Full Circle: System Failure

Take two steps back to move one step forward. That seems to be what is happening with healthcare reform. Lawmakers are looking for a “new approach,” and we’re no closer to affordable health care than we were last year. My guess is that we won’t be much further along next year either.

In the meantime, the number of uninsured people keeps growing. And no wonder. How many families can afford premiums in excess of $500 a month with $10,000 deductibles? And that’s if you are healthy. God forbid you should have a pre-existing condition when you apply for new coverage.

And how do the unemployed even come close to affording COBRA insurance? In Florida, as in 40 other states, COBRA premiums can cost three-fourths of a person’s unemployment benefits. Folks who lose their jobs are just trying to keep a roof over their heads and food on the table. It’s about the here and now, not “I’d better cough up a COBRA payment just in case I get sick.”

Small business owners and the self-employed are stuck in the middle of the healthcare quandary. They make enough money that they don’t qualify for Medicaid or other programs, yet the high cost of health insurance could easily put them out of business. Losing group coverage recently brought this home to me firsthand.

I’ve rarely filed a major medical claim. Most years, I have only routine tests like a mammogram or cholesterol check, and occasionally I didn’t even meet my somewhat reasonable yearly deductible. On forms where I was asked to rate my physical health, I would proudly color in the “excellent” bubble without hesitation.

Pride is a sinful thing and it only takes an insurance company to humble you. Apply for independent coverage and you’ll be reminded of every little sniffle you ever had. Insurance companies comb through your past medical history with laser-like precision before calling you with a myriad questions:

Why did you have this prescription in 1989? I don’t remember being sick in 1989.

How long did you use that antibiotic cream in 1999? Uh… until the rash went away.

Why did your doctor order an ultrasound in 2006? That was a mystery to me, too.

Insurance reps seize on any strand of information to increase your monthly premium. You’ll be quoted one thing, and then a few weeks later they’ll regret to inform you that the price has increased because your ingrown toenail may cause gangrene down the road.

I don’t think people purposely avoid buying health insurance. They simply can’t afford it. When monthly premiums exceed income, what choice do they have? Others have deductibles so large that they may never be able to climb out of debt if a serious illness struck.

Lawmakers had hoped that a new healthcare bill would limit the ability of health insurance companies to deny coverage. Being denied coverage is not as prevalent, however, as trying to afford the astronomical prices that health policies cost.

Even if America’s healthcare system is overhauled, I’m afraid it won’t be much help until health insurance becomes affordable. Of course, insurance companies have to make money to stay in business. They blame rising medical costs and the uninsured for driving up those costs.

It is indeed a vicious circle, but we must begin somewhere. Health insurance reform should be the start.

Wishing you good health,

Mary Ann

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