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January 31, 2006

Substantive, Angry Post About Health Insurance

Well, now that Regina and I have been denied insurance from California Blue Cross--she because of a benign breast cyst that she had in 1985 and me because I have the gall to want to continue my antidepressant prescription--perhaps we can open a "health savings account." President Bush only devoted one paragraph of his State Of The Union speech last night to that diabolical piece of Newspeak. The speech in general was Bush's usual revolting mixture of unfettered corporate toadyism and Flaming Sword Of Jesus claptrap, dusted with little shavings of unjustified imperial hubris. What an asshole. Still, the health savings accounts stuff really got to me. As I said earlier in this pompous paragraph, I don't have health insurance anymore.

Or at least I won't soon. We somehow persuaded our old insurance to give us an extra month while they checked to see if they could somehow transfer our old policy. This seems somewhat obvious, because both companies are Blue Cross affiliates. Health insurance membership transfers should be as easy to get as a Costco card, or at least no more difficult than a driver's license.

If bureaucracy were our health-care system's only problem, I wouldn't have this pervading sense of dread. The Bush Administration is simply a milksop for the insurance and HMO industries. Let me give you a preview of how these savings plans will operate:

Working class and middle class Americans, not all, but many, will be persuaded by government propaganda that it's somehow smart to ditch their reliable, employer-based health insurance plans in favor of a savings account they can "control." This will give them "personal responsibility" over potential life-and-death situations, which is, of course, exactly what everyone wants. Then we'll start saving money, assuming there's anything left over once we're done paying off our insanely exorbitant credit-card interest-rate bills, which really got jacked up by government fiat on January 1. But let's assume we save. And then someone gets sick. Let's say I get sick.

Let's go all out. Let's say that I get testicular cancer. It will then be my responsibility to "negotiate" fees with HMOs, while I'm facing a life-threatening disease. I have no knowledge of how much medical treatment is going to cost, and I won't be going to a kindly country doctor, because they don't really exist anymore. The health-care system is going to ream me for everything I've got, and I'll be forced to put my bills on my credit card, which I'll never be able to pay off, and then I'll go into bankruptcy, which is no picnic anymore since the new bankruptcy law that took effect on Jan. 1.

Basically, we're fucked six ways to Sunday. If these savings accounts are going to take flight, then it will be the final death blow to an already aggrieved American middle class.

Do you think I exaggerate? Well, at least my son has health insurance. That's right. Elijah got medical and dental, for the sum of $79 a month. So at least it's relatively inexpensive to insure children.

Well, not according to the latest House budget cuts passed today. Let me quote from the UPI story: "The bill trims an estimated $6.9 billion for the Medicaid health program for the poor by giving states more flexibility to pare back benefits and charge higher co-payments for services. It also cuts some government payments for prescription drugs..."

The key phrase is "charge higher copayments." That spells out Bush's health-care policy, and, in many ways, all his domestic policies. My family is lucky. We're middle-class enough so that a Medicare cut isn't going to screw us directly. But Bush and his health-care industry cronies are not just gunning for the poor. The squeeze is on, people, and "health savings accounts" are leading the way.

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Comments

Please don't kvetch, though. Otherwise, I'll have to take some time away from writing my masterpiece to offer up some Dr. Denis Leary therapy.

Whoo hoo on the Dr. Denis Leary therapy! ;) It's my favorite antidote to the Dr. Phil therapy...*shudder.

Does the Denis Leary theory involve a pack of cigarettes and a bottle of cheap vodka?

I read that the 'House' is trying to cut student aid...which means poor students like myself will continue to stay poor. Which unfortunately gives me more motivation to be an angry blogger. Harumph! That's right I said Harumph!

I'm interested in the notion of a relevant health insurance article. Why not? Dr. Phil thinks I'm a winner, and that's all that really matters. Right?

"What an asshole." I second that. Didn't watch the speech, just watched the commentary on The Daily Show, which is really the only positive thing that ever results from politician's speeches. Sometimes you gotta laugh to keep from crying.

