Walking the Insurance Tightrope
By Lucie B. Amundsen
When my husband quit his job last year and joined me as a
freelancer, a friend sent me a gag gift of aspirin. On the side
of the box she had printed out instructions. “Use for aches,
pains, fever, double vision and spontaneous loss of limbs.” I
laughed … and then I didn’t.
When you decide to cut ties with the boss, it means that you
and your family are on your own not only for income, but
also medical coverage. So of course, we buy health
insurance with a fairly high deductible. Should we meet with
that hypothetical bus we probably wouldn’t lose the house -
the big stuff, in theory, should be covered. But there are
plenty of routine maintenance expenses that aren’t.
It turns out this makes me part of a growing population of
“underinsured” Americans and, for once, I’m trendy. There
were about 16 million of us two years ago when the medical
journal Health Affairs put out its study on the subject, and
the number was only expected to grow as employers buckle
under insurance costs. The study concluded that compared
to those with more adequate insurance, underinsured
people are far more likely to blow off going to the doctor or
filling prescriptions because of costs – about 54% skimp on
care. That’s only 5% less than people with no insurance at
all. As I’ve become less assured by my insurance, I’ve done
it, too. I guilty watched for weeks as three-year-old Milo
closed one eye when looking at picture books, posters and
PBS until I finally caved. I took him to our local optometrist
and inside ten minutes he was able to determine that Milo’s
depth perception was fine. He really was just “being a pirate
looking through a telescope” as he had been telling me all
along. We left with a kiddy coupon to Dairy Queen for what
has become known as the $72 ice cream cone.
And let me say upfront, that I don’t begrudge my eye doctor
that money. (In fact, I’m pretty sure he didn’t charge me his
full rate when he learned that insurance wouldn’t be picking
up the tab). I want him, and all our docs, to be able to pay
off their student loans and achieve some reward for their
years of training and doing a dang hard job. Furthermore, it’
s certainly in my best interest that their practices be solvent
and able to buy that all important “machine that goes PING!”
keeping them up-to-date with standard technologies.
But that leaves me, and all my 16 million brethren, stuck in
the middle. Even though we all concur that health is our
number one asset and we want our providers to get paid, it
still stings to shell out $200 out-of-pocket for my kids’
perfect dental check-up (sans X-rays) AND a high buck
insurance premium.
I have been moderately active for years on the universal
health care issue and have watched years of legislative
sessions close without even the hope of a single payer
system or significant change. But recently I have found
myself with strange bedfellows on the issue. Wal-Mart, along
with other big corporations like Kelly Temp Services, have
joined with union leaders to form “Better Health Care
Together,” a group dedicated to "quality, affordable health
care for millions of workers by 2012.” Perhaps it will have to
be Big Business to finally crack the nut of HMOs.
The organization is out to fundamentally change the old
style of business-supported health care without seeking a
fully government-funded answer. Instead it casts
accountability to individuals to take more responsibility for
their own health and the medical community to get more
value out of the health care dollar. Apparently, at the
moment, 80-cents of that dollar is going to end-of-life-care.
It seems like a tall order for five years from now, but had I
been told five years ago that McDonald’s would serve sliced
apples with Happy Meals and a salad with edamome (soy
beans) and almonds, I wouldn’t have believed that either.
But until the reform happens, I find that health coverage is
never too far from our minds. The children and I were
watching a woman in a cherry picker fixing a street lamp
recently. Milo asked, “When I’m a big person, how do I get to
do that?” I answered he could go to vocational school and
learn about electricity and wiring and tools. “And the best
part Milo, not only do you get to ride in a cherry picker, but
you’ll get dental insurance, too.”
Without taking his eyes from the big machine Milo said,
“Wow, Mom, that’s amaz-able.”
Yeah, it really is.
