You Get What You Pay For

The health care insurance crisis is now affecting even those who have health insurance. In the article, “Cancer Debt: The Hidden Costs Behind Insurance,” patients reveal how their insurance coverage did not cover the entire costs for their breast cancer doctor visits and procedures. Even though Susan Braig was insured with a “catastrophic” policy that covered hospitalization, she still has accrued $40,000 in debt after being diagnosed with breast cancer in 2004. Another patient, Nelda Lopez, mentions that although her plastic surgeon was listed under her insurance as being covered, her insurance did not cover the reconstructive work for her double mastectomy.

As noted during a previous blog on the problem with health care insurance, a classmate stated that insurance coverage was not as expensive as people believed, and inexpensive coverage was available for those who could not afford the overwhelming costs of health care insurance. However, based on the information from this article, as with any other expense, you get what you pay for. You pay for cheap insurance, and you get less-than-quality coverage. The article reports that, “…officials at the American Cancer Society say that with the bad economy and people buying cheaper insurance policies, the number is growing.” So, when you buy cheap insurance policies, make sure to read the fine print. Even a “catastrophic” policy that covers hospitalization has limitations, such as high deductibles.

What is the health care insurance industry doing to prevent this from continuing to happen, and to provide citizens with better insurance options? Isn’t the United States government obligated to provide quality health care and insurance coverage to all of its citizens, regardless of race, creed, or socioeconomic status? According to the CDC's National Center for Health Statistics, the number of uninsured persons under the age of 65 in 2007 was 43 million (16%), and the number of uninsured children under the age of 18 in 2007 was 8.9%. It would seem that after reviewing the overwhelming statistics of people who are uninsured, the health care insurance providers would try to develop a better solution, other than cheap insurance with high deductibles. It is obvious from this article that cheaper insurance does not necessarily mean you receive quality health care coverage. The article reveals that, “The cancer society has set up a hotline for people having trouble paying for cancer treatment. Without much advertising, call volume was up 12 percent in January compared to the previous year, and up 37 percent in February.”
According to the CDC, health expenditures in 2006 reached an overwhelming $2.1 trillion, with health expenditures using public funds accounting for 46% of that number. During this economic crisis when unemployment numbers continue to rise, numbers of people are losing their homes, and the market is unreliable, the number of uninsured individuals has dramatically increased. The CDC reports these statistics:
· From January-September 2008, 59.6% of unemployed adults aged 18-64 years and 22.3% of employed adults in this age group had been uninsured for at least part of the past year. Also, 32.2% of unemployed adults aged 18-64 years and 13.5% of employed adults in this age group had been uninsured for more than a year.
· From January-September 2008, 18.9% of persons under 65 years of age with private health insurance were enrolled in a high deductible health plan (HDHP), 5.0% were enrolled in a consumer-directed health plan (CDHP), and 18.0% were in a family with a flexible spending account (FSA) for medical expenses.
· From January-September 2008, 43.3 million persons of all ages (14.5%) were uninsured at the time of the interview, 55.2 million (18.5%) had been uninsured for at least part of the year prior to the interview, and 31.1 million (10.4%) had been uninsured for more than a year at the time of the interview.

With these overwhelming statistics, you have to wonder what numbers will incite worry in the hearts of the CEOs of health care insurance providers? When will it be enough? As I’ve mentioned before, I am one of the uninsured individuals and have pondered actually purchasing a cheap insurance policy, or a “catastrophic” policy as mentioned in the article. However, with the extremely-high deductibles associated with those cheap insurance policies, I have been reluctant to make the purchase. Now, with the information from this article, I am further doubting the quality of these policies. What do you think? Is the high-deductible plan worth it? Or, should I continue to grace the offices of the public-health department, until I’m able to afford a better health care plan? Is it ethical for me to have to make these types of choices about health care, because my salary is in the low- to mid-income bracket? Should my health care choices be judged based on my socioeconomic status?

To pay for her cancer debt, Susan Braig, “…has started making something she calls ‘prescription jewelry.’ She uses pills, capsules and medical supplies that have been sealed or glued so they're no longer usable. Her goal in making jewelry out of medical gear is ‘to show that health care, like cancer, is a luxury.’” And, Nelda Lopez, “…is still paying off (the$2,100 plastic-surgery bill) one-and-a-half years after the procedure. Meanwhile, she has postponed steps two to four of the reconstructive surgery, which would make her reconstructed breasts look more natural.” When will we all be able to make better health-care choices? Hopefully, one day. I'm still waiting...