My employer, a small law firm, switched benefits providers this year (from Aetna to Blue Cross). There were three choices for coverage (and I cover my family, so none was cheap). PPO, HMO, or HSA coupled with "high deductable" PPO. I took the HSA. We don't consume much health care on a regular basis -- no maintenance meds or chronic conditions -- so the option works for us. We pay a hell of a lot less per month than we would if we chose the no-deductible PPO, and we get the same choice to self-refer to specialists, etc.

If any family member has more than $1,500 of expenses (at the network negotiated rates, so lower than if we walked in off the street, and payable from pre-tax income via the HSA), the coverage kicks in. There is a maximum aggregate of $3,000 deductible for the whole family. So if my wife and I each have $1,500 of expenses, our daughter's coverage kicks in. If we have a baby, we pay for the first $1,500 of my wife's care from pre-tax income, and she's covered for the rest. One way or another, we're on the hook for a maximum of $3,000 per year. The rate differential between the HSA PPO plan and the straight PPO plan helps make up most of the difference. Plus, my employer contributes monthly to my HSA. And if I don't spend pre-tax income I put into my HSA, I get to roll it into investments. It isn't all that bad, but maybe more complicated than some would want to deal with.

I'll admit it isn't for everyone, and I'm no fan of Bush, but there is a lot of abuse of health care benefits. That does make health insurance cost more for the rest of us. I could see how this system would make someone less likely to run off to the doctor at the drop of a hat.

Maybe I run in unusual circles, but most people I know are more likely not to seek medical attention when they should than to take a frivolous trip to the doctor's.

i was blown away a few years ago when i
developed a serious sinus infection that
caused one of those fevers that could kill
(106 and rising steadily), and discovered that
if you don't have insurance, doctors don't have to see you. and they won't. what the fuck is the point of being a doctor if you refuse to
help a sick person? of course if you're sick, you CAN go to the ER, but that's only if you
want to have 11 different collection agencies calling 50 times a day for the next 900 years. our health system is so wrong on so many levels that it is sometimes hard to believe that it's even real, and that hopefully any minute now
the president will go on tv and be like 'psyche. we were kidding. did you really think we could be serious about that? now hows about some universal health care?' but apparently, to
quote the mighty subhumans, 'it's only going
to get worse.'

Are you on an individual policy from AZ? The insurance term "portability" or transferring pre-existing conditions from one policy to another without lapse only applies to group policies. The best thing for you to do is to try and get on with some kind of group policy so that your family's pre-existing maladies(crazy pills, benign cysts) get covered. Are you a member of any trade associations? I am not a professional writer so you may know the specific associations I am talking about. Some kind of writers guild or whatever. These associations may have group policies for you to join. As long as you stay with the individual policy the insurance industry can pick and choose which old injuries they will cover or, as in your current case, deny you altogether.

This is certainly an issue nation-wide. People either can't afford coverage or choose to eat steak five nights a week instead of buying health insurance and depend and you and I to pick up the slack. Try and get with a group policy or get what the insurance industry gives you. Fairly easy choice. Best of luck Mr. Pollack.

Thank you for not kvetching. There's nothing I find more annoying than when people make lifestyles choices and then complain when those very choices are financially depriving them of something else. It's affluenza and as Dr. Denis Leary would say, "Shut the fuck up!"

I think until the middle class stands up and demands system changes, it won't. This will have to come from middle middle class and lower middle class, as well as the self-employed. No one else is so squeezed in terms of financial burden without financial benefit (reduced fees at county health clinics, WIC, etc.)

Personally, I am set with my husband's benefits- family coverage of less than $200 a month with no deductible and retirement that's an automatic 10% of his salary plus employer contribution to SS and IRAs. BUT the nearest secular bookstore is 45 miles away. That's the sort of choice we have to make today.

Our benefits are the exception rather than the rule and when I was a school teacher in Texas, two people- a teacher who was in a car accident and a son of a teacher who developed meningitis- so depleted the school district's health care banks, that premimums went up $50 a month for everyone. There are too many situations like that and it's completely unnecessary.

I'm covered on my mother's health insurance, yeah I know yuk it up, for another six months, and then I will officially be sodomized by insurance premiums.

