Denied Again

Today we were notified by a different, out-of-state provider that they wouldn’t cover us. They cited the same things the local company did; my already treated “condition”, Heather’s post-partum depression and Leta’s plagiocephaly (her head is normal shaped now). Plagiocephaly is something that is red flagged until a child reaches the age of thirteen. Part of me feels that we are living in a combination Brave New World slash Gattaca world where we shouldn’t have conceived without consulting a geneticist first.

Thanks to everybody who commented and made recommendations. Our monthly premium will be nearly four figures on the state plan. This is with a $1,000 deductible with an out of pocket maximum of $3,000. I think we’ll probably end up doing the next scale up, which reduces the fees by almost a third and will be the $2,500 deductible and the $$6,000 out of pocket maximum. The good thing about the state plan is that it’s month-to-month, so if other options open up, we can bail.

I’m going to look into the Chamber of Commerce, small business associations, catastrophic only and other options that you’ve all mentioned and sent in. Thanks so much for all the suggestions. As we’ll be forming a business, I have a feeling that while we’ll be able to get insurance, the fees will be higher than the state plan. We’ll also probably do a health savings account or some kind of savings plan for health care. I had hoped that some of the money we made could go into a college fund for Leta, but that may have to wait awhile. I don’t say this for sympathy, I say it because I think we’re not alone. I think a lot of people are taking the money they’d use to do other things with and pay for health coverage.

If you live in a country besides the U.S. and have universal coverage, what is the cost? Does it work for you? Do the taxes kill you? Do you think the medical care you get is adequate? Excellent?

Here’s the freedom and peace of mind I think every person deserves: if one is sick or has a health-related problem, one finds the nearest or most favorite physician and makes an appointment or walks in and gets help. Every person alive deserves this. That we don’t live this way is hypocritical and inexcusable. We have the technology.

If you want the scary big picture, look at the charts (PowerPoint, but Keynote will open them) on this page (source: US National Center for Health Statistics). According to the charts, in 2003, $1.3 TRILLION dollars was spent on personal healthcare in the United States. That is 15% of GDP. Where does the money go? The biggest slices go to hospitals, physicians and “other”. I’d love to know what that other is. Prescription drugs and nursing homes get the rest.

How do we make a change? How many of us will it take? Where do we go and who do we talk to that will listen? Is it time to start petitions and marching? Protests? What do we want? What sacrifices will have to be made? How will universal care take away someone else’s freedom/liberty (fries)?

  • Janice

    Hey, I am from Canada. We pay about $100 a month for Alberta Health Care. (It varies by province) We just go to the doctor, and don’t even see the bill, ever. I have had nothing but amazing care, for myself and my family. Rural areas have a hard time finding a good family doctor, so that is a problem. All in all, I am very happy with the Canadian Health Care system. I hope it all works out for you and your family, that really sucks having to pay so much.

  • HANK

    Itís really quite unbelievable that universal health care is not accessible for all citizens. I understand the political ideology of a free market, but it still seems ridiculous. In Australia, health insurance is universal and taxpayers contribute 1.5% of their annual taxable income. The service covers all costs of everyday doctor, dentist visits, IVF treatments, optic health, x-rays, etc. But in some instances it only pays for a percentage of services, and you pay the remainder. In addition to government services, private healthcare exists which can costs a maximum of approx. $100-$160 a month (per individual), and provides similar services to the government, except quicker. For me personally, the universal coverage is excellent, but annual reports in our country always indicate people who require surgery or healthcare in hospitals are incredibly disadvantaged, because of waiting lists. One instance exists where a boyís skull was removed and because they couldn’t operate on him until a few weeks later, he had to live in a motorcycle helmet to protect his brain. So universal healthcare is good for me, bad for him, but its healthcare for everyone. Come Down Under, weíll take care of ya.

  • Martha

    New Zealand has pretty much state funded healthcare. We still pay about $50 for a doctors visit, dental is only subsidised for children, but most big things are free – maternity services etc. People do still die on waiting lists for major operations like heart. For this reason we decided to get my husband health insurance as he isn’t the healthiest speciman. He got turned down flat, but looking at his history I can see why.

  • sgazzetti

    All the time I lived in the U.S. I never had adequate, or usually any, health care coverage. I just hoped and felt eternally precarious. Now I live in Slovenia, where health care is universal. I am self-employed and my resident visa requires that I have coverage. I’m insured through an international agency on a policy valid anywhere outside of the U.S. and Canada. I don’t trust it and have never made a claim — I have it for the catastrophe scenario, and to satisfy the visa people. The beauty of Europe is that if you don’t have the national coverage and have to pay for a doctor visit, you can actually afford to do so. I had an emergency appendectomy, spent three nights in the hospital, and it came to about $500 (less than my deductible). Try that in the U.S. I never bother to file a claim because I figure the bloodsuckers will just find some pretext to deny it and then cancel my policy for having a ‘condition’. It’s cheaper and easier here to just visit the doctors and pay them the reasonable fees, with no insurance interference whatsoever. Okay, you wait a little longer and put up with some red tape, but it WORKS — people can actually do it. Your tales of woe confirm what I always suspect, fear, and loathe about insurance. How to fix the problem at home? A damn good question…

  • John

    I don’t understand the whole insurance thing at all. I’m 21 and in my last year of college, so I’m still able to be under either my mother or father’s plan. However, next semester, I don’t need a lot of credits to graduate. I was immediately threatened with losing my insurance AND some school benefits. I had to pick up a bunch of random 1 credit courses in order to keep a bunch of stuff. As a part time student, I would have ended up paying more out of pocket than as a full time student. Crazy. We just got the insurance thing hammered out, thankfully. But seriously…it is things like this that make me want to get the hell out of this country. They will milk me of all my money, then peace out. I wish you the best of luck in this process. I can only imagine the hell it is for you.

  • Michelle

    I agree with HANK, the Australian system is pretty excellent. The only health insurance I pay is for extras (major dental, physio, optical frames/lenses etc) and it comes to about $14 a fortnight. My last visit to the dentist was only $40 and GP visits are under $30 and once you/your family spend a certain amount a year they’re free. Even my most recent spate of 10 optometrist visit only cost me a total of $100. Emergency room visits are free (but often abused by cheapscates or people who find it hard to get into a GP). Unfortunately there are less and less GP in full-time practice which is making it harder here to get an appointment unless you’re already on a clinics books. Sure waiting lists are long for some operations but doing the maths the number of months you’d have to wait vs the cost of hospital insurance for the same period your better of waiting. The amount of tax we pay in comparison to what we get is reasonable (other than health we get decent unemployment benefits, reasonable schools etc.)…. and then there’s subsidised prescription medication. The US system just doesn’t make sense to me.

    Anyways best of luck to you all

  • Catherine

    Here in the UK the universal health care – free at the point of need – is paid for out of the pot of money raised through taxes and ‘national insurance’, and no, the taxes don’t kill anyone.

    Some people pay for health insurance and private health care.

    The national health service is not perfect, but is getting better and has served me well. I have difficulty believing the state of things over there.

  • Walking Contradiction

    At least you saw it coming when you quit your day job. Now, you just have to keep searching, and searching, and searching. You WILL find something reasonable eventually! Until then, wrap your house in saran wrap and bubble paper, and hope for the best………

  • Walking Contradiction

    OR move to Canada.

  • HANK

    Or, so it seems, any other Commonwealth country.

  • Daniele

    Hi! I’m from France. “State” (“State” is to be understood here as “Federal” would be in the US) health insurance works like this : any body who works contributes in two ways. 1. A portion of one’s income tax goes towards health insurance; its hard to say how much exactly, but some of the money filters through to the health system or “Social Security” as its called. 2. Either your employer or yourself – if you’re self employed – pays a direct contribution to the state as a percentage of the worker’s income. This is where the bulk of the health insurance’s cash comes from. An employer may pay up to 33% of an employee’s salary directly to the state as a contribution to health, retirement and family allowance plans. The same goes for someone who is self employed (give some take some, it would be too long to go into all the details here), except for there is a catch : you start paying even before you’ve earn’t a cent! As in the US, its easier NOT being self employed. One thing though, I believe anyone can subscribe to the state health insurance system, providing they pay for it. I have no idea how much that would cost, but have a feeling it would be a handsome amount. Last but not least, in France there is a thing called “Universal Health Coverage” whic basically entitles any human being, French or not, tax payer or not, to health care in the country.

  • megan

    I’m in Germany, but from California so the change of system has been confusing for me. When I was covering myself I paid 125 euros a month on a foriegn student plan. That covered everything though: vision, dental, and physical therapy when I hurt my neck.

    Now I’m working and a larger chunk comes out of my paycheck towards health care. I pay 225 – 250 euros/month and I’m better covered than I ever was in the US and when/if hospitalized I have my choice of physician and a private room. Part of what I pay covers those who can’t pay. It took getting used to but makes perfect sense.

    I checked into what would happen if I ever moved back to the US and I’ll keep my German coverage, it will still cover me better abroad than a US provider.

    Health care is a basic human right, goverments are obligated to provide coverage for their citizens. What’s happening to you is flat out wrong.

  • minxlj

    Here in the UK things are way, way worse than people like to admit, but not a day goes by without the newspapers slamming our NHS. We pay for it with our taxes, and additional ‘National Insurance’ (6% on top of our taxes too). This is ‘free’ healthcare, yet we have the biggest problem of MRSA in Europe (probably the world) cos our hospitals aren’t as clean as they should be, there are constant reports of people lying in beds shoved in corridors in hospitals (cos there isn’t enough room), and we don’t have the option to opt out of this. If I could, I would stop paying my NHS costs and pay for private healthcare, but I can’t opt out of it so I’d be paying twice. We already have to pay for
    Don’t get me wrong, the NHS served me well when I was a child with chronic asthma, and I’ve definitely spent more time in hospital than most people. But our health service is in desperate need of rehabilitation, and the whole country knows it.

  • Kristina

    Hey, I’ve been reading your blog for ages, but never commented so far. I live in Germany (and happen to be a medical student) and we have universal healthcare here. It’s said to be expensive and insufficient, but for me it has worked fine, especially compared to the situation in the US. I was shocked to read all those comments of inadequatly insured people, I had no idea the situation is in fact THAT bad (especially if you hear your professors praising US medicine every single day – well, the US might have the best research and ultramodern treatments, but as it looks it’s not accessible to most of the people). I was also shocked to read that maternity and pregnancy costs don’t seem to be covered by a lot of insurances, does that mean you have to actually pay to deliver your child in a hospital?!

    Over here most people (up to 90 %) have compulsory health insurance with fees around 12 – 16 % of your income. Your employer will pay the other half. People who earn more than a certain yearly amount might as well leave compulsory health insurance and get private insurance, which offers more (single rooms in hospitals, head physician treatment etc.). Your healthcare insurance will pay for almost every treatment you need (including physio, surgery, dental work if you have made yearly preventive checkups, rehabilitation, …). Only recently deductibles have been introduced: 10 Euro (= $ 12) per GP visit per quarter of the year, 10 Euro per specialist visit if you haven’t seen your GP first, 10 Euro per day in hospital (for a maximum of 28 days), plus deductibles for up to 10 Euro for medication. However, the maximum amount you have to spend on deductibles is fixed to 2 % of your yearly income (1 % if you suffer from a chronic condition such as diabetes). I expect the dedubtible rate to rise a bit in the near future, as this was only the “introductory rate” to make people feel comfortable with it. But it’s still nothing compared to the US. For children it’s again completely different, they get almost everything for free and are normally covered by family insurance.

    You have free choice of your doctor, free choice of hospital, … There are no real waiting lists like in the UK. You might have to wait for 1 or 2 months (this depends on the hospital) to get elective surgery, such as for example hip joint replacements. But if you need to have heart sugery NOW, you will get heart surgery NOW. People complain a lot about the healthcare system, and surely there are still a lot of inefficiencies which have to be reformed. But on the whole I’m content with what we have here.

    I really hope that you can find a solution to your insurance problems!

  • Maria

    Again, all my love and support and best wishes to you both ant to your lovely little frog.

