We continue to concentrate on the wrong thing — getting the uninsured into the present system — when we talk about health care reform.
Increasingly, those of us who are privileged to be in the system find that we can’t afford health care, either. The whole system is rotten, wasteful, too expensive and too inefficient. We pay more money to be sicker than folks in any other advanced nation.
There are a lot of problems with our system, but the biggest is the basic premise — employer-based health care through for-profit (and we’re talking for HUGE profits) private insurance companies.
If private health care coverage weren’t so expensive for all of us, the 1 in 7 who remain uncovered would be in it. But it is, and will be, expensive by definition. A profit has to be made.
I wrote this column — "‘Health care reform?’ Hush! You’ll anger the Insurance Gods!" — back in November because it’s time that people like me — in the top income quintile — started pointing out how unaffordable this wasteful system is for us, which means it’s worse for millions of others who are also in the system. An excerpt from that column:
… I make more money than most people do here in the wealthiest country in the history of the world, and I live paycheck to paycheck, in large part because of the cost of being an extremely allergic asthmatic, and needing to do what it takes to keep enough oxygen pumping to my brain to enable me to work so I can keep paying my premiums and copays. My premiums in the coming year — we’re going to a new plan — will be $274.42 on every biweekly check, not counting dental or vision care. And I’m lucky to have it. I know that, compared to most, I’ve got a sweet deal!
I’m in the top income quintile in the U.S. population, and we can’t afford cable TV, we’ve never taken a European vacation or done anything crazy like that, we haven’t bought a new car since 1986, and aside from the 401(k) I can’t touch until I retire (if I can ever afford to retire), we have no savings.
Yet I will pay my $274.42 gladly, and I will thank the one true God in whom I actually do believe that I have that insurance, and that I am in an upper-income bracket so that I can just barely pay those premiums, and that neither my wife (a cancer survivor) nor I nor either of the two children (out of five) the gods still let me cover is nearly as unhealthy as the people I see whenever I visit a hospital…
On Jan. 6, we ran an op-ed piece from B.J. Welborn that told another middle-class story. An excerpt:
But the picture is not always rosy. A recent experience made me realize that although I have a comfortable income and a good education, pay taxes and have an insurer pick up most of my health care costs, an overburdened and undermonitored health care system can leave me vulnerable and scared. Here’s my latest scare:
Last year, an out-of-state company bought my husband’s firm in Columbia. We were forced to change our insurance. This change required baffling paperwork to keep my Gleevec coming, and though we tried valiantly to figure out the process, different people at the insurance company told us different things. The process dragged out; the clock was ticking for me. Soon, three weeks passed without my lifesaving drug. I wondered if anybody cared.
I checked with my pharmacy and found it couldn’t order Gleevec from its supplier. I searched for Gleevec at other pharmacies. This drug, still in clinical trials, isn’t like a common antibiotic kept on drugstore shelves. I couldn’t find it. And even if I could find Gleevec, how would I pay for it? $3,000 this month, then $3,000 the next month?
My anxiety mounted. When I washed my face, small blemishes bled, as they do when your blood can’t do its job. I was slipping through the cracks, and I was cracking up…
The "what if" game is terrible. Millions play it, and one day, you or a
loved one could too. Anyone can get a chronic disease — diabetes, stroke,
mental illness, heart disease or cancer.
Let’s face it: You, too, could slip through the cracks of our health care
system. So, it is up to you to make our potential leaders aware of what’s
really going on. It’s not just the poor and uninsured who are hurting, it’s
also millions of hard-working, middle-class Americans who foot the bill for
others’ health care…
Then, on Friday, Feb. 1, we had this letter to the editor:
Health coverage could make writer sick
I am absolutely disgusted by the state of our nation’s health care.
I am a college-educated woman with a bachelor’s degree, an employee of a prestigious university, but most important, a wife and a mother of young children.
I live in fear that one of my family members will become seriously ill or simply require regular preventative care that my health insurance does not cover.
For example, last year, I discovered that the health insurance for S.C. state employees does not cover routine pelvic exams, and without health insurance, that type of procedure can cost almost $200. And other medical procedures aren’t covered until after I meet the $350-per-person deductible.
With one child in daycare and the costs of my children’s health care and regular childhood illnesses, I simply can’t afford to pay $200 or $350 or $550 for my own care. So I don’t go. And I hope that I don’t get sick.
That letter prompted this one on today’s page:
Health insurance costs leave little for care
I read the letter “Health care coverage could make writer sick” by Martha Brown with interest.
While wholly sympathetic to her concerns, I feel, by comparison to many of us, she would be embarrassed by how good she has it.
As a provider for a healthy and active family of four, I am shackled with a monthly insurance bill in excess of $800. For this, we are provided with a policy that covers only 80 percent after a $1,000 deductible per person. It would appear that our policy was written to provide for the economic health of our insurance company, rather than that of my family.
Our provider enjoys strong local recognition, and I hope it is competitive with other carriers, but my bill has become a payment for asset protection rather than health care, and I’m not sure how well it provides for that.
“Health care is expensive” is the most common explanation received when I question our agent, doctors and others about our situation, but price is irrelevant when, after insurance payments, no money is left over for health care.
Surely, mine and Ms. Brown’s situation is not unique. We live in the greatest society that has yet existed, but our current profit-driven health care system is clearly in direct conflict with what is best for its citizens.
More people should come forward with these stories. It’s embarrassing — neither of my two bosses, my employer or my wife, was particularly crazy about me going into such details — but this stuff needs to be available as we debate these issues. And we must debate them — the status quo is not sustainable.