Sangry* About Healthcare

Feb 11 2012 Published by under [Medicine&Pharma], Uncategorized

Many comfortably middle class folks I meet view the uninsured as a great mass of people making bad choices, ignoring their personal responsibilities. Many of them do not believe that anyone they know would be uninsured.

If you fit in that group that that assumes "people like me" have healthcare, you must read Kevin Zelnio's post about his son's recent bout of pneumonia. See, Kevin recently started his own business as a writer and consultant. We keep hearing about small business being the the lifeblood of our economy, and every business starts out as one person trying to make something happen. When you first begin, insurance is an insurmountable expense. You need to put bucks back into the business and (gasp) pay for food and shelter. You have no bargaining power for insurance rates. I have met several entrepreneurs over the years, and all of them have gone uninsured for at least a year (unless they had a spouse with employment-based insurance).

Image from Kevin's son (Click for original)

Kevin shares with the world the gut-wrenching fear of having a critically-ill child while recognizing that a hospital admission could wreak financial havoc for years. He also pulls in the statistics for the uninsured in the United States, illustrating what a wide-spread problem this is. Please read his post now, if you have not; I will wait.

The details and names and locations change, but I hear this same story a lot. In some ways, Kevin is lucky; his son suffered a single acute illness. Most of the families I see must deal with a chronic disease, one that will be ongoing, perhaps forever. In a few weeks or months, Kevin will receive a final bill and know his debt. The number may be astronomical, but it will be finite. If the diagnosis is cancer or asthma or kidney failure, the expenses keep piling up.

Some politicians suggest that charitable impulses will take care of these issues. As a pediatric subspecialist I have donated my care before. However, even if all the doctors and nurses and technicians involved with a patient agree to donate their services, there are still enormous expenses. The hospital must pay for supplies and utilities and documentation. Part of your stay pays for the custodian in the hallway and the folks who change the lightbulbs. They may not touch the patient, and their part cannot be assigned to any particular patient, but without them the hospital could not function. If one patient cannot pay, then those costs must be borne by those who do. Part of the inflated cost of care in this country comes from spreading out uncovered costs this way.

One of the big triumphs of Obamacare thus far is a mandate for dependent child coverage, with no exclusions for preexisting conditions. Before that, I saw families who wanted to buy insurance but could not. One child with a chronic illness excluded them from family coverage; the company would not create a package for two parents and all-but-one-child. See, children are supposed to be cheap for the insurance company. Yes, they get shots and have some illnesses, but major pediatric health problems are pretty damn rare. Create special family plans that exclude one child? "We can't do that."

So what's a family to do? In the current insurance climate, major illnesses cause most personal bankruptcy in the US (at least before the housing bubble burst).  Some families divorce, because the mother and children then become eligible for Medicaid if mom doesn't work - and yes, I have seen mothers quit jobs to get coverage for their children.

The US really does not have a system of healthcare or coverage. We have a patchwork of solutions that have popped up over time, much as our electric grid grew. Obamacare (I do not consider this a derogatory term) provides a step in the right direction; by making all healthy people buy coverage, we spread the costs out and make insurance less expensive. Exchanges should grant collective bargaining clout to the self-employed, so they can negotiate the better rates of larger businesses.

We have a long way to go, but it's a journey we must take. No one should have to break up a marriage to get healthcare for their child. No one should have to choose between bankruptcy or their child's life.

*Sangry = Sad + Angry

If you wish to contribute to a fund for Kevin's son's hospitalization, please click here.

Also, as Scicurious writes, contact your congresscritter about this issue.


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