"That hasn't been my personal experience with insurance companies..."

by: Matt Stoller

Sat Sep 01, 2007 at 07:00


Today, my new health insurance kicks in.  I've been uninsured for four months, since May, after being accidentally kicked off my COBRA plan.  For most of that time, I didn't know that I was uninsured, but for the last month, I've been working to get insurance.  I'm a healthy 29 year old unmarried male, so my situation isn't particularly bad.  But the fear and anxiety, the constraints on freedom, are real.  The constraints sound small.  I haven't, for instance, been playing basketball since I learned I was uninsured.  And when I went to the beach last weekend, I didn't body surf in the waves because I didn't want to risk any injuries. 

I've been staying inside more, taking more time to cross the street.  I've been living, in some senses, in fear.  Every time I hurt myself, every headache or stomachache, I got scared, because I knew that my financial world would be destroyed if I got sick or injured.  Is that freedom?  Is that my fault?  Is it reasonable to have to go through a ridiculous bureaucracy of private insurance companies so that I am 'allowed' to get sick or injured without going bankrupt?  Of course not.

But I am under no illusions that the insurance I will get means that I am covered.  Jane Hamsher, who just got done with chemotherapy for breast cancer, offers this story.

I'm one of those lucky people who has insurance. And Blue Cross has decided to deny the $4000 test I had last fall which determined I had invasive breast cancer as "not medically necessary." I am, of course, fighting it. Meanwhile, I'm being harassed by phone calls from a company called Grant & Weber. They are a collection agency that "specializes in healthcare accounts receivable resolution." Which means basically terrorizing sick people and threatening them with financial ruin who can't afford healthcare in George Bush's America.

Vultures.

Seriously, what the fuck?  Why is this the case?  I know it's popular to rail against the insurance companies, lobbyists, and politicians.  And surely, they are the people that are most directly profiting from this immoral murderous system.  But as citizens, this is our country.  And it's because we let this happen that it happens, that millions of us live in fear.

I had a call last week with the person in charge of administration for the good liberal organization responsible for my COBRA coverage.  I asked him if he could backfill my coverage.  Before he started working on the problem, we had something of an argument about whether I needed to be fully covered for these four months considering my new coverage would start on September 1.  I pointed out that insurance companies like to point at gaps in coverage as an excuse to deny care, claiming that injuries or illnesses were 'preexisting' situations developed during periods while the patient was uninsured.  He didn't believe me.  I asked him if he had seen SICKO, because there's an interview in that movie with former insurance company inspectors who seek excuses to deny people care by combing peoples' records and finding these 'gaps', and he laughed skeptically since I had cited a Michael Moore movie.  "That hasn't been my personal experience with insurance companies," he said.  And this came from a good liberal working at a good liberal organization.

And that's why we have a shitty system, that's why I was afraid of playing basketball until this morning, that's why Jane has to fight debt collection agencies instead of focusing on recovering from cancer, and that's why millions more are afraid and have had their liberty stripped from them.  Because Americans do not yet accept responsibility for our collective welfare.

Tomorrow, I'm going to go to the beach and jump in the waves.  It's a small thing, not really that important in the grand scheme of things.  But that's actually what liberty is.

Matt Stoller :: "That hasn't been my personal experience with insurance companies..."

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Ugh (0.00 / 0)
I'm glad I moved to Ireland. The health system here needs work, but it's a much smaller mountain to climb.

when I lived in the UK (4.00 / 1)
I was covered by their national health program, but I continued to shell out for my individual health insurance policy in the US for several years, until my family moved back to the US and we got a family policy.

I have a family history of cancer and was concerned that if I got cancer (or any other "pre-existing condition") while living abroad, I would never be able to get insurance if we moved back.

We were always planning to move back someday.

I am fortunate that I could afford to pay for this policy, but it is ridiculous that I had to flush money down the toilet for years solely to avoid the risk of becoming uninsurable.

As it happened, I got pregnant before we left the UK. If I hadn't had my American private insurance policy, no costs related to the pregnancy and labor/delivery would have been covered.

I ended up with a simple midwife-assisted birth in a hospital (no medical interventions, not even an ultrasound during the pregnancy), but even then the total bill for prenatal and labor/delivery added up to many thousands of dollars.

Don't get me started on why many insurance policies do not fully cover midwifery care, even though it is associated with better outcomes AND lower costs.

Join the Iowa progressive community at Bleeding Heartland.


[ Parent ]
What's wrong here is... (4.00 / 2)
that you're 29 years old and afraid to go outside without insurance coverage. Damn.

