Cancer and no insurance - can you help?

Some of you know that one of the reasons I left the US with my family is that we had become "uninsurable." I've just come face to face with what could have happened to one of us if we had stayed--and worse yet, it's happening to someone who was a friend of mine.
More below the fold...

For my last 10 years in the US, I lived in Portland, Oregon and worked as a freelance writer and editor. It's not the most reliable way to earn a living. We lived from check to check, feast or famine. Sometimes things got bad enough that I took on side jobs, like delivering phone directories.
One local freelancer who seemed to have a better handle on his career was D.K. Holm, a film critic with a sideline in writing books. Me and mine are all huge film buffs, and many times at a "sneak preview" or first night of a new film we would spot Doug with his lighted pen scribbling away, and have a chat afterwards. We socialised a bit, had many mutual friends, and shared a penchant for snark and black humour.
The thing is, Doug has been diagnosed with esophageal cancer--and he doesn't have insurance. Getting and keeping health insurance when you are over 40 and self-employed is damn near impossible, unless you are a high earner every single month with no pre-existing conditions. Who knows, maybe Doug got blocked by the same "pre-existing condition" that they used for me--he's a bit overweight (too much popcorn no doubt).
There but for the grace of the UK Home Office go I...
When a freelancer can't talk, they are instantly unemployed. There's a lot you can do online but in the end, you have to be able to interview folks, and you have to have the energy and brainpower to do it--something that chemotherapy and surgery quickly take away. I can't begin to think how I could have done it. Freelancing for a living is a production job,like home sewing. You have to churn out a continual number of paid words daily, and spend the rest of your time selling your next assignment and chasing up pay for what you've already done. The per-word pay is low (and lower now than it was in my day, since most clients force writers into all-rights contracts) so you just have to keep going relentlesssly.
Cancer has a way of putting a stop to that, especially when it affects your ability to speak.
In the absence of a national healthcare system, people like Doug are up the creek without a paddle. So what can we do?

1. The big picture is, we've got to get the US healthcare system sorted, full stop. So if making a personal donation to a guy like Doug is not your thing, that's cool--just keep campaigning for local and national candidates who promise to fix it--and hold their feet to the fire when they get it.

2. If you happen to live in the Portland, Oregon area, attend the fundraiser tomorrow night (Sunday). Appropriately, it'll be at Cinema 21 (616 NW 21st--a great rep cinema), starting at 6pm. Tickets start at $10 and you can get one in advance here . There will be entertainment (Thomas Lauderdale from Pink Martini on the piano--always worth seeing--and more), there will be booze and munchies, there will be a silent auction with stuff from local artists, restaurants and shops. Oh, and a couple of our and Doug's mutual friends--Katherine Dunn and Gus Van Zandt--have donated some stuff for the auction too.

3. If you're not in Portland, or you're a recluse who wouldn't be caught dead at a funddraiser, dig deep and send our mate a check payable to "Doug Holm" and mail to:

Doug Holm
P.O. Box 4146
Portland, OR 97208-4146

As much as it's great to see that the good people of Portland's arts scene care enough for a guy who has given many of bad reviews (and trust me, when Doug gives you a bad review, you KNOW it, LOL!) their time, energy and money, I know what battling cancer can cost: My father-in-law maxed out his lifetime $1,000,000 benefit before his death, and one of my former editors almost lost everything when her daughter was diagnosed with leukaemia. A benefit night will lift Doug's spirits, and it might pay some medical bills, but we need to change the system in November.

•  I spent my 20s uninsured

  I learned to drive very carefully.  I feel for your buddy.  I'm glad he has famous and powerful friends to help him.  I wish you luck in your benefit.  

  I could not afford ins. when I was younger.  On the other hand I was then and am now living largely hand to mouth.  Neither could I afford and increase in the 30% that the various government took from my check (I think it's closer to 40% now).

  Not to minimize the problems of the uninsured, but consider this:  The middle class largely has free healthcare right now through their employers.  National healthcare will likely end employer healthcare and replace it with higher taxes.  This isn't money we are using to travel to Paris; this is rent money.

