assuredly uninsurable

I've been wanting to write about healthcare reform for a while now. I feel really passionate about it, but I have so much to say that I end up getting overwhelmed and then say nothing. I've also been a little hesitant on what to say and how to say it, because it is such a divisive and polarized political issue. I know my views are sure to tick a few people off. But my unwillingness to choose a side in the conservative/liberal identification game, along with my tendency to blather on about my personal political agenda, basically means that somewhere along the lines I am sure to piss off EVERYONE I KNOW. Especially my mom, but probably more so for saying the word "piss".


Anyways, there are a million things I could say on this issue, but for now, I want to start with just telling our story. The reason I think our story is important is because I think that most people who are against healthcare reform have some notions about the "uninsured", and also about what government-run healthcare is really like. In our family, we have struggled with private insurance, but we have a child who is on a government-run plan. I will talk about Jafta and our experience with his insurance another time. But today, I want to give a face to the problem for an average American family like ours.


Mark worked at a church for the first ten years of marriage. He had decent insurance at this job. During this time, I didn't really know much about the health insurance crisis. We had insurance, and so how other people were affected wasn't really a huge concern of mine. Like a lot of people today, I assumed that people who didn't have insurance just needed to look for a different job with better benefits, or just pay out-of-pocket and get it on their own. But it wasn't my problem, so mostly I just didn't care.


My first brush with the systemic problem came when Mark was in a major car accident. It was a freak accident - something you never expect will really happen to you, and one of the reasons insurance is so important. Had we not been insured, we would have lost everything to this accident. Thank God we were. We had an HMO at the time so most everything was covered. But when we saw the bill, two things stuck out. First, there seemed to be a serious game of "name your own price" when it came to the bills. The hospital/doctor/ambulance would state their price, and then that price would be considerably reduced to the contracted rate. Which begs the question, WHAT IS THE REAL PRICE? When you buy something from a street vendor in Tijuana, you expect that the first price thrown out is just a high-ball starting point for bargaining. You don't expect it from healthcare professionals, but that is exactly what happened on every bill received. Usually the "contracted price" was about 25% of the initially requested price.

The other systemic issue we noticed, which is no surprise to anyone, was the exorbitant cost and low quality of care Mark received in his month in the hospital. He went days, literally days, without seeing a doctor. I had to chase nurses down in the hallway to ask for help when Mark was struggling with basic functioning. As a family, we felt we couldn't leave him at all or he would be ignored. We had to advocate constantly for him, and often took to doing things ourselves (bathing, toileting, etc) because it was so hard to get someone to respond. It took days for someone to notice that his brace was on incorrectly, and the result is that his bones healed incorrectly which led to two later surgeries. He was booted out of the hospital way too soon, and came home completely and totally dependent on 24/7 care. I literally don't know how he would have survived if he didn't have family to care for him. And the hospital bill for four weeks of substandard care? $500,000. Then another $190,000 for two subsequent surgeries to fix the crappy job that was done in the hospital. And do you think the hospital offered a refund for their shoddy handiwork? No.

There is a lot more I could say about that experience, but I am already digressing from my point, which is to talk about how we became an "uninsurable family". When Mark left his job at Rock Harbor to do private practice, we knew that insurance would be a factor, but I was completely ignorant as to how big it would be. I had seen commercials on tv for insurances plans "starting as low as $90 a month". I figured we would just buy our own insurance, and that it would just be something we added to the budget. I knew we would have some pre-existings, but neither of us had cancer, right? Mark's accident was in the distant past, and while I figured we would pay a higher premium, I had no clue that some people just can't get insurance no matter what they are willing to pay. We called broker after broker. We filled out forms and answered honestly. Because of Mark's car accident, he was considered UNINSURABLE. He wasn't given a higher premium . . . he was flat-out denied. And surprisingly, so was I. A string of miscarriages (that required no medical intervention whatsoever) also rendered me uninsurable, and we found ourselves with no options, even if we were willing to pay. The church did not offer COBRA, and we talked to numerous underwriters, all of whom told us the same thing. We won't insure you, and NOBODY WILL.

Now, Mark and I did manage to find a way around this. We were able to form a corporation and gain insurance as a company of two people, since we are in the same field. But not everyone has the education, savy, ability, or money to do something like that. I know there are many people out there without insurance because of health conditions. And these are the very people that need insurance. Why we would want the government to stay out of offering this right to every person, especially the sick, is beyond me.

We are very fortunate to be insured, but this is still a broken system. We pay $1000 a month to insure the two of us. That's $12,000 a year, and doesn't include our kids. This is only catastrohpic insurance. We have a $5000 deductible every year. I got pregnant in August, so we paid that deductible in 2008, and then it started over in 2009. And once I had Karis, we had to pay the deductible again for her hospital stay. Even after the deductible, our plan only covers 75% of a hospital stay. So my delivery bill was $1900 after the deductible.

