Wednesday, August 19, 2009

Why I support a public option for healthcare

Please, please bring on a public option for heathcare. Cover the gaps due to employment change, don't make people chose between avoiding poverty and illness, and stop denying coverage to people who need it.

I know people personally today who are facing serious illness and gaps and not having as much luck as I did when I faced similar issues (and frankly I didn't feel lucky at the time). Check out my blog pal David's thoughts on healthcare; and I know he's ill, but that isn't what his blog is about. He's facing his illness without letting it define him and I admire that. There's my friend Tom, he of the scintillating wit and the Spanglish Soap Opera fame, who is recovering from an unexpected stroke. I'll be helping raise funds later to cover the medical costs through a fundraiser for him at his church. It seems terrible that we're counting on the equivalent of a bake sale to help save someone from medical debt, but there you are. There's my dear friend Tracy, who would have many eloquent things to say on the topic of healthcare reform but she isn't here to say them. And I can't try without tearing up, and I seem to be out of tissue right now.

I don't want to give up my current employer-sponsored plan. I would probably prefer a private insurance option if I faced a gap in employment again. But if neither of those were available, shouldn't there be an alternative that would cover me and people like me and my friends?

IHere's my story: in the past 10 years, I've held 12 jobs. 13 if you count the theater work I do, which I don't because it feels more like a hobby and fun and 13 is unlucky. But my best jobs have been fun, so perhaps I should count it. I'm not a transient worker, I'm not undependable, I've got portable skills and I've never left a job for cause - but RIFs and reorganizations are common nowadays, and I've not been immune. I've had three gaps in employment. Two times I lost employer-provided insurance. My choices were: 1) go without insurance 2) find a private policy or 3) pay for Cobra.

The first time, I opted for Cobra, expecting it would be a short gap. Cobra only offers employers the thin veneer of psuedo-responsibility to make them feel better after they release someone. But in fairness to the company, they aren't enhancing shareholder value by insuring people who don't work there, so I can't blame them for the approach. I ended up unemployed for 9 months. I took a part-time job at Border's when the gap was stretching out. Even with unemployment benefits and part-time work, I never made as much in a month as I was paying for heathcare. Eventually, we ended up uninsured, with 2 kids under 2 years old. I tried to get private insurance, but since I'd had pre-existing back pain issues the costs were exorbitant. Then my son had an emergency room visit, which was very, very expensive to be faced with in my situation. I remember he was bleeding on me and I started wondering if I could afford treatment in the ER or maybe he didn't really need to go. When I hit that point mentally, I realized I couldn't make an unbiased decision about his healthcare because money was getting in the way of health. I decided then that whatever debt there would be I could deal with later, so we went. I could always earn more money later, but you can't buy back health.

After his stitches were in I tried to get the kids enrolled on the State of Illinois plan for Children's health insurance, which was a joke. The paperwork burden was immense, and intrusive. No one who knew anything about the program was available to help by phone or in person. I called, phone calls were not returned. I went to offices, waited half a day, and couldn't get any answers. The system wasn't set up to understand that my tax returns and last job's pay stubs didn't reflect the then-current reality of negative cash flow. I still don't think that my kids small college funds were moot to the evaluation, but they wanted those statement balances, as an example, and tracking down every nit and gnat they wanted was a fool's errand. I've got a graduate degree and had the time to figure this out since I was unemployed, and still couldn't get the kids enrolled.

I was trying at that point to be a stay at home mom, something which I'll never know whether I'd be good at or not. I suspect not, but would have liked the chance to try. I gave up on the effort, figured I could better use my time in other ways to get out of the situation. I buckled down on my job search and took a job for 1/4 of my previous salary but it had benefits and was enough for me to pay for daycare. So I accepted gratefully.

The other time I had a gap, I opted for private insurance and that worked far better for us. But it wouldn't have worked at all, except that my back issues were far enough ago that they didn't count as a pre-existing condition anymore. I felt very, very grateful that my back hadn't troubled me much in the previous 5 years.
If I couldn't figure out how to use the supposedly-available programs, then how would someone fare who had less education than I had? If I was mentally anguished trying to figure out if I could afford an ER visit for my son, how would someone in more dire straights be able to handle that? What if my pre-existing conditions had occurred more recently? What if I wasn't able plan on earning more money in the future?

If you disagree, I can respect that. But please keep the dialog to the facts of what's actually in the proposed plan - you can leave out the death panels.


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