The horror of comprehensive health insurance

It wasn’t my choice to become a walking, talking healthcare reform example. But lately that is my fate. Friday night I got a sore throat — these things seem to always happen on the weekend of course. By Sunday it was incredibly painful and so swollen my face was beginning to be deformed. Fortunately, Monday my PCP was in, a quick visit, a $20 copay and $10 more for prescribed antibiotics and now, less than 24 hours later, it’s already noticeably better.

It was bad enough that I was completely out of the game all day yesterday and I’m still running a pretty good fever. It’s scary to think what might have happened without health insurance, because this was the most painful sore throat I have ever experienced and it was spreading rapidly — a side effect of being on auto-immune drugs and cortisone no doubt.

First thing I see now that I’m up and running is this lovely article making the rounds with the usual suspects:

LA Times — Fullerton resident Jennifer Harris thought she had a great deal, paying $98 a month for an individual plan through Health Net Inc. She got a rude surprise this month when the company said it would cancel her policy at the end of this year. Her current plan does not conform with the new federal rules, which require more generous levels of coverage.Now Harris, a self-employed lawyer, must shop for replacement insurance. The cheapest plan she has found will cost her $238 a month. She and her husband don’t qualify for federal premium subsidies because they earn too much money, about $80,000 a year combined.

“It doesn’t seem right to make the middle class pay so much more in order to give health insurance to everybody else,” said Harris, who is three months pregnant. “This increase is simply not affordable.”

Those suffering from ODS are conflating this with employee group health insurance and claiming Obama lied when he said those plans would be unaffected. But on the case above … madam, I’m sorry to say it like this, but you are either an idiot or one hell of a thoughtless, selfish piece of work. You damn well better afford it, because you absolutely will have to use it sooner or later and you don’t want to go the ER or the chemo wing on 98 dollar a month insurance. That policy would be maxed out if not cancelled faster than you could say malignancy. Either way, the uncovered costs would land you squarely on the charity or Medicaid rolls.

See, I’ve had to live and breathe health insurance for the last two years, I am insurance licensed, and here’s a dose of reality: if you had a policy for $98 a month it was either a piece of shit or a very, very special deal. I looked for almost an hour online and I can’t even find any private policy anywhere for that price, the closest I can find pre-ACA would run about 150 a month, it covers no preexisting conditions, it has huge itemized deductibles and a low annual cap. Meaning your 98 dollar premium is either a special deal just for a select group and others are taking up your slack, or far more likely, it’s junk insurance. If the latter, that means if you got really sick or really hurt, and that was your only insurance, your only option for comprehensive treatment would be to throw yourself on the mercy of your fellow Californians’ generosity and you’d probably end up bankrupt for life in the process.

A private comprehensive policy that covers preexisting conditions, that has no annual cap, and covers preventative care for no copays at $238 a month is a fucking wet-dream compared to what’s currently available right now. A real policy would run you more like $500-1000 a month. You were basically marching into battle wearing body armor made out of paper mache. Now, thanks to the ACA, for an extra $140 a month you get the real deal, guaranteed, for life. You won’t end up a ward of the state if you get your brains scrambled from cancer or a windshield, but you’re whining because along the way someone who isn’t covered at all now might enjoy the same protection that is going to be handed over to you at that low bargain rate.

I don’t know if this lady is a Republican or has an ideological ax to grind or what, she may be the nicest person on Earth for all I know. But for all those conservatives out there with a sad face because millions might get covered now, you assholes had the WH and Congress and the Senate, and the entire country behind you after 9-11, and a budget surplus to boot. Your party could have solved this problem just like you pushed Medicare Part D.

But instead you blew trillions on tax cuts, a needless war in Iraq, and bailing out Wall Street. Because that was more important to your leaders than making sure millions of people can get a few dollars of antibiotics to treat a routine sore throat, to keep it from turning into septicemia and eating bloody, oozing holes into necks and jaws before killing us horribly and infecting everyone around us. Or suffer a thousand other horrible, unplanned accidents or afflictions seen everyday in offices all over this nation.

So just bite me. Obamacare is here, it isn’t going away, and every time I hear ignorant selfish pricks whine about it, it makes me smile a little wider.