So, if you do the math, my pregnancy cost us:
$9000 (9 months of premiums)
$5000 (deductible in 2008)
$5000 (deductible in 2009)
$5000 (deductible for Karis)
$1900 (hospital stay)

= having Karis cost me $25,900.

And I have insurance.

Please know I'm not saying this for a pity party. Mark and I are fortunate, we're scraping by, we don't need anyone's sympathy, yada yada yada. We may have to lay off the Starbucks and eating out for a while, but we will manage. The point I want to make, though, is that some people can't. This kind of expense would put some people into bankruptcy. People WITH insurance cannot afford bills like this. That is not okay. And these numbers are for a pregnancy. I can't imagine what a serious accident or illness would cost.

I share all of this in an effort to put the insurance thing into perspective. Regular, hard-working people are struggling. This is not a problem that just effects illegal aliens or the unemployed. (Although those people are deserving of sympathy, too). This is a problem for many average Americans.

There is so much more I want to say about this . . . I want to talk about how we are already paying for the uninsured, about how government-funded health insurance does not mean socialism any more than libraries, public parks, or schools do. I want to question why we think money-hungry HMO's are managing our health with any more benevolence than the government would, and how 0ur current system has most of the very issues we fear about countries like Canada and England (long waits and crappy care). I'm hoping I will get around to talking about that, but for now, I would really encourage everyone to look at this issue with FRESH EYES. Move beyond the political, because this is not a political issue. This is a social justice issue, and our level of compassion should not be defined by our political alliances.

35 comments:

  1. Wow. Thank you for posting this. I am conservative, Republican, whatever you want to call it, but I have been feeling more and more tender towards this very issue. I am okay with a government ran health care system as long as I can still keep my private insurance if it is a better fit for my family.

    Also I went to Rock Harbor during Mark's accident and I also worked with Nancy at the time. My heart was breaking for your family. I had no idea that the hospital made the mistake that created the need for the extra surgeries. That's horrible!

    I also wonder if you would be uninsurable in another state. CO does no treat pregnancy as an illness and it is excluded from private plans unless you pay an extra monthly premium. Also, a friend of mine has decided to leave it that way and discovered that a pregnancy without insurance, paying cash, would cost about $4000 out of pocket. I cannot believe Karis cost so much.

    Anyway, I am also very annoyed by the facebook survey about women being drug tested to get their welfare check and food stamps. All of my "friends" have said yes and it breaks my heart. It is real easy for those of us that have to look down on those who have not. Let's not punish children for the mistakes of the parents!

    Okay enough of my novel, I must get the kiddo to bed!

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  2. Kristen, as you might imagine, this is a major topic of conversation at my house. EVERY DAY, Jeff sees cancer patients who are hard working, good people with no insurance. And, when they get cancer, they lose their jobs and whatever benefits they received. It is horrendous. I think the biggest thing is that we need to decouple medical insurance and employment. Allow for private insurance to continue and create safety net care for those who cannot afford private insurance.

    Like you guys, Jeff and I were hit with over $150K worth of medical bills from Grace's birth/NICU stay and two emergency surgeries he had to have during his medical training. (A time when we were making less than minimum wage...derived from combining his meager salary with hours worked.) We were also blessed enough to have an HMO...for which we paid $500 per month. That bill was one fourth of our monthly income at the time...not sustainable for most families. Though we are insured, my pregnancy will likely cost us around $12K this time.

    I would love to see the following:
    1.) Eliminating politics from this issue.
    2.) Engaging doctors and people who actually KNOW what is happening in the system to solve the problem. Creating working groups with stakeholders to make decisions about how to best make a new system work.
    3.) Raising funds for healthcare coverage via extensive taxation on cigarettes, alcohol, fast food and other good and services that are KNOWN to cause health problems. I do think that we have to take responsibility for what we put into our bodies.

    As a final note, I get so worked up when people suggest that the Canadian system is better than ours. We have millions more people and our health care is far superior to the care that is available in ANY other country in the world. Our physicians are more highly trained (spend 4-6 more years in school) and our technology is cutting edge. We cannot have these benefits in a system where the government is footing the bill. Even some of my Canadian friends have said that if someone had a real problem (cancer, etc) in their hometowns, their community raised funds to send them to Seattle for care.

    So, as liberal as I am, I really do think there is going to have to be a level of self-evaluation and personal responsibility that comes with changing the system. I sincerely hope that we can find a way to provide coverage for every person in our country, but I think we are going to have to grapple with some very difficult realities and make some trade-offs to get there.

    Thanks for posting,
    A

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  3. Well Kristen, you knew I would have to comment...

