Greg Knauss’ recent blog posting “Bugged” describes his experience in the hospital when his son’s bug bite turned into something much worse. As it turns out, without insurance, he would have been expected to fork over almost $24,000 in medical expenses. Knauss’ comments have encouraged me to write more about my recent hospitalization, because I was in a different place all together: If it weren’t for government-mandated affordable care, I would be dead or bankrupt.
Knauss makes the point that the Affordable Care Act – “ObamaCare” as it’s known in political vernacular – will provide a safety net to many Americans who don’t have health insurance. If you’re insured, or if you can afford a lengthy hospital stay, it’s easy to poo-poo this as yet another government “entitlement.” But until you’re staring this situation in the face, you cannot possibly understand how terrifying the prospect of going without insurance really is.
As some of you know, I spent the last part of June and the first week of July in the hospital because of a foot infection. I had stepped on a sharp piece of plastic that punctured the bottom of my foot. I went to the doctor shortly after noticing swelling in my foot, but an infection had already set in. Bonnie brought me to the ER at the local hospital two days later; I was admitted and surgery was performed immediately. I ended up spending a week and a half in the hospital recovering from that.
Unlike Knauss, I didn’t have COBRA coverage. Anymore.
For the uninitiated, COBRA enables workers in the United States who lose health benefits to continue them temporarily. It isn’t an “entitlement” – you pay the entire premium for the insurance, up to 102 percent, actually.
For a family like us, COBRA was absolutely vital: my daughter’s been hospitalized several times, some of us take expensive prescription medications, and I suffer from chronic health problems that require drugs and regular monitoring from doctors. I’m an insurance risk, just the sort of risk that companies love to reject, similar to how Greg describes himself. But going without insurance would quite literally be a death sentence for me, and possibly for other family members too.
I paid out of pocket for COBRA every month I could after I lost my job. I was happy to. It was the continuation of services that kept us healthy and alive during my ten-year tenure at my previous employer.
It was only when the eligibility period ran out that I was finally forced to go without.
Fortunately, I live in a place where there is a safety net. I live in Massachusetts. In 2006, our governor signed a health care insurance revision bill into law. The law mandates that Mass residents can obtain a minimum level of healthcare insurance coverage, and makes sure that you can get free health care insurance if you earn less than 150 percent of the federal poverty level.
That governor was Mitt Romney, and the law I’m referring to is colloquially known as “RomneyCare.” It’s also been widely described as inspiring large parts of the Affordable Care Act.
The bottom line is that the vast majority of the residents of Massachusetts – an estimated 98 percent – have some sort of health care coverage, even if it’s the bare minimum needed to cover catastrophic events like hospitalization. Thanks to RomneyCare.
It was this insurance that I was able to get. I’m sorry to admit that those Federal poverty guidelines pertain to me, so I got the free coverage. Quite frankly, the economy and the publishing industry have not been kind to me since losing my last full-time job.
Without RomneyCare, I probably would have put off getting to the doctor or the hospital until I’d been much worse. And I’d be footing the bill for that ten day hospital stay. For the surgery, and the anesthesia. For each and every pill I took, every bandage I used, every linen that needed to be washed. For the bags of antibiotic administered intravenously. For the nurses, doctors and technicians who treated me every day. For the months of followup treatment I’ve required – a month and a half of IV antibiotics, more pills, daily visits to a wound care treatment facility for hyperbaric oxygen treatment, a visiting nurse who comes once a week to check on my progress, the specialized bandages and medicines I must use to keep infections at bay.
Two months later, it’s still not over. All this, because a piece of twisted, sharp black plastic less than two centimeters long got stuck in my foot.
I have little doubt that without RomneyCare I’d be declaring bankruptcy at this point, because I have barely the money to keep the lights on right now, let alone pay for a ten-day hospital stay to treat septicemia. Let alone the months of specialized post-surgical treatment I’ve needed to recuperate.
It was a totally unexpected event that I couldn’t have reasonably planned for. And even if I had, it would have required me to be able to afford to pay the expensive insurance premiums which are totally beyond my reach right now. I take no pride in admitting that. And to reiterate: I paid for private insurance as long as I could. I didn’t want to burden the system if I didn’t have to.