  1. unbound says

    I can’t believe she is complaining about $238/mo. My employer-sponsored plan costs several hundred a month, and I have to play the first couple of thousand out of my pocket before any benefits kick in (I’m pretty sure my company’s plan is illegal based on a few things I’ve read in the ACA since it doesn’t pay anything if you only visit the doctor a few times a year).

    Of course, the crack “journalists” at LA Times couldn’t be bothered to check out the claims and provide any real perspective in their article…

  2. says

    From a German perspective, the discussion about general health insurance in the USA seems completely insane. Although there are ways not to be health insured in Germany, normally you can be insured, even if you have no income and no family members or spouses to rely on.

    And even in low quality forms of insurance, live saving operations, e.g. heart transplantations, are included…

    Good luck to you and gute Besserung!

  3. says

    As regards the $238, my health insurance doesn’t come free either, since me and my wife have a decent income and qualify as middle class. I am paying about the sum of money, but I have only to advance 300 Euro per annum out of my own pocket and have to pay myself for general, not medically indicated drugs, e.g. aspirin or nose spray.

    Could somebody pleaaaaase explain to me where the fucking problem lies for many US citizens?

  4. says

    Glad you’re getting better.

    The only thing wrong with the ACA is that it doesn’t go far enough and it probably means there won’t be a real fix for ages because of it.

    A little anecdote:
    I’m a dual UK/US citizen (which gives me the advantage that what follows was entirely legal and above board.)
    I just got back from visiting some friends in Harringey in North London (working class area, very multi-everything) where I got really bad bronchitis: horrible can’t-breathy bronchitis. So my friend phoned her doctor told his receptionist (one, not a whole accounts department) the situation. I went in the next morning, was seen, nebulized, seen briefly after the treatment, given prescriptions for pills and an inhaler. All of this was pretty-well as efficient and pleasant as it would have been over here with my own doctor.
    And, since I’m over 65 it was all free. (Of course it is paid for by a tax, but I once read that the per capita cost is about 1/3 the cost over here).

    There are problems with the NHS. It’s not perfect (just read a British newspaper any day) but it seems a damn sight more fair and moral than what we have now in the US.

  5. ischemgeek says

    I get health insurance through my uni as a Canadian student. It covers stuff like prescription medication, eye exams, etc.

    I pay about $450/yr for it.

    Hospital stuff, on the other hand, is covered through taxes. And, speaking as someone who will be a professional engineer in one of the most lucrative disciplines in the country a few years’ time, I’m perfectly content with paying more in taxes to ensure that others can obtain the same care I’ve received.

    As a final note: I have a chronic health condition. Before the ACA, the US was completely off my list of places to look for work. Because the nature of my chronic condition is such that every time I get sick, I might end up in ICU. Hasn’t happened since I was a kid, but it could happen in the future. That’s asthma for you – it’s an unpredictable beast. I couldn’t take the chance that I’d work in the States, have a severe attack, and end up bankrupt.

    Now, I can consider building a life in the States. I probably still won’t because the tea party scares me, but it’s something that’s on the table. The naysayers should consider that – people with chronic conditions have money, too, and I’m not the only person I know who has refrained from travel to the States on account of having a chronic condition that would end up bankrupting me if something flared up bad enough.

  6. DonDueed says

    Somehow I doubt that she’s the nicest person in the world. The nicest person in the world would hardly be complaining about having to spend a mere 3.6% of her family income on a good health insurance policy. Especially considering she was already spending 1.5% of her income on a piece-o-crap policy.

    I pay about the same dollar amount as my contribution to an employer-paid plan that has a $1500 annual deductible (though preventive care is covered without deductible).

    Hope your throat is better soon, Stephen.

  7. lanir says

    @neleabels: From a thoughtful US perspective, what’s going on in the US with health insurance is completely nuts too. :)

    We have a lot of people over here. And if you tattery policy on the daemon side, many bug-fixes, and some features have also been dropped. Think about it there doesn’t have to be a very large percentage of people making a fuss to give the appearance of a huge debate, not if they’re using modern communication tools. It doesn’t take much to write a webpage and it doesn’t take very many people to whip up an article like the one above. It seems a bit weird to me that at one point the article says that up to $94k/yr gets significant federal help then says that at $80k/yr the example lawyer won’t get any help. And there’s really no word at all, even a vague hint about what is changing coverage-wise for these people who are having their rate jump. So it’s all apples and oranges anyway.

