Bill Frick writes from New York City:
My first experience with the dark side of our health insurance system was back in the sixties when I was diagnosed with Crohn's disease. I subsequently had three surgeries. At the time I was on a quarterly payment system with my insurance company. They had always sent me premium notices for several years. Then after my second surgery, they did not send a premium notice and I forgot to pay the premium. They reinstated my policy, but with an exclusion for Crohn's disease.
Since this disease is chronic and characterized by many exacerbations and sometimes incredibly high costs, I found myself in a difficult situation. The company soon stopped sending premium notices altogether. I kept my insurance in force by sending them registered letters when the payments were due.
Fortunately I found a job that had an excellent group policy that has covered me ever since, including my retirement years. Maintaining health insurance was an important motivation for staying in this job until I could retire with insurance.
What I learned from this experience is that unlike most businesses in the capitalist system, insurance makes money by not providing services to people. The more people who buy insurance they don't utilize, the more money the company makes. Likewise, if the insurance industry can screen out high risk cases [i.e. people who really need it] they can also make more money. I think experience shows that one can not depend on the good will of the insurance industry to regulate themselves, any more than one can expect the financial industry to do so. Some controls are needed to assure everyone can buy insurance.
I think that fear is a complicating factor in thinking about health insurance. Those of us who have it are afraid that any change will make our lives more difficult. We are afraid that bureaucracy will keep us from getting what we need. For myself, I need more information about how a single payer program would work. How would it affect my current insurance arrangements.? Would I have to pay more taxes?
It may be helpful to listen to concrete stories of those who are not in the system or who are struggling with it. Facing a chronic disease and death are terrible enough. With bankruptcy and financial ruin, fear can become even more pervasive and further destroy the capacity for coping and healing. Siituations like this can demoralize not only patients, but their families. I know many people who barely have enough money to pay the rent and meet living expenses. The high cost of health insurance makes buying insurance almost impossible. One person I know, had to go to the emergency room with severe abdominal pain. She was than saddled with a bill that she may never be able to pay off. Another aquaintance lost his job due to severe illness. He also lost his family health policy. While he may eventually become eligible for government help, the cost of purchasing a policy for his family is made more difficult, if not impossible, by his reduced income from his loss of salary. There are millions of Americans in similar situations. I think we need to keep listening to their stories and keep asking ourselves if our current situation is the best we can do and what attitudes we have that prevent us from finding a more humane response to the suffering and fear of those who live outside our current system.
An outstanding TV Program on this issue is Now On PBS for 03/20/09. The url for this show is http://www.pbs.org/now/shows/512/index.html
I know this is a complex issue and I am not certain what resolution is best. But if we can let go of ideology, deal with our fears and listen to our own real needs and the needs of others, we may move toward some answers.