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I cannot recall a debate as vigorous as the one over health care reform. Charges of nazism, socialism, communism, death panels, etc. are flying around like I've never seen before. I know my friends get sick of me talking about it. One thing I find fascinating, not a single person I have discussed this with- not one has not said that we need to do something about health care in our country. I have a lot of Conservative and Libertarian friends. I find this to be pretty surprising. While I know some who hate what the Democrats are proposing. Everyone I know agrees something needs to be done.
As a corporate employee for the first half of my career I was shielded from real health care costs as many people are today. As a group, as long as we don't pay for something directly, we tend to not think about it. I remember when there were no co-pays. You just went to the doctor, handed him your insurance card and it was "taken care of". Then, there were $5 co-pays. Now there are $30 co-pays and deductibles and the employers are asking us to even kick in on premiums. It seems that Americans are finally starting to feel the pain. I've always been conscious of what I spent on health care, even when the bill was going to the insurance company. Most people I knew back in the good old days weren't so conscious. They'd run to the doctor for every sneeze and sniffle. No more.
I left the arms of corporate American 8 years ago. I was shocked at the cost of the premiums for my family of four. The single largest obstacle to making the transition was getting health insurance at a "reasonable" price. I was paying more per month for health care than I had ever paid for a car payment (and I've had some pretty high car payments). Health care was my second biggest monthly bill surpassed only by my mortgage. Over the years I kept tweaking up the deductible to try to keep the premiums reasonable. Finally about three years ago I bumped the deductible up to $2,500. But that did not stop Anthem from raising my rates about 30% that year to about $700/month for the family. I did some shopping, found another company and got a quote for over $500/month. Done. The next year, they raised my rates to $770/month. It was over a 40% increase They sent me a nice letter assuring me it wasn't based on anything I had done individually. It's all those darn Ohioans who used their insurance so much in the previous year. My agent told me this was typical. A company would give you a low quote to get you on board, then jack it up the next year. OK. Fine. I paid the $770 thinking now I'd see reasonable increases going forward. A few weeks ago (about a year after they dropped the over $200 increase on us) we got another lovely letter from the insurance company. In an effort to control costs they were dropping one of the two provider networks they had in Ohio. This was going to result in my premium going from $770 a month to about $680. This, they told me, was good news. The not so good news, not a single doctor I see, Ty sees or the girls see were on the new plan. Worse yet, Children's Hospital was not on the plan. We called our agent and began scrambling again. Let's look at alternatives. Let's have them apply to our doctors and Children's Hospital to get them in the network. I figured for the $100/month savings, if I wanted to go see my own GP, maybe I'd pay out of pocket. Then, we got another lovely letter from them. The "savings" we had been quoted had evaporated. Our new rate would be $1,008/month. Same thing happened as last year. Individually, we had done nothing wrong. But, those darn Ohioans had done it again. Used too much insurance. So, off we marched to the insurance agent again looking for options. We opted to go with an HSA. Basically, we're going to self-insure. Thank goodness the business has been successful and we can afford to set aside $5,000 for our new deductible. I know that's an option a lot of start up business owners don't have.
I'm sure my agent has heard the bitching and moaning I did a thousand times before. But, I couldn't help myself. I was telling her how fed up I am with the health insurance companies holding us hostage. I have borderline high blood pressure (controlled under medication) and borderline high cholesterol (also controlled under medication). In the health insurance game, when you're in the individual market and/or a small business owner that's known as two strikes. With many insurance companies, three strikes and you're out. IOW they won't cover you. High blood pressure and high cholesterol are not exactly rare diseases in America where 30-50% of people are impacted with one or both of these conditions. I'm relatively healthy. I eat right. I exercise. I'm not obese. Heck, I'm in better shape than most guys I know my age. No one would even know I have these conditions if it weren't for the fact I actually go to the doctor and medicate myself for them. Yet, they make me an undesirable candidate for health insurance. Every time I apply with a new company I wonder if they'll cover me and what they're going to want to charge. I wonder if/when I'll get that third strike and then I won't have any options left.
My agent then began sharing her story. She and her husband are small business owners and self-cover for insurance. She is with the same company I'm trying to leave. She has MS and a skin condition, both pre-existing conditions that prevent her from leaving the company she's with. To make matters worse, she and her daughter were attacked last year by a random whacko on the street. So, they needed medical attention. She got a not-so-nice letter from our company this year. Due to the fact that she had used her insurance too much, her rates were going up 61%. As someone who has been screaming for health care reform, I wanted to get her perspective on health care because she and her husband are Libertarians. I wondered if they would think that the government should stay out and let the market take care of things. She didn't offer any specific solutions. But, she was in agreement with me that something needs to be done. The company she is with now can raise her rates as much as they want, any time they want and there is absolutely nothing she can do about it.
The next day I was talking with a friend who is a Conservative. Her husband works for one of the largest companies in Cincinnati. I was telling her my health insurance woes and that I was now facing a health insurance payment that was about 50% higher than the mortgage on my first house. I was complaining about how a person who wanted to start up a small business might not be able to afford $12,000 a year for health insurance (plus co-pays plus a $2,500 deductible) and this situation literally prevents many people from going into business for themselves. Then, I got a surprise. She and her husband have a $3,000 deductible on their company provided health care. Wow! Back when I was working for a corporation we had no deductibles on health insurance. We were fully covered. But, now even Fortune 500 companies are sharing the pain with their employees. I have another friend who works for a small company. She doesn't make a lot of money and pretty much lives hand-to-mouth. Her employer offers health insurance. But, with a $2,500 deductible. Her son has a congenital heart condition. What this means for her is every January the clock resets and she has to pay at least $2,500 each year for his medical expenses. I would classify her as one of the working poor (or at least very lower middle class). She is fortunate enough to have a job that provides benefits. But, the deductible is one she would never choose for herself because a family that is having trouble paying the mortgage doesn't have $2,500 a year just lying around.
I know two people who have lost their jobs within the last week. Both came totally out of the blue. One was a VP working for a company that kept promoting him and giving him more responsibility right up until the day the owner of the company called him in and decided he could do it cheaper without him. What was one of his family's greatest concerns when he found himself on Monday afternoon without the job he had on Monday morning? How was he going to afford health care coverage? Asthma, an eye condition that threatens his vision, a diabetic child- all of these conditions are in his family and those things do not look good on a health insurance application.
The health care proposal on the table from Obama and the Democrats is far from perfect. It's got some really weird stuff like a mandate to get coverage but no public option. Obama said during his campaign that he was against a mandate. A mandate where an affordable public option exists at least makes some sense. But, a mandate that forces people to buy from the very companies that are responsible for a large part of this mess, I'm not so sure about that. Many Republican ideas have been included in the plan. But, as soon as an idea is embraced by Obama or the Democrats it becomes anathema to the Republicans. It's like they've never heard of it before.
I don't know what the answer is. But, I do know that the current situation is unsustainable. If things continue on the trajectory they are on for even a few more years we are looking at a national crisis. People will be forced to gamble more and more with going without coverage which is a financial and/or medical disaster waiting to happen. We are all one layoff, one diagnosis or one accident from being one of those who cannot afford insurance or who cannot buy insurance at any price.