I just spoke with a woman who got health insurance quotes on our website today. Turns out she was sitting in a Denver emergency waiting room when she got the quotes, and was still in the ER a few hours later when I called her. She and her husband have no health insurance, although their four children are on MediCaid. She went to the ER because of severe pain in her breast, and when I spoke with her, she was waiting for a needle biopsy. She has no health insurance. Her husband’s employer offers coverage, but he did not enroll because of the cost. She and her husband do not qualify for MediCaid. She was hoping to find a policy that would cover the treatments she was having today.
She was a very friendly, polite lady. She seemed resigned to the fact that she was going to have to pay this bill on her own, without insurance help – although it couldn’t hurt to try. I explained to her that individual health insurance in Colorado will not cover pre-existing conditions, and indeed most carriers would decline an applicant who is currently awaiting a diagnosis for a breast ailment. I told her about Cover Colorado, but let her know that the earliest effective date she could get would be Feb 1, and that even with Cover Colorado, pre existing conditions would not be covered for six months because she has not had continuous coverage. I explained to her that there are social workers who will help uninsured patients negotiate medical bills, and advised her to talk with the hospital’s billing department to see if they could set up a long term payment plan. Who knows what her bill will end up being? Best case scenario is a needle biopsy that finds a cyst that just needs to be drained. Worst case… let’s hope not.
I felt sad as I explained to this woman that there was nothing I or any other health insurance agent could do for her. Is this the best we can do? I don’t know this lady’s story. I know she had four children by the time she was 26. I don’t know what sort of house the family lives in, or what kind of car they drive. I don’t know what kind of clothes they wear. Could it be that they choose not to buy health insurance so that they can take exotic vacations? Possibly, although I doubt it. The feeling I got when I was talking with her was that they are a middle class family that is barely scraping by, and that the already stretched budget wouldn’t handle a few hundred extra dollars a month for health insurance. It’s easy to judge people like this. To say that they shouldn’t have had four children, since they can’t afford medical care for the family. To say that they should have found a way to get health insurance in place before today. To assign blame to the victims of our broken health care system is an easy way to assuage the guilt. That way we don’t have to acknowledge that the problem this family is currently facing is everyone’s problem.
The system we currently have – where health insurance is optional, health care costs are skyrocketing (and are higher than in most other countries), and the number of uninsureds is also rising – isn’t working. In any other developed country, the woman I spoke with today would be able to focus on her treatment and what needed to be done to make her well, rather than worring about how to pay for the treatment. Worry doesn’t help people heal. I believe health insurance should be mandatory, and that premiums should be based on a family’s economic situation. In the case of this family, the premiums would be low, since they don’t have much money. But the coverage would be there. And she wouldn’t have to spend her time in the ER worrying about money.