    I am Canadian, a registered nurse, and a mother of five. I have witnessed and participated in our government run system as both a patient and a care giver. Our system is not perfect. We do have wait lists for certain medical procedures (non emergent ones) but contrary to popular American beliefs we do not wait for treatment in the case of life altering situations.
    We also do not flock to the US for "good" medical care. Of course there are situation that people seek treatment in the US for certain specialized or experimental treatments not available here but we don't need to cross the border to get adequate care-simply not true.I have personally cared for several American patients who flew North for care not available in the US. I would not take that and generalize that the care in the US is sub-standard.

    American physicians and nurses are not better trained than their Cdn counterparts. The majority of all physicians go through 4 years of pre-med, 4 years of med school, and another 2-10 years of specialized training. In fact, Cdn trained healthcare workers are regularly courted by prominant US hospitals because of their education and experience.

    The care in the US is not any better on average than it is here in Canada. I spent 2 months with a family member in a US hospital while they battled cancer. I can assure you the care was mediocre at best.

    Yes, our system has flaws. Yet we live longer than our American neighbours, have a lower infant mortality rate, a lower obesity rate, and never, never does anyone have to worry about how they are going to afford care.

    Health is not a business. It is a right of all, not because they can afford it or are lucky enough to have good insurance but simply because they are citizens of their country.

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  4. Thank you for sharing your story. I hope you don't mind that I tweeted it. :)

    You are right, it is a social justice issue. No one should go broke because they get sick.

    <><
    Andi

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  5. Hi Kristen,

    I'm also Canadian and want to back up what Jenn shared. I'm not a nurse or in the health care field at all, just an average citizen. I recently got to talk to an American nurse and she said all of the things that Jenn pointed out as misconceptions about our system, but as I shared with her how our system actually works for the average person she realized that she had been really mis-informed, probably by a lot of the people that benefit from having a non-government run medical system.

    In Canada our medical premiums are based on our previous years income tax. Whatever you make determines what you pay. I spent many years at the lowest end of the income bracket (I was just out of college and working minimum wage) and my premium was $65 every THREE months. What did that get me? Everything. I could walk into any doctors office, specialists office or emergency room at any time and NEVER see a bill. We never get them. I don't think most Canadians even know what it costs the government for a doctors visit because we don't ever get the bills. That's all taken care of between the health care provider and the government. And I receive the same care as someone who might be making 6 figures.

    Same thing with prescriptions. Your previous years tax return determines your premium, and after you've paid out your premium in prescriptions the rest are free. You literally walk up to the counter, give them the script and once it's filled you walk away, no money exchanged.

    Like Jenn said, long waits are for things that are non-emergency procedures. Several years ago I was having problems with my eyes and while I was at a walk in clinic for a sinus infection I mentioned it to the doctor. He checked it out and within 20 minutes I was at a specialists office, and he was checking me out. He had delayed from going into surgery so he could see me. They were worried that it was a benign brain tumor. He sent me right up to the hospital and I had a CAT scan. It ended up being something else, thankfully, but within 2 hours I went from a walk in clinic to a CAT scan machine. The other times that I had to go in for procedures because of the condition that I did have my waits were only a couple of weeks for things like a lumbar puncture, as a non-emergency patient.

    I think a lot of what people hear in the US about other medical systems is scare tactic from those that make money off the US system. A lot of times the facts are wrong, or not all that accurate. They've done studies and Canadians on average are in much better health and live longer than Amercians. I think it's simply because people don't worry about whether health care is available to them so they go to the doctor early on and the doctor is able to focus more on preventative care, not dealing with health issues when they're already progressed. Canada also has lower malpractice rates. When you take money out of the equation between doctor and patient, doctors can actually focus on patient care, not whether they're going to get paid for their time and be able to stay afloat.

    My husband is a dual citizen and his parents live down in the US, so the healthcare thing hits home for us on that level. They've had a chance to use both systems and they're hoping that the US develops a public system.

