Tuesday, July 10, 2012

Health Insurance Reform

My friend Stephanie is, to me, a perfect example of why we need “ObamaCare” to stay in place, and why we need to go even farther than the Affordable Care Act, and truly reform the way we think about and pay for health care in this country.

Steph is a young lady I met during the tail-end of my radio news anchor days.  She was hired on a part-time basis to help produce talk shows, and as so many who start in that position do, she worked her way up to an on-air job.  Soon realizing that her part-time status was not likely to become full-time, with the attendant “benefits” (health insurance), she left for another job which offered her full-time status and benefits.

Why one’s health insurance is linked to a job has never made sense to me.  Of course, you can buy your own health insurance (if they don’t reject you for a “pre-existing condition”), just as you buy your own car insurance, homeowners or renters insurance, and life insurance (yes, I know, some benefits packages also offer a form of life insurance), but if you buy your own health insurance, you’re going to pay through the nose.

Steph was diagnosed with breast cancer several months ago.  Thank GOD she had good health insurance, so her doctor bills and chemo were pretty much covered.  Then, a few weeks ago, toward the end of her chemo treatments, something hit her like a bolt out of the blue.  She had a stroke.

Her boyfriend got her to the hospital quickly enough to minimize the damage, but plenty of damage was done.  She lost movement on much of the right side of her body.  She bounced back quickly, and within a few days, was sending e-mails and posting on social websites from her hospital bed, using her left hand only, and struggling to get her brain to issue the necessary commands to accomplish the task.  She will need a ton of physical therapy and a considerable number of prescription meds, on top of the huge array of chemo meds.

The doctors said she should be able to leave the hospital soon, but will need a lot of p/t in the coming weeks and months to regain some mobility and learn the work-arounds when much of the right side of your body isn’t taking commands any more.

Her employer, which I choose to identify only as a local outlet of a gigantic multi-national conglomerate, did her right when she told them the docs told her the earliest she’d likely be back at work would be December.  They said her job would be there for her whenever she could come back.  Steph had burned so much vacation and sick-leave time in dealing with her breast cancer and chemo, that the company said their only choice was to place her on indefinite leave, and that meant she could keep her benefits (health insurance) only by taking the dreaded COBRA – which, in her case, means she’ll be on the hook for about $550 a month.

For a young woman just getting started in a career, not making the King’s ransom in salary, and not having had enough time to stash away a bunch of money in savings, and not being able to work, $550 a month is a huge nut to crack.  Her family and friends have assured her they’ll help, while she takes the long re-hab road a step at a time.

Can you imagine what her next several months will be like?  Chemo, on top of intense physical therapy, and a daunting daily array of prescription meds.  With no insurance, it would seem to me that any young person in a similar situation would be facing bankruptcy and other dire consequences.  With her COBRA, and a lot of help from family and friends, she at least has a fighting chance to go back to work.

I don’t have to paint the entire picture for you.  Her life from this point on is one huge health insurance nightmare.  If the dweebs in Congress roll back all or parts of the ACA – like the ban on pre-existing conditions as a cause to reject a health insurance applicant – she’s doomed if she goes back to work and then gets laid off.

Modern medicine has already saved her life – twice.  Yes, the care is expensive.  Yes, the necessary medications are expensive.  But for Steph, and literally thousands and thousands of other young people like her – people who often balk at paying for health insurance “because they won’t need it until they’re a lot older” – many of the key provisions of the ACA are vital.

It’ll never happen to me?  It’ll never happen to my children?

Ask Steph and her family about that.


  1. "Why one’s health insurance is linked to a job has never made sense to me."

    It goes back to World War 2, when cash wages were effectively frozen by the federal government. A work around for this to attract better workers was to offer them free health insurance, which wasn't counted in wages. The rest, as they say, is history.

    1. Thanks; I didn't know that. My dad was self-employed, so I wasn't introduced to the joys of company-sponsored health insurance until I landed my first "real" job.