The system isn’t perfect. Premiums and service costs continue to rise into the stratosphere. There’s still a serious need for health care reform in Massachusetts and throughout the United States, and the Affordable Care Act doesn’t change that.
Knauss writes:
We can make this work. We have to make this work. A bug bite cannot be the thing that draws the line between a middle-class life and poverty, between opportunity and the stagnant dead-end of could-have-been. Our friends, our neighbors, our children, the future of this country as a cohesive society — as an endeavor where we see each other as more than opponents, as more than comptetitors [sic] — depends on it.
There are millions of Americans who can’t afford routine medical treatment, much less catastrophic care. Many seniors and others on fixed incomes have to decide from month to month whether they pay their utility bills or get the medication that keeps them healthy. Expecting friends, relatives, churches and charities to help them all is ridiculous. Expecting them to barter chickens for doctor visits is insultingly stupid.
And current “entitlement programs” – many of which inadequately cover the needs of these people to begin with – are being eviscerated by legislators who use the guise of reducing government spending to conceal their craven pandering to corporate interests and lobbyists.
I find it inconceivable that we’re still having a national discussion about health care as a privilege only for the wealthy or those lucky enough to work for an employer who offers affordable insurance. We need to recognize it as a fundamental human right if we’re to ever evolve as a compassionate society that actually wants to uplift its population to prosperity. We’ve heard a tremendous amount of lip service from the political right in this country about that, but their actions to dismantle the ACA and Medicare are completely counter to effort.
RomneyCare saved my life. And it kept our family out of bankruptcy.
The system worked.
Top hole. Well said.
I’m still still waiting to come into the tent. If Romney wins, I’m screwed.
“We need to recognize it as a fundamental human right if we’re to ever evolve as a compassionate society that actually wants to uplift its population to prosperity.”
Except nothing can be a right if it forces others to do something. That’s what a “right” to health care entitles.
The problem with the ACA and the whole debate is that it confuses health care with health insurance. The ACA is only about health insurance- and the insurance industry supported it.
It does nothing to reduce the cost of health care- that’s the problem. And more government regulations only make situations like yours more likely, because health care is more expensive.
THAT’S the real problem.
We all have to fight to keep our healthcare and get the healthcare America Deserves. Please visit http://www.occupyhealthcare.net to learn what we are doing to help Greg and all Americans.
“The problem with the ACA and the whole debate is that it confuses health care with health insurance.”
And as I said in my posting, the ACA doesn’t do anything for health care reform. And everyone I know, including literally every health care provider who’s helped me in the past two months, agrees that’s necessary.
The ACA is a stop-gap measure, but it’s something. And something is better than nothing.
Matt B–
A few thoughts in response to your post:
–The ACA’s priority was to ensure access to care. Costs are a huge issue, no doubt, and will require more action over time…but ensuring access was a key step to reduce harm and morbidity/mortality. After access was secure, then costs would be the next target. I would agree that the ACA supports insurance companies, but this is because in the US we have a system that requires insurance to allow access to care. Any steps to move away from for-profit insurers were shot down.
–There are a number of definitions of physician professionalism that require physicians to take care of patients under any circumstances (http://journals.lww.com/academicmedicine/fulltext/2000/06000/toward_a_normative_definition_of_medical.10.aspx and http://gme.cchange.com/portals/7/media/ProfessionalismArticle.pdf). There is also a federal law (EMTALA) that requires physicians to provide emergency care. Therefore, we could argue that physicians are already expected to care for patients regardless of their ability to care; defining healthcare as a right does not impose greater burden on physicians.