Not to sound like a broken record, but my worst case scenario, was going to Shoal Creek hospital with Dt's. Granted a bad lifestyle choice got me there, but never-the-less I was there. They said they wouldn't take me unless I had health insurance. But they added that if I didn't stay I was likely to have a heart attack or stroke, so they highly recommended my visit at their facilities. When they doped me up enough to where I couldn't feel the Dt's, they let me wander around the building, which I decided to leave feeling that I was cured. Not thinking about the horse tranquilizers in my system, they said that if I didn't stay for the full three nights, that my insurance wouldn't pay for my stay. So I could've left with a 6 to 7 grand bill, and possibly a hefty funeral sum for my family, or I could continue to ingest whatever they gave me for the appropriate amount of time.

Which is fine, that's just the way it works.

What got me, was that there were multiple people in the hospital, some were homeless, and this was like a second home for them. A guy I shared a room with was in their for the third time that month. One of the nurses told me that the state pays for all of their trips.

If it cost my insurance a little under 10 grand for three nights, what are the taxpayers paying for this one guy as an example who on his third trip, and might have accumulated roughly a 30 grand bill? I don't have specifics, but this is going on all over the country. And it's happening as a result of a lifestyle choice. A person who is a raging drug addict, can't reasonbly expect for the government to pick up their hospital bills when their lowered immune system catches up with them.

I think I'm going to send dubya a duplicate picture of that Bruce Springsteen album with a close up of his butt with a bandana hanging out of his back pocket, except I won't be wearing any pants...and my butt is not as easy on the eye as the Boss's.

Neal, you forgot to mention the teensy detail that the other half of an HSA is required insurance (with lower premiums) which covers any expenses over $3000. If you just put the money you save on the premiums into your savings, you come out ahead, with no more risk. That's the theory anyway. Complain if you want, but at least do it accurately.

Where's the fun in that?

Fine. But I don't trust that the HSA's will remain that way. I've had the ground shift from underneath me too many times...

Sure, things could change. But you'd still have the money in your health savings account. That's the whole point. Without a savings account, if you lose your coverage, you're completely screwed, because you have nothing to show all for the money you've spent on insurance over the years.

Don't get me wrong, Bush is a massive tool who destroys everything he touches; I'm not disputing that. But HSA's are the least of our worries. They're totally optional. You have to pay for your medical care already, either with high premiums up front or with high co-pays later. The only difference with the HSA is you get some tax savings, and you earn interest on the money you pay in to the account.

HSA's don't do much to solve the general health care problem, but they're hardly "the final death blow to an already aggrieved American middle class."

Neal, you should check with the Authors Guild. www.authorsguild.org. They have discounts on health insurance available for authors.

-John.

Oh, Christ on a crutch. Pollack, at the rate you're going, you're going to give us an unironic "I Am Friends With a Working Class Black Woman" article anyday now, aren't you? If I had a nickel for every time I have heard a Northwestern U. grad complaining about the difficulty of obtaining health insurance I'd have...one...fucking...nickel. I'd love to see how the old Neal Pollack would reply to this piece of "substantive" writing.


Please, please, please go back to making fun of Jonathan Safran Foer.

My friend's daughter is going to college in Canada, and got her arm slashed by a guy's spikes at a punk show. There were medics on-site who stitched her up, and then sent her to the hospital. Two hours later, she was sent home, all fixed up. The next day she received a call from the insurers: they just wanted to make sure she was feeling all right, and reminded her that if the hospital sent her any bills at all, she was to send them right along, and not to pay a thing.
And she's not even a citizen.
Suck on that.

So because I went to a good college, I'm not allowed to complain about how hard it is to find health insurance? I don't necessarily see how that's incongruous. I'm not making any claims to poverty, but how can you doubt that the health-care system is fucked beyond compare?

And I will make fun of JSF when the time comes.

Good college? You and your wife have an ELITE education and most likely one y'all didn't have to pay for. Of all the people in the country, you and Regina have had the most access to resources. That you both CHOSE to be self-employed is why you don't have health insurance. This is a lifestyle choice. You understand this, no? Maybe not...

