually pay a surcharge of 1% in addition to the levy. This seems to work well… No one really complains about having to pay it.
I really hope you are able to get covered somewhere (that doesn’t cost 3 cars).
Good luck.
December 11th, 2005 at 8:05 pm
I do not have an insurance policy for you, but I am in your boat. Also: I am a HEALTH CARE PROVIDER who does not currently carry insurance because I’m self employed and etc. I don’t have a Leta, so it is less risky. I have spent a good amount of time writing letters. Thank you for this post. Please continue your campaign for access to health care. Sqeaky wheels, grease, etc.
December 11th, 2005 at 9:53 pm
I have a friend here in Colorado who is in breat cancer remission at this time. She and her family closed on a house in North Carolina, got new jobs, enrolled the kids in new schools, then made the call to change her address with the nation-wide insurance carrier. It turns out that BlueCross BlueShield actually does not cross state lines, and that she was uninsurable if she left the state of Colorado. So, they are now essentially being held prisoners in the state of Colorado by the Health Insurance industry. Start a revolution, Blurb!!
December 11th, 2005 at 10:36 pm
It comes down to: are we all in this together? Some things are bigger than any one person and it only makes sense that we all share the burden. If that’s socialism then so be it. Mind you that word doesn’t scare me the way it does 50% or so of your fellow citizens, I’m Canadian.
Good luck to you and your family, I’m sure you’ll work it all out.
December 12th, 2005 at 12:10 am
And this is exactly why I’m a socialist.
My insurance rates are out of the goddamned roof, because I had a congenital malrotation of the bowel that was not found until I was 15. I had surgery, it was fixed, I’ve had zero problems since then, but it’s a stain on my insurance record. Bah.
I hate this country. Seriously.
December 12th, 2005 at 1:24 am
I already knew it was flawed, but moving to Germany opened my eyes to the complete incompetency of our health system in the USA. I’m still wrapping my mind around the feeling of living in a country now that covers everyone, period. It is a basic human right, and it should be everywhere.
December 12th, 2005 at 1:26 am
K, so this may not work for you, but I was in your position, and it worked for me.
I got a part-time job at Starbucks. It’s easy work, and if you work more than 20 hours a week you get slammin’ benefits (plus all the free coffee you can drink.)
I really hope it works out for all of you.
December 12th, 2005 at 1:42 am
I’ll spare you my amazment and anger and political implications at your situation, mainly because they’re much the same as yours, only the’re not revolutionary here. I suddenly feel inmensely lucky to have been born in a country on which health services are automatically granted for everyone, employed or not. I just want to send you my love and my strenght and a lot of positive energy so you can cope with this situation.
Soon, the score will be Blurbodoocery 1 - Health insurance companies 0.
December 12th, 2005 at 3:14 am
I am a member of a health plan thru my company, however, over the last five years, my premiums have increased while covered services and prescription medications have decreased. The company sites that it is just to costly to keep paying what it used to pay for it’s employees coverage. But did we see the 4th floor execs taking a pay cut so their lower employees could have a decent amount of health coverage without selling a limb? Fuck. No.
December 12th, 2005 at 4:26 am
in my country health insurance is a freaking farce! i’m a documentary maker and i met with a little accident when i went in search of the perfect shot and did they cover my entire bill? NO! but the sucker that i am, i still pay my premium without fail. gaaaah!
December 12th, 2005 at 6:14 am
WOW. What a spot to be stuck in. That really sucks.
Being from the great white north, I couldn’t imagine not being able to simply walk in the emergency when I needed to. It’s beyond me how universal health care is not the norm world wide.
I hope you guys find a financially reasonable solution soon!!
December 12th, 2005 at 7:01 am
Wow, I had no idea healthcare costs so much in the US. Still, here in the UK we have the ‘free’ NHS??? Give me a break…we pay for it on top of our huge taxes and still have to pay for dentists, prescriptions, opticians etc etc….we might as well pay for it up front! It’s this kind of monopoly treatment that means people are wage slaves unable to break free and follow their dreams like you have, or they end up getting screwed afterward when they could be paying for 3 cars…
December 12th, 2005 at 7:59 am
I’m so sorry that you’re going through this hassle. Health Care should not be this difficult to obtain or afford. In reference to your statement:
“I’m a believer in universal health care. Especially if the rich pay more. If I make a million bucks a year, I should have a portion of that money go to those who need it more than me, just for the opportunity of making that kind of money. I’d gladly pay it. GLADLY.”
No doubt America has major problems when it comes to insuring it’s citizens and it is honorable that you would gladly pay more for universal healthcare if you were a millionaire. However, it should be a CHOICE to pay more. Not a requirement, or it IS a step toward communism/socialism. If people prefer a communist government - more power to ‘em. Just go live in a communist country.
December 12th, 2005 at 8:09 am
Amen, brother. I have been ranting about this situation for a long time.
