Health insurance and a real person, by Jane Powell: The shame of these United States

I am fifty one years old. I don't smoke, and I never have. I don't drink, and I never have. I don't use recreational drugs, and I never have. I am not overweight, and my cholesterol is low. But back in 1990 when COBRA ran out from my last job, and I had to purchase health insurance as an individual, no insurance company would take me (and I was only 38 then).

Why? Because I happen to suffer from a couple of chronic diseases: psoriasis and depression. And God forbid, I had actually sought treatment for them, instead of suffering in silence. I might as well have embroidered a big scarlet "U" on my chest, for "uninsurable." But I was lucky- I somehow managed to get into the State's Major Risk Medical Insurance Program (MRMIP). It cost a ridiculous amount of money, but at least I had insurance. The premiums started out at over $100 a month, and by this year were up to $525 a month.

The program was set up to provide insurance for the uninsurable- AIDS patients, cancer patients, and people with terminal diseases. But a funny thing happened- it turned out that people with chronic diseases were uninsurable too. Soon there was a waiting list. Then they had to start offering special insurance just for people on the waiting list. And the whole thing was predicated on the idea that people would die and their slots would open up for others. Except that AIDS treatment got better, and cancer treatment got better, and people were just refusing to die off like they were supposed to.

So the State decided to kick everybody out if they'd been in the program longer than three years. They gave us a certificate that would force some insurance company to take us. They promised it would only be ten per cent more than we were paying now and the coverage would be similar.

So I stayed with Blue Cross because it was the cheapest- a mere $575 a month. This month I received a letter announcing that my premium would be $733 a month starting in January. That is $208 more than it was at the beginning of this year and $483 more per month than it was in 2000. And that's just the premium- not the twenty or thirty per cent of the costs of medication, office visits, tests, etc. The premium alone represents twenty-five percent of my income. Let me reiterate that: one quarter of my yearly income. They charge it monthly against my Visa bill, because if I want to pay by check I have to cough up two months at a time, and I just don't seem to have $1466 laying around usually.

I should mention one other thing. Three years ago I had cancer. I'm in remission now, but if chronic diseases made me uninsurable before, a bout with cancer pretty much puts the last nail in the coffin, so to speak.

No doubt some of you are thinking that I should give up being a writer and get a real job, with some of that fine employer-paid group health insurance. And I suppose I could do that, spend a year paying out of pocket for all my pre-existing conditions which won't be covered, and praying I don't have a relapse. There's just one tiny problem with that- what if I get laid off, or the company goes out of business? Eighteen months of COBRA, and then I'm back where I started- uninsurable, and back on the MRMIP waiting list, no doubt. If there is one, because maybe the State will have given up on it by then.

It is an outrage that in the richest and most powerful country in the world, millions of people have no health insurance, or are paying through the nose for continually reduced coverage, while lobbyists for the insurance and pharmaceutical industries spout nonsense about people becoming better consumers of health care, weighing costs and benefits, and not running to the doctor every time they have a runny nose. I don't run to the doctor for every little ache and pain- that's why my cancer wasn't diagnosed until Stage IV. And my cost/benefit analysis went like this: "Will this treatment keep me from dying?" Not, "Gee, can I save Blue Cross some money by not having this treatment so their CEO can get a raise and their stockholders make lots of money on their investment?"

Like the archaic keyboard I am typing this on, which was designed to keep the keys from jamming on a manual typewriter, employer-paid health insurance is left over from employer attempts to circumvent wage and price controls during World War II. It is a ridiculous system used by no civilized country in the world except the U.S., and kept in place by powerful industries who are reaping huge profits on the backs of sick people. And well people, for that matter. The very idea that health care should make a profit is obscene. It is a basic human right. Unlike the archaic keyboard, which we've all learned to type on, I believe most people would happily give up the ridiculous "health-care system" for a single-payer system that makes sense.

But we have to rise up and demand it- the politicians are never going to give it to us, because they have the best damn health care in the world, paid for with our hard-earned dollars. The insurance industry and the pharmaceutical industry have millions to spend on lobbyists- we don't, because we're spending all our money to pay the freaking premiums!

I know that there are many people who have no insurance at all, and that there are those who might think me lucky to have it. I just don't feel very lucky- a quarter of my income down a rathole which supposedly might keep me from having to declare bankruptcy should I actually get really sick or be in a car accident. Right now I'm planning to refinance my house, in part so that I can reduce my mortgage payment enough to make up the increase in my health insurance premium. There is a hell of a lot wrong with this picture.

And daily I think of how the $87 billion we are spending in Iraq could provide single-payer health care for every man, woman, and child in America.