    I’m writing from Spain. I’m a freelance as you, and I pay 28% of my declared income to a National Health Fund called the National Security (Seguridad Social). Because I’m under 30, and a female (female unemployment is much higher than male, so we have benefits like this) I qualify for a 25% reduction in my fee. Still, it’s 175 euro (about 200 dollars?) /month. That covers both the health insurance and a retirement benefit. Were I not a freelance, it would also cover unemployment benefits.

    As long as the health insurance is concerned, the National Health Fund covers almost everything. Primary care, childbirth, pediatricians, minor and major surgery.. Also mental health, but only the really serious cases and mainly as outpatients. Dental health, speech therapy, etc. are not included.

    Medications are free for the elderly (independently of their income, why? because they’re a big share of the population, i.e. of potential voters) but everybody benefits from a discount on the price of meds. This is a huge expense for the National Health Fund and thus for the State (in the same sense as French “State”), so thy’re turning now to generics.

    If you’re unemployed or a foreinger (which means you don’t pay Social Security Fees) you are also entitled to healthcare. It is a fundamental right and the Spanish society recognizes it as such. If you have have your insurance complany pay for it.
    The system is socially fair, but overwhelmed and badly managed- it takes couple of hours to be seen by a family doctor, and a couple of months to be seen by an specialist and to have a blood test taken, even longer to undergo surgery. Unless it’s an emergencyt, of course. When I go to the gyno, I make an appointment for the next year.

    Politics always say the’re committed to manage better the health system and are always very demagogic on this point (I mean, they make big unrealistic promises and take no steps to fulfill them) because they know that we Spaniards are VERY sensitive on this issue. Any political party proposing to cut the services of the National Health Fund or to privatise the health system entirely is bound to disaster.

    Of course, the universal healthcare system is not covered only by the benefits payed by the employees. So what? That’s what taxes are for!

    You’re welcome to Spain. Any time.

  • Mena

    I wouldn’t want to live anywhere but Australia. I am a full time occupational therapy student (Go Leta!) and I make regular use of services for which I don’t have to pay a cent for – other than my tax contribution.

    In the past week I have seen a doctor of my choice (free) and within a day of making an apointment (yay), had blood tests (ew! but free!), and saw a cognitive behavioral therapist. The latter I do pay for but I get a 50% student discount and I go because I need it. One hour of therapy costs $50 AUD which I feel is very reasonable. As a low income earner I pay less than $5 AUD for my antidepressants.

    Our public health system has been under considerable scrutiny recently. I have worked in paediatric occuaptional therapy settings and the waiting lists there were astronomical for public OT services. I’m talking in excess of six-months. Many parents end up resorting to paying for private therapy as six months if far too long for any child to have to wait. Not when their social, emotional and physical development is at stake.

    One question. When will the producers of cigarettes, alcohol and industrial pollutants start to foot the bill for their contribution to widespread ill health? The Phillip Morris Lung Cancer Institute?

    I hope it all works out!

  • Zak

    Another Canadian here. Toronto. The Canadian system is not without its problems. Here in Toronto the big one is generally waiting time if you need an MRI or something like that. Emergency services are fine though. And we never see a bill from the hospital other than for phone and tv rentals. Just over a year ago I was on vacation in the US and suffered a kidney stone attack. I ended up spending 5 hours in an albeit excellent facility in Phoenix. Those 5 hours consisted of 2 scans (done at the same time), 2 doeses of a painkiller with IV fluids, a doctor looking at me twice and a bed in the emergency room. Total cost: $4500 US. Thankfully my wife’s health plan through work is excellent and covered the entire thing. The same treatment at home (an earlier attack) may have cost the same, but the only thing I paid for was parking across the street.

    Many people say that the taxes in Canada are much higher (maybe a bit), but the additional services we get, especially if you require health coverage is worth it.

    Toronto would love the blurbdoocery.

  • Julia

    Your health care system still amazes me… no matter what, I just can’t seem to be able to get over it 😛 I live in Scandinavia, taxes are insane, but I’m basically used to it (even I do keep complaining about them all the time :P). I know it’s very unlike that I ever will become a millionare, not with these taxes, but I hope to survive after all. And since I’m in the middle of getting my free double master’s degree (thanks to our school system), I probably should just shut the fuck up and stop complaining.

    We also have a decent public health care system, which works pretty nicely most of the time. I believe it cost about 8 USD or so to see the doctor or then you can decide to pay 20 USD in a year. 20 bugs give you a freedom to visit the doctor every day all year round for free.

    This system only gets pretty ugly if you will get an injury which would require a minor surgery… the lines are huge and not so accute cases have to wait for a very long time.

    That is the main reason why I also have a private accident health insurance (which costs me about 40 USD in a year), which is only covering the “accidents”. I trust the “normal” doctors in normal flu cases, but when I will kill my leg, I definitely want to walk to the best orthopaedist right away for free. Thanks to my horrible knee genes, my insurance company has already paid me two knee scoopings in the last five years and as far as I know, they don’t seem to have any problems with it or me.

    I guess overall this system (public helth care system and high taxes) we use is pretty nice for poor and middle class people, rich are the ones who hate it 😛 I guess after all basically the rich people are the ones paying everything and keeping this system alive.

  • Jany

    I’m living in Switzerland: The health insurance system becomes quite an expensive problem here. There an obligatory basic health insurance, whose rates rise actually every year. YOu can try to save some monthly money by either changing health insurance provider every year by comparing the rates for the basic, or rise your “out-of-the-pocket”-part. The basic coverage is sufficient, but if you want extras, you have to conclude extra insurances and, of course, pay for it, as for dental treatments, natural and homeopathic medicine, international coverage, etc.
    For middle and low incomes the health insurance is a big problem, for families too, so the social services pay part of their health insurance.
    The government wants hospitals and medecins to work more efficient and to take more care of the budget, but this, experience made, doesn’t work all the times. For example, i’ve been to the urgencies of my local hospital once, they examined me during four hours. Then, i got one invoice, and another, and another, totally five invoices from the same hospital, but different services ! Quite disgusting! Five enveloppes, five, stamps, maybe five different accounting departments in the same building ? And they want us to pay more every year for such a service, an hospital who is lucky to be state owned, because on the private market it wouldn’t survive practising like this…

  • LeafGirl77

    I’m Canadian, and although I’m currently in northern Ontario, I’ve spent the majority of my life in southern Ontario, near Guelph.

    I feel like a bit of a git, because I don’t really know how to answer this question. All I know is that at my last job, the taxes that came off my pay cheque were around 20%. I assume some of this goes to health care. I know that as ones pay cheque increases, so do the taxes. My stepmom pays 35-40% I think.

    While regular visits to the doc (gyno, sicko, etc) are all covered, vision and dentist visits are not. Also, as someone else mentioned, MRIs take a while. I waited 8 months in 1999 for one, and that was the short wait. BUT, because I got a referral from my campus doctor (I was doing my undergrad at the time), it didn’t cost me any out of pocket cash.

    It was suggested recently that every time we go to the doctor, they hand us a sheet of paper letting us know how much the cost would have been without coverage. I truly think they should do that so we know how good we’ve got it.

    I firmly believe that if I need to go to the doctor, I can go; regardless of if I have sufficient money in my pocket. I’m a little concerned about the two tier health care being proposed for Alberta, but I don’t live there so I don’t get a say. I don’t like the idea that people with money get better care than those that don’t. I guess I’m a bit of an idealist, but that’s where I stand right now.

  • LeafGirl77

    Oh yeah….

    And prescriptions are not covered. For that, you do need some kind of insurance. I was fortunate enough to buy into my school’s plan for $124 for the year (presciptions, massage therapy, physio, orthotics…)

  • megan

    This makes me think of a friend in college in California who’d had a heart transplant when he was 16 and was heavily dependant on his meds to keep his body from rejecting the organ. He’d joke that his parents’ health insurance company had a contract out on him to end the huge bills they were covering.

    when he wasn’t joking he would wonder what would happen to him when he turned 24 and no one would cover him.

    They saved his life at 16 and wanted to wash their hands of him eight years later.

  • Ang

    An unbelieveable amount of the money that goes to “hospitals, physicians, and other” is going toward their respective malpractice insurance. For example: Many hopsitals do not employ anesthesiologists, but contract a private group…because something around half of what an anesthesiologist charges is going straight to their malpractice insurance. Hosptials cannot afford the increase in coverage.
    Having worked in a VA hospital (the closest thing to government healthcare in the US) I realized that it is impossible for a gov’t hospital to break even, let alone turn a profit. Our health care system is ridiculous; health care with a physician of your choice in a reasonable time frame at a feasible price should be a right…but the number of things that will need to change are enourmous.

  • April

    I live in Canada so I don’t pay for health insurance. I can’t imagine having to pay for hospital and doctor’s visits. Some people say that our health care system isn’t as good since we get it for free but I have never had anything but excellent care from doctors and hospitals anytime I’ve had to go to them.
    I’m covered by student health insurance until I finish university. Its about 200 dollars a year but it covers everything and I only end up paying 10% of my prescription prices.
    I hope you guys have better luck with your health care dilemma. Health care is a right, not a privilege.

  • Elise

    For some non-anecdotal information regarding health care in Canada, quality of services etc, I refer you to the Canadian Institute for Health Information, a private, not-for-profit organization whose mission is to collect and analyze information regarding health care in Canada:

    Within the site, there is a link to “Reports” and a ton of information, much more than can be summmarized in a quick post. To start, I recommend “Health Care in Canada 2005”

    I don’t have a link, but there was a Supreme Court of Canada ruling this year that found the wait times and unequal access to health care in Canada constituted a violation of basic human rights. The case was regarding whether the Canadian system, which does not allow any private health care providers (a two tier system) violates constitutional rights of Canadian citizens. The ruling is believed to be the first chip in the foundation of the single tier, equal access Canadian system by making it possible for people to pay directly for health services from private doctors, clinics and hospitals.

    Incidentally, a two-tier system has been in existence in Quebec for years, much to the chagrin of the rest of Canada. My experience having serious health problems while living in Montreal in 1997 was mixed. Going through the government paid health services was very HMO-like, no choice and long waits. I had blood drawn and didn’t get any results back for 4 weeks, that’s how long the back-log was at the government run lab. When I finally did get to see a specialist, it was only because we had an on-site doctor at my company who called his gastroenterologist friend when I fainted at work one day and was able to get me an appointment in three weeks (the standard wait to see a GI was 6 months at that time). But I got my diagnosis and didn’t have to declare bankruptcy along the way.

    Good luck with your research.

  • TB

    It is absolutely time for protests and petitiions. Unfortunately, in the US, there are too many people who have been lulled into to complacency and are content with the shitty HMO bones their big corporate employers throw at them.
    The health care situation in tbe US is deplorable. I wish there were an easy answer, for you and so many others. People are dying because of insurance lobbies and lack of governmental support.

  • Karen Rani

    All my fellow Canadians are right – the system here isn’t perfect but we never see a bill, aside from the occassional ambulance trip ($45 or so) and phone usage.
    When I had my oldest, our work benefits covered what the province didn’t and I had a swanky private room. When the Troll Baby was born however, we were 1 month away from benefits at hubby’s new job and so I had to share a room with 3 other moms and their babies. I still recieved excellent care, ate pretty well, and the nurses took the baby for 5 hours so I could really sleep after labouring.
    I sure hope you get coverage that is cheaper – that is a ton of money to have to shell out every month. Not to be ignorant (but I don’t know) – is it not better to sock that money away every month in case of emergency rather than give it to a company, never to be seen again unless something comes up?

  • Chuky

    This is all so depressing. My husband and I are moving to Utah in the Spring (from LA) and i am officially worried about our healthcare now.

    We have a history of problems getting coverage. I once took Accutane, and now according to Blue Cross, I am a risk for plastic surgery. My husband had mild arthritis (not rhuematoid) in his knee that he sought treatment for (ie. big Advil pills) while he was training for the Olympic trials. Now we are both marked as risks.

    We were denied coverage by a couple of plans, and now in order to have coverage, we pay a 50% increase in premium on a plan that is essentially useless to us.

    I would love it if you could let us know what you find out, since we are basically in the same boat – we own a small studio, and are going to have to buy our own coverage.

  • Charles R. Kaiser


    I moved to Canada in 1993 when I got married. If I hadn’t, I would be dead now (and if not dead, certainly BROKE!). There is no way that I would have been able to afford to pay for the medical care that I needed in 1998 in the United States.