  Can someone tell me what C&O are proposing to prevent this?

  by Rgandhi3k on Sat Apr 26, 2008 at 01:49:59 AM PDT

  •  Neither Dem candidate has proposed

    increasing taxes to pay for healthcare.  Please go to their websites to look at their respective plans.

    by The Distillery on Sat Apr 26, 2008 at 01:53:27 AM PDT

    •  Bet you a dollar...

      We end up paying more for it somehow.

      by Rgandhi3k on Sat Apr 26, 2008 at 01:59:01 AM PDT

      •  I couldn't...

        I couldn't possibly pay more than I pay right now.

        by ChristieKeith on Sat Apr 26, 2008 at 02:02:58 AM PDT

      •  More or differently?

        Increase taxes and decrease current medical expenses?

        by Futuristic Dreamer on Sat Apr 26, 2008 at 02:35:34 AM PDT

        •  One can hope.

          I don't imagine that if my employer is motivated to withdraw my insurance that they will compensate me for the loss.  Granted, as someone else mentioned, there's no guarantee they won't take it away whether we get federal insurance or not.

          by Rgandhi3k on Sat Apr 26, 2008 at 02:40:53 AM PDT

  •  You're wrong

    The middle class does not have "free" healthcare. Number one, I am middle class, and I pay for my own health care at $582 a month.

    Second, I don't know one single person who gets free healthcare through their employer. They all pay something monthly, plus co-pays and deductibles that amount to thousands of dollars, PLUS many of their employers are discontinuing health insurance, citing rising costs.

    Third, health insurance is a benefit. It's part of your compensation, and you pay for it with your labor. It's not FREE. You earn it.

    Today, a friend of mine who has severe ongoing health problems lost her job. She did not have health insurance at that job. She did not make enough money to have private insurance, if anyone would even have insured her in the first place, which they wouldn't, given that she has so many serious pre-existing conditions. I spent the whole day trying desperately to find her somewhere to get free insulin, since she'll be out on Monday and, without her paycheck, has to make the choice between paying her mortgage and buying her prescriptions.

    I failed to find it for her anywhere.

    She has a master's degree. Grew up in a wealthy PA suburb. Father a doctor. Middle class as they come, right?

    As the pool of people with "free" employer health care gets smaller, as their share of the costs gets larger, as they see their friends and family members collapse under the weight of illness and medical bills... even those with insurance... the day will come when universal health care will be available to everyone in this country, like every other developed nation on the planet.

    By then, of course, most likely my friend will be dead. Well done, America.

    by ChristieKeith on Sat Apr 26, 2008 at 02:02:12 AM PDT

    •  I am not suggesting

      That we don't fix healthcare.  I am merely contending that we make sure our solution doesn't push struggling families over the edge.

      I meant free health insurance, by the way.  Big difference I know.

      Do I think you should have health insurance?  Yes.  Am I willing to get evicted so you can have it? No.  With gas prices and rents going up like e to the X and wages stagnating any increase in expenses is deadly serious.

      Historically the burdens of social programs fall disproportionately on the middle class.  I know they are telling us this time they won't, I am just a little cynical about those sorts of assurances.

      I sympathize, by the way.  I was once turned away from a free clinic for not being homeless.  There are programs for the poor.  The middle class suffers.

      by Rgandhi3k on Sat Apr 26, 2008 at 02:19:37 AM PDT

      •  Are you nuts?

        Only the upper class will pay more for healthcare in a single payer system, they just want you to think you will.  You, as well as the rest of the middle class will have more financial stability than you do now.

        by Futuristic Dreamer on Sat Apr 26, 2008 at 02:41:23 AM PDT

      •  The choices that you put forth

        are not ones that would have to be made to fix the healthcare/health insurance system in America.

        But, as long as we're conflating these sorts of things, I could ask, "Am I willing to forego the luxury of casually entering into, and then failing miserably at, unecessary wars?"  Well, actually probably Yes.

        by PeterHug on Sat Apr 26, 2008 at 05:15:44 AM PDT

        •  Well said.

          by Rgandhi3k on Sat Apr 26, 2008 at 08:50:02 AM PDT

    •  Family

      I intend no disrespect, but her father wouldn't want to see her suffer, would he?

      by JG in MD on Sat Apr 26, 2008 at 04:48:09 AM PDT

  •  since when is insurance....

    through employers free healthcare for the middle class?  unless you are extremely lucky, there are deductibles, copays, and a lot of conditions that are not covered.  employees have money deducted from their pay for the insurance, and those deductions are going up for a lot of people.  

    by nonnie9999 on Sat Apr 26, 2008 at 02:14:27 AM PDT

    •  I did mean free insurance. Sorry.

      by Rgandhi3k on Sat Apr 26, 2008 at 02:20:26 AM PDT

  •  Who on earth in the US has free healthcare?

