In 2003 I was diagnosed with Crohn’s disease, a chronic inflammatory condition of the lower bowel that I had suffered with for many years. In 2003 the condition worsened; I lost nearly 60 pounds in 4 months and was in constant physical pain. I was always fatigued and found it difficult to even play with my young son after a day of work. I was finally properly diagnosed and had surgery to remove a section of my bowel. I felt immediately better and to this day have remained in good health with only minor symptoms. I take a maintenance drug, which would cost me over $500 a month with no insurance, and regular B-12 injections as I do not absorb this vitamin naturally due to the disease.
By any definition of the Insurance Industry, this is a pre-existing condition. If you lose your insurance and do not maintain coverage, you may not be able to get Health Insurance again, or at the very least have a lengthy waiting period.
Last April, at the beginning of the economic downturn, my employer closed. I was left with the dilemma of maintaining coverage through COBRA or risking my health, as there would be no way to afford the medication I take or worse yet, the exorbitant costs should I have a major flare-up of the disease. I had the added worry that, should I let my coverage lapse, I would no longer be able to obtain medical insurance in the future due to the pre-existing condition. To make matters even more complicated, my wife was blessed with a high risk pregnancy and required weekly ultrasounds and monitoring tests, all with a specialist that was now "Out-of-Network."
Hoping that my unemployment would not be lengthy, I opted to pay the COBRA for my entire family, which was $1,023 per month. Unfortunately, it took nearly 4 months to find new employment and we depleted all of our savings, borrowed heavily from family members and paid nearly as much with credit for the uncovered medical bills and the COBRA coverage. We are a frugal family. Both of our vehicles are over 10 years old and we could have lived relatively easily on my Unemployment Benefits and my wife’s small wages (she was working part-time due to the difficult pregnancy) if not for the exorbitant medical costs. To this day we have been unable to replenish our emergency funds.
We now have employer based insurance, but more expensive than our previous plan and my wages are the same. When I acquired this new job, I was required to provide proof that I had maintained coverage as I obviously had a pre-existing condition. If I had not maintained coverage, I would have been denied coverage for a period of 18 months. The absurd note here is that the Insurance Provider was the exact same provider as my previous job and they would not contact one another internally to determine that I had maintained coverage. In fact I had to get that information from the COBRA administrator who failed repeatedly to send the paperwork.
All of that said, I can honestly say that we were the lucky ones. Our beautiful Jillian was born without complications last September. We are not in bankruptcy or defaulting on our mortgage. However we are now living paycheck to paycheck, narrowly paying our bills, with no end in sight. My new job is very stable in this tough economy, but I essentially took a pay cut as the Medical Benefits are much more expensive. We have no cushion should there be a major medical or other financial expense. A public option, with no pre-existing condition clause would have eliminated all of the stress and financial turmoil my family has gone through and we are by far not the only ones.
Employer based insurance seemed to make sense 50 or 60 years ago when it was thought that a person would stay at the same job for life. Not any more. As you are well aware, the economy and job market are turbulent. In the last five years I have had to change jobs three times as businesses downsized or closed all together. Unemployment is stressful enough without the added worry that an illness might result in financial ruin.
Mr. President, now is not the time for a modest proposal. Now is the time for something radical and far-reaching. You yourself have said that a Public Plan would be good competition for private plans. Please do not waiver from this idea. The average American citizen needs this now, not in some better, but distant future.
I urge you Mr. President: be bold, be decisive, do not waiver. My family needs your help and I am far from alone in this need. I wish you luck in the fight ahead. We will all need it.