    Here in Canada we have universal health coverage. The best explanation of our coverage that I could find online is located at

    Sure, sometimes we have long waits for certain things. I had a long wait for an MRI once, and it was scary, but I don’t have to worry about going bankrupt to stay alive! Our taxes are a bit on the high side, but my standard of living doesn’t seem to b much lower here than it did when I was living in the States, AND when I travel outside of North America I can proudly say that I am a Canadian now!

    George W. Bush *IS* the Anti-Christ you know!

  • Alison

    I live in the UK, but got interested in US healthcare system after my mum spent some time in intensive care in the States 3 months ago.

    Having experienced the NHS all my life, money aside you do get a better standard of care in the States. Patients (and their relatives, since my mum was unconscious for several days), are treated like customers. Each injection, procedure, that happened to mum, right from the ER, was explained to me in great detail. Why it was happening, what it was etc. In the UK, you don’t get this communication.

    In the States, doctors tend to paint the picture what is on their minds, in the case of mum it was suspected meningitis. In the UK, the doctors would tell you, ‘we don’t know, we are running some tests’. This was a culture shock for me. I suspect as being a more direct participant in paying for your care, through private means, you

    All the above said, money has to come into the equation. I live in a country were not a second thought is given as to: will I be able to access treatment? In the States I was acutely aware: what would happen if no insurance? As soon as mum was admitted, the insurance question came up, and whilst I was able to answer ‘yes she is covered’, I wondered what would have happened if not. Would she have been thrown out in an unconscious state?

    When mum was discharged, I nearly had a heart attack when charged the equiv of 400 quid for medication at the pharmacy. (Later claimed from the insurance co, but thoughts ran away with me if I didn’t have the money upfront). The maximum we pay in the UK for any item is £6.40, and we complain that is expensive.

    In the US you get more tests too. Cost is at the heart of the NHS, and you don’t get tested for everything under the sun. You generally are under one consultant for a hospital admission, in the States you are seen by several.

    The downside of UK stuff is waiting lists. I’ve now been waiting 9 months for a hospital outpatient appointment, and no chance of one coming soon. Operation waiting lists, sometimes go on for a couple of years.

    I’ve also used hospitals in France and Italy (emergencies). Casualty / ER departments appeared devoid of people, thus suggesting a more efficient system. Indeed the media plays on this, when it comes to shipping NHS patients elsewhere in Europe, to get their operation.

    The NHS for all its faults, I wouldn’t be without universal free health care.

  • Mar

    I totally hear you. As a family of 4, I pay over $1,200 a month for private insurance. How ridiculous is that? My husband and I are both self employed (separately). We have no pre-existing conditions. There are 2 legitimate health insurers in our state that issue private policies. We make too much to have our kids covered by the state policy for low income children, but not enough to actually pay for our premiums. We are unable to get ahead at all for our kids college funds, for retirement, for needed repairs/improvements to our house, all because I am afraid of something happening to one of us.

    It’s criminal, really.

  • Shelli

    (An aside, I find it fascinating how many people that read you are from such a wide variety of countries. It is so cool!)

    I just saw on TV last night that Peter Jennings was working on a documentary when he died and they are going to be airing it. It is about the health insurance crisis in the United States. You can find a link to it here: I intend to watch it. I thought you would find it interesting as well.

  • Steph

    I can completely relate to the health care frustration. My son was born with Spina Bifida and has to rely on catheters to empty his bladder. We are small business owners and have had our share of insurance woes and making sure that he and our other children are covered.

    I think forming a business and establishing health care coverage that way is the way to go, but it’s also frustrating since you won’t be able to save and set a little money aside that easily.

  • Melanie

    For the first 13 months of our marriage my husband and I were without health insurance here in Utah. Blue Cross turned us down for my husband’s asthma/allergies and my use of anti-anxiety medication. We ended up getting catastrophic insurance until I started a 30 hr/week job at the U of U (30 hours is considered full time at the U and all FT positions are benefited). We are students but the student health insurance is like $400 a month for both of us which is something we cannot afford. It IS scary to live in this country without insurance, during that year without it I was constantly petrified that one of us would come down with something that the catastrophic insurance would cover. Thank goodness the disk in my lower spine chose to freak out *after* I started my University job.

    I have a Canadian friend who said that I would’ve waited months to get an MRI in Canada, which is ridiculous since I could neither work nor walk before my surgery (which was scheduled a mere week here in the US after my initial injury). This same Canadian friend was extremely sick for months while living in Canada and they couldn’t figure out what was wrong with him because he needed an endoscopy (which he was on a waiting list for, of course). He ended up going to the US for treatment of an esophogeal ulcer (sp?). Still, he claims he would take Canada’s health care system over ours because it’s more affordable in most cases.

    When I lived in Idaho, my neighbor was a Canadian-born orthpedic surgeon who told me that the waiting lists and doctor shortages in Canada can be attributed to the fact that doctors in the US earn what he called a “decent wage” for the work they do (I see the doctors in the US being *overpaid*, especially the specialists, but this doc claimed that MD’s in the US pay more for schooling, sometimes up to 300,000 if you’re a heart surgeon or something). He moved to the US for the money, basically, which is sad because it sounds like they need him up there.

  • Stacey K.

    Jon, we can start here. We can start now. We have two years. I believe enough is enough. You should not have to make a choice between whether or not Leta has medical coverage or goes to college. It used to be in this nation that parents strived to give their children opportunites that they themselves didn’t have. Going backwards cannot be an acceptable direction.

    Join me in my focus for the 2008 election. NATIONAL HEALTHCARE. PERIOD. I will not be deterred by the war (though wounded and traumatized veterans will benefit under a single payer system far better thant the LIMITED VA benefits they have now). I will not be deterred by gay marriage, the economy or the price of gas. My single focus will be NATIONAL HEALTHCARE and I am starting right now by writing to my elected officals, the DNC and RNC and I’m giving them a “heads up”. I am about to become a major pain in the ass. I want to see written documentation of every elected officals “healthcare policy”. I will not accept an email “blurb”. I will bombard inboxes with my requests. If an individual declares candidacy, I want to see, in writing, their healthcare policy or the policy they support. Join me in becoming relentless.

    Democracy only works if we work at it. Think of what we could accomplish if those of us who agree that the time has come for national healthcare spent just 1 hour a week staying on top of the issues, and sending out e-mail. Create an e-mail address just for this issue and get to when you can. If we pull together we can a least feel we participated in trying to achieve a fundamental right, where literally, lives are at stake.

    Join me. Please.

    This link will take you to a healthcare consulting firm which provided an abundance of information for the 2004 election – sole issue, HEALTHCARE. It is a lot to read, so make some coffee:

    Here is the link to Physicians for a National Healthcare Program:

    Here is the link to find out how the elected officals in every state vote on the issues:

    Here is the e-mail address of every elected senator:

    Click here to contact your congressman:

    The DNC:

    The RNC:

    Sorry if I’m coming off preachy.

  • Mars

    I live in Texas and I have been reading your blog and Dooce for a while now (love ’em, by the way). Hearing about your current situation prompted me to call my insurance agent hubby this morning and ask, “Is this true?” I knew my Dad had to get insurance through our state high-risk pool after battling colong cancer, but I didn’t a child would be turned down for something as minor and common as plagiocephaly. Boy, am I naive. My suggestion to you is to get an insurance agent to help you out by “shopping” around to get you the best deal for your family. My hubby just helped our self-employed friend reduce his rates for his family by half. It takes some tenacity and creativity, but it can be done. Good luck to you! My thoughts are with you.

  • Leta

    Jon, to answer your question at the end of this post, yes, it is the perfect time to start marching and gathering petition signatures and writing letters. Why? Because it’s an open field on both sides for the 2008 election. This is a long enough time for a politician to compose a coherent strategy, and a long enough time to have a real impact. Less than 1/3 of Americans have adequate, private insurance. Of these, lord only knows how many are trapped in corporate hell just to keep their bennies.
    (My incredibly talented husband has always dreamed of starting his own business, but it scares me too much- my dad was self employed and I spent my entire childhood uninsured. The health care crisis, among other things, is squashing the entrepenurial American spirit.)
    The fact is, the government is already the country’s largest insurerer- 120 million people are covered by Medicare, Medicaid, and government employee insurance. Virtually the entire 5% of high-cost patients are already covered by Medicare, so it would cost LESS than most people think to extend coverage to everybody.
    Especially if the debate is framed as “What do folks want more, universal health care or the Iraq war?”, imagine all the good squeaky wheels could do.
    If the rights to “life, liberty and the pursuit of happiness” were outlined in the Constitution rather than the Declaration of Independence, would health care then be a right?
    We can make this THE issue in ’08 if we get it together, kids…what’s stopping us?

  • Christine

    I totally feel for you on the HI front. We own a small business in NY and pay $650 a month for $1000 deductible, $3000 out of pocket for 2 of us. Now with one on the way, our premimum per month will go up to close to $800 a month. That’s more than our mortgage, and we have a 2 year old house! Health care is crazy in this country and we’ve pondered moving to Canada.

    Good luck.

  • Anne

    Wow. You can chalk me up as one of those people who has never had a problem with insurance coverage. I hear and read the stories, but it’s still really difficult to relate. I have no answers. I AM starting to not take my health insurance for granted, though, as I’ve done in the past. I feel incredibly blessed to rarely pay anything for doctor’s visits (sometimes a $15 co-pay), pay nada for giving birth and have a $10 co-pay for prescriptions. We’ve used the ER a couple of times and that was $75. What do we pay a month? I’m looking at my husband’s pay stub and we pay $163 a month (if I’m figuring this right) for our medical premium.

    Man. I hope The Hubs never quits his day job.

  • Coelecanth

    Canadian too. It’s possible that someone has already mentioned this, but hey, I’m at work, shouldn’t even be taking this time. :) Only the provinces of Alberta and British Columbia have health care payments over and above taxes.

    Are the taxes killing me? Nope. But then I’ve never lived outside of this system. I don’t have a good sense of how much a bite your government takes. To an outsider it might feel like robbery, I just can’t tell.

    The service varies. When I had heart irregularities it took 6 months to get the proper test. I was under 40 so they didn’t take it seriously. Mind you the condition went away before the test so they could have been right. When I busted up my arm it took 3 days to get into surgery. That felt reasonably speedy. I wasn’t bleeding to death or anything.

    Basic doctoring is really hit or miss. I’ve never found a GP that I liked so I’m stuck going to Medi-centers. The doctors there are by and large recent immigrants and the newly minted who’ve yet to get their own practice. It’s quick, just walk in and wait 1/2 hour or so, but the quality varies.

    This province is actively trying to privatize health care. 10,000 people came out to protest the bill that was the first step in this privatization scheme and our beloved provincal legislature did it anyway. Not good. All in all, I’m reasonably happy with my healthcare situation, but it’s getting worse. One by one the provincal government is taking away coverage. Anything dental, eye exams or ambulance rides, all come directly out of pocket unless you have blue cross or the like.

  • Maria

    I’m reading all these comments and all I can think is: How come that the world’s first economy cannot (or will not) take care of their own citizens’ health?? It is not easy to understand.

    Jon: I believe it’s very positive that you brought this up- so many people sympathise with you, and so many of them are on the same boat that maybe from this point many of your readers wil regard healthcare not only personal drama (which it is) to a social problem, nationwide.

  • Creatrix

    One correction: here in Canada, all health care insurance is *not* free. It depends on the province you live in. It’s free in Ontario, but here in BC we pay $96 per person per month. The government is promising to cut long waiting times, because people are literally dying while waiting for some surgeries. And in many places it’s impossible to find a doctor, so people use walk-in clinics (open only certain hours) or the emergency room (where you have a 6-hour wait on average). I still think it’s a better system, because there’s enough of a public uproar happening that changes are being made.