Mark R ~
The “Pay-for-Performance” initiatives that give bonuses to physicians if they deliver “quality care” can backfire – and primary care physicians may decide not to accept a new patient with a chronic health condition (i.e., obesity, type 2 diabetes, etc.) or refusal to accept a vacine for fear of it affecting his/her P4P quality quota.
http://www.kevinmd.com/blog/2012/02/doctors-allowed-fire-patients.html
http://en.wikipedia.org/wiki/Pay_for_performance_%28healthcare%29
Hi. I feel you, and I feel for you. Have worked 7.5 yrs for a huge HMO. Am on leave d/t harassment and PTSD from same. HMO has new policy- they can cancel your bennies after 6 mos’ leave. They cancelled them 1 June. On 5 July I got cellulitis on my shin from a scratch. Hospitalized 9 days. Bill: $100,000 and growing. No husband, parents, house, savings. Will qualify for PCIP but not til December. COBRA at $900/mo was out of my reach. Trying not to be terrified; trying not to get sick. Age 56.
Mark B – I am not sure that I follow your logic here – in countries such as Canada and New Zealand (where I have lived, also the US) – “health care” is universal; everyone is covered. The costs of this health care, which is not insurance, is lower as a proportion of GDP than is the case with the US. Dealing with health as “insurance” is asinine – insurance companies only make money when they do not have to pay out. Most Canadians and Kiwis are happy to pay taxes to ensure that they do not have to live in fear, like Ven or K Comalli above. Having used the health care system in both countries, and the health insurance system in the US, I too am happy to pay (slightly) higher taxes, knowing that all are covered.
Bonnie–I agree pay for performance models of care have been of mixed benefit at best. It speaks to the fact that we need to find better/more reliable ways to measure quality of care than using arbitrary cut-offs that might not actually reflect value of care. Re: your comment re: physicians refusing to accept patients who might have worse outcomes–there will need to be a way to account for sicker patients and populations that generally don’t do as well.
Matt L–note that I didn’t say that I *agree* with propping up insurance companies; only that this is the system the US has. Even the watered-down proposal of a public option insurance plan within insurance exchanges was too politically fraught to muster the needed support. Single payer systems are better in many ways, but not apparently what the average American (or the average politician) is currently willing to accept. The ACA leverages the system that currently exists to expand coverage while expanding some government coverage through Medicaid–nothing less, nothing more.
One thing to help fight the infection is to completely eliminate sugars from your diet. Sugar in the bloodstream is a cheap and easy fuel source for the Bacteria. By depriving it of that you help to contain the population while your body and the antibiotics do their work.
[...] Affordable health care saved my life – Yes, it was RomneyCare. But isn't that what affordable health care is supposed to do? Possibly Related Posts:Is Organic Really Good?Natural Food HypocritesDon’t Tell Me What to Eat This entry was posted in This just in… and tagged diet, food, health, links by Maria Langer. Bookmark the permalink. [...]
In Australia we have Medicare 1.5% tax to cover most of my hospital expenses. i can take out private health insurance if I want to and there is an additional tax if I am a high income earner and do not do so.
It covers most hospital expenses althoguh there are waiting lsits for non emergancy surgery and some procedures are not covered.
It’s not perfect but we don’t see $100,000 bills for emergancy treatment
Somehow Australia has survived this ‘socialist’ takeover
@MattB:
> “more government regulations only make situations like yours more likely, because health care is more expensive.”
In the UK, we have the NHS. It’s free at the point of use for everyone, and funded by our government, i.e. by us tax payers. It costs a bit over £2,000 per year per person in the UK, which I believe is quite a lot less than the American system costs per person.
I can understand if you don’t want to pay for everyone else’s healthcare, but at least in the UK, it doesn’t seem to be more expensive than everyone paying for their own individually.
Matt B:
“Except nothing can be a right if it forces others to do something. That’s what a “right” to health care entitles.”
Except *every* right forces others to do something. The right to fair trials costs all of us the tax money to support the judicial process (summary “justice” is way cheaper). The right to vote costs us all the money which goes to support the process of elections.
Health care for all our citizens is a moral imperative.
Can anyone point to ny country in the world which has universal health care where the citizens are lobbying to have it removed/dismantled
I have lived in UK, Canada, and the United States. What is going on the United States with health care is totally criminal.
> Except nothing can be a right if it forces others to do something.
Your argument is ridiculous.
