The Uninsured and the Unaffordably Insured

[Orrex]

We hear a lot about the millions of uninsured Americans, and this is frankly (and, I think, self-evidently) a travesty in the most technologically advanced country in history. The idea that people working full time jobs—in some cases several full time jobs—still can't afford basic health insurances is an obscenity, and serious, relevant action needs to be taken quickly.

But it seems to me that a related problem is the fraction of the population that does pay for health insurance but can't afford to use it. Or can't afford the gamble that using it would entail.

For instance, if you need to undergo a procedure with a $5,000 pricetag, how much will it cost you in spite of your insurance? Do you know with certainty that you will pay X-percent and only X-percent of the final cost? Or will you be hit with a copay and a deductable and an up-front must-pay fee and an out-of-pocket expense and God knows what else? It's entirely possible that the $5,000 procedure could cost you in $2,000 or more regardless of the several thousand your employer charges you annually for insurance already.

To me, the sheer volume of uninsured Americans is shocking, since it means that a huge portion of the population lives from day to day coping with a mysterious pain or hoping that an infection will clear up on its own, simply because they can't afford the visit to the doctor or the subsequent treatment. But equally shocking is the number of Americans who are insured and who likewise can't afford the doctor or the cure.

What are your thoughts? How might this be addressed? Is there any hope that it will be addressed in the next decade? The next two decades? Ever?

[IsisDawn]

1. Moving to the Netherlands

My husband and I are moving to the Netherlands. We are both in our late 20's and figure we will save about $700,000 in our lifetimes on healthcare costs. It is a shame that in this country no matter how responsible you are you are always one accident away from financial ruin.

[Warpy]

2. If I had either youth or health, I might do the same

As it is, I'm looking at property in Mexico. The Mexican national health insurance system isn't as fancy as the one in the Netherlands, but it's better than the Botswana like system I've had to navigate in the past 20 years of being uninsurable.

This country sucks for everyone but the rich. We are the laughingstock of the world for putting up with a government that worships the military while short changing every citizen.

[Bridget Burke]

4. Too old to start over & too young to retire!

Well, we'll eventually be able to retire. If we live long enough.

[Warpy]

9. Yeah, I hear that

Mexico is still reasonable away from expat colonies in tourist areas.

I imagine when I get my act together that I'll just buy a place as a vacation home and start spending more and more of my time there.

[napi21]

3. You've toughed on a BIG part of the problem that NOBODY is talking

about. Paying for insurance and not being able to afford to use it!

As an example, last Sept. I broke my ankle. I went to the ER, they took Xrays, confirmed it was a compound fracture, put a temp cast on it, and made an appointment to have it set and a perm. cast put on the next day. I HAVE BCBS ins that is an 80/20 plan, meaning for hospitalization,the ins Co. pays 80% of the bill and I pay 20%. After all was doneand I received all the bills, my out of pocket expenses were $2,500 in 2006! The only reason they were ON<LY $2,500 is that is the CAP on OOP expenses for a year. That did NOT include my $250 annual deductible or the cost of any meds. THEN, in 2007, the Doc. said he would have to remove one of the rods he put in because it was working itself out and would soon cause problems. Sooo, I had to pay another $250. deductible (new year), $199 to the Doc, $100. to the surgery clinic, $100. to the anesthetist(they bill separately), and of course the meds are additional.

Well, guess what? I don't have an extra $3,000+ hanging around! Our total annual income is $24,000, so savings is just not possible. So far, NO candidate has proposed any real fix to the HC system in the US!

[Lydia Leftcoast]

6. I have a $5,000 deductible, after which my hypocritical, sanctimonious

insurance company (which loves to send me glossy brochures about how much they CARE about their clients and look, they'll even give away free pedometers), will pay a whopping 80%. So if I should be so unfortunate as to need $100,000 of hospital care, I'll end up paying $25,000.

And yet, I am technically "insured."

[napi21]

7. Yes, and NOBODY is talking about THAT! I actually have to laugh

at them charging me $35.00 (+ the $25 office copay) every time my husband has to go for his blook test because he's on Lipitor and they do a blood test every 3 months to check for possible liver damage. Of course there's that little tidbit of $40 a month for the Lipitor too!

I guess what we all should do is write to every candidate and ask them just what they plan on doing for THIS PROBLEM?

Ya know, you're almost better off is you haveNO health insurance at all! At least then, the hospitals already know they have no option but to just write offyour costs!

[Marblehead]

5. insurance companies

take 30% of our health care dollars, and their job is to find ways not to cover us.

[Orrex]

10. That's true, of course, and it underlies the whole problem

I work in the finance industry reviewing intricate contracts for billion-dollar clients, and I'm no dummy, but even so I still have to call my insurance provider to go over every single line of every single bill. Short of a desire to be deliberately opaque, there is no justification for the impenetrably incomprehensible pay/don't-pay guesswork involved in even the simplest policy.

Why is this tolerated? Oh, hell; let's be honest: why is it completely ignored?

I know the real answer is that the insurance industry has a huge lobby, but could we at least have a little honest examination of the issue in Washington?

Who's a good representative to take up this issue? Waxman is my hero in all things oversight-related, but he's got his hands full with the myriad Bush scandals. Who's the next choice?

[Vinca]

8. Most people who file bankruptcy for medical reasons had insurance.

Most people think they're well covered until something happens. Me, I don't have that problem since I can't afford insurance in the first place. We're looking at Canada.

[Flying Dream Blues]

11. Or if you're self-employed, good luck getting it at all!

My husband recently sold his small business, which had been providing us with group insurance. Now that we're both self-employed, he applied to the same company that has been our provider, for family health insurance. We have 18 months eligibility on COBRA, but were hoping to get insured right away for lower premiums.

Should be easy, right? Not so much.

We are late forties, early fifties, and both in fine health. My husband has allergy and sinus issues, which 7 years ago required surgery on his sinuses. It fixed the problem, and he's had no asthma-type symptoms in years. We live in the allergy capital of the world, so it is considered no big deal to have these kinds of issues. He hasn't even had to take an antibiotic for anything in 2 or 3 years.

We all submitted to very detailed interviews about every visit to every doctor we've had over the last 3-4 years. In my case, they were very concerned about my chiropractic visits (even though they never paid for one of them, due to our exorbitantly high deductible). I go because I get upper back/shoulder stuff from time to time. Also, why did I get all those blood tests? Gee, I think it's called a "check-up" and gee, when you're almost 50 maybe you need to get a look at those hormone levels. They treated it all as if I was hiding some fatal illness from them.

My husband went for his 50 year old checkup, and because he snores, the doctor sent him for a sleep test. It was inconclusive for apnea, and he never made the second appointment at the sleep clinic. He did a complete workup on everything cardiac and chest related, and it all came out glowing.

We just got a letter back telling us we were REFUSED insurance at ALL (at any cost) because of his "health issues" related to his SLEEP TEST. They enclosed a letter about how we "might" qualify for the "risk pool", so maybe check that out. Bottom line is, we are healthy and UNINSURABLE...AT ANY COST.

Moral of story, be careful of what tests you get. Don't ever go to the doctor for ANYTHING. If you go near a doctor, you might cost them money, and they are only interested in insuring people who put money in and never plan to take any out.

Fixing this *(&^^ has GOT to be a top priority. This is a travesty!