My sister Ronnie is recovering from surgery that she underwent in the same week that her daughter had a concussion. While most of us in the same situation would be licking our wounds, Ronnie’s grateful. And thinking about those who aren’t as lucky as she is. Here’s what she wrote in her column in today’s Philly Daily News –
After years of excellent health, my family incurred, in one insane week, what must have been thousands of dollars in medical costs that would’ve thrown us into a financial tailspin if we’d not had the insurance to pay them.
Why, in the richest country in the world, should luck factor at all into something as basic as access to affordable medical care for America’s citizens?
…A 2005 Harvard study showed that about half of the 1.48 million Americans who filed for bankruptcy in 2001 did so for medical causes. Their out-of-pocket health-care expenses averaged $11,854 – and three-quarters of these people were actually insured when their illnesses began.
…every year more than half-a-million Americans who assumed that they were covered are forced into bankruptcy anyway just because they got sick.
Think she’s wrong? Think bankruptcy from health care costs is just a problem of the unprepared, financially dim-witted masses who don’t know how to work hard or manage their money?
Let’s ask my brother, the hard-saving financial conservative who believes we all sleep in the financial bed we have made with sheets woven from our choices about work, lifestyle and money.
Big Bro
My brother has a friend who is dipping deep into his retirement savings to pay for a catastrophic illness after passing well above his $1 million dollar lifetime cap. If things go on as they are, his friend is looking at potential bankruptcy.
When he saw what his friend was going through, Big Bro, ever the pragmatist, called his benefits officer and asked how much it would cost him to raise his lifetime health coverage cap to 2 million dollars.
The answer? It’s not possible.
That’s right. He cannot buy insurance through his employer, for any price, that will cover him above $1 million in health care payments.
He is currently exploring the possibility of buying some other sort of insurance, outside his employer-sponsored plan, to protect himself. We’ll let you know if he finds it.
Bottom Line
It’s not insurance. It’s a crap shoot.
See you in Vegas.
Dealing with your health insurance company is in deed a crap shoot. And, just like in Vegas, the odds are dramatically skewed against you.
In a recent edition of the LA Times was a story about the insurer Health Net who was forced to reinstate coverage on 926 people because the state of California was about to sue them. Some of these people had their coverage cancelled while in the midst of chemotherapy treatments. I write about it in my blog, “My Prostate’s in a Mason Jar by the Door”, http://perishosprostate.blogspot.com/, 9-16-08.
Folks, coverage of your accumulating health care costs does nothing to bolster the company’s bottom line. I learned this first-hand while going through prostate cancer surgery, chemotherapy and 2 years of hormone therapy. The conclusion: your health insurance company does not give a rat’s ass about your health.
Comedy Writer Jerry Perisho
From your sister’s article…”every year more than half-a-million Americans who assumed that they were covered are forced into bankruptcy anyway just because they got sick”.
That’s just terrifying. We’re still waiting for my husband’s health care to kick in after his immigration to Canada, and I live in constant fear (he’s 3 years post gastric-bypass with tons of complications), that he’s going to get very sick before it does.
A friend of mine who is a life-insurance professional concluded, for health insurance, that it made more sense for his family to purchase an umbrella policy for catastrophic problems and remain ‘exposed’ for the everyday stuff. I don’t know if he agrees with my view of it as a $100,000 deductible.
If there were an easy fix to this, it would have already happened. This is probably one of the most complex issues of our time, and we need the right solution.
Other nation’s governmental health care systems have failed, and clearly the private path we have here is suffering miserably.
In looking at the election we have coming up in November, I don’t think either candidate has it down correctly. While we may be at risk for individual disaster, I would rather it (healthcare system) stay the way it is for the moment until a better solution can be reached.
The cited article quoted a Harvard study where half of the 1.48 million that filed for bankruptcy did so over medical causes, but I wonder how much debt on average the individuals had to drive them there. You also need to assess that crowd for honesty in the excuses…something that the article does not explore. Also, keep in mind that 750,000 people filing bankruptcy for health reasons is a big number, it is just 0.2% of the total US population. So should we be asking ourselves if we are fixing a problem for the extreme minority?
I would also really love to see the number of people that are affected by $1 million cap. While entirely tragic, how many people statistically hit this cap? I have no idea what that number is, and I should before I freak out about how to increase the cap.
It seems to me that the fix to the problem may lie in creating a better mechanism for those few that have extreme cases, not to change the whole system to accommodate the few. Again, I don’t have anywhere near enough data to offer a solution, this is just my thought on one path that should be explored. It is also the path that the government seems to be going down with respect to the financial/banking world. Perhaps a similar safety net/fund would suffice.
I surely am not informed enough, nor bright enough to drive the solution myself, but I sure hope that there is someone out there that is willing to dedicate themselves to this in an effective way.
love this post, and your sister’s column.
the system is broken, for sure. and things are even worse for the many millions outside the system.
shruggling — we already know we disagree about health care. i just can’t see how the health insurance industry is helping much, in the big picture — it is in business to make a profit, as large a profit as possible in each quarter. it does not care about fairness, nor about long-term health benefits; it cares about winning right now, and in the next quarter. after that, you might have another insurance company, if one will take you, so they don’t care. the insurance industry is a casino, and the odds are stacked in favor of the house.
i frankly do not think the problem is only on the extreme end of needs. most people who have insurance also have horror stories about it. the system isn’t working for regular folks. it also isn’t working well for a lot of doctors, especially primary care physicians, who spend tons of time and money doing paperwork and fighting for compensation that should be covered but is arbitrarily denied.
here we are as a country, shoring up huge failing financial institutions while their directors walk off with unthinkable personal profits — and we can’t offer basic health care to our citizens. that is just shameful.
AFLAC was our answer and a great compliment to our health insurance.
On the cancer policy we have, at a whopping $133 a quarter (for our entire family), we are covered with experiemental drugs for cancer treatment – with no max pay out! Having AFLAC, in addition to our health insurance, has proven to pay for itself many times over. Especially the “Accident Policy” – as I have a 17 year old and a hubby that loves power tools and toys (like a 17 year old)!
While I originally got this policy 10+ years ago (through a former employer) – I know people who have recently contacted AFLAC and were able to get approved for their accident and cancer policies.