  • lautura

    in some ways the system is already as you mention – the rich are paying more. i am a paramedic in an urban system and i would say the vast majority of people that i see on an ambulance are people that are either already supported by the government (through medicaid or medicare) or people who don’t have insurance and have no way to pay (or plan to do so) – the homeless. these people don’t see a doctor, they don’t get regular preventive care, so they use the ambulance as a taxi and the emergency department as their doctor’s office. those costs need to be offset somewhere. the hospitals lose millions and millions of dollars on people like this. our legal system does not afford us the opportunity to refuse someone who wants to go to the hospital because they have a blister on their foot. if they have a complaint, we have to take them.

    to a large extent, the disaster that is our health care system is linked closely with the disaster that is our legal system. for starters, doctors get paid a huge amount of money, but also get a huge amount of money taken out of their salary to pay malpractice insurance (funny, yes, it’s the insurance company that wins on this yet again). people can sue medical professionals for the smallest thing. while i agree that there are cases where egregious errors have been made and there should be some action taken, it’s not the norm as far as lawsuits go.

    so the people who do have insurance do pay more. that said, there is still something wrong with that system as the insurance companies are in the business to make money. that’s what insurance is all about. you have insurance on your car _in case_ you will happen to get into an accident. your rates go up if you have a record of getting into frequent crashes. why? because the insurance company has a much higher chance of having to pay out of you, and therefore will not make the money it wants to off you. same thing with health insurance, especially with tricky aspects like depression. if you have already been diagnosed with depression, the health insurance company realizes it’s a life-long illness that needs money to be medicated, they won’t want to touch you with a barge pole. in their mind, it’s really no different to diabetes.

    i lived in the uk for several years and was exposed to the nhs. i can’t say that it’s the answer – there is a reason why more and more people there are getting private insurance…because the nhs has many severe flaws to it, just like our own system. it’s great if you just need your average checkup, but like in canada, if something serious goes wrong, the system may not be what you need. regardless, that is a whole separate discussion that i could launch into – what is wrong with the nhs.

    obviously this is a subject close to my heart (especially when i take those sort of people to the hospital that have a blister on their foot) – if you want more information, let me know.

  • Ms Sisyphus

    Another happy Canadian here to sing the praises of our system.

    “If you live in a country besides the U.S. and have universal coverage, what is the cost? Does it work for you? Do the taxes kill you? Do you think the medical care you get is adequate? Excellent?”

    As an Ontarian, I cannot answer the first question. I don’t have the first clue as to how much healthcare services in this province cost becuase, like my compatriots, I’ve never seen a bill. We don’t pay a sepcific health premium or anything like that; a portion of our tax dollars are allocated to healthcare funding.

    As others have pointed out, healthcare here does not include dental or vision or prescription drugs, but damn near everything else is covered. Obstetrical care (including abortions, and wouldn’t that make W’s head explode), hospice care, routine dr vists, Emergency services, you name it.

    When I had my Diva Girl, I was a student living on student loans. My OB was the chief of the department at that hospital. I had monthly, then bi-monthy, and eventually weekly visits, all at no charge to me. Plus 2 ultrasounds and the regular raft of tests. Zen Baby was delivered by a midwife, in a hospital. Again, all costs completely paid for by my province. The Ladies are also completely curent in their immunizations, again, thanks to Universal Healthcare.

    Yes, there are wait times for some things. But as I pointed out last post, it’s a triage format. Often, if you are made to wait, it’s because the medical professionals think you can. If they believe your case is critical, you can go from discovery to debulking surgery in a matter of weeks, with only a spate of tests causing that delay. (If I were an American, Zen Baby would more than likely be dead.)

    Taxes aren’t insane. I’m pretty sure they cap at rought 40%. Certainly nowhere near the 70% nmber your conservative apologist was spouting last post. And our standard of living here is good. People have nice houses and SUVs and pretty shoes and can afford to take in a movie or gorge themselves at McDonalds. Wlamart and Best Buy are going strong.

    And the healthcare is, in my experience, excellent (see above re: Zen Baby and dead.)

  • Bob

    I didn’t read all of the posts above, so I might repeat something already said. Gov. Mitt Romney of Massachusettes is trying to get a universal health care system established for his state. The fees are scaled by income (I think that he said the poor would have to pay $2.00 ?per week? for their coverage) and it would cover 100% of all residents. The Bush administration is offering 1 billion for the trial – providing Romney can get the bill through the state legislature and get the plan established.

    I’m with you, it is ridiculous that a nation as rich as ours has as poor a health system as we do. Heathcare should be a right, not a privilege of the rich.

  • christine

    I am canadian and feel pretty lucky. We do pay (in manitoba) 14% taxes on every purchase as well. If you need to go to the emergency room you will wait 6-8 hours minimum unless you are shot or bleeding profusly. It is also a bit challenging to find a doctor. BUT no bills ever, no concerns about costs…

  • Tiggerlane

    Ang — You are so right! My husband has been an RN for over 20 years, and has seen doctors drop out of private practice like flies in the last 5 years, due to rising malpractice costs.

    And what role do the prescription drug companies play in all this? I would love to know if other countries are bombarded with advertisements in every possible medium for this drug and that…amazing that we are a “say no to drugs” society here in America, unless, of course, that drug is made by your friendly local pharmaceutical company….

    Also, there are many people that are taking advantage of the system, and are getting free health care on our tax dollar that they really don’t need. Drug seekers flock to our emergency rooms, many get monthly checks for disabilities that may or may not really exist, and the like…what does that do to the rising cost of healthcare in America?

    And don’t get me started on how the poor seniors are being horribly confused by the Medicare options and coverages…

    Yes…we need change, and petitions, and loud voices, and ANYTHING to make our health care system work!!! I would love for our administration to quit being so arrogant, thinking they have everything all figured out, and ask some of your countries how we reform our healthcare system!

  • s

    I’m from the USA and lived in England for the past 7 years – I now live in Canada. Yes, the UK’s socialised medicine is good in some respects, but teeth-grindingly appalling in others. The care you get is shoddy and the waiting lists for even the most mundane procedures are insane (24 months for an angioplasty? You’ll be dead by then). However, I will say that if it is an emergency, you’ll be fine. So enter the hospital from a car crash and you’ll get the best of treatment. A good friend of mine did an intern rotation in England while I lived there and actually watched nurses not wash their hands between changing sheets and bedpans and re-dressing a wound. Another example is that a good friend of mine is dying from uterine cancer at the moment because she got an std from a boyfriend at 17. She wasn’t allowed a pap smear until she was 21 – now it’s too late to cure it and she has 5 years to live.

    Health care is crippling both England and the USA but I must say that I feel quite satisfied that if I do spend my money, I get the best of care, and that is certainly not guaranteed in England.

  • LeafGirl77

    I also forgot to mention that our recent Liberal provincial government charged everyone $300, $600 or $900 (based on income) for health care. I can’t remember if that was a one time thing, or yearly. Being a student, I was exempted.

    Honestly, I don’t even know if it went through. Perhaps it was simply suggested.

  • arden

    you prove my point of why i am under my husbands insurance and carry my own policy for an extra $281 a month…i am completely un-insurable due to a pre-exisiting medical condition according to the state of california…i was able to jump on his, i guess because it is illegal to deny a policy when it is under group coverage at a company…i carry the extra policy in the event my husband ever lost his job. crazy? i don’t think so. i sleep better at night and can hustle $281 alot easier than a couple grand.

    i think that mars comment on getting a broker to help you shop around…there might be something out there you are not aware of.

    best of luck…

  • Canadian Entrepreneur

    Besides our universal basic coverage, group coverage (as offered by an employer – for things like dental, private rooms, etc. above and beyond the regular stuff) in Canada can be found for entrepreneurs. The way this works is that an ‘organization’ acquires a group coverage plan for all its members – who then don’t have to individually qualify, just like in a big corporation.
    I don’t know if this type of thing is offered in the US, but you can try: Make a list of all professional, semi-professional, or ‘formalized’ interest groups/organizations that you could potentially belong to. Call them up, check their websites, or create your own *grin* (Bloggers Society?) Then of course compare your annual membership costs + coverage cost to what they want to charge you as an individual.

    Some examples in Canada include: CAA (Cdn AAA), CIPS (Canadian Information Processing Society), IEEE Canada.

    Hope that helps.

  • Jen

    I am from Canada, BC. My employer offers extended health coverage. I currently cover myself and my common law boyfriend. My cost is $78 twice per month. My employer pays the rest. The coverage is ridiculously good and things such as naturopaths, eye care, prescriptions, etc are all covered. If I did not have coverage through work, I would go through MSP, (Medical Services Plan) which is the provincial government’s coverage. It covers only the very basic coverage – and does not cover dentists, prescriptions, etc. It covers medical care at the most basic level. You pay based on your income, so it is hooked into Revenue Canada so the man knows. You can also apply for relief – IE if you are a student or have other extenuating circumstances but they will humiliate you and give you the run around first. My common law was paying for MSP before I put him on mine – it was about $100 a month but the coverage was incomplete.

  • Sam

    On the one hand, I say I agree. Insurance is tough. I live in Brooklyn, self-employed with a wife and 2 kids and pay about $1k a month. Then again, I live in NYC where half-day preschool costs 11k a year and my 1992 car costs 2k a year to insure (liability only!). My financial guys says I’m supposed to be saving $600/month per kid for college which, frankly, is a bigger scandal in my opinion. But 12k a year for insurance is a tough nut, no doubt.

    And on the other hand, I gotta say: wellll…. DUH! I’m sorry but is this news to you? Even when I worked a corporate gig I was aware of what my employer paid for my insurance and what my self-employed friends paid for insurance. I am kinda shocked this is coming as a shock to you.

    One other thing: I pay about 15% of our household income on health insurance. I see the doctors I like, when I like, and receive what I consider the best care in some of the finest facilities in the world. I’m not sure that universal healthcare would be cheaper or better.

  • Lesley

    I don’t know how Americans manage with that Christly awful “model” you have where private insurance companies control your medical treatment. What a scam that is. I’m increasingly alarmed at the changes I see coming in Canada where privatization of medicine and insurance is increasing and there seems to be no plan in place – the feds are letting the free market take over and sitting passively by while it happens. I wish they’d get their asses over to Denmark, Sweden and Australia to study their systems and come up with a plan for how all this is going to work. Instead it feels like we’re heading in the direction of the US system of shitty health care for poor people and the skies the limit if you’re rich and can afford it.

  • Jen

    I’ve read through most of the comments so far, so I hope I’m not being too redundant:

    in Vancouver, BC, Canada I end up paying about 35% of my income to both federal and provincial taxes (which go to everything – not just heathcare), as well as $54/month as a single person making over $30,000/year for my provincial health care card. I’m positive on that figure, since I just got the bill yesterday.

    This covers all doctor and hospital visits. It does not cover ambulance rides ($75), dental, vision, prescriptions or “alternative health practitioners” such as massage therapists, chiropractors, psychologists, etc. I believe dental and vision are subsidized for those under 6 and over 65.

    Single people making less than $30,000/year are given a lower rate based on a sliding scale, as well as percentage of their prescriptions covered. In my first year out of University, I made about $20k and had my monthly fee totally waived, and my prescription costs 80% covered.

    Anyone working for an employer offering benefits will usually have their benefits cover the $54/month BC Medical fee, as well as a percentage of prescriptions, “alternative practitioners,” dental and medical.

    So no, the taxes don’t kill me.

    I’d say the care I’ve gotten has ranged from absolute shit, to absolutely amazing – depending on the practitioner.

    I’ve experienced long wait times for diagnostic tests. It was really hard to find a family doctor taking new patients (since there is a doctor shortage here, many people end up solely using walk-in clinics because they can’t find a family doctor) – though I’m free to see any doctor I wish, there are no HMO mandated practices.

    I don’t have any serious health problems plaguing me at this time (touch wood), and I do know that our system is seriously lacking in some areas. While anyone who needs life-saving treatment is arguably treated very quickly and competently, “quality of life” medicine is seriously lacking. For example, with the boomer generation getting older, waits have been up to a year long for hip and knee replacements.

    So it has its ups and downs. Ultimately my “quality of life” health is something I need to be proactive with, and push doctors on sometimes, because they don’t always want to act. I’ve waited hours in an emergency room because I badly sprained my ankle playing soccer and needed an x-ray (and that’s sortof at the bottom of the triage pile on a busy ER day). But the bottom line is, I don’t carry any terribly crippling worry about my personal or financial welfare if I were to need an emergency or life-saving procedure.

