Health Insurance Nightmares Shared By Our Readers

In my blog “Why Not Single-Payer,” I asked readers for their thoughts. I received arguments, which I’ll share in a later post. But first I thought I should reprint some of the awful-but-true stories of smart, hardworking people who have been unjustly treated by our nation’s Rube Goldberg-style health insurance system.

One reader explained:

We are self-employed, have been for nearly 30 years. In a family of four, we have three different health insurance policies, due to pre-existing conditions which are mostly benign, and cost little to treat. No surgeries needed, rarely medications, yet when we tried to change companies, due to cost, my husband and son were both turned down….

For my family, this means that we have deductibles which add up to about $20,000 total. God forbid we have any catastrophic events. If I could combine policies, I could keep that deductible to a much lower figure—not easy, but better. The monthly cost of all these policies (and it goes up every few months) at this time is running nearly $900.00. I try to put a bit aside for the HSA, but for the past 8 months, due to the recession, it has been nearly impossible.

I am afraid to get regular checkups myself (needed, because my mother was recently diagnosed with colon cancer), because I am afraid of being dropped by [my insurance company]—I don’t want to trigger any red flags. What a mess.

Here’s another about unreasonable cost:

I'm a progressive Democrat and I'm one of those scared people you wrote about. I've worked for 42 years consecutively and consult part-time. My husband who passed away three years ago worked 43 years consecutively. He received 3 social security checks before he died. I worked and have my own social security. Are you getting the picture? My husband and I did most things right. We lived frugally, but we've always gotten the raw end. Unless we transform to the French medical system, I think millions of people like me will be hurt. I should say further harmed. It's not been fun. I have Medicare now and it's the best medical coverage I've ever had. However I can't pay one penny more for additional coverage or prescriptions.

This is about the frustration of battling insurance companies:

The HMO police are far worse than any government health police in my opinion! I've already dealt with them many times. When my child had had 5 bouts of strep throat in 6 months, and could no longer swallow solid food, the doctor recommended an urgent tonsillectomy. The HMO police said it wasn't medically indicated. I had to pay for the surgery myself. Luckily the doctor’s insurance staffer kept fighting and I eventually got a partial refund. For my own surgery and other more recent health problems, I had to fight for every line item on every hospital bill. The HMO game plan is to wear you out until you give up on the claims.

And this one’s about medical bills:

My sister died at 37 from a metastatic sarcoma (the same thing that got Ted Kennedy, Jr.’s leg). I watched her die, went to her funeral and, in mourning, went back to pack up her apartment and sift through stacks of medical bills, trying to figure out what she owed to whom and how we would get them paid. This doesn’t happen in most industrialized countries and shouldn’t happen here. It's a disgrace.

I guess I should add my own story here:

I changed jobs last year, going from an employee to a consultant. I went to the insurance company that previously covered my family and applied to continue with a private non-group policy. To my astonishment, the insurance company that covered us for 8 years accepted me but denied my wife and both of my children, all for different—and exceptionally unremarkable—“preexisting conditions.” Fortunately I was able to scramble around and get group coverage through my wife’s employer. But I was lucky. I have no idea what someone else in my position could have done if they weren’t lucky enough to have a spouse who qualified for employer-sponsored health insurance.

The first writer is correct: the system is a mess. According to the most recent estimate, 52 million Americans are uninsured [1], and 25 million more are underinsured [2]. Even Americans with insurance are struggling with soaring health care costs [3] and have to battle with insurance companies to receive the coverage that they are due.

We finally have a realistic chance to fix the system. Both the U.S. House and Senate will likely vote on sweeping health care reform legislation during the last two weeks of July. There will be a series of votes on amendments that will determine whether we get real reform—whether the people or the special interests will win. And there will be a relatively small number of lawmakers—mostly “moderate” Democrats in the Senate—who will cast the key votes for or against.

President Obama famously declared that “nothing can stop the power of millions of voices calling for change.” Please add your voice to his. Visit our friends at Health Care for America Now [4], go to the “get involved” page, and help us win this desperate, crucial battle.