If your house catches on fire (maybe the previous owner hired a shady electrician who put the wrong cables in your walls) then others in the community — including professional firefighters — will be forced to mobilize and put the fire out. When your house fire is put out, everyone benefits, not just you. That is why everyone pays. Your neighbor 3 doors down’s house did not catch on fire because it was put out first. People are buying and selling homes in the neighborhood and fixing them up, confident that if one house catches on fire, the fire department will stop it there and the whole neighborhood won’t go. Everybody benefits. Everybody pays.
If you are assaulted on the street (maybe you say something ignorant and somebody punches you in the face) then others in the community — including professional cops — will be forced to mobilize and arrest the attacker. When your attacker is arrested, everyone benefits, not just you. That is why everyone pays. Removing a violent person from the street is a community benefit because he won’t hit the next person. Making the streets safer encourages business activity, new malls, new homes, new businesses. Everyone benefits. Everyone pays.
If you are hit by a car on the street (you may be crossing on a green light and a drunk driver comes out of nowhere and cripples you for life) then others in the community — including professional doctors, nurses, paramedics — will have to mobilize to rescue you and treat your wounds and try to get you back to your life and family and job and home so that there is minimal impact on your life, including minimal impact on your community, for example, your job may need you, your family may need you. When you are rescued from being broken up on the road, that is good for everybody. We don’t have to see a car accident and just stand around and watch somebody die, along with our kids.
Similarly, if you catch Tuberculosis at the movie cinema and you go to your doctor and get cured before passing it on to everybody else, that is better for everybody. If you notice a lump under your arm and you go immediately to a doctor and he takes a cancerous lump out before it spreads and puts you into years of chemo, then that is better for everybody.
Fire, police, medical. These are our 911 services. What we invest in them together as a society benefits everyone. In areas where these 911 services are better, business make more money, people work harder, people enjoy life more. That is a basic fact.
The problem in the US is that some people (over 26, under 66, over a certain income level) are excluded by law from the medical part of our 911 services in order to force them to participate in a multilevel marketing scheme from insurance companies. What is your rationale for that? If we exclude those same people from police protection and told them to buy police insurance, that would be awesome for insurance companies and terrible for everyone else.
And what makes this really bad is that by excluding those people, we did not even save money. The US *PUBLIC* medical system is bigger than the public systems in other countries, but in other countries they cover everyone and have better outcomes.
Further, what makes your argument truly ridiculous is that in the current US system, the people who are FORCED out of the public medical system — that they themselves pay for in their taxes just like everyone else in every single industrialized country — fall into terrible health over the course of years and end up COSTING US MUCH MORE LATER when they get back on the public system at 66. By the time they are 66, diabetes has ravaged them and they have fused disks and all kinds of problems. We exclude them, make them suffer, provide billions for private health insurers, and then the taxpayer has to pay outrageous bills to try to put that person back together at 66.
And what’s more, if every single person in the country gets a checkup every year even when they are healthy, then the cost of medical care to the entire country goes way down. Doctors can tell you that you gained 20 pounds over the past year, you should address your diet and prevent yourself from coming back next year 40 pounds overweight, and then 60 and so on, until you are beyond help. That is what happens in Canada and Europe. Doctors are there regularly in your life even when you are healthy, keeping you healthy. In the US, you show up in the ER with complications from diabetes, weighing 300 pounds, and haven’t seen a doctor in 15 years.
THAT HELPS NOONE.
With the possible exception of anyone who competes against the US. That is why foreign countries invest in the Republican Party. To keep the American people poor and sick so that other countries can drink our milkshake.
You’re a traitor to your own people and you don’t know it, because you think that it’s OK to put a cash register between a sick person and a doctor.
[...] Loop’s Peter Cohen shares a similar experience, and Marco Arment provides equally good thoughts on the issue. Category(s): Uncategorized [...]
[...] Loop’s Peter Cohen shares a similar experience, and Marco Arment provides equally good thoughts on the issue. Category(s): Uncategorized [...]
According to his website, Romney’s health care plan will “prevent discrimination against individuals with pre-existing conditions who maintain continuous coverage”. What about those people with pre-existing conditions but no health insurance?
Exactly. Those people are screwed.
This is a topic which is near to my heart… Many thanks!
Exactly where are your contact details though?