This is in response to nyceve's request for insurance stories.
My husband and I are not looking for subsidies - we just need a fair shake and the financial security to continue to thrive. We'd never qualify for subsidies - and we shouldn't when there are others who need them much, much more.
I'm a management consultant in a niche field where I'm one of the top three in the world. My husband works in the business to take care of a lot of administrative work so that I have more capacity for client work. The business brought in about a half a million last year and we cleared about $300K after expenses. We considered that to be a slow year. You'd think that would be enough.
My husband only recently joined my business full time - prior to that, he had a part time job in a unionized field where he worked just enough to receive health benefits. He would have given up that job long ago for someone who needed it more if the health insurance racket had not made us afraid.
We'll make our first COBRA payment in October, and then we have eighteen months of coverage before we're locked out of the system.
You see, despite our apparent health and affluence, we both have pre-existing conditions. We're healthy today, but we've both had issues in the past that the insurance companies have decided make us bad risks.
Oh, and the same criteria applies to private disability insurance, as well. So we have no coverage for loss of income if I can't work, except the same Social Security available to everyone, with all the hassles. The moment I stop being able to get on planes to go see clients, we have no income coming in.
We have savings, but if we got hit by an expensive illness - and loss of work - we'd start going through that money pretty fast. Since we're relatively young (we're in our 40s), the business is relatively new (it's less than five years old) and we've invested all of our earlier savings into the business to get it going, then we'd be destitute within just a year if we were hit with that double whammy.
Even if my husband was the one to have a health crisis, we'd still not be out of the woods since that would also affect my ability to produce.
With that as background, here are my responses:
- What must reform look like?
All the bills, including the odious Baucus bill contains insurance reforms that prevent recission and pre-existing condition exclusions, lifetime limits and annual caps. That's a step in the right direction.
But all those reforms do no good at all if insurance is priced out of reach. Most of the markets in the United States lack a truly competitive playing field. Without that, there is nothing to keep the insurance companies from finding ways to game the system.
It also does nothing about the layers of bureaucrats between doctors and patients who make more money when patients go untreated than they do when patients receive care - even if that care saves the system money in the long run.
We need a robust alternative to the private insurance game - and sorry, Snowe but coops don't cut it. I know Group Health in Seattle better than most - they're well-respected in my professional community as a group that works tirelessly to improve care and lower costs - but the model is simply not scalable and requires too much disruption of the current health care delivery system.
The ideal system for people in my situation: a base public option that provides for basic medical coverage, including catastrophic coverage plus a suite of private insurance options if we want higher levels of serve. For example, I'd probably welcome the ability to pay more for a primary care physician who can work within my complex schedule to get all my preventative tests, blood work, mammograms, etc. scheduled for the same day.
- What constitutes sufficient reform and what would be insufficient?
Sufficient:
--The stuff that's in all the bills so far: immediate reforms to eliminate pre-existing condition exclusions, recission and introduce community ratings.
--A robust suite of options from public to private that provide choice at a variety of price points.
Not Sufficient:
--A mandate to buy insurance that does not increase competition or lower prices for most people.
--Subsidies that don't kick in fast enough when people have a crisis of any kind that lowers their incomes without warning.
- Is the Senate Finance bill totally insufficient?
It's not totally insufficient - I believe that it contains the provisions that eliminate the whole concepts of pre-existing conditions and recission - but it is far from enough to make a big difference.
- What happens to you and your family if there is no public option?
We'll be able to purchase insurance, which is an improvement from the current state of affairs. However, we'll still be subject to the same bureaucrats whose incentives run towards keeping people untreated and sick, preferably dead - instead of healthy.
If someone is between me and my doctor, I want that person measured on how healthy we are as a country rather than how much money their company makes.
- If you are mandated to purchase private junk insurance (without being offered a public option), what will you do?
Pay the fines, self-fund and take our chances.