Principles for change (4.00 / 1)
Personal stories like yours (and many others) underscore the reason why we must challenge Democratic candidates to embrace a not-for-profit national health care system that guarantees coverage for all citizens.

Every candidate needs to talk about having a national, single-payer health care system that serves the public good, because universal access to health care protection, like universal access to fire and police protection, is a matter of life and death; access to care should not compete with corporate profits and the uncertainty of free-markets.

The Democratic prescription for reforming our health care system must rest upon three fundamental propositions outlined in Michael Moore's Health Care Proposal:

1. Every resident of the United States must have free, universal health care for life.

2. All health insurance companies must be abolished.

3. Pharmaceutical companies must be strictly regulated like a public utility.

As long as care decisions are based on corporate profit rather than medical science, any health care reform proposal other than universal, single-payer will fail.


High Deductible health insurance (4.00 / 1)
I am self paying my insurance--which increasing yearly until it became $350/month HMO.  I am healthy and dont go to doctors.  When it became too high and I found out --using the same company Blue Cross--I can get another plan that cost $140/month but with a $1,700/yr deductible PPO. 

So I switched. 


"Security For All" => "Liberty for All" (0.00 / 0)
Your personal experience is yet another reminder that "liberty for all" depends on "security for all," as I argued in "Keys To Victory #3: Constructing Liberal Identity, Values & Narrative For A Political Realignment":

Now, in Part 3, I address how to construct a diverse liberal identity.  The key to doing so lies in weaving together issues, values and narratives, and doing so with a diversified messaging and organizing strategy.  To bring things solidly down to earth, I will focus on two key concepts that I believe have tremendous potential for liberal politics, both in 2008, and for decades to come. These concepts can be expressed in a simple pairing: "dignity and security for all."

As I will explain, there is more than just a rhetorical echo of another famous liberal formulation, "liberty and justice for all."  In a very real sense, dignity is the lived foundation for justice, just as security is the lived foundation for liberty (this is a key aspect of Locke's social contract theory).  What's more, when these concepts are presented together, they represent a fuller and more robust expression of Franklin D. Roosevelt's "Four Freedoms" --freedom of speech and expression, freedom of every person to worship in his own way, freedom from want and freedom from fear.

Important as health care is, it is best understood as part of this broader foundation that also applies not just to social security, but also to physical and political security for people all across the globe.  This kind of security for all is the most potent and fundamental means we have for combating terrorism, and it's the exact opposite of Bush's "war on terrorism."

"You know what they say -- those of us who fail history... doomed to repeat it in summer school." -- Buffy The Vampire Slayer, Season 6, Episode 3


The operative word is fear. (4.00 / 1)
Also in SICKO was the comment that Americasn are afraid of their government, while in France the government is afraid of the people. That's why the French get 5 weeks vacation and unlimited sick days paid, health care paid by everyone, maternity leave paid. What's wrong with America? Fear. 

Distorting Our Lives Because of Lack of Healthcare (4.00 / 2)
Lack of a universal healthcare system means that lots of people distort their lives in odd and stupid ways such as:

1) Get married to get healthcare coverage or stay married to people they shouldn't

2) Stay with jobs they would rather leave (and work harder and longer to ensure they aren't fired)

Also, in this recent article, we learn that American employers that offer good benefits are reluctant to hire new workers because of the cost of expensive benefits, so they just work their employees harder and pay them more:

Europe's universal health coverage makes it easier for employers to offer shorter weeks, since additional workers don't increase their health-care burden, Williams said. "The lack of universal health coverage plays a large role in fueling overwork in the U.S.," she said.

Of course, overworked people get sicker, have more accidents, don't take care of their children as well...


That's wholly privatized, market based medical care for you (0.00 / 0)
Health care that is covered by private insurers is an oxymoron.

I am not against private health care providers when there is competition among them, real consumer choice and government oversight to prevent price gouging and consumer rip-offs.

But I am totally against private insurers as the sole source of insurance coverage.

Their only goal is to make money by minimizing their risk by selectively insuring those least likely to get sick and finding ways to deny coverage to the insureds through perverse schemes like "pre-existing illnesses". 

Private insurance is a perversion of the whole idea of health insurance, which is to minimize the risk of the public by putting everyone in one big pool and collecting enough in premiums to pay for the care of those who need it.

Only in socially-backward, politically corrupt America would elected representatives in government allow the private sector to use private insurance in order to make a profit off of people's medical care while denying coverage to nearly 50 million people.

As it stands, 1 out of every 3 dollars goes to insurers' profits and the administrative costs of figuring out how to deny coverage. 18,000 people die every year because of lack of health insurance.