  • Tuck

    I have to agree with everyone that the U.S. system is flawed. I work for a mid-size law firm with decent coverage – for what the insurer decides they will cover. This summer I spent a month in the psych ward and in an outpatient program for a simple major depressive episode and discovered that our “selective” coverage was even more selective. My mental health coverage had a separate $1,000 deductible on top of my major med deducible and then paid only 50% of my covered charges. And God will have to help me if I ever become unemployed, because I’ll NEVER be able to get individual coverage because all insurance companies now consider me a leper because I’ve been treated (and continue to be treated) for a mental illness. Is it any wonder U.S. citizens have developed a mentality of hiding our illnesses and health conditions from others because of the dire consequences we face when we try to get them treated?

    Jon, you hit the nail on the head. There won’t be any change until there’s a selective bombing campaign in Washington, DC that takes out the insurance lobby. It is a self-perpetuating monster that won’t let reasonable alternatives replace the present expensive, broken system because it would mean its own death – and we all know that suicide is a mortal sin.

  • Andrew in Toronto

    Looks like you are inudated with Canadians…so here’s another. No system is perfect. The Canadian system is definitely riddled with problems as you can see from the other posts. But here’s a few key points.

    Rarely (to never??) has anyone died from waiting for a scan or test. Wait times are a function of priority. You wait because there are people before you that need a scan more than you do. At least that’s the theory.

    Two tiered? Well sort of, almost 95% of the Canadian population lives within a 2hr drive of the US border where you can go and pay for a scan and have it done immediately (and they fax the results to your doctor same day!)

    Cost? I work for the City of Toronto in Economic Development and one of the tools we use to woo American business to Canada is that proportionatly, we pay 1/5 the cost for the same health care. The reason lies in the fact that we don’t have the bureaucratic overhead of insurance and other incindentals like malpractice insurance etc.

    An American coworker of mine related an experience to me today. His father had triple bypass surger a few years back. At the end of the day the bill was $70,000US. he had insurance but was still required to pay 20% which was $14,000US. In contrast, my father 3 years ago had the same procedure, the cost to him, $0.00. I can’t imagine.

    I would never be so presumptious as to suggest that you should leave your home (country) however, could I suggest that you voice your discontent with a ballot?

  • ui

    Before you all blame the insurance companies I think you need to ask yourself this: Have they paid more for my healthcare than I’ve paid in in the last 5 years? Anyone in the US who has had a baby, for example, the answer must be yes. Any real health issue at all. The trouble is medical care costs, not insurance alone.

  • Tee

    As others have noted, Australia has a pretty unbelievable universal health plan, plus affordable extra private cover for elective surgery, hospitalisation and extras. I feel it works as a lovely Keynesian compromise.

    Healthcare and Education are a right, not a privilege. The fact that both are so inaccessible in the US (more or less) demonstrates that the most booming of economies are rather exclusionary. It’s enough to make me more of a hairy socialist than I already am.

  • Sara

    My family is very fortunate to have decent health insurance; we are public educators. It sickens me, though, to see how much the school district pays for our family of three: $750 a month. And for what? We have Kaiser and rarely use it (there’s still a co-pay). We see a naturopathic doctor for most things, so, of course, we have to pay out of pocket for that because our insurance doesn’t cover her (that tax free medical account comes in handy). When I was pregnant and wanted my naturopathic prenatal care covered, we were denied. Even though she was authorized to do other things and prescribe us medication, they wouldn’t pay for the monthly visits, or anything having to do with my pregnancy. They also wouldn’t pay a dime toward a birth in any place other than a hospital, and this was under a different and more expensive plan. I ended up delivering our baby in the ambulance (short labor, short labor) so the hospital couldn’t charge anyone for the delivery. With insurance, the delivery was only $200 ($800 without) — perhaps ambulance births should be the next wave in natural birth? It’s certainly cheaper.
    So yeah, we should be writing letters and marching in the streets. This situation of yours, and many others, is impossibly ridiculous; horrifying. Best of luck to you and your family. I hope you are able to find something more affordable, but more than that, I wish you good health!

  • Elise

    George Annas in the New England Jouranl of Medicine way back in 1995 talking about health care reform and how important language is when trying to sell universal health care to Americans:

    He’s one of the smart ones that has been wrestling with these ideas for more than a decade.

  • ‘nee

    Yet another Canadian: I love our system. I pay about $50 a month for health care in Ontario for myself and my partner, not including vision or dental – I pay another (mere) $50 for that stuff through my workplace insurance.

    It’s a good system. It has problems, but they’re not systemic or organizational, they’re labour-related. I’ve never had to wait for treatment, myself: possible cancer? Zip! Into the MRI scan within a week. I was ready with the elbows to knock the old ladies with hip replacement concerns out of the way, but I didn’t even have to.

    There are lots of people who complain about having to wait, in pain, for services… But that’s because the more immanent cases are treated right away. The waits in Canada are only because there’s a shortage of skilled practitioners; they don’t have the personnel to run the diagnostic equipment or labs 24/h a day.

    Private insurance and right-wing concerns are trying to convince Canadians that our health-care system is inefficient and that we are getting ripped off, and that makes me laugh. Private insurance, they say, would be better. Ha! Our health-care costs are lower per-capita than the US, and we actually have universal coverage. The irony is, well, ironic.

    I’ve even heard people here in Canada say “I pay all this money for health care (?!) and never even use it!” And to that I say “Great!” It’s not the kind of benefit you want to have to cash in on.

    We take it for granted, and we are very, very lucky.

  • Jen

    I’ve read through most of the comments and I’ll be honest when I say I guess I just didn’t realize how many people have trouble finding adequate health insurance coverage. I am very blessed with the fact that my husband and I have excellent healthcare coverage through his employer and I have always had excellent coverage through any employer I have worked for. My out of pocket expenses have been very low and I’ve been able to receive the healthcare I’ve needed. My mother is British so I obviously have a whole side of my family who live in the UK and I can tell you that every time I visit or talk with them the topic of healthcare comes up, and they complain just as much about healthcare as we do. I’ll also say that the comment that universal healthcare is bringing the nation to it’s knees has been uttered more than a few times. They have universal healthcare in the UK but they also talk about how large the taxes are as well as the kind of care they get, which they say is not thorough or complete enough. They are constantly on waiting lists to get basic procedures done in edition to being put on the lists for much more serious conditions. One of my uncles said, “I could literally be dying and be put on a waiting list to get help.” This honestly scares me. I don’t know how I feel about universal healthcare and putting my government in charge of it when I hear others’ horror stories about it. I like knowing that I can go to any hospital and get excellent care. Also, as a side note, I’ve been to visit many of my sick relatives in hospital in the UK and I have always been appalled at the conditions of the hospitals compared to those in the US. Either way, it’s like being stuck between a rock and a hard place when you have to go without insurance. I can’t imagine what you are going through but I hope a somewhat decent solution will be in the near future for you.

  • madge

    I’ll apologize in advance if this has been mentioned, denounced or otherwise covered in previous comments or entries, but…

    In New York we had (it still exists, I just moved away) a Freelancer’s Union that you could join and get health benefits. There was talk a few years back about it going national. Or, perhaps there is something else like that in your area (although, wait, Utah, maybe no…).

    Probably totally unhelpful, but if FU did end up going national, you guys would definitely qualify.

  • Jennie

    Having just spent an uninsured night in the Emergency Room with my husband and his kidney stone (we’re calling it the Christmas Stone, since it will continue to absorb our Christmas fund along it’s journey to freedom), I feel the pain of everyone who can’t afford health insurance!

    At various times in our family life, we have been insured thru hubby’s employer:
    80/20 – a blessing when our oldest was diagnosed with rhabdomayosarcoma at 8 wks old, and still,he wasn’t “paid for” until he was 13 years old!)
    PPO’s – there when tonsillectomies were needed
    Sham PPO – employer said we were insured, but when arms needed casts, we were told he didn’t pay his share of premium
    Uninsured – when I needed emergency hysterectomy.

    It’s both scary and sad to live in fear of the other shoe dropping with regard to your family’s health and well-being….

  • hannah

    I’m in the UK and we are in the very fortunate position of having completely socialised healthcare. The cost just comes from taxes which are based on how much you earn. Some people gripe about the cost, but essentially they aren’t actually all that high. Council tax is another matter, but also a diffeent story.
    There is a lot of moaning about the NHS but essentially it works, and it works well. It’s suffering from being an out of date system with not enough money and too many demands being placed on it, but everyone gets treated and most people (99.9%) get treated well and in reasonable time. Some things aren’t free at the point of access like opticians, dentists and prescriptions, but you can fill in a form that lets you claim back all of those charges if you have an income under a certain amount, and if the costs are difficult then your income probably will be. I’m a university student and I can claim back all my prescription costs, my dental costs and my optician costs. In fact the only major problem most people have is finding an NHS dentist with space on his/her roster.
    Good luck getting health insurance!

  • meredith

    I believe you could qualify as self employed now (and I believe Heather would, too)….so you would have to pay self employment taxes (half of it is a write off) but the money you would now pay for health insurance is a write off, too. Play it right and you won’t be paying any taxes (lots of people pay very little taxes as they start a business). I do not think you need to do anything special to be considered self-employed, but what the hell do I know, I am a real estate agent not a tax accountant. But it would be worth looking into. Still a hard pill to swallow every month. (haha)

  • grass

    I live in Canada, BC to be precise. I do pay monthly for my healthcare but it is covered by my spouse. I never see the bill. I’ve lived in three provinces, Ontario, Quebec and B.C. and health care in all has been great. I suffer from migraines and have had several CAT scans, never waiting longer than a month. I recently had a stomach ailment and had several diagnostic tests within a month. Some of them were at hospitals, some at private clinics where they are paid by the government.

    Both my parents have had cancer, one was treated in the U.S. because we were living there, and one was treated in Canada. The care in Canada was comparable to the care at one of the best U.S. hospitals – John’s Hopkins.

    I’ve made several emergency visits, including in Quebec, and never waited longer than four or five hours. For example, I recently cut my finger open with a knife and needed stitches. I went to the hospital and waited less than half-an-hour before being stitched up.

    Granted, my experiences have all been in big cities. But as far as I’m concerned, I’ve received amazing care.

    As for the person discussing the Supreme Court of Canada case, three of the seven judges found was that banning people from having private insurance was a violation of human rights, and that waitlists were too long. One concurring judge also found it was a violation of rights based on the Quebec Charter. The decision has been highly criticised as it totally contradicted evidence that was presented at the trial level. Three judges disagreed with the conclusion, and given that there was no clear majority, it’s very much still an open question.

  • Sarah

    One of the benefits of being poor in Michigan is Medicaid. (My husband’s job does not offer health coverage.) My entire family has full coverage–eye care, dental, maternity care, hospital emergencies, etc. I don’t know how long our state government will keep the program going though….

  • grass

    sorry that should read covered by my spouse’s EMPLOYER, not my spouse! oops! 😉

  • Rachel

    One problem with health care systems in Commonwealth countries is that the very young and very old are the ones that suffer. A premie baby has to weigh so much in order to receive a life-saving operation and if you are past a certain age they won’t do anything life-saving either. They pretty much have to make a cutt-off point to save money. If you probably won’t live and the operation costs a lot they won’t do it.

  • shameless

    I’m intrigued by the number of posters who are American and somehow unaware of the vast swath of us, who despite coming from middle-class backgrounds and being employed at salaried jobs still lack the wherewithall to pay for health insurance for our families. Anyhoo, we were covered for awhile under small-business insurance company who I think has changed names now. What did I learn? Read the fine print. They didn’t cover things like pre-natal care and basically anything ailing the female reproductive organs. READ THE FINE PRINT and don’t get screwed. Also, here’s some info about various disjointed efforts to get single-payer systems in the works at state and federal levels: Rep. John Conyers (D, MI)
    Maybe you’ve seen this already, but Tammy Baldwin (D, WI, home of my mind but not my body, sadly) is involved with this:

  • Daisy Mae

    I have the nerve to complain about my health plan and the fact that they won’t cover all of the medications I have to take on a daily basis. They seem to think that brittle diabetes is an optional condition that doesn’t really need all of that insulin that the doctor perscribes. (five to six shots a day). Then I read your post. It puts it all into perspective when you hear of someone elses plight with the insurance companies.

    I’d have to say I am extremely fortunate. They cover one of the two types of insulin I have to take on a daily basis. They cover part of my nexium and pancrease I take for pancreatic reasons although not all of it. But by golly our monthly premium is definately not nearly four figures and our deductible is not $1000. It’s bloody highway robbery if you ask me. The politicians talk a good game about how they are going to fix this and fix that in healthcare, but you never see it.