    Even people who have benefits have to pay for them in premiums, reduced salary, co-pays, deductables etc.
    And fewer and fewer employers are offering insurance (or offering it for employees only--not spouses or children). And more and more employers are putting their workers in the same situation Doug is in, by making them "self-employed contractors" i.e. freelancers.
    So if your taxes go up, it will be because your out of pocket healthcare costs have gone down.
    I currently live in the UK where I don't pay much more in taxes than I did in the US. However, I really DO have free healthcare. No more co-pay bills, no more denial of claims, no more $2500 deductables, and most importantly for us--actual coverage, which we couldn't get anymore in the US due to pre-existing conditions (my son has autism, my husband had a back injury, and I am "overweight"--all of us were denied coverage by Kaiser.)

    by expatyank on Sat Apr 26, 2008 at 02:53:29 AM PDT

    •  Doctors

      by Futuristic Dreamer on Sat Apr 26, 2008 at 03:08:50 AM PDT

      •  Doctors have free healthcare?

        I beg to differ.  My husband is a physician, and we pay $800 a month for our healthcare just for the two of us.  Our two sons, in their 20's, have none, and it worries me daily.  

        My husband spent 20 years on call at night, rushing to the hospital emergency room to treat any traumas that came there, and was essentially staffing that hospital at night FOR FREE, and they charge us up the wazoo for any medical care we get there...just like everybody else.

        Doctors are just as mad as everyone else.  My husband treated hundreds of patients for free because they had no money, but the hospitals don't have the same heart.  Nor do the insurance companies or the drug companies.  They've made it nearly impossible for him to practice because they refuse to pay him for the very legitimate claims he submits for those that are lucky enough to have insurance.  

        They'll say, "Sorry, Dr., but we're not paying you for the surgery you did on Mrs. So and So because she stayed in the hospital ONE DAY LONGER then we think she needed.

        Do you hear that?  Some paper pusher behind a desk a thousand miles away is now making decisions about how long one of my husband's patients needs to stay in the hospital!  As if he just kept her there for the fun of it!  

        We're all in this boat together, and we're ALL mad as hell.

        by Shelley99 on Sat Apr 26, 2008 at 03:45:54 AM PDT

      •  Absolutely not!

        I'm a family doctor. I sure as hell don't have "free health care". Most physicians are considered self-employed, and therefore responsible for their own health insurance. I'm part of a family medicine group run as a not-for-profit group, and we provide health insurance for ourselves and for our clerical & nursing staff. The cost for this health insurance has skyrocketed over the last five years, for us just like everyone else. We ask both the doctors and the support staff to pay part of their premium, but over the last two years premium increases were so drastic we decided to eat the cost as a group (meaning it came out of the doctors' pockets) because it more than wiped out the modest raise we gave our employees.

        So no, we doctors don't get "free health care". We pay through the nose just like you do. Of course, if you're a thoracic surgeon making $1.5 million a year, that $14,000 a year for a premo low deductible policy is no big thing. But if you're a rural family doc working 85 hours a week and hoping to clear $130,000 in a good year with two kids in college, it's a huge burden.
        Just sayin.

        by Ralphdog on Sat Apr 26, 2008 at 04:56:58 AM PDT

      •  At least the ones who work for large hospitals

        or HMO's. One of my friends parents is a doctor, she has medical insurance where there are no copays, and when I asked how much here parents paid for that her answer was not a lot, because her dad worked for UPMC.  I know UPMC's nurses don't have benefits like that.

        by Futuristic Dreamer on Sat Apr 26, 2008 at 09:37:29 AM PDT

    •  Congress does

      They have absolutely gold-plated totally free healthcare.

      They are also beholden to the insurance industry, the pharmaceutical companies, and the healthcare conglomerates.

