I have to admit that I haven’t been following the evolution of the health insurance reform legislation in Congress. That’s because it was making me sick. When I saw old people whipped into a frenzy by Republican extremists circulating misleading information about government death panels, I simply tuned out. It’s just not worth raising my blood pressure over. Literally. If I get sick, or even if I go to the doctor for my annual checkup, I pay out of my own pocket. At least, the first $2,600 of it every year.
That’s the deductible on the health insurance plan that I buy through the State of Maryland. You see, I have personal experience with a “public option,” and not by choice. When I went out on my own as a freelance writer, I could not buy private health insurance. It’s not that I could not afford it. It’s that no private insurer would sell me a policy. At any price.
No, I don’t have a terminal disease. I’ve never had cancer. Don’t have HIV. Or a heart condition. Or even high blood pressure. (For some reason, it’s incredibly low. A nurse once asked me if I was dead.) However, like anyone who’s been on the planet awhile, I do have a few conditions, none of which I consider particularly serious. But apparently the arthritis that I was diagnosed with in my mid 40s – just a few months before I left my job to freelance full time – is enough to make me a leper in the world of private health insurance. No one would touch me.
Maryland is one of 35 states that maintain “high-risk pools” for people who are denied private coverage. The premiums are typically higher than private insurance, unless you fall below a certain income, at which point the rates are partially subsidized. The system has worked well for me so far. I pay my premiums and also contribute regularly to a health savings account, which I can tap into to pay for my own healthcare costs up to the amount of the deductible. Because I pay out of my own pocket, I make more careful choices about what healthcare services to use. I’ve found some helpful sites on the Web (like http://www.healthcarebluebook.com) that tell me what the going rate is for certain services, like x-rays.
I’m grateful, and lucky, that Maryland has such a plan. Freelancers in states without high-risk pools have tough choices. They could become a part-time barista at Starbucks, a company that provides insurance even to part-time employees. They could change their marital or dependency status. (Recently, a friend’s 23-year-old daughter left a job and thought she would buy private insurance, only to find that – because of a melanoma removed from her leg 10 years ago – she was denied. She and her boyfriend moved up the wedding by a year so she could get onto his policy.) They could return to the full-time, traditional workforce. Or, if they are healthy and feel lucky, they could risk going without insurance.
Whether through a state-run program or by manipulating the private system, people like us are getting by, at least some of us are. Anti-reform zealots complain about the government rationing healthcare. The fact is, healthcare is already rationed – by big companies whose obligation is to make profits, not protect the health of citizens. If we don’t get meaningful reform now, we will in a few years, as a larger percent of the population experiences the arbitrariness and unfairness of the current system in America.