      I think Rx drug prices started their phenomenal rise when we stopped paying the Pharmacy for our prescriptions, and sending the reciept in for reimbursement. Once we got to the "co-pay" system, where we paid a small fraction of the real cost, things went to hell in a hurry. (IMHO)

  2. Tim,
    Part of the reason drug prices rose so high is because other countries (with socialized medicine) put caps on what they would pay for drugs so they are taking the perceived loss by raising our prices. The same thing goes for medicaid and medicare and the uninsured, all of those costs get passed onto the rest of us.

  3. Tim, you and I both know that hard cases make bad law.

    And you know very well, indirectly, that MD's are paid handsomely for their knowledge, hospitals are paid for their equipment and other 'utility' for the sick, and chemo/bio/scientists and their employers are also remunerated for their smarts and their cures.

    Which of those groups will you chop?

    There is a via media in all this which is NOT ObamaCare. Rather, it is an intelligent and focused re-working of Medicaid/Medicare in combination with charity.

    First thing: get local, not national. Subsidiarity is far more effective than "national solutions" except in national defense. Take the skid-chains off providers of all sorts (in terms of regulation burdens, useless or inane protocols, etc.)

    Let those providers find ways to help, and let local/state gummints HELP them when necessary.

    1. Dad, we can certainly agree that there is a middle-path with an "intelligent and focused re-working of Medicaid/Medicare in combination with charity". It sounds good, wise, and reasonable. Certainly those giant programs can be re-worked to make them more efficient/responsive, and more autonomy can be given to the states to run their own shows. I'm not so sanguine about the "charity" part; are you referencing something like GHWB's "thousand points of light" here?

      Hard cases do make bad law, but my bleeding heart wonders how we can best help young people like Stephanie. My daughter is just a bit younger, but my wife and I have the resources to help her through, God forbid, a situation like this. Steph's family doesn't. I just don't want this medical emergency to ruin her life any more than it has. She'll fight back, learn to deal with her disabilities, and will return to the work force (in a dimished capacity, to be sure). I just don't want it to put her behind the 8-ball financially, forever.

    2. Most charitable people avoid publicity. A friend of mine, an MD, spent 1/2 day of every week working free-of-charge at the Rescue Mission in Milwaukee. That was NEVER publicized, period. Lots of other DDS' and MD's do the same sort of thing.

      Are they the real "1000 points"? Yup.

      We probably disagree about 'ruining Steph's life.' First off, she is alive, which in and of itself is positive. From your remarks it's not hard for one to infer that 'only "productive" lives are not-ruined.' Not likely your intent, but....

      You could look at this another way: if Stephanie remains home-bound but alive, she will require (and receive) actual charity from a lot of folks. Since actual charity is a virtue--and is rewarded--what's so bad about that?

    3. There's a story out there - you can find it on the internets - about a well-known woman who has, so far, triumphed over the major health challenges that have befallen her.

      Breast cancer was probably the easy one. Multiple sclerosis has doubtless been tougher, and will always be a factor in her life.

      Both are ghastly expensive to treat (I know something about the former) and both leave the survivor, should they be lucky enough to accomplish that, with a pre-existing condition that effectively precludes the possibility of obtaining health insurance. Had it been left to charity and the kindness of strangers, she might well have been disabled or dead by now.

      Luckily for our heroine, she won't worry about that insurance detail because her name is Ann Romney. She is wealthy beyond our imagining, but her life is no more valuable than yours or mine.

      We can all be as lucky as brave Ann, at least in our ability to have a fighting chance at survival. All we need is to be able to buy - with money we earned - health insurance. I am unable to fathom why anyone would deny that to a fellow mortal.

  4. Directly to the 'utilitarian/Benthamite' thing, see this: http://www.imaginativeconservative.org/2012/06/why-everything-is-not-economics.html#more

    The payoff grafs are the last 5 or so, but the run-up ain't bad, either.

  5. Stephanie isn't just a proof of your point, but she is also a proof that anything can happen. She's still pretty lucky, in that sense, that she had insurance to serve as her fallback in those times of trouble. It comes at a steep price, but no amount of money can match the fact that she’s alive right now.

    Elnora Cowger

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