      For these reasons, your typical Congress-critter has no incentive to change the system.  Especially since the aforementioned moneyed interests provide big donations to help these people get re-elected over and over.

      And once they retire, they keep their free healthcare.

      This is also true of the current crop of Presidential candidates, so none of them (save John Edwards) have proposed a system in which private providers and insurance companies don't get to continue their parasitic blood-sucking.

      Until the common people of the US realize just how badly they are being abused, this lethal status quo will not change.

      I, too, am an expat currently living abroad (in India at the moment, where healthcare isn't free, but it is extremely affordable).  Perhaps one day we'll come back to the US, but a huge factor pushing against this is the lack of reasonable healthcare.  So I don't know... maybe Vancouver for us eventually?

      by Technowitch on Sat Apr 26, 2008 at 03:38:14 AM PDT

      •  No they don't

        They have the same healthcare other federal employees do; they have decent benefits, but it's defiantly not free.

        by Futuristic Dreamer on Sat Apr 26, 2008 at 09:31:24 AM PDT

    •  State of Oregon High Risk Pool

      http://www.omip.state.or.us/

      I have the Maryland version of this (which is the best in the country, and is quite affordable). Basically state subsidizes insurance because it ends up being cheaper than paying 100% for the cost of cancer care (which public hospitals are ethically obligated to do).

      by The Bagof Health and Politics on Sat Apr 26, 2008 at 04:26:12 AM PDT

      •  Yes, we had OMIP at one point, after my husband's

        COBRA ran out. $800 a month for just us (and that was 10 years ago or so), plus relatively high deductables (at that time, I think they are better than typical now) and co-pays, plus rationed care through an HMO.

        You're correct that Doug will be getting treatment of course, I assume he's at OHSU, which is a good place to be. But they will be sending a bill, and at full cost (no discounts as some insurers arrange). He may be able to get some written off in future, though my family's mileage with that at OHSU varied. My daughter ended up declaring bankruptcy due to unpaid and unpayable medical bills, and has recently confessed that she is in hock to the docs again as her daughter has needed routine medical care but is uninsured.

        OMIPalso  excludes coverage of any pre-existing conditions for 6 months. Were I him I would be signing up to cover future needs, if he has enough money to cover the premium, but he'll still need to fundraise to cover the cost of care. I'm sure that's what the hospital will advise also--though if he isn't working it may not be feasible, you couldn't afford the premiums without a regular income. Freelancers don't even get unemployment :-(

        Sucks, doesn't it?

        by expatyank on Sat Apr 26, 2008 at 07:21:14 AM PDT

        •  I pay $150 a month for MHIP

          Maryland's high risk premiums are capped out at 110% the healthy price. It has a 30 day all incompassing waiting period and doesn't exclude pre-existing conditions. It's a better system than most states have.

          by The Bagof Health and Politics on Sat Apr 26, 2008 at 11:43:33 AM PDT

  •  "Free" healthcare?

    Are you a concern troll?  No one has "free" healthcare.

    I work for a state agency so I have better health insurance than most people.  But it is not "free", and neither is my healthcare.

    My premiums for my husband and I are over $300/month.  We have low co-pays for participating physicians, but fewer doctors participate every year.  And this is GOOD insurance.  Most people either pay more than I do or have far less generous benefits (i.e. restrictive HMO's, etc.

    As soon as I see "free health care through employers", my Republican-dar goes way up.

    Are you a concern troll, or just ignorant?

    by hackwriter on Sat Apr 26, 2008 at 05:02:07 AM PDT

•  I cannot afford to donate any money

  right now.  But I encourage you to pursue Oregon state programs to see if they offer something he can qualify for.  Oregon is pretty progressive, so I would think they would have something for uninsured cancer victims, even if he doesn't readily qualify for it.  It's worth a look.