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  6. Kirsten,
    Thanks for that amazing post, I really hope that the "right" people read it! I should be horrified with your personal story, but sadly am not. Now doesn't that say something? As an American I have become numb to the fact that our citizens are actually turned down for health insurance, that we file bankruptcy left and right in order to pay for our health care and CNN finds it more important to give us non stop coverage on who is gaining custody of Michael Jackson's kids rather than who in the hell is going to "save" us from oursleves with this healthcare crisis we have been living in for decades now! I think we should stand in awe of the Canadian system (as well as some of the european countries) they have their act together! They have decided that providing the most basic of needs is not up for debate. You are a citizen of their country, you are given the best care they have to offer, at a price that is deemed affordable to each and every family, period. No questions asked! Our family doctor is Canadian, and an outstanding human being, I trust him implecably. He has talked to us many times about the Canadian vs. American systems, and he himself has practiced in both countries. He too feels that if we could even remove healthcare here from being tied to employment that would be a start in the right direction. He strongly feels that most American doctors would be interested in getting back to basics, which is patient care first! Our system doesn't allow that, and fosters coruption all over the place! I don't want to discredit what anyone has to say on this, as I think all talking points are valid. But if our care is really cutting edge, and we truly have the best trained doctors in the world, and our overall care is really superior to that of ANY other nation, what good does ALL of that do, when millions of us don't have access to that care, can't afford that care, or have lost the job that gave us that "right", or lose EVERYTHING else we owe to gain that care???????? That is NOT a system to be proud of, I am actually ashamed of it. It should not be a wish or a dream that all Americans have high quality care, we CAN afford it, and we can afford to give it to all equally, without question. IF we put politics aside, religion, status and hold personal accountablity(I agree that we need to be responsible for what we put into our bodies)than we can achieve a system to be truly proud of. One that doesn't discriminate on ANY level!

    I don't think the plan that Obama is suggesting is near enough! It's only a baby step in the right direction, I wish we could just get down to business and use "real" people those in the trenches to come up w/ a viable nation wide plan. It is complicated of course, but it's not impossible. Many out there have convinced the masses that it's socialism at it's finest, well our current healthcare system is a "con" that would challenge even Bernie Maddoff!

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  7. Although we may not like it, we all know the only compassionate and humane solution to our crisis is a public health care system. I believe is frightening about it is our nature to devalue that for which we do not struggle.
    Obesity, smoking, drug abuse--these are the tip of the iceberg of a lack of self-regulation. Are we willing to overlook the chubby man chomping down on an In-N'-Out Double Double, or a colleague with the cough who smokes a pack or two a day?
    I often ponder my 17 year-old students who are pregnant or already have a child. I ask them how they will survive financially. They are confidently oblivious. Yet young female teachers often agonize over whether they can afford to have a child? Obviously, the expected contributions/ responsibility of the older women gives them pause. The teens' medical needs (and that of their babies) are met, along with a stipend for food, and school-provided childcare--something not available to faculty nor staff.
    What to do? What to do? I think Anne made some viable points. Decouple jobs from health insurance. Place a substantial tax on any and all comestibles, even entertainments, that negatively impact health. Fresh vegetables and fruits are untaxed; that rib roast, Grey Goose, with Oreo Schnappes are hit with a 25% PHAT (Public Health Additional Tax). That way, those of lesser means can afford to eat well, and those who want to live large can do so.

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  8. Mom of 2- Ottawa1:11 PM

    I am also a Canadian and universal healthcare is wonderful. My family has always had excellent care by great doctors and specialist- I brought my teen to the emergency room last month and we were seen immediately and referred to a specialist within days. I have never had a medical bill- not one- think about it.
    It is not perfect- but we never have to wait to be approved by an insurance co.- we all have a right to healthcare. Imagine if all schools were private and only the richer were educated. Not insuring the whole population makes no sense.
    In the province I live in there is no healthcare premiums. We just have to renew our healthcard every
    5 years.
    My younger son said to me a few weeks ago- it would be great to live in the USA if you were rich- but it would be really hard to be poor there!

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  9. Mom of 2 - Ottawa1:15 PM

    I also wanted to add that all Canadians 65 and over get their presciption drugs paid for- the first $100 anually comes out of pocket then the government pays the rest-
    These things are never told to Americans-just negative stories to scare you from Universal healthcare.

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  10. Thanks, Kristen. I've been unsure of this issue--struggled back and forth, and hearing a personal story definitely does give me fresh eyes on it.
    P.S. I LOVE your new header with the photos over the years- very creative. :)

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  11. yes yes yes yes and yes.

    health care in america is a disaster, and the fake, inflated price tags that insurance companies don't pay (but those who pay out of pocket would need to) are ridiculous and unfair.

    a personal healtcare story--when my husband and i were first married, i worked as a youth pastor at a church and he was a teacher at a christian school. neither of us had insurance. i remember falling and passing out at an ice skating youth group event and refusing to get into the ambulance they called because we could barely make rent and i knew we couldn't afford a ride to the hospital and treatment.

    during that time, i also received excellent gynecological care from planned parenthood. that probaby would have shocked the congregants at my church--but they weren't exactly lining up to pay for our health coverage! PP is NOT just an abortion provider--they provide routine GYN care or any woman in need of medical attention--even married, christian youth pastors!

    people need access to SO much more than an annual pap smear and birth control, and the govt needs to step in to make decent health care affordable and available to everyone--not just the wealthy or lucky.

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  12. Anonymous6:53 AM

    I've never commented before but I wanted to applaud your honesty.

