When I talk about healthcare, I have some skin in the game-and I mean more than the parts that hang out of the hospital gown during exams.
No I mean I’ve been paying my own healthcare for 19 years because I’m self-employed. I might have become one of those 70 million uninsured but healthy 18 to 34 year olds but I rapidly had two children after starting my own business and with babies you just don’t get the uninsured option.
In almost two decades I have been through HMO’s, HSA’s, private plans, minimal plans and plans that cost close to $800 per month. I can tell you, as a self-payer, that no matter where you start your plan, it will increase by 20% in six months and by 30% on the renewal date. So to keep it reasonable, you have to keep moving.
Luckily, we’re all healthy. My two sons are athletes and I work out several times a week. Unfortunately, being healthy has no impact on health insurance premiums. I’m with Blue Cross now and despite the fact that I have very low body fat and am on or underweight for my age, I pay as much for my policy as a woman who is diabetic and 100 pounds overweight. I have called and complained many times but the health care system just isn’t set up to reward healthy people.
It’s not really set up for those without insurance, either. I’ve been reading a lot about how low income people use the ER as their primary source of care, but I don’t see how. I’ve spent a lot of time in the ER-both of my sons play football and rugby and I have two aging parents. I am there so much I know some of the staff by name. But about 18 months ago the mother of one of the other boys on the football team called me about her son. She is not from this country-though she is here legally. He had had a concussion during practice a week earlier and had been okayed but he was now beginning to slur his words and his arm was losing strength. She had called the large, urban teaching hospital where he’d been airlifted after the concussion-but they told her she couldn’t bring him in because she didn’t have insurance.
I didn’t doubt this because I had sat in the ER two years earlier for a broken bone and watched a woman with a broken leg be turned away because she didn’t have insurance. She couldn’t even drive home because it was her right leg. She just sat in the wheelchair and cried.
The football mom called me on a Monday evening-I remember this because he had first exhibited these symptoms on a Friday at a school event. I am familiar with stroke symptoms because my dad has had them and it sounded as if this 18 year old boy was having a stroke. I asked her to meet me at my local hospital. Long story short, I bullshitted my way past admissions and got him into the ER and in front of a doctor. He was in fact having a stroke, but he was treated and today he is fine. But it still scares me to think that his mom had held off taking him in-and in fact had been refused admission at another hospital-because she had no insurance.
I believe health care is a fundamental right for all citizens. We don’t need to deliver the $800/month plan for everyone, but we do need to guarantee ER access and annual or semi-annual preventive and well-care visits. Like income tax, people should pay towards the plan, even in a graduated fashion. And we need to incentivize good health-not penalize it.
The problem with the debate in D.C. this week is that most of the debaters have never lived without insurance. I doubt most of them have ever spent any real time in an ER, watching people be turned away. They need to spend a weekend there to fully understand what’s needed.
Then maybe they too will have some skin in the game.