  Good luck and best wishes.

  by The Distillery on Sat Apr 26, 2008 at 01:51:35 AM PDT

  •  Oregon Health Plan

    is unfortunately not taking any new applicants at this time. They recently had a "lottery" for potential new members, don't know when it will open again.
    My granddaughter's name was on the "lottery list." She didn't get coverage either.
    He may be able to get SSI/Medicare eventually but that's a long process and requires you to spend down all but a tiny amount of any assets you may have. Usually takes an appeal or two as well. We went through that with our son after our last insurance denial--long, drawn-out process but eventually got him covered. We got $1/month in SSI, which made him eligible for coverage through Medicare. It was only temporary though, as usual he was thrown off after about 6 months and we had to start all over again. At that point we were almost ready to move so we went without insurance... and crossed our fingers while counting the days.

    by expatyank on Sat Apr 26, 2008 at 03:15:24 AM PDT

•  Not to sound crass, but

  if you are an freelance writer and an editor and you write something like "Me and mine are all film buffs . . ." well, I can't take you all that seriously.

  Would you say, "Me are a film buff"?

  Sorry, just saying.

  But I hope your friend comes through okay.  I just don't think this is the place for this type of plea.  Once again, just saying.

  by Endangered Alaskan Dem on Sat Apr 26, 2008 at 02:39:15 AM PDT

  •  grammar police!

    When I write for a living, I never make grammatical mistakes. When I blog, occasionally I do. However, in this case you're wrong... "Me and mine" is a colloquialism meaning "my family and I," therefore it's a plural construction and takes "are" rather than "is" a the verb.
    Sorry, I am in another line of work now but as my colleagues can attest, the copy editor in me just will not retire :-)

    by expatyank on Sat Apr 26, 2008 at 03:00:04 AM PDT

    •  The copyediting gene is relentless

      It passes through generations wreaking havoc. I wonder how it manifests in the illiterate . . .

      by JG in MD on Sat Apr 26, 2008 at 04:54:58 AM PDT

      •  I think they call it OCD

        Instead of fixing words, they even things up on shelves and make sure nothing touches on their plate.
        Which also describes an awful lot of copy editors <grin>
        What kills me is reading books that desperately needed editing, it really takes away from enjoyment of the experience.

        And now to go exercise my havoc-wreaking powers on some M.Ed. students' work!

        by expatyank on Sat Apr 26, 2008 at 07:24:43 AM PDT

    •  Nobody was suggesting the use

      of the term "are" was erroneous.  

      by Endangered Alaskan Dem on Sat Apr 26, 2008 at 10:40:47 AM PDT

•  Tips, if you wish

  but Id prefer a donation to Doug

  by expatyank on Sat Apr 26, 2008 at 02:48:11 AM PDT

  •  I have got to say...

    While I am sympathetic to your friend's plight, I am concerned about the propriety of soliciting checks--particularly without a non-profit tax ID--on this forum.

    by Rgandhi3k on Sat Apr 26, 2008 at 02:56:41 AM PDT

    •  So buy a ticket to the fundraiser

      or contact one of the folks listed on the Web site as involved and ask if a donation can be funneled through a non-profit.
      Or you might prefer to donate to a non-profit group working for universal healthcare in the US--that would be great too.
      If you're worried about veracity, please follow the links--article from our local Pulitzer Prize-winning weekly, further links to coverage in the local  daily, and elsewhere, many of these by writers I know personally as well.

      by expatyank on Sat Apr 26, 2008 at 03:06:15 AM PDT

•  If Republicans thought killing people was wrong

  we wouldn't be in Iraq.  They don't give a flying fuck how many people they kill, American, Iraqi, or anything else.  Our current health system, and our foreign policy, are proof of that.  Given our leaders philosophy of fuck everyone & everything, who wants to place bets that Bush nukes someone before leaving office?  To the Republicans "moral value" is measured in dollars, they don't know of any other kind.

  by Futuristic Dreamer on Sat Apr 26, 2008 at 03:06:33 AM PDT

  •  Themselves and their bank accounts

    Only two things the Republics care about...to hell with everyone (and everything) else.

    by catnap1972 on Sat Apr 26, 2008 at 05:45:28 AM PDT

    •  Not that this helps their bank accounts

      It takes "fuck everybody, including myself" attitude to be against healthcare now.  Unfortunately that's the Republicans platform.

      by Futuristic Dreamer on Sat Apr 26, 2008 at 09:42:35 AM PDT

•  I just tried that Cinema 21 link

  I tried to put in $100 and it choked. Then I tried putting in 10, for 10 tickets, and it choked on that too.

  I'l try again later.

  by vard on Sat Apr 26, 2008 at 06:34:02 PM PDT