I have health insurance through work (thank God), and my kids are both healthy (thank God), but nevertheless, I always feel two steps from disaster. And when cost of living raises are 3%, yet health insurance premiums are increasing 10% per year, well, you can do the math.
The healthcare situation in this country is an absolute mess. Here’s hoping that posts like this will help get the conversations started.
December 12th, 2005 at 8:17 am
This is giving me flashbacks to when my family was uninsured for only a few months in between jobs and I swear I gave myself an unlcer worrying about it so much. It still makes me sick thinking about what could have happened to us had one of us had a serious medical problem.
As far as a suggestion goes, I know someone mentioned insurance through an alumni program before. Where I went to school, their program is through GradMed - http://www.gradmed.com - and it looks like many school participate. I know it says short-term, but I think there are different plans of varying lengths and i may help until you find something more permanent.
Best of luck - we are sending good thoughts from the frozen tundra of the midwest.
December 12th, 2005 at 8:30 am
Taxes are not a choice. They are the law. The very notion of pooling resources so that the many pay for the few is in itself a communal ideology. The problem is that profit is involved with health. Profit does not care. Profit allows discrimination. Profit, when tied to health care is, as we can see, a disaster. Spare me the communist talk. We already participate in a veiled communal program with any insurance we buy.
December 12th, 2005 at 8:39 am
Oh, shoot. So sorry to hear, and I feel your pain from personal experience. I was self-employed, very early twenties, in San Diego when I got booted from my parents’ insurance policy. I tried to get individual insurance from one of those huge insurance companies, and I honestly filled out my application and included a bout of depression that happened in high school. I was denied coverage by not only this company, but a second major company I tried, and a week later I was in the emergency room being prepped for an emergency appendectomy. No insurance. The bill was $26,000. I made less than that in a year, and was struggling just to pay rent in S.D.
Long story short, when I got out of the hospital, I applied for another policy through the same company that provided my auto insurance (State Farm). And I “neglected to tell the whole truth” on my application, received coverage at a reasonable rate (about $100 a month) and kept it until I got a job with health benefits. I am not proud of not disclosing the information, but I had seen first-hand what happens when you tell the truth, and I needed coverage (mostly for an emergency event like a car crash or accident) no matter the moral cost. Tragic.
But in order to reduce the hospital bill I spent almost 2 years trying to prove my poverty to the hospital. Ironically, I made “too much” to qualitfy for aid programs. I considered claiming bankruptcy. Eventually the hospital lowered my bill, but the stress of fighting and worrying took it all out of me. In the end I moved from San Diego to Virginia to live with my parents until I could get straightened out. But I would say the insurance crisis definitely changed the path of my life.
Best of luck to you all. I find it horrible that people with enough balls to be self-employed, to strive for that old “American dream,” are the ones who can suffer the most at the hands of America’s f-ed up health care “system.”
December 12th, 2005 at 8:45 am
Not exactly, Jon … while profits are a problem with Health Care, the bigger issue is insurance and lawsuits. For a company to offer health care, the amount of insurance they must carry is staggering. This issue needs, as you said in your original post, some creativity and sacriface. Universal Health Care looks good on paper, but doesn’t offer you the level of care you can get in our current system. The problem with our current system is that is isn’t easily accessible to everyone.
This is a serious issue and needs to be approached with serious solutions … not with the Left citing that the Right is the problem and vice versa.
December 12th, 2005 at 9:30 am
The bigger issue is not lawsuits. that’s a talking point from the right. Bill Frist (amongst others) made that claim when sponsoring legislation. The reality is that lawsuits represent a drop in the bucket in health care costs.
This problem is very complex. You’ve touched on a single aspect, to be certain, but it’s gonna take more than reducing lawsuits. This could be the defining issue of our time, much like the New Deal. I don’t think the current powers that be possess the creativity or political will to tackle this head on. And that’s what it’s going to take. Millions of people standing up and saying something. Millions.
Maybe “Universal Care” isn’t the solution. But it’s a starting point. A goal, perhaps.
December 12th, 2005 at 9:37 am
Taxes are a choice. You have the choice to elect the people that decide what becomes a tax and what does not, as well as how those taxes are spent.
The notion of communal ideology says that the bureaucracy understands better than we do what our needs are and how to satisfy those needs, thus trampling the individual’s liberty whose needs don’t match up to those that the bureaucracy deemed more important. Don’t bring up arguments that this is already the case. I am all too familiar with our current welfare state. I just don’t want it to get any larger and robbing me of my ability to choose. In fact, I’d like to see it a hell of a lot smaller. If a tax neutral (i.e. cutting other programs - I won’t list my favorites here) program comes along, I’m all ears. My liberty is more important to me than any government program.
That being said, I still believe some type of universal health care is necessary. I just don’t know how to implement it without robbing people of their freedom.