My Personal Tale of Healthcare Insurance

I wanted to get this story out before the Sunday vote in the House. If you believe in healthcare reform, call your Congressman. Most of them will have their offices open tomorrow.

Here’s my personal experience with healthcare from this week. Our healthcare insurer Aetna informed the company that our premiums were almost tripling. For a family of four, our premiums would go up from just over $1000 to over $3000. Why?, we asked. That’s just the way it is, they said. We’re going to have to drop our insurance, we said. Yes, they said, we expected that. And that was that. If you are a business with a small payroll, you and your employees are at the mercy of the healthcare insurer.

So, now I have to go out and get insurance for the family. My wife’s employer, also a small business, offers insurance, but I thought I’d go out and see if I could get insurance directly.

I called Anthem Blue Cross. Nice lady at the other end. Took down all the details. Then we came to pre-existing conditions. I said my son had one and described it. She said that she’d have to put me on hold. She was back in less than 10 seconds. Anthem Blue Cross could not offer any insurance at all. Sorry.

I then called Kaiser Permanente. My wife’s employer offers Kaiser and I thought I’d see if I could something directly with them. Kaiser doesn’t decline on the phone, you have to put in an application, which may be declined (it’s more polite, but everyone spends much more time making and reviewing applications). The guy on the phone was helpful. If you get Kaiser at your wife’s company, take it, was his advice.

Now, we have options. Even if we didn’t have my wife’s insurance, we wouldn’t be out on the streets, if something were to happen. But for many Americans (over 30 million of them) there are no options. If they don’t have a job or they have a job that doesn’t offer insurance, and they have a pre-existing condition, they won’t get insurance. Hospitalization in this country can cost $20,000 and up. Which means that they could be just one major illness away from bankruptcy.

Now, about this bill. It’s a very, very long bill. If you really want to understand the issues it tackles, go read Ezra Klein. But basically it boils down to a few things. Health insurers should not be able to deny insurance based upon pre-existing conditions. It also bans recissions (kicking an insured person out) and life time caps (another cute trick to limit payouts). To make this work for insurance companies there has to be an individual mandate (everyone must get insurance).

Six months after the bill is passed, denying insurance based upon pre-existing conditions for children will become illegal. That’s when I’m going to call Anthem Blue Cross again. I can only imagine how many people are waiting with far more desperation for that six month boundary to be crossed.

Here’s where you find out who to call http://www.congress.org/

If you are calling right now, call your Congressman. If you read this blog, and you live in the US, you probably have a nice job and healthcare at work. If I were you, here’s what I would say to his or her aide on the phone:

Congressman (or Congresswoman) I have a nice job and healthcare insurance. I am calling you in spite of the fact that I have nothing to gain if this bill passes. That’s because I feel for those people who do not have insurance today or can’t get it. We cannot be a great country if we let our people sink into misery because we’ve let healthcare become the monster it is today.

Please fix healthcare by voting yes on healthcare reform.

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3 Responses to My Personal Tale of Healthcare Insurance

  1. Maneesh says:

    We received a similar call few weeks back. Situation is outrageous!

    However, I don't believe that insurance companies jack up premiums to increase profits. It is done to compensate for the increasing costs incurred by the insured. So the question is – why is the healthcare cost increasing?

    Lots of valid reasons such as, top notch quality of care, capitalistic policies (pharma companies), oft abused legal system, and so on. Here is an interesting take by R Chidanand in TOI.

    "…Americans hate to suffer, much less die, and will go to any extent to be "happy" and prolong life in contrast to attitudes in India and many other developing countries…"

    A typical American has more healthcare needs than anyone else in the world. Just the mental healthcare is a huge cost. US consumes 70% of the global antidepressant sales.
    So if americans have a huge need to feel 'happy' and live 'long and pain-free' life than, then insurance premiums have to keep going higher and higer!

    Like

  2. papa-jones says:

    I totally agree with Maneesh and Chidanand , in India we call it sukh-rog or hypochondria …..thats the sole reason American health care system is totally screwed up and now they dont have any sense of direction to really call what is disease and what is not ??

    If world follows American doctors I am sure the entire planet will fall sick wich thankfully is not happenning since people in rest of worl dont have money to subscribe to American health care beliefs ….

    To summarise all in few words I would say America was dream and Americans were living the American dream for past one century thanks to science and technology and a very few exceptional scientists /technocrats and leaders …..but since all dreams are bound to be broken this one too has broken and its time Americans wake up to the reality and start living like rest of the world …..they would have to change a lot of things to adjust but they will be happier and less Obese though that maynot look attractive :-))

    Like

  3. Maneesh says:

    An interesting report on NPR today raising doubts on the value of prostate cancer tests and surgeries. The fun byte starts at 04:30

    http://www.npr.org/templates/player/mediaPlayer.h

    Like

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