categories: Bad Advice / Cocktail Hour / Don't Talk About Politics
When my wonderful five years at Holy Cross were up I was able to take advantage of COBRA health coverage. The acronym stands for Consolidated Omnibus Budget Reconciliation Act, but it’s appropriately threatening, deadly snake, right. All the act states is that employers’ insurance plans must continue to cover employees terminating for any reason for eighteen months after termination. This protects many people, but for an example, think of someone battling cancer: can’t work anymore, gets to keep insurance. For a while. If she can pay. My own COBRA amount was about $2200 a month (a month, yes) for me and my family, which would allow me to keep the excellent insurance I enjoyed via Harvard Pilgrim. But of course, newly free-lance, $26,000 was not a possibility. I lucked out, however, as the Obama administration stepped into the mounting unemployment fray of 2009 with a 2/3 subsidy of COBRA coverage across the board, across the country. So, for a mere $700 a month, my family remained covered, and this was marginally affordable. All the while, news stories came and went: the COBRA subsidy would be ended. It had been saved at the last minute during negotiations over unemployment benefits. It was dropped. It was restored. I remained worried for the entire 15 months of the original subsidy (which was not extended), a time of various health crises for my family.
You may recall I had neck surgery. Or anyway, I certainly recall it. Or before and after it. I tried for over a year to heal without surgery, and may have kept at that foolish enterprise, except my insurance was going to lapse. So, I scheduled the surgery, and when the subsidy ended, no way around it, began paying the full COBRA premium.
In the midst of healing, the 18 months of even the unsubsidized COBRA coverage was up. That is, the specter of no health insurance at all was looming. I had a lot of expenses coming, too, though the surgery had been fully covered, not cheap, and thanks. In the midst of healing, in fact, still pretty looped, I got on the phone. Harvard Pilgrim first, as I loved their coverage. The fellow on the phone was very efficient, very kindly, very articulate. “Yes,” he said, “We certainly do have coverage in Maine, and we certainly do have individual policies.” He put me on hold, called up the relevant figures. “Here it is,” he said. “One price. Very similar to your old coverage. $6800 a month.”
“A year,” I said, not quite delighted, but resigned: we could manage.
“A month,” he said.
I tried to do the math. “That’s. That’s. That’s.”
“That’s $81,000 a year.”
“Who can pay that?” I said, not really incredulous: this is the state of our health insurance system, after all.
“There’s a table,” he said, calling it up. “Okay. The suggested yearly income for this premium is… let’s see. It’s $1,100,000.”
“I won’t even be making $81,000.”
“Try Anthem Blue Cross/Blue Shield.”
Anthem actually does have policies for the self-employed who don’t make millions. I called, got the run-down on premiums. Something fairly comparable to my old coverage had comparable rates to the quote from Harvard Pilgrim. But the Anthem salesperson went over the other options with me. In the end, we came up with a $15,000 deductible plan. (Per calendar year, folks–whatever you do, don’t get hurt at the end of December!) It has some benefits, like free yearly check-up. Plus, you get the rates they’ve negotiated with your health-care providers.
(A particular sin of the “system”: if you have no health insurance, you pay at least double what people with health insurance pay. That is, your health provider skins what he or she or they gave up in strong-arm negotiations with the insurance companies out of people with no insurance, who are generally the least able to pay at all.)
Our rate? $560 a month. For now. Because of course the Maine State Legislature has just given the insurance companies a 12% rate increase. Not too bad, as they’d asked for 39% ahead of the health care act going into effect, as if that act doesn’t hand them 40 million new customers. (Corporate radicalists love state’s rights: states aren’t as powerful as industries. States are easy to push around. Even proudly progressive states like Maine.)
Worrisome. But, we can manage $560 a month, and do. And have enjoyed reduced fees on about $10,000 of follow-up appointments and therapies on my neck, for example.
In our family, though, there’s a medication that costs $1000 a month. When we moaned to the local pharmacy (don’t forget pharmacies take probably 50% of these outrageous prices…), we were given a $200 break. So $800 a month. Insupportable. (What do people do who have fewer resources than we? Well, they don’t take the meds. They get sicker. They die. They end up in jail, if that’s the sort of med we’re talking about. They use the emergency room for small problems. The use the emergency room for all problems. They cost us all a fortune.) We paid for one month of the medication in question.
Then got to work, looked into buying via mail from Canada, a legal ploy. 1/10th the price! Same exact prescription! And for a foreigner!
The Affordable Health Care Act made some inroads into the health insurance disaster. Very much more is left to be done, especially for those who don’t work in the benefits culture. If you’re thinking about going freelance, well, keep thinking. If you’re thinking about voting for a corporate radicalist candidate next vote, please.
Because this bad system costs all of us a lot, and not just saps like me. Or actually, not all of us, just the ones who pay taxes, who are, more and more emphatically, not the ones profiting from the healthcare disaster that continues to bloom all around us.