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December 17, 2005

Catch 22: Health Insurance in America

The New York Times has been running a series on the major problems with the American health care system. Today's article is particularly revealing of one of the biggest "traps" in the system.

Sick and Vulnerable, Workers Fear for Health and Their Jobs

As usual with the NYT, you have to get most of the way through the "mood setting" heart-rending personal stories to get to a succinct point, but there really is one, and it's an important one.

The Catch-22 of the American health care system is that while many people work "for the insurance," when they become too sick to work and are most in need of that insurance, they are most at risk of losing it.

Indeed. Not only does our health care system make it difficult to afford insurance at the lower levels of employment in the country, it gives employers enormous leverage in keeping employees in line if they have the least fear of needing serious medical care. And if they actually use that insurance, they're really at the mercy of the employer.

Posted by Tully at December 17, 2005 12:33 PM
Comments

A personal story. Not intended to be heart rendering, but I have had personal experience with this. My wife was diagnosed with HCV 5 years ago, and was unable to work due to the treatment. Luckily her employer carried her on his rolls for about six months (work at home part time). 18 months of COBRA after that, and 3 years of state sponsored insurance (very expensive, and a high deductible). I've spent well over 100K in medical/insurance in the past five years. It's one of those things that you think will never happen to you until it does.

The good news is she is cured (40% cure rate going into treatment, so we were lucky), and her old employer has hired her back (good insurance again! Hooray!). We were able to weather her illness due to a good employer, and a solid income, but having been through this I don't see how most would be able to financially get by. My heart goes out to those people stuck with an illness like this that have no choice but to work. Unless they have a very understanding employer life must be hell. It makes you wonder about the benefits of socialized medicine.

Posted by: Dennis at December 17, 2005 03:43 PM

Been there, Dennis, though not with HCV. That's a nasty one. The miracle is that there aren't more people in bankruptcy court.

Then there's all those conditions that people think their insurance will cover, only to find out that the coverage is limited to MUCH less than the costs of treatment. If they're covered at all.

Posted by: Tully at December 17, 2005 08:35 PM

A Harvard study says that one half of all personal bankruptcies are caused by health problems. It affects 2 million each year.

If my wife's illness had been diagnosed 2 years earlier the policy wouldn't have covered it. I didn't have a clue. I thought we were INSURED. I'm a lot more aware of what we are covered for now, but there are still a multitude of illnesses that aren't on the list covered by our policies. It's almost like a crapshoot. I hope I get the right illness if it's critical.

I have semi-decent health insurance for my employees (strong on preventive care) to try to attract skilled workers, but it's become more expensive. It's closing on 10% of my labor cost! And I've had to raise the deductible to keep it within reach. There was some grumbling within the ranks, but market forces won't allow me to pass the cost to my customers anymore. I can see a point where I will have pass a lot of the burden directly to the workers, or just drop it entirely.

Posted by: Dennis at December 18, 2005 01:53 AM

I have a comparison here. A former high school classmate in Canada with advanced Parkinson's and my girlfriend with MS, diagnosed about 8 years ago.

The one with Parkinson's gets all the treatments including operations that extend her ability to take care of herself. There is not much of a wait for her and she has her meds. In terms of her care, there are few worries.

For my gf with MS the meds are epensive, she's stopped taking the Copaxone for a while. She's scared shitless of losing her job (they have layoffs every 4-6 months at her company) and the fact that getting hired by someone else with an eye on the bottom line will be problematic to say the least. Getting new medical insurance would be very expensive ... and medicare, should she get old enough to get helped by it...
she doesn't even have it on her radar.


Not saying that we need to go national a la Canada but the direction we've taken ever since the non-profits like Blue Cross were taken over by corporate types who had the lawws changed to allow them to be for profit we've been screwed.

Posted by: Marcus at December 19, 2005 05:05 PM

Partisan bickering since the days of Nixon has kept us from fixing this, and continues to do so.

The left should want to fix the mess because the macroeconomic impact of job insecurity is ultimately a depression of real wages.

The right should want to fix it because job insecurity keeps workers clinging to their corporate jobs instead of, say, starting their own businesses.

Or, maybe the right doesn't care about that any more, or about having a thriving middle class. Costs too much. Money better spent creating a middle class in Iraq, I suppose.

Posted by: Kent at December 20, 2005 09:40 PM
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