    In May, my husband contracted MSRA from the local hospital after an er visit (the er visit was for fast heart rate one evening that turned out fine). Neither of us are insured (he had just started a new job and wasn't eligible for insurance until after six months). He spent twelve days in the hospital on heavy duty antibiotics and had surgery to drain infection. Due to this we are now about 70,000 dollars in the hole and looking at bankruptcy. As newlyweds with an infant and college educations it's not exactly how we pictured our late twenties.

    It's easy for people who have never been affected by lack of insurance or being under covered by their insurance companies to talk about the evils of government help in this area. But like you and I, anyone can end up in this position.

    Melissa

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  13. I don't believe that government funded health care is the answer to the problem, however, I do believe in government regulation, and making new laws that the private insurance companies would need to follow, making it possible for all Americans to have affordable insurance. These companies are making money hand over fist. I'm not ready to trust the government with my health care benefits. They've screwed up every program they got their hands on.

    I read so many of the "clauses" in this bill, one of which states the government would have access to our bank accounts to "pay-back" money they think we may owe for benefits. This is absurd.

    I think the government has enough power and they use it poorly.

    It's time the listen to the citizens before drafting such a bill.

    I do understand your concerns, however. My father was self-employed. Growing up we didn't have any health insurance. If we were sick, we didn't go to the doctor, unless it was severe. My father paid all of the medical expenses out of pocket because private insurance would have bankrupted him.

    So yes, regulation is necessary. Government control of health care truly scares me.

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  14. OMGOSH!THANK you for stopping by my blog so that I could read this!

    SUPER important post ~ Great blog as well!!!

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  15. Thank you for posting this story I also always felt so strongly about health care that hesitated to talk about it until now. But the system has to change. As someone who grew up in Italy with universal health care coverage and who has had a government run program for the last ten years (military Tricare) I know it can and will work.
    Let's give it a chance!
    Ciao
    Anita

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  16. Oh Oh OH! Love the post. I'm so sorry to hear about your troubles with insurance and the cost of pregnancy/maternity care. (One of the reasons I'm hoping for a homebirth when I get preg again... not only is the care amazing with a midwife, it's safe for low-risk women, but it's CHEAP!)

    I was telling my husband the other night, "Honey, there isn't much that I hate in this world, but I hate insurance companies!!!!!" I'm amazed that we can have a system where insurance companies are supposed to support people with claims while having their priority to the shareholders. It makes me sick. Talk about a conflict of interest... and I'm always wondering... "How come nothing is being done about this???"

    I was just thinking of changing my insurance because I'm getting fed up with mine. It's my understanding that they won't cover me if I see a Naturopathic Doctor - WTF? But, I suspect that if I try to change I might really screw myself now that I'm on my fertility adventure, which of course, isn't covered.

    A friend of mine "negotiated" with the hospital ahead of time to pay cash and ended up paying a much smaller amount. And, I found that when I did that before having my ultrasound a couple weeks ago, the price they gave me was much lower than if I hadn't asked, it hadn't been covered (which I knew it wouldn't), and then they would have billed me a higher price. Again... WTF?

    OH! It gets my blood boiling! I hope we get some better solutions SOON!!!

    Hugs and Love to you,
    Kristen

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  17. Oh, and I disagree with Anne who wrote that we have superior health care! What a joke. Simply look at our infant mortality rates. Look at the rates of death and illness due to incorrect prescription dosages and handling.

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  18. Irene6:18 PM

    What a powerful and true post! I have been enjoying your blog lately because I have an interest in adoption, but it is this post that made me want to comment, and especially what you said at the end: "This is a social justice issue." I strongly believe that health care is a right and I definitely feel that the insurance companies are sitting in the middle taking in huge profits from people.

    Your story is very powerful, because like you say, average, hardworking people are ending up in bankruptcy because of medical bills - even when they have insurance! And the astronomical sums you pay for coverage now are just sad. I also pay for individual coverage now because I am a contractor, and it plain sucks.

    I come from one of those European countries that are often demonized in the media, but truth is that I do a lot of my check ups, dental work etc. when I go there on vacation, because it is good and affordable. We might pay more taxes there, but we don't have to pay thousands of dollars out of pocket for insurance!

    I also found Melissa's quote very important: "It's easy for people who have never been affected by lack of insurance or being under covered by their insurance companies to talk about the evils of government help in this area. But like you and I, anyone can end up in this position." So, so true!

    To all of you struggling with this, I hope that the time is right and the momentum is there to really make changes this time, but I am really worried about the health insurance lobby, one of the strongest there is.

    Kristen, thanks for this important post, and all the best to you and your beautiful family.

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  19. wow, what a GREAT post,(found you through Welcome to My Brain) I am struggling through my thoughts on this one too, but having family who is GREATLY affected by their lack of insurance makes it a very personal issue for me, thanks for writing and I am tweeting!