I am pleased that Matt now has coverage. But do not be deceived into thinking that you have done anything but marginally minimize your risks.

Privatized insurance needs to be totally scrapped and replaced by universal single-payer insurance PAID FOR BY THE U.S. GOVERNMENT.

Once the U.S. government stops squandering taxpayers money by unnecessarily privatizing government services through no-bid unaudited contracts to corrupt outfits like Halliburton, there will be plenty of money left to pay for universal government-paid health insurance.

All that is needed is to take the current Medicare model, extend it to the entire population, and remove the black holes in the coverage that leave basic illnesses uncovered.


The really cool thing about getting insurance... (0.00 / 0)
after a fear-filled gap in coverage, is how you get to switch from a fear of falling to a fear of losing your insurance. What a load, this system. Crash around in the waves like a lunatic. With a basketball, even.

Importance of unions (0.00 / 0)
This is just one more reason why, under the present lousy system, unions are so important.  My mom's a retired NYC public school teacher, and she has great medical benefits for which she pays an amount that she can actually afford.  That's the only way she and my father (who worked in the private sector) were able to afford all his medications, hospitalizations, doctors' visits, etc.  We already have single-payer health care in this country; it's called Medicare, but it too has problems.  I don't think it's any coincidence that in this antiunion environment, increasing numbers of employers aren't even offering health care benefits, and when they do, many of them are shifting more and more costs to their employees.  They know that they can get away with it.

I had insurance once... (0.00 / 0)
...for about three  months. It took approximately 90 dollars a WEEK out of my take home pay. When you only make around 590 dollars bi-weekly, that's insane.

Employers take so much out of your pay sometimes that having insurance means less food and other essentials.


[ Parent ]
New healthcare system still decades off (0.00 / 0)
The crapitude of the US healthcare system is extreme and virtually all-pervading, and that's been proved beyond several peradventures.

What has not been shown (so far as I'm aware) is how, in this universe, we could move from here to what we'd agree is a decent system (which I take to be single-payer) short of some crisis in which the current system collapses.

Just once, I'd like someone to walk me through how feasibly we might get from here to single-payer given the best circumstances reasonably possible.

Without a plausible plan for legislative action, documentation of the current fubar gets us not very far.


It's a closer reality than most think (0.00 / 0)
We already have a single-payer system in place. It's called Medicare. To make it universal, simple remove the age limit. People would sign up for coverage as it is currently done by seniors today, and they'd be able to choose any doctor they want, coast-to-coast, border-to-border.

Currently, the employee Medicare tax is a paltry $51 per pay period. To increase Medicare funding, employees who opt-in must redirect their bi-weekly health insurance contributions to Medicare. In my case, that would mean sending my $126.49 HMO bi-weekly contribution to Medicare, instead. (Note: The $126.49 I pay every pay period represents only 28% of the cost for corporate health insurance; my employer pays the other 72% or $321.89 every two weeks.)

For me, this proposal would not increase my taxes or deductions, but it would increase my contribution to Medicare from $1,328.86 per year ($51.11/pp) to $4,617.60 per year ($177.60/pp). Additionally, my employer would save $8,269.14 per year on paying the cost of health insurance for me.


[ Parent ]
Only goes to show (0.00 / 0)
What a stranglehold the forces of evil have over the political process, that is.

I'm no expert; but if it were the mechanics of the switch that were holding things up, I have a feeling we'd have got Medicare for All a long time ago.

We've been so long at it (since FDR capitulated to the demands of the AMA in 1935, at the latest) that I'm disinclined to believe that any magic bullet will become available this millennium.

The most likely reason for the current system collapsing is bankruptcy through excessive cost; and life after that won't be too pleasant for consumers of medicine for a good many years.


[ Parent ]
I hear ya... (0.00 / 0)
....personally I at one time had a staph infection and couldn't get it treated because I had no insurance. Eventually I was forced by a friend to go to the ER. I tried to apply for their chairty program since I am a low income student. Basically it was merely a run around deal that involved them 'losing' my paperwork three times and not contacting me for 6 months until my bill was in collections.

I also have a tooth that's half gone and eating isn't the easiest thing. I have no way of getting that fixed anytime soon. I applied for Peace Corps and they turned me down merely because of my dental problems which could be fixed througha  few visits to the dentist.

I tell these rather grotesque stories because this is the kind of stuff that get's forgotten. It's not neuroticism that kept you inside like some people have said on here.

It's a scary, Fucked up thing that no one should have to deal with. but so many of us do...


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