    I really hope things work out for you guys and you can get affordable coverage. You’d think they would at least give you a jar of vasoline with that quote!

  • Sravana

    I hear you, Jon. When I went back to school (at 48) I lost my health coverage, and went private. I have a $3000 deductible, and they won’t pay anything re: psychiatric, because I have been on meds for depression for years.

    I did notice that if I had 3 waivers, they wouldn’t insure me. I guess that’s the rule that has the Armstrongs over a barrel.

    {{{Jon, Heather, Leta}}}

  • Kathy

    I know I’m not the first Australian but let me add my $0.02 worth. Here we have a taxpayer-funded publuc health system called Medicare, which all taxpayers support with 1.5% of their pre-tax income. Medicare entitles us to see GPs and some specialists at greatly subsidised rates or sometimes free; to attend public hospital emergency rooms without charge; to free maternity care; and to any required surgery performed free in a public hospital (although, as you would expect, some procedures have long waiting lists). If you don’t want to wait, or you want to choose your own specialist / surgeon, or want to go to a private hospital, you can pay the full fee privately or you can buy health insurance. Due to waiting lists on the public system, the high oput-of-pocket cost of specialties like dental and optical, and so on, about 40% of Australians are members of private insurance funds.

    I am not one of them. I believe in and use the public health system. For the firsat 10 years of my working life, I was healthy and I made no claims on the system but happily paid my share of the levy via tax. Now the shoe is on the other foot. I have had 2 babies in the past three years with 2 highly complicated pregnancies, involving several hospitalisations and 2 emergency c-sections, for a total out-of-pocket cost to me of $465 (that was for medications and the gap fee for doctor visits).

    It is a fantastic system, it doesn’t bankrupt us as a nation or as individuals, and my greatest fear is that this or some future conservative government will mess with it.

  • KittyKelly

    The healthcare system in the US is indeed embarassing. My husband and I do very well, but we are young and have changed jobs several times. Each time there has been some huge issue and delay in the changeover. It’s always a problem getting reassigned to the same doctor we’ve been seeing for years. They never want to cover anything that’s not a routine checkup.

    Though it sounds like some of you with universal care do have to wait sometimes, in reality it’s not much different here. I live in Los Angeles, and unless you are about to die you can plan on waiting in the ER for hours and hours. We once waited with my extremely sick six-month-old daughter for 6 hours before someone even checked her. She was vomiting into a trashbag in the 10×10 “waiting room” surrounded by adults suffering from various contageous diseases and viruses. It was horrifying, and absolutely terrifying at the same time. And this is the glorious sevice we pay an insane amount of money for.

    I have to think that if we are making so much more than so many others, and even we are having a tough time afforing health care (and housing — gotta love LA) .. Things have gone very very wrong.

  • Jay

    I’m confused. This situation seems perfectly logical. First of all, insurance companies are businesses, they provide a service, this service is no more a human right than owning a car. Second of all, no offence, but we’re talking about a family here who owns a (beautiful) house, presumably a car, apparently more than one computer (from what I’ve read on their sites), a clearly high end digital camera, and niether of them have jobs. I’m just trying to put this into perspective here. I sympathize with the Armstrongs for being denied health insurance when they are willing to pay for it, but lets face it, I wouldn’t exactly describe their situation as tragic. Sucky, yes. But then again, there are solutions out there (i.e. get a job like the rest of us working schmucks), and I can’t say I feel bad for them for having to deal with the consequences of their own choices when there are other choices available. I’m just trying to stir up a little debate here in what seems to be a rather one-sided discussion of a serious issue that deserves to be looked at from multiple perspectives.

  • blurb

    Jay, what exactly is your perspective? That insurance isn’t a right? I agree with you. Insurance is not a right. Insurance is a business.

    I don’t see much logic in your second point other than it seems you disagree with entrepreneurship, access to health care and those who want to make a business outside of working for the man.

    So perspectives. Bring it.

  • Bubblez

    Gee, you guys have a BITCH of a system in the US. I’m going to say AGAIN (because i know im not the only one… hi everyone in australia!)that as an Aussie, you just pay the 1.5% medicare levy, and pretty much don’t have to stress about everything… My private health insurance is about $15 a week for extras like optometrists and dentists, and although i have to pay up-front for doctors visits, (my dr charges $45 because they don’t bulk bill adults), you still get a rebate of something $27, but you can go to a doctor that is cheaper, or who bulk bills, but i prefer to stick to one who knows my family medical history. I feel a bit guilty because I don’t think I have ever really had to be concerned about health insurance or anything like that before.

    Hearing what you guys are going through is awful, and I really hope everything works out for you. If not, you can always come live in Australia! It’s nice, warm and sunny here too, and there are lots of pretty things and beaches you guys could take photos of! 😛 …ooh, and you don’t have to worry about college here, because you can put your studies onto a hex debt, and pay it off once you are working full-time and earning a wage of over $400(ish) a week…

    Just a thought 😛

  • Mike

    I am in the USAF, in Spain. The military offers complete, 100% coverage for me for 0 dollars.

    I realize that this is not, and never will be, an option for you, but have you ever thought about guard/reserve? They don’t get full, free coverage unless called up, but they have access to Tricare (our version of insurance) for reduced rates, and I don’t think they can deny family members.

    Just something to thnk about… One weekend a month, two weeks a year. And if you pick the right job, you’ll more than likely never get called up.

    (I despise GWB too, but I didn’t enlist because I agreed with him or his policies.)

  • HANK

    Jay are u saying because they’re not poor and on the street its not that bad and they can’t really complain about not being able to access affordable health insurance? well okay, i don’t have running water in my apartment, and no one will supply me. But i have an apartment, so i should just die of thirst while not complaining too loudly. Or (as you suggest…get a job like the rest of us working schmucks) change my way of life to get it?

    Health is a necessary part of all life, and all human beings have a right to be able to access insurance. If you have to pay thousands to get it, or if you are denied and denied again, you have every right to say its bullshit, the degree of which is not dependant on the number of laptops you own.

  • maria


    I live in the UK. We have Free health Care. If you are in the higher earner bracket you pay approx 40% tax on income over 30,000 Pounds (51 000 USD). If you are making less the 30,000 pounds a year, then you pay 22% tax. Average Salary in the UK is 22,000 pounds a year. So most people pay 22% tax.

    I also have Privat Health Care Benefits from work. Not cause it’s really needed, cause you can go and see a doctor/hospital for free. But If you need a referal to specialist etc, it’s quicker and more efficent. We also have a doctor in the building, so that makes it easier to go to the doctor if you need it.

  • Jennifer

    I live in the UK, having moved to London five years ago from NYC. The idea of universal health care is noble, but in practice (at least in the UK) it is unfortunately a bit of a farce: the base level standard of care here is shamefully poor, at best. (Don’t even get me started on the dangerously negligent doctors and staff at the hospital when my baby was born. Their mistakes meant I had to stay in for an extra three days.). Terrible, terrible, terrible. I actually pay out of pocket for care when I return to the States a few times a year, it’s that bad here.

  • Jenna

    My boyfriend was in the same position a few years ago. He has a pre-existing condition that’s not going to go away (he’s type 1 diabetic) and he was trying to get his own business started up and was denied health insurance coverage by every private company he contacted.

    We live in Oregon which started up the ‘Oregon Health Plan’ a few years ago which cannot deny coverage to anyone so he got on that. It’s not cheap, but not outrageous easier. Maybe if people start pushing to get programs like this in their own states eventually we can move towards something ‘universal.’

    I have to say that I’ve grown more and more outraged about the health care system in the U.S since I’ve been living abroad.

  • mirandola

    Another UK person here. My (admittedly limited) dealings with the NHS have been fine. Helpful doctors – very helpful dentists – and nice clean environments.

    My dad had to wait 18 months to get to the top of the list for a knee replacement, but he can now choose to go in for the operation whenever he wants – i.e. when HE decides that the pain is bad enough to be worth the operation. His doctor was very open, willing to explain and to answer questions. And we don’t have to pay anything for it.

    I’m sure there are a lot of problems with the NHS, but it’s also something of a national sport to complain about it.

  • VTOL

    Not sure if these were already posted or not, but I’ve found both links very useful. – I particularly liked his ‘Oh Canada’ article.

    And just for kicks, here’s an article from yesterday’s WSJ – – click on the question of the day and vote.

  • Tuck

    1. US pays healcare taxes too. It’s called Medicare payroll taxes. Just not everyone gets to use Meicare and Medicaid unless they qualify based on age or income, but that doesn’t mean that the rest of us don’t have to pay.

    2. Jay – Jon and Heather are working and earning money, just not for an employer that subsidizes their healthcare. Being self-employed, they are probably legally responsible for paying their own social security AND medicaid taxes (not to mention those for their babysitter). Why shouldn’t they (we) expect a return from a system that they (we) have paid and continue to pay into in?

    3. Healthcare costs are inflated because the government and insurance companies negotiate what they will pay the healthcare providers. Just take a look at your Explanation of Benefits the next time you go the doctor for a simple visit. Say you’re insured: the doctor will bill $300. The insurance company/Medicaid will automatically reduce the fee to $150. You’re co-pay is $20. The insurance company/Medicaid will pay $130.

    BUT if you’re uninsured? You’re stuck for $300. That’s the fairness of the United States healthcare system. And that’s a CHEAP example.

  • Melanie

    Totally not going to solve your insurance problems – but I just wanted to tell you that my 13-year-old daughter was watching over my shoulder as I scrolled through the pick-up-stix photos of your sweet little Leta…and she was in awe. She said “Mom, who is that baby? She is soooooo cute!!!”

  • Ashik

    Just a quick comment re: previous entry. Because of my bracket, I pay an INSANE amount of tax. What pisses me off is that I have no say about how that money is spent. It would make the bi-weekly process of seeing just how much didn’t make it into my bank account so much more pleasant if I knew it was funding universal health insurance and not this ridiculous war.
    The fact that the Senate has had the balls to refrain (for the most part) from cutting into services to get the budget out the door is worthy of praise. But really, can we re-prioritize in this country please?

  • Ashik

    Sorry, I meant Jon’s previous entry of a couple of days ago. The “why is there such awful health insurance in this country” one.

  • bobby

    I don’t mean to sound rude- but didn’t you guys think of this before you quit your job? I mean, health insurance for my family and I is a major factor in selecting jobs.

  • Reader

    This has probably been said a thousand times, but all’s not rosy with healthcare when you’re “working for The Man”, either. I pay several hundred dollars a month for my work-provided health plan, and while that’s not a thousand dollars, they won’t cover ANY office visits or treatment or drugs for conditions I had prior to starting this healthcare plan–the old “pre-existing condition” clause. But they manage to extend it to cover all kinds of things, including prescriptions for ongoing conditions. To see just how ludicrous this is, although I’m not a diabetic, if I were, technically my insulin wouldn’t be covered because I had the disease prior to taking this job (which is really what it boils down to, since if you work for other people, your health insurance stops and starts based on taking a new job). And I’m doing contract work, so this is something I’ll be dealing with again and again and again.

  • Reader

    To Mike from Spain, above: In the US today, signing up for the Guard or Reserves = see you in Iraq, posthaste.

  • Megan

    When I got pregnant this year I was working for a small business that doesn’t have health insurance benefits. The company will reimburse you for buying an individual plan, so it’s basically like finding insurance as a self-employed person. In order to get maternity care I would have to be on a waiting list for over a year for any insurance plan in my area. That was not too helpful, considering I was to give birth in 9 months! It truly is the most riduculous system, it makes me sick to know that there are women and children out there that can’t get coverage to give birth or be born!

  • rr

    Megan, there is free coverage for pregnant women and children in every state. You may not have gotten the doctor you preferred, altho my preferred doc accepts these plans.

    Meanwhile, ugggggghhhh… if you don’t get insured before getting pregnant, you gotta know it’s gonna bite you a bit, right? Having a baby can be very expensive. Why do people act shocked by this? Why do people quit their jobs before they look into the insurance thing? Why do people decide to take to the street only once these issues effect them directly? It is a bit annoying. I’m sorry, but that’s how I feel.

  • z.