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  20. I don't even understand why we call it "insurance." Insurance implies that the cost and extent of coverage ought to be proportional to the level of risk involved. When someone can't afford car insurance because they got in too many wrecks, we don't particularly feel sorry for them. It's their fault, and, hell, who are we kidding, they probably shouldn't be on the road anyway.

    But with health "insurance," we're talking about human beings. People who've had cancer or depression or traumatic injuries aren't any less worthy of being alive and well. Why are we even using an insurance model in the first place?

    I'm not totally against passing the costs onto the consumers. I resisted switching from my generic ADD med to a name-brand one for a long time, because I knew it would end up coming costing me a lot more. And in the end I made the switch, because the new drug was so good it was worth the extra cost. And that's the way I think it should work, among people who can afford to pay. They shouldn't be totally insulated from the costs that they have no concept of the marginal benefits and costs involved.

    But at the end of the day passing on the costs shouldn't be the primary objective. Nor should making a profit be. Because that whole model makes absolutely no sense when we apply it as a means to a completely unrelated end--that of making it possible for people to live and be productive in society.

    What kind of people are we that we as a country dole out something so basic as the ability to live based on the ability to pay? How is that not "rationing"?

    And since we all have a personal story, here's mine. A few years ago, when I was 22, I reconnected with an old high school buddy. He had been having a hard time with depression lately, but he said he was starting to feel better. His current job, as a waiter, didn't offer health insurance, but he said he was trying to get a new job so he could get on antidepressants. Unfortunately the new job never panned out. And just five weeks later I was at my buddy's funeral. He had shot himself.

    What gets to me is that he had actually reached a point where he was willing to get treatment. Now I know it's not certain that he would have followed through. And, yes, he did have a substance abuse problem too. (In some folks' eyes I'm sure that makes him less worthy of treatment.) But he wanted help. He should have at least had a chance at treatment. Instead he ended up in a coffin, at just 23 years of age. Our country lets people die like that.

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  21. Found you through Jena's tweet. Thank you for such an incredible post that echos my thoughts so much better than I could piece together. There are so many things about this topic that make my blood boil - and all the comments have been so wonderful too. I'm self-employed, and went that route after I'd started the process to adopt. Little did I realize that planning to adopt will get you denied by every insurance company for a standard policy. I finally got a high deductible plan where I could automatically add my baby on, and was relieved that well-baby visits are covered. But then my little one bonked her head and started throwing up. I'm ashamed to say I waited and tried to convince myself we did not need to go to the ER, because I was terrified about how much it was going to cost (ER plus CT Scan due to her age, probably sedated, etc.). As has been said, I believe people just don't understand the entirety of this issue if they have insurance and haven't had to make a major claim through it. Most importantly, which you touched on - education, fire, police, parks, libraries - all a RIGHT for people when living here. But health care? Nope, that's a for-profit business. I simply don't get it. Thank you for such a great post. I hope you reach a few people who can see things in a new light (and I'm going to forward on/repost this if that's ok).

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  22. I'm going to have to disagree with most of the comments here.

    I didn't have insurance several years ago, so I bought my own. A few months later, I was diagnosed with cancer - but ONLY BECAUSE OF AN ELECTIVE SURGERY, which was arranged by a specialist. People in Canada have had to wait 3 months for the same surgery I received in the States. I'm not making that up just b/c I'm American. It's true and it's happened.

    The current US bill wants to decrease the role of specialists in health care.

    In France, gap insurance is required to cover what the gov't won't pay. Most gov't programs around the world are facing funding problems. In england, they constantly cut "elective" procedures.

    There are big changes that need to happen in US healthcare, but the rest of the world is not setting an example.

    Yes, there is bad care in America - but there is also AWESOME care at places like Duke and Johns Hopkins and the Cleveland CLinic. Which is why politicians from Canada and Italy have come here for their care.

    There are real problems in the Canadian healthcare system - and I think it's disingenuous to suggest otherwise.

    More Americans are covered than most people realize - and even more people would be covered if the government didn't restrict things like crossing state lines for access to insurance. Yes, the same gov't that suddenly wants to give you healthcare has restricted your access to it for decades (and across party lines.)

    I'm sorry that this blogger has had a bad experience, but most hospitals are willing to work out payment plans. If not, a contact to your state's insurance head or attorney general can help.

    I know b/c I have my own bills to pay. I'm not rich. Not even close. I'm glad to pay them though. It may not be perfect, but healthcare costs money - and you'll be paying for it through premiums or taxes - but it's never free.