    In other words this is simply awful reporting. When the bulk if your article is about statements you blithely accept, which you then quietly provide data showing they’re false in your own article without calling it out… That’s an obvious mistake. So is providing very specific examples that are not fully defined then later giving very broad generalizations on what “might” be the background for those examples.

    In my personal experience, a friend of mine who was injured at work due to negligence on the employer’s part and lost considerable use of one arm which will never recover and took years of litigation and not working to pay at all, later found his employer health insurance which cost about as much as the ACA plans was literally writing off everything as a pre-existing condition. Even doctor visits for unrelated care. Is this an extroardinary example? Sure it is. So is the lawyer with the $98 per month insurance. But at least the lawyer will be getting something for her extra money.

  8. says

    that means if you got really sick or really hurt…
    Or, you know, pregnant! Which it says she has been for three months. I hear those bills aren’t cheap.

  9. Orakio says

    @3 neleables –

    A lot of the situation with American politics boils down, unfortunately, to authoritarianism. A large minority of the populace wants, desperately, to have the ‘right kind’ of leader to listen to, and to punish anyone who doesn’t obey. To have this false security, they’ll suffer almost any privation, so long as they think the ‘wrong kind’ is being punished even more.

    Now, Obama, being ‘the wrong kind’ mostly by virtue of his political party, partly by his skin color, and partly by being the wrong kind of Christian, to this minority, is to be opposed at all costs. To the authoritarian follower, if he says the sky is blue and health care is good, then the sky is obviously red and health care is bad, not because of any subjective benefit to them, but simply because they can’t tolerate anything that lives outside their myopic worldview of a good leader.

    American conservatives can’t handle their own health care plan specifically because Obama and the Democratic Party implemented it. No other reason, just because of Democratic involvement.

  10. says

    #2 it is insane, certainly highly irrational. In a weird way though, that cultured irrationality may prove to work in our favor. Tens of billions of dollars have been poured into a massive, multipronged PR/misinformation campaign in the states. The people who laid out the bulk of that money didn’t do it because they’re fundies or anti-science, they’4e mostly neither, they did it for a return on their investment: they’re very rich and they want to pay lower taxes and have an even freer hand to make more billions. For decades it paid off, but they’re now hitting two obstacles. The first is, cutting taxes from say 90% to 35% is a nice payday for a rich person, but cutting them from say 9% to 3.5%, not so much. There’s a built in limit, you can’t cut lower than zero, so they’re were already getting less bang for the buck and having to push ever more unlikely schemes like flat taxes and nibble around the edges on property taxes, etc.

    But the real biggie is their movement, their entire campaign built up over those decades to serve their economic interests, has now been hijacked away from them at what should be the height of its power. Instead of pushing tax cuts as the sole reason detre, a coup has taken place and the new leaders are using those carefully constructed resources to oppose Obamacare and do stupid shit along the way like threatening to miss a debt payment on Tnotes. Which 1) doesn’t help rich people much either way and could actively destroy their wealth, and 2) is doomed to fail because people want healthcare and we have the WH for the next three years at least.

    That’s the ironic part. Their movement became so acculturated into irrationality and so dependent on seething raw hatred that all it took was a few know-nothing grifters to out grift the original bankstas.

    That movement has basically been robbed by the Teaparty and clowns like Cruz. We’ll see if the rich get back in the box, but right now I think they may be totally fucked. If so, much of the money will dry up stranding a bunch of teatards out there all by their lonesome for historians and socialists to ponder and write about for years to come.

  11. magistramarla says

    Leo @ #8
    My thoughts, exactly! Her $98/month policy would most likely have failed her big-time, especially if she has a C-section, which is sadly very likely in this country. Also, I wonder how much extra her insurance company would have been charging her to add the baby onto her policy.
    I predict that it would have been quite expensive, since those insurance companies know how expensive a young child’s medical needs can be, what with all of those well-baby check-ups, vaccinations, ear infections, unexplained fevers in the middle of the night, etc.
    She’s going to be much, much better off with that comprehensive plan that she will be buying now. Unfortunately, it will be impossible to convince her of that.
    AND WTF? A couple who makes $80 K per year complains about this? Even when we lived in California, my hubby was making only a bit more than that annually and we were paying more than $238 per month for his federal employees group insurance. We were still able to live quite comfortably in Ca.

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