    Among all the aussies and canadians and all, I’m from Mexico. Here, if you are employed, your employer has the obligation of sign you up for public healt care that is mixed with retirement plans.
    But Mexico has a large portion of population sel-employed. Those people can sign themselves up for public health (it’s not that much money) or look after private care.
    This year a legislation passed granting access to over 10 million families without healt care. The wealthiest pay around 600 dollars for the entire family. The first three deciles of income don’t pay. There are concerns about the economic vialibility of this measure but still it is a step forward.
    And about quality and waiting periods, I really do not know because both my parents work in the public health care system so we get to jump a lot of waiting and quality has always been good but mainly because my parents know a lot of the doctors.
    I think the main problem here is providing medicines and that becomes the largest expense for the sick. There is a lot more to it but this would become an essay about healt care instead just a tidbit of information.
    Best of luck,

  • Mike


    That is NOT necessarily true! You sign up for the Army, then I would say that it’s a safe bet. Bet hell, we actually have people “deploying” to here for either 2 weeks or 4 months depending on the situation, never more than that. You don’t see many USAF computer programmers pulling guns on Ali Baba.

    Like I said, it depends on the job, and where your guard/reserve unit is.

    It is NOT guaranteed to secure you a spot downrange, that’s for sure.

  • Reader

    Sorry to step on toes. It just seems like a significant step to take just for healthcare. I’m just sayin…

  • Wendi

    i’m sorry, but i have to agree with jay and bobby. it seems like a prudent parent would have made certain he could obtain health insurance coverage for his family before he decided to “work outside of the man”. i wish you the very best with your “entrepreneurship”, and i sincerely hope you’re able to find affordable health care for your family, but if i were you, i’m pretty sure i’d be wishing i had thought this out a little better before i parted ways with “the man”. you certainly can’t blame HIM for your lack of forethought.

  • blurb

    By all means, attack me. That is certain to get your point across.

  • sarah


    It’s always productive to point out what is no longer useful, just as self-righteousness and you-should’ve-thought-about-this lectures can make one feel better. After all, if it’s really all Jon and Heather’s fault, then you can rest easy that the same situation could never happen to you. This is the same mentality that stereotypes those on welfare as useless and lazy–because, if you admit that hardworking people don’t always make, you admit that you, yourself, are fallible, and that the government might not always take care of you, and that’s scary to think about. But scared or not, it doesn’t make your judgment fair.

    I’m in the same boat as Jon and Heather but lucky enough that I don’t have a child in the situation with me (yes, luck, just chance). I researched individual health insurance (or thought I had) and was really surprised when I was denied. There’s very little information out there about how insurance companies don’t have to abide by any rules when it comes to individual health insurance–there aren’t even any laws setting a cap on the premiums. Because I’m human, I assumed that since individual insurance cost so much, it wouldn’t matter that I had two minor pre-existing conditions. I thought that’s what all the extra money was for. I only recently have found more information and it’s been from people who are in the same situation. Insurance companies don’t advertise that they’re not going to cover you.

    And what about all those prudent parents who aren’t self-employed and still can’t get adequate health insurance for their children?

  • VTOL

    Why the hold on my comments? Have I been flagged?

  • hibiscusfire

    Wendi, etc, I feel like you might be missing the point by holding self-employed small business owners like blurb/dooce responsible for their lack of access to health care.

    45 million people in the US are uninsured not because they all decided to “work outside the man” but because the system is messed up. Insurance costs so much in this country that those of us who have it paid for by our employers don’t grasp what a struggle it is for people who don’t have access to it for free. And not everyone has the chance to work for a liberal, generous “man” who can also afford to pay his employees a fair wage with benefits.

    I work in a free clinic where we provide (minimal) health care for the uninsured and I can promise you that most of the people who I see are hardworking individuals. 80% of the uninsured are employed, and many others are can’t work but don’t qualify for state run health care.

    For instance, last week I saw a self-employed contractor with hypertension who had to quit his job due to a back injury and can’t afford healthcare. The week before I saw a retired nurse who can no longer work because of the damage that diabetes has done to her legs. These people will both likely die from treatable diseases within the next 10 years, much earlier than they should have. Though the world isn’t fair, it is disappointing that this happens in the richest country in the world, where the highest paid CEOs saw an 35% increase in their salaries in the last few years.

    Unless you make sure to only support businesses that pay fair wages and provide healthcare to their employees, I wouldn’t throw stones in glass houses.

  • sol


    1. Children are covered in the US. There are programs.
    2. If Jon and Heather want they could have COBRA benefits, meaning pay for the insurance Jon’s employer was paying (plus 2%). So the cost should hardly be a shock.
    3. He wasn’t fired, he quit. So while I have sympathy for the situation it is not a situation I would find myself in. I could be laid off, or fired, or the company may go belly up, but no, I would not quit my job without checking into insurance first.

  • Elise

    The whole point of a social safety net is that it’s supposed to catch everyone who falls from their ideal situation, for whatever reason, without judging them. The biggest sacrifice that this country is going to have to make to be able to to accept some form of universal health care is the self-righteous belief that money, success and health makes you a good person. Cream rises, but shit floats.

  • hibiscusfire

    Could you afford to provide for your family with this?

    “In 2003, sales associates, the most common job in Wal-Mart, earned on average $8.23 an hour for annual wages of $13,861.The 2003 poverty line for a family of three was $15,260. [ìIs Wal-Mart Too Powerful?î, Business Week, 10/6/03]”

    “Wal-Martís most affordable plan includes a $1,000 deductible for single coverage and a $3,000 deductible for family coverage ($1,000 deductible per person covered up to $3,000). An average full-time worker earns $17,114 a year.”

    “In 2003, Wal-Mart employees, in total, covered approximately 40% of the plan costs (5500 Filings). Nationally, on average employees at large firms (over 200 employees) cover only 16% of single coverage costs and 24% of family coverage costs (KFF, 2004).”

    “Part-timersóanybody below 34 hours a week ñ must wait 2 years before they can enroll. Moreover, part-time employees are ineligible for family health care coverage. Full-time hourly employees must wait 180 days (approximately 6 months) before being able to enroll in Wal-Martís health insurance plan. Managers have no waiting period. (Wal-Mart 2005 Associate Guide)”

    “If a full-time employee elected for family coverage, an average employee would have to spend 27% of their average earnings before the health insurance covered any costs. (Wal-Mart 2004 Associate Guide and UFCW Analysis).”

    and the best part…
    Your tax dollars pay for Wal-Mart’s profits:

    The estimated total amount of federal assistance for which Wal-Mart employees were eligible in 2004 was $2.5 billion. [ìHarperís Index,î Harperís Magazine, Vol. 310, No. 1858, 3/2005]
    One 200-employee Wal-Mart store may cost federal taxpayers $420,750 per year. This cost comes from the following, on average:
    $36,000 a year for free and reduced lunches for just 50 qualifying Wal-Mart families.
    $42,000 a year for low-income housing assistance.
    $125,000 a year for federal tax credits and deductions for low-income families.
    $100,000 a year for the additional expenses for programs for students.
    $108,000 a year for the additional federal health care costs of moving into state children’s health insurance programs (S-CHIP)
    $9,750 a year for the additional costs for low income energy assistance.”

    source with references:

  • Eight Hour Lunch

    Jon, I love ya man (no, not like that), but I’ve got to disagree with you here. (Don’t hate me).

    As you know, Heidi and I were in the nearly the exact same situation a few years ago. I had a job I hated and nowhere to go if I quit. I understood that quitting meant that I’d be without insurance for a while. Given our situation, we decided to take the risk of quitting *and all of the responsibility for making that decision*.

    Yeah things were crappy, and we were denied independent insurance. Where we differ is in our response.

    The power of government is the power of force. Make no mistake. If I decide I don’t want to pay for your “free” health insurance, I’ll go to jail. If I put up a fight, there’s a chance I could die.

    By what right can *anyone* put a gun to someone’s head and demand someone’s money just because they “need” it?

    You had insurance, you chose to quit. It sucks. I’m truly sorry. Just don’t presume to force the rest of us to pay for your decision.

  • Angie

    Just wanted to say, Jon, that one of your comments struck a resounding cord with me:

    “Here’s the freedom and peace of mind I think every person deserves: if one is sick or has a health-related problem, one finds the nearest or most favorite physician and makes an appointment or walks in and gets help.”

    YES! Everyone deserves that. I know what it’s like to walk on eggshells, hoping not to get sick or hurt. I know what it is like, finally having to go to the doctor, hoping to get a payment plan for the bill.

    Something must be done. I wish I knew what.

  • sandra

    I grew up in – and live in – the US, but lived in Australia for a few years. Even as a foreigner, I had AMAZING health care coverage there. To the point where before I left, I made sure to see a bunch of docs for all my regular appointments. I have no idea why we can’t get it together here…well, actually I do – but it’s still ridiculous.

  • I dunno

    I don’t agree with that part. I feel like everyone deserves basic and decent healthcare but I don’t think your “nearest or most favorite physician” is a right.

    I work hard and do things I don’t enjoy sometimes and one of the main reasons is so I can enjoy great health benefits. You don’t. Fine. But we can’t ALL go to Harvard or play second base for the Yankees. Not everyone gets their turn. Sometimes you really do have to earn it. I don’t like the parents who yell at the coach for not starting their kid either. Your kid didn’t earn it! Your kid didn’t shoot free throws all summer long and neither did mine, so they don’t start. Suck it up.

    Basic healthcare, okay. The rest, not so much.

  • Wendi

    Blurb ñ i certainly wasnít attacking you. in fact, i wished you success in your endeavors to avoid ìthe manî and still provide for your family. your complaining probably wouldnít bother me quite so much if you hadnít spend the last month or so patting yourself on the back in a public forum for escaping the workaday world that the majority of us live in. i mean, bravo and all, but enough already with prostituting the dog to pay the light bill. donít want to work for ìthe manî? donít. but please donít whine about the sorry benefits your ìnew employerî offers.

    Hibiscusfire – my comments were directed to soley to jon, not to the millions of people in this country who work and who aren’t lucky enough to have their health care taken care of by their employers. i am one of the lucky ones (or as i’m sure jon would say – a ìpoor unfortunateî who works for ìthe manî); my health insurance is paid by my employer. i am grateful that health care is not a worry that i face on a daily basis. however, my husband is self-employed, and we pay out of our pockets for his insurance. itís not cheap, but itís necessary. i fully understand the situation a great number of americans find themselves in with respect to health care in this country and completely agree that something needs to be done. i have no idea what that something is, but feel certain that a grown man who elected to stay home and play on his computer all day and then complains because he has to pay money to go the doctor isnít really getting us anywhere.

  • Mars

    I don’t fault Jon & Heather for not knowing in advance that they would be denied coverage, especially with regard to the minor reason for Leta (essentially “flattening of the head,” which is extremely common in babies nowadays due to the “put ’em to sleep on their backs” campaign). I am an attorney and my husband is an insurance agent, and I didn’t know this was such a problem. I guess because I’m lucky enough to have a great group plan at work. But aren’t we all at the mercy of our employers? I hope those that scoff at Jon & Heather never lose their jobs through no fault of their own and have to face this situation.

  • dooce

    wendi, you just made my shit list:

    “…but feel certain that a grown man who elected to stay home and play on his computer all day and then complains because he has to pay money to go the doctor isnít really getting us anywhere.”

    Jon elected to stay home TO RAISE HIS CHILD. Do you have any children? Do you have any idea how hard it is to sneak a few seconds just to check your email with a child? He is the primary care-giver now. He’s the one changing most of the diapers. Jon has spent almost every second of his free time since he’s been at home trying to find us affordable health insurance or taking care of the almost endless admistrative tasks for my website, NOT dinking around on a computer all day long. SO BACK THE FUCK OFF WITH YOUR FUCKING JUDGMENT ALREADY.

  • anon

    why not COBRA?

  • Tiggerlane

    Give her hell, Heather!

    And as a sidenote, I was an employee of a company that refused to offer health insurance. So, I did my part, and BOUGHT THE COMPANY. Guess what I still don’t have?

    It’s impossible for me to afford. I understand what my boss meant all those years — and I’m just trying to get health insurance for me and my daughter, not even counting my 52-year old smoker husband who got hepatitis during the Vietnam war when the removed his appendix in some crappy hospital.

