Steve, a career coach, discusses the many pitfalls of qualifying for and affording good health insurance.
I often see people who are in soul-killing, corporate jobs, who’d love to start their own business, but they don’t dare because they have a child or spouse with medical issues, and they fear medical expenses would bankrupt them. If you are self-employed, insurance companies discriminate against you. There is no good reason for treating us differently than others, but I have found no good options for insurance as a self-employed person. At one point, an organization for the self-employed approached us, promising good insurance through a large pool of self-employed individuals. It sounded great, but when we got to the numbers, it was expensive, bad insurance that didn’t cover much.
People rely on their health for survival. Whether self-employed, beginning a small business, struggling with mental health issues or other preexisting conditions, everyone deserves the peace of mind of knowing they can get the care they need, when they need it, at a cost that won’t bankrupt them. It is unconscionable that the insurance companies gladly take our premium dollars when people are young and healthy, but when we have the audacity to get older and/or sick, the insurance companies drop us. I’m really tired of hearing about situations like a client who couldn’t get insurance because she’d had a bout with cancer. What are they to do?
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Passing legislation would allow people like Steve and his clients to obtain affordable coverage that is currently unattainable due to self-employed status or lack of coverage through an employer. Rather than relying on his wife’s insurance, Steve would have options. Access to preventive care would be increased, underlining a shift in focus towards overall wellness. Those of Steve’s clients denied coverage due to high medical risks would be able to access “catastrophic policies” as a stopgap maneuver until full coverage is made available in a few years. Reform will improve the quality of life of American citizens, and it must happen now.
Blue Cross Blue Shield cancels a couples’ policy, leaving them with a $200,000 medical bill.
When Linda’s Blue Cross Blue Shield of IL COBRA coverage ended for her and her husband on December 31, 2008, their premium jumped from $577.00 to $1,036.30 per month. In order to save money, her husband switched from a BCBS of IL group policy to an individual policy that had a $5,000.00 deductible (a policy she first heard about on Oprah). Because her husband was rarely ill, they were not worried about the large deductible and the 20% co-pay. Upon making this change, BCBS of IL never explained to Linda the difference between group and individual insurance, nor did they require a physical exam before approving him.
Linda believed her husband had secure health coverage until his bypass surgery in October 2009. Although the surgery had been pre-approved by BCBS of IL, one week following the surgery, BCBS of IL claimed that her husband had a pre-existing condition and rescinded his policy. BCBS of IL based this decision on the fact that her husband had three high blood pressure readings, even though these readings were the result of taking Mucinex DM (extra strength) – a cough medicine that is known for raising blood pressure. He had never been treated for, taken medicine for, or had been diagnosed with high blood pressure.
At this point Linda owes medical bills of $208,000, $89,000 of which is about to go into collection.
Of BCBS of IL she says, “You have insurance, you pay for insurance and then you’re not covered…They didn’t check his records before approving his individual policy. They did nothing but take our money…and now they’re sticking us with the bill.”
Although Linda has written to local, state and U.S. senators and representatives, only President Obama expressed genuine concern over her situation. In the end, Linda regrets ever changing her husband’s group insurance to save money with an individual policy. We need to hold insurance companies accountable. All Americans deserve the peace of mind of knowing that the health insurance they pay for will take care of them in their time of need.
A father is thankful for Illinois law that allows his daughter, diagnosed with Leukemia, to stay on the family plan until she turns 26, but wonders what happens next.
My name is Mark Kraemer and I am grateful for the excellent health insurance that I have through my employer. Without it we would not be able to afford my daughter Carolyn’s Leukemia medication—Gleevec. Thirty Gleevec pills, which would cost us $5443 out of pocket, only cost us a $40 copay. If not for this insurance, our family would have been bankrupted long ago.
Carolyn, who recently turned 23 and is not a full-time student, would have lost her dependent coverage this year. However, thanks to a new Illinois law, her coverage will extend until she is 26.
Once Carolyn turns 26, we will have to scramble to find alternative coverage. We are trying to cover Carolyn until the patent on Gleevec runs out, which we have heard could happen in 2013. Perhaps lower priced generic versions of Gleevec will also become available once the patent runs out.
We know that Gleevec is obscenely expensive, and our hearts go out to every patient who must wrestle with this problem. We are grateful that Gleevec and later generations of kinase inhibitors are available, but know that certain people who desperately need them could be denied their benefit due to cost.
We realize how lucky we are–Carolyn is still with us and we have avoided bankruptcy. But we are mindful that millions of people in the US don’t have the health insurance benefits we do, and that we are vulnerable to financial ruin should any change occur in my coverage.
This is why we have had such hopes for health insurance reform. The bills currently under discussion in Congress would ban the denial of health care coverage based on preexisting conditions, allow more families to cover their children until they are 26 or 27 and increase competition to keep health care costs down. We also hope legislation that lowers the cost of prescription medication will be enacted soon. Health insurance reform is the moral thing to do.
My name is Rich Godwin and I am an entrepreneur. It is a challenge to open a business and provide health care for my employees, my family and myself. The costs involved are outrageous. In five years, my family’s health care costs went from $500 a month to $800 to $1100 to $1600 to $2200. It infuriates me that my insurance costs got to be higher than my mortgage.
The American dream is being compromised because health care costs are eating into small business profits and making it nearly impossible to remain competitive. We cannot keep allowing costs to spiral like they have.
Dave works freelance, shooting films and stills. Depending on his earnings, he bought insurance on the individual market or in tougher times, went without. Luckily, he was insured the day he was diagnosed with colon cancer.
Dave began his chemotherapy treatments and had surgery on August 1st. Soon afterwards he was back in the field, shooting films in war torn Sarajevo and Serbia with his chemo pump at hand. He could not afford to take a break and lose a paycheck.
In October, Dave found that none of his medical bills were being covered. His insurance company was conducting an investigation, looking for preexisting conditions that would allow them to avoid paying the bill. Dave fought back and eventually the insurance company paid up. But afterwards, Dave saw his premiums jump 50% and 60% each year.
By 2008, his insurance premiums had increased to $28,000 a year and no other company would take him on. The total amount he paid to his insurance company exceeded the cost of his cancer treatment. But without competition and burdened with a preexisting condition, there were no choices.
Our health care system does little to help the sick. The health care bills under consideration would introduce competition, bring down premium rates and make denying coverage based on a preexisting condition unlawful.