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  23. A Canadian reader6:21 AM

    Some of my friends and relatives have had cancer- they had their surgeries immediately- We don't wait 3 months!- Who told you this?-
    Sometimes chemotherapy is given first to shrink the tumour- then surgery is performed- but we certainly don't sit at home waiting for a call- or worry about medical bills.

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  24. Also came over from welcome to my brain.

    Just clarifying based on the post above this one. The post two posts above mine was talking not about how he thought he would have been refused cancer treatment but how his cancer was found as the result of an elective surgery, a surgery he felt would have been denied in another country thus chaning the prognosis for his cancer.

    I too have to chime in but from a perspective that hasn't been mentioned yet: as someone who has tried to wade through our current government healthcare program Medicaid. My MIL was diagnosed with terminal cancer two years ago. She was covered by insurance until her cancer made employment impossible. She then became eligible for Medicaid. Well, not immediately, because you have to have no assets in order to qualify for Medicaid. Literally, nothing. Your bank acounts must have less than $1000 in them, if I remember correctly. For a person who is not working and will never work again, getting down to $1000 means you will have about what you need to make ends meet for one month, then you qualify for Medicaid, but then have no money left over and no source of income once that month has passed. Once on Medicaid, we experienced both pros and cons of having the government involved in healthcare. Pros: she was immediately eligibly for nursing home care, no waiting. Cons: she was only eligible for a nursing home that had a Medicaid bed available. Thankfully, we ended up in a great place but due to limited number of nursing homes in our area, we could have ended up with the only other nursing home which is really a crappy place to be. It was also a confusing mess of what is covered, what drugs are available, when she will be covered, and a waiting game of is she covered or not. Not necessarily worse than insurance but I think that if the government is involved it should simply and improve our lives, not make them more complicated.

    I too want health care reform but I am frightened of how ill equiped our government is to deal with issues when real people are involved. Governments often deal with black and white and not shades of grey. Ours (and probably many other country's) somehow manages to do a terrible job of helping people ie Medicaid, foster care, welfare, unemployment, prisons. A government is a system and often lacks common sense and compassion, two things that are needed when the issue involves people and their health.

    One thing to consider with the current system, as someone else said, health insurance is governed by state laws. If you could purchase health care across state lines, this might make a differnce. There are so many things like that (tort reform to help with malpractice, cost controls to eliminate $15 asprins, incentives for healthy individuals who never use their insurance, etc.) that I hate to see our country swing so quickly to a totally new system.

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  25. Just now reading this- I have been reading through your blog this afternoon. Just as an aside I am also an adoptive mom and "know" you from Hannah's Prayer Forums. Anyway agree with you a lot. I would consider myself conservative and am in a very conservative enviroment but I have been extremely frustrated with the people I know and their reaction to healthcare. They truly seem to say that it is immoral for the government to provide healthcare for the poor??? What!? You get the comments "Nobody is denied healthcare" Well sure if you show up at the ER on death's doorstep and then you can accept a hefty bill. Or they act as if people without healthcare are just lazy and have no desire to do what it takes. It is crazy! I truly have trouble wrapping my mind around where this mindset comes from. I mean I get disagreeing with the hows of providing healthcare but to claim a moral wrong if the government gets involved just makes me shake my head.
    And as another aside- I am a nurse and I am so sorry for the care you received- we are not all like that:)

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  26. I haven't been reading your blog for very long (sorry, just found you!) so I'm just now reading this post that you linked to.

    Anyway, keep drinking that Starbucks!

    Starbucks offers all employees full medical, visual, and dental. To get this insurance, all you have to do is work 20 hours a week! It was perfect for my Husband and I when we were in grad school.

    The insurance covers ALL pre-existing conditions and extends to family members.

    This doesn't solve any of our nations problems, but I wanted to give a shout out to Starbucks.

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  27. Amen sister. My husband is a Realtor and therefore considered an independent contractor. Our healthcare premiums are RIDICULOUS! I am ready for something new.

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  28. This could be the best written post I've read on this subject. It sums up my feelings perfectly. I don't know when this became a political issue when it's really about those who are sick, getting the treatment they need to get healthy.

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  29. I'm Canadian, but my husband is American. We lived in the US for our first 5 years of marriage. You sum up my thoughts/feelings, but you have so much personal experience with the system to back it up. Thank you SOOO much for sharing. I am so confused that it was mostly Christians in the US that apposed health care reform and were really "it's all about me" in their approach and reasoning. Yet, it was non-Christians who thought sharing with others, helping the least of these was OK with them. My husband said one of the reasons why he would like to stay in Canada is that he doesn't feel he could willingly go back to the US system. He gets the same standard of care here as he did in the US, yet, it's available to all. I feel "universal" health care creates a universal sense of togetherness. Not one of us is more deserving of care than the other. In the US, only those who had EXCELLENT health care seemed to be the most likely not to care that others were going without.