    Just me, at 37-years old, and my 12-year old daughter — and I can’t find a decent policy to cover us.

    So, I applaud Jon and Heather – for working for themselves. That is a life choice, and to be honest, I’d be willing to bet they would make the same choice even knowing what they know now about their health insurance situation.

    Hang in there, guys! You don’t owe anyone an explanation – they’re not in your shoes.

  • hannah

    It’s quite interesting reading all the other posts from people in the UK. Both of my parents were nurses for dozens of years, and now my mother works at the end of the system that ensures that care homes are doing their job. Yes, the NHS has serious problems, but on the whole they do alright. Yes MRSA has been a big problem as of late and yes some nurses are less than scrupulous about keeping hands and wards clean, but the vast majority of people get treated reasonably in time, and with positive results. Okay you’ll wait a while for an appointment, but they will do every test necessary to see what on earth is wrong with you. My mother has been having medical problems that don’t seem to correspond to any known disease, so she has essentially had a health MOT in order to find out what it was. I went to the doctor because I was suicidal, and got the best care I could ask for. Both of my grandparents got excellent care when they had to go into hospital and they didn’t live in a rich area of the country – because sadly that age old problem of rich areas getting better care does apply here as well. I don’t want to dismiss people who have had trouble with the NHS but I do think that the fact that hundreds of thousands if not millions of people get treated admirably well by a very overstretched, underfunded and understaffed system. The NHS is nearly 60yrs old and hasn’t been significantly updated in its structure since it was put into place, in that respect it is doing brilliantly. We have had a massive population explosion since Attlee decided we should suck it up and give socialised healthcare, and yes the NHS isn’t coping brilliantly with all the associated problems. But still, we get healthcare that is free at the point of access and which works a good percentage of the time. Compared to all those countries that don’t offer socialised healthcare or that are providing far worse healthcare, we’re doing brilliantly.

  • sarah

    Tiggerlane–thank god someone’s finally pointed out that Jon and Heather don’t owe anyone an explanation of their choices. I find the personal judgment disheartening, especially because Jon and Heather aren’t whining about themselves–they’re bringing up an issue that affects so damn many of us! Jon’s using his website to allow people a space not only for discussion but for ideas on what to do–and all of these suggestions in the comments aren’t just for Jon and Heather. They’re helping the readers, too. And if I must judge, I’d have to be in favor of the decision to do work that allows both parents to spend time with their daughter. I think that’s responsible parenting right there. And, Jon and Heather, I know that even if you were able to easily pay for individual insurance right away, you’d probably still raise the issue because it’s been your habit to root for the underprivileged and to call on your audience to THINK about the politics in this country.

    Another point Jon raised that’s been ignored in all of the judgmental comments: it’s not just about the ability or *willingness* to fork out some money because you choose not to work for “the man.” It’s also about the fact that insurance companies may deny whomever they wish–it is about profits, as Jon said, and until profit is not a factor in health care, it’s only going to get worse. And then no one, other than the extremely wealthy will have health care. And I suppose that’s all right, because the wealthy really are better people.

    I’m willing and able to pay out-of-pocket for individual health insurance–and the fact that I’m willing and able doesn’t make me more deserving, it makes me luckier. Unfortunately, I can’t get individual insurance due to a history of depression (though successfully treated, with a drug that’s generic). And I can’t get COBRA benefits because they’ve expired already (had them for a while). And, guess what? I WORK FOR THE MAN. SEVENTY HOURS A WEEK.

    You could tell me that because I decided to go to graduate school and because I decided to adjunct instead of working a nine-five, that I deserve not to have health insurance. You could also tell me that I deserve not to have health insurance because I couldn’t just suck up my depression and had to be a whiny baby and ask for help. But again, telling me so is just a reflection of the fear that it could also be you, and the easiest way to assure yourself that it won’t happen to you is to assure yourself that you’re a better person than the rest of the world. Because better people never suffer.

    And I just have to give props to everyone who refuses to remain silent about the crises of our current political and economic system. Complacency has already gotten us into a whole lot of trouble.

  • JDo

    This is a really interesting discussion you’ve inspired. And people have strong feelings about it, and certainly they’re entitled to feel however they want. But here’s where I get annoyed, as an economist. I don’t mean to pick on Eight Hour Lunch, but his (flawed) argument is what I caught and is a prime example of how I think the national debate is just so screwed up. He wrote:

    “You had insurance, you chose to quit. It sucks. I’m truly sorry. Just don’t presume to force the rest of us to pay for your decision.”

    It turns out that even without a national health care system, taxpayers already pay for other people to be insured. How? Federal and state governments provide huge subsidies for private firms to provide health insurance in the form of tax deductions. This necessarily means that the government has to make up for these non-trivial revenue losses somehow, most likely by taxing people like you, me, and even Eight Hour Lunch at a higher rate.

    So the issue isn’t so much about having “us” pay for “your” health insurance coverage; rather, it’s about whether we can spend what we already are in a better way that ensures more universal coverage and lower health insurance premiums/costs. I wish that people would focus more on this aspect of the health care crisis rather than on arguing about who’s entitled to what or whether I’m going to pay for your gall bladder operation. And of course I wish that people in general had a better understanding of how insurance is supposed to work as well as some of the basic adverse selection issues…

    Anyway, sorry for the soapboxing and sorry to hear about your situation. I wish you and your family the best.

  • marrije

    Hi Jon,
    I’m not going to read all the comments, because I don’t need the aggravation (I think you and Heather are great and absolutely doing the right thing, even though it’s really non of my business what you do).
    I’m just going to add a data point. I live in Holland, and have just received my insurer’s new quote for next year (we’re getting a new universal healthcare system). I will be paying 125 euros a month, including quite a good dental plan. My 2 kids have free coverage. Practically everything is included in this plan, except for orthodontics. No hospital bills! No GP bills! Also, I will be paying about 1000 euros less that I was this year, and I’m not anyone’s employee, I’m independent.
    So on the whole I’m really happy with our healthcare situation over here.

  • Anja

    I’m a Norwegian living in Denmark, so I’ve been reaping the benefits of universal health care all my life. In Denmark, seeing the doctor is free, seeing a specialist (with a referral) is free, going to the hospital is free. Having a baby – or an abortion – is free. The state pays a percentage of prescription meds, and seeing the dentist is free if you’re a child (adults pay through the nose). Opticians are private.
    We pay 40% income tax, which is quite a lot, but you know what? I think it’s great. I don’t mind spending part of my paycheck to make sure that everyone is taken care of. The standard of living in Denmark is high, also compared to the U.S.

    I don’t think there’s any doubt that the health services in the U.S. are excellent. The problem is that they’re not accessible to a large amount of the population. It’s not a question of the quality of the care you get, it’s about getting any care at all. And to the person who complained about poor people using the ambulance as a taxi: Guess why they’re not seeing a regular doctor instead?

  • Guard member

    To those who posted that joining the Guard or Reserves is an automatic trip to the sandbox, I call bullshit. I was active military for 5 years, and have been in the Guard for the last 4 years, and have not once been overseas, and it hasn’t been for lack of trying. Not everyone is shipped overseas, we still need folks at home, as evidenced by the hurricane relief efforts. I can’t give any advice on the Tricare benefits that the Guard/Reserve get, because I don’t utilize them – my spouse is active military, and I use those health benefits. Still Tricare, but better than the Tricare plan offered to the Guard/Reserves. I wouldn’t join the Guard/Reserves just for the Tricare though, so not worth it, IMO.

  • Guard Member

    Oh, and by the way: There is more than just the Army Guard, there is also an Air National Guard, which is Air Force, so joining ‘the Guard,’ doesn’t have to be shipping off with some Army unit to Iraq – there aren’t many Air Guard people deployed overseas right now. Some, but not many.

  • Laurie

    Wow! What a debate!

    I’m one of those lucky few Americans who can afford the health plan offered her by her husband’s company. My husband, son and I are on the State of Louisiana’s health insurance plan. I wish you could hear the complaints. People here think that the $400 we pay a month for our family plan is expensive. People obviously don’t know what expensive is.

    I’m also lucky that the company that does the TPA for the State has a “family man” as their CEO. The plan we were on (we’ve since changed to another plan within the State) provided no out-of-network benefits. We knew this when we elected the plan; it was cheaper that way. Soon after electing that plan, our son was born with a liver disease. Within a month it was evident that he needed a liver transplant. There was one hospital in our network that does liver transplants, but the doctor who would have performed the surgery had never done one on a tiny infant. The insurance company decided to send us to Nebraska where we would get the best treatment for our son, AND covered it all as if it were in-network. This included the surgery for my husband to donate part of his liver to my son. Our out-of-pocket expenses? Less than $2000.

    With all of that said, my husband and I realize that one of us will always have to work for a large company (like the state!). My son’s transplant and all of the treatments that came after that cost our insurance company a bundle. If we worked for a small company, the insurance would no longer be affordable. If we decided to try to get independent benefits, we would be laughed at. But a liver transplant that was performed not quite two years ago is understandable as being “uninsurable”. I get that. Thank God for that group health plan.

    One thing I think is good to note to some of your commenters: working for “the man” does not automatically guarantee you health insurance, affordable or otherwise. There is no law that mandates a company must offer health insurance to its employees. If it is offered, you must have at least 75% group participation (at least in Louisiana) to be even CONSIDERED for insurance. THEN, you have to take your industry into consideration. Not only does the health of your group affect your rates, the health of the industry you are in does, too. In other words, if you are a fireman, and the employees at your fire station are in good health, your rates could still go up because the fire fighting industry could be unhealthy as a whole. SUCKS doesn’t it?

    Perhaps another thing to note is the fact that an employer holds the reigns in making the health insurance decisions. He wants cheap rates, the health plan is going to have high deductibles and a high out-of-pocket max. He wants lower benefits, the rates are going to be pretty high. So if at renewal time the boss man doesn’t like the high rates, and he and his family are healthy and don’t utilize the plan much, he’ll most probably make the decision to raise the benefits to keep the rates low.

    So Jon, my suggestion (and I saw one commenter make the same) is to get an agent. I worked for one until I quit my job to go back to school. I’ve watched him work magic on people I swore would be uninsurable. He’s gotten Blue Cross to insure people at the rates they want with the benefits they want, and be glad to do it. He’s got to be some kind of wizard.

    Good luck to you. I’m with you on this fight for more affordable health care for the masses.

  • KC

    I just re-read my previous post. It reads a little harsh. I just wondered if the state plan was a viable option, or a last resort. Options do seem hard to come by. I had no idea how hard until I read the comments from others. Man, talk about a catch 22. If you use your insurance for treatment, you become uninsurable. This is not a health care system, it is a racket.

  • Katie

    Hi Jon,

    I didn’t read all of the comments, but I just wanted to share with you something my mom once told me…

    I grew up very aware of my family’s money problems. I was also a kid who wanted my parents to be happy all the time. So when something would go wrong, I would sort of worry about the cost.

    My mom said to me when I was about 20 years old, “Katie, it doesn’t matter what happens to you, we will always find a way to pay for whatever it is that you need. Doctors will fix you and we’ll get a bill… and we’ll figure it out. You are the only thing we own outright, and they are not taking you away from us and that’s all that matters.”

    (That last sentence should be read with a sarcastic tone, not a serious one.)

    It’s a good point, though. It sucks – the position that you and so many other Americans are in (I was in it a few months ago). I was lucky enough to find cheap insurance through Tonik, a division of Blue Shield, but it was only because I’m under 30 and sort of healthy. As someone who is almost always freelance in the TV industry, I am always worried about the health insurance thing. It’s terrible, the way it’s set up here. I lucked into a gig that is giving me decent health insurance right now, but when I’m done with this gig, I’m not sure where it’ll come from next.

    Someone once said the stance of the democratic party is simple: our society is only as strong as our weakest member. I don’t know a whole lot about universal health care or health care in general, but enough money is made in this country, if you ask me, to provide health insurance for every American. If I made a ton of money, I’d expect the government to take what they need for reasonable expenses. Health care is the most reasonable expense imaginable, if you ask me.

    I wish you and your family luck. I adore your website as well as Heather’s… you are great people. Keep telling yourself what I always tell myself when it comes to things I need but can’t afford: it will work out. It always works out. Somehow.