Give some factory worker who works 39.75 hours, just shy of the ability to receive benefits, who had to drop out of high school 'cause daddy dropped dead of a heart attack and their income is needed, who prays everyday that his/her car won't break down and they won't be able to work that day and thus won't be able to eat, give them health insurance first.

First of all, I'm tired of the work decisions my wife and I have made being called "lifestyle choices." Trust me, if I could choose, my "lifestyle" would be a lot different.

I recognize that I've had a relatively privileged life. But it's only relative. I am not from the yacht-club set. And I also recognize that other people have had it way tougher than me. But what does that have to do with the collapsing health-care system and the falling economy? Am I not allowed to see it from personal experience just because I have a degree from Northwestern?

Also, by that "factory worker" you mention, do you mean "you"? Let's not play "spot the yuppie" by making up working-class strawmen. Unless, of course, you do mean you or one of your relatives, in which case I'm an insensitive asshole.

Without health insurance.

"I recognize that I've had a relatively privileged life. But it's only relative." I think this is the same sort of attitude I encountered in HWOSG before I had the desire to chuck it across the room in complete disgust. Good thing it was a library book, otherwise Dave's tripe would have dented the drywall.

I had a temp job in a factory (does that count)? Or should I enumerate the times I have been personally affected by extremely low resources, just touching the fringes of poverty? I don't think it will do any good.

You know how the health care system works. You have a choice- work within the system and have health insurance, or chose to work outside it and go without. With y'all's education and background, that "relatively priviledged life", y'all are both so easily employable it's nearly shameful. There is a price you have to pay for not working a 9-5 job. Y'all have made it. Does it mean you don't have a right to get upset that this country is assbackwards when it comes to taking care of its own? No.

But stop complaining, please. You are too skilled a writer to be kvetching about this on your own blog. Write your congresspeople, become THE voice of a generation who don't believe that one should have to sacrifice their life's passion for the right to adequate health care and health insurance. Organize a protest. Write a health insurance manifesto. Tikkun Olam, dude. Tikkun Olam.

Um. I have a book coming out. This topic MAY just be covered in it. Also, i want to add that people who work in the system have just as many problems as I do with insurance, or are at least starting to. Families of all classes, other than the very richest, are getting screwed in these nasty times.

Factory workers, priviliged college students, writing as a lifestyle choice...hmm. I spent seven months living in a shotgun house with MASSIVE insects miles from town. I went close to 2 months without having a conversation with anyone. That was a lifestyle choice.

I gave Austin the finger and never looked back. Lifestyle choice.

I have also been priviliged enough to work a job that didn't have health insurance. And the company would not give me enough hours anyway. If there was ever a calculation of an hour in a decimal sense, this company was the inventor of it, and the 'screw your employees out of money, and then sodomize them when they have an injury on the job' policy. I quit. And never looked back. Lifestyle choice.

Being successful at writing is more like dedication AND winning the lottery. Not so much lifestyle choice.

Throwing Eggers HWOSG against the wall and urinating on it. Priceless.

"There is a price you pay for not working a 9-5 job."

Yeah, those artist and writer fuckers totally deserve what they get. Contributing to arts and letters in America is so totally elitist, not to mention masturbatory and pointless.

And hey, I happen to need me a new quail hunting partner this week. Last one met with an unfortunate accident. You interested?

I hate health insurance. Though these people gave me a good price. This blog is really informative.

I am Health's Ass...and not just on my website. I am a writer and haven't found any decent health insurance through writers' groups, so don't get those comments. Luckily, since I am north of 60, we have a plan for the self-employed here in AZ. I pay almost $600 a month and it's decent--a hospitalization is only $100. My 24-year-old is on HealthNet, PPO, and regularly gets reamed for huge copays and coinsurances. Recently, she woke up in time to put out a huge fire in her room and the paramedics insisted she go to the hospital ("Her throat is as black as her face, Mom"). The bill for what would have been a $12 cab ride was $736 and they want every penny! The insurance company refused three appeals, saying there was a little >> by "ambulance" and if I had looked, three pages later, it was explained that a deductible would apply to that item. This was in addition to almost $400 on the ER bill that the company sneaked out of.

Being insured is almost as bad as not being. I have a friend on Medicaid and he gets better doctors and more services!


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