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  30. Anonymous9:32 AM

    Way to go Nathania! Everything you listed is perfect.

    As far as the pregnancy (giving birth, etc), you simply went about it wrong. Paying cash out of pocket to your OB, hospital stay, would have cost you much less than the $26k, period. All you need to do it be a cashing paying customer and discuss this with a hospital before giving birth.

    Health care - is not a right! No where are we and should be given health care. What makes it a right to have it?

    K.C. in Oklahoma

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  31. I just started reading your blog today and this is a great post. Something my husband and I dealt with in 2008 after I was
    Laid off, also an lmft by the way. We got group insurance through forming a Corp too, but we too were paying high monthly premiums and had huge deductibles. Still do. And now we are in the position of saying no to having another baby because of the out of pocket expenses we would have to pay. And we are both super healthy, tax paying, doing everything right good people. It's so sad and I too have tons to say on this topic.

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  32. Anonymous11:31 AM

    Whew - I have read your post and ALL the comments! Good topic! I have struggled with this topic.

    I had to go to the emergency room for terrible pain (turned out to be ovarian cysts)... and at the time I wasn't covered (I ended up being within the 63 day break to apply for Cobra- so just backdated my payments and it was like I was covered the whole time - this is Cobra's grace period) but cobra is so expensive! For my husband and myself we paid $700 a month!

    The bill I would have gotten was $6000!! It's so much money but I realize something --- i had the luxury of a doctor waiting right there for me in the middle of the night - is that something I deserved? No! It was a service that i (more my husband!!) deemed was worthy to pay for - otherwise I wouldn't have gone in. Was the doctor obligated to care for me? No! Did she do it to be nice? No! She did it for the money - it's her job (and of course she has a passion for it, but deserves her wages).

    Where is the line between someone (future health care providers) taking years and paying tons of money and loads of time in med school, and non-med people just thinking it's our right to be cared for by them and stay in their facilities with all the SUPER expensive machinery? Hospitals ARE luxury!

    As someone said, but in other words, simply, you get what you pay for unless sweet hearts decide to give you charity (think Ebenezer in the Christmas story as an example of what I'm talking about - the principle doesn't change).

    We will all end up paying for this "government-funded healthcare" somehow - and I suppose the poor will benefit and the rich will have to sacrifice for it - that's where it becomes a political issue. The government doesn't have any money we the people don't give to it. We are the people.

    It sounds so wonderful that no one should go un-covered. Of course! It sounds so wonderful to me.

    But then where are the opportunities to be charitable? But as someone has said, people AREN'T and WON'T be charitable (just look at the poor children in many third world countries and the rich in their palaces right near them) so the government needs to be there to ensure that care happens for people who can't pay. But is that not happening now? I don't see it here like it is in third world countries.

    I don't know enough about this topic to keep going onto where each string leads and to how far the government should be involved in enforcing that care happens. But look at the story of the good samaritan in the Bible - the sick man on the side of the road needed charity, needed care from a charitable doctor or someone to pay for the care he needed.

    We are dependent people, and sickness is the fall of man and the curse is death. Jesus took the curse so we could have eternal life. This world is flawed. Heaven is not.

    I wish no one had to be poor or sick or orphans or homeless or die in the whole world.... I wish for heaven. And until then, I am called to be charitable.

    29, Laurie, CA

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  33. Anonymous3:59 PM

    I completely agree with your post on the problems in the health care system. I have had similar experiences with the births of my children under an individual insurance plan. We paid $7500 out of pocket for my youngest son (on top of $560/mo premiums). And this was an uncomplicated delivery. We too looked at insurance statements and were mystified by the game the company and providers were playing with the costs. For the birth of my youngest daughter we dropped our insurance coverage and enrolled in Samaritan Ministries (a christian health sharing group). This covered the cost of the birth entirely--but I had to negotiate all the payments directly with the providers. The "discounted" rate for an uncomplicated birth totaled over $13,000 (brought down from original quotes of nearly $30,000). In the case of childbirth my husband calls this pricing policy an "extreme form of birth control." Though inflated pricing seems to be part of the entire healthcare system. It is totally corrupt and needs to change.

    But I fall on the other side of the approach to a solution. I don't think a gov't system would give me the care I am looking for. I already don't like some of the things the gov't decrees that I do not agree with and feel powerless to change. I don't want to sign up for more of that when it comes to decisions about my health. Yes--we need to take care of those who can't provide for themselves. But for those of us ready and able to work at gainful employment--I want the corrupt relationship between insurance companies and medical providers broken up so that realistic rates can be negotiated. And true catastrophic coverage wouldn't be so high. That is where the solution lies--back to the patient and their doctor and a level of accountability currently not found anywhere in the industry.

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talk to me.

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