My Health Care Story

Not sure where to start this story….so I guess I’ll start from the beginning of my health insurance experience . I have to point out that many of the dates and figures are close guesses. I don’t have anything to back them up, but since they are my personal experiences the “gist” is there and the dollar amounts and dates are close.

My Dad got transferred a lot and right after high school, I had spent a about a year and a half living in Illinois without meeting a lot of people. I’ve rarely had a hard time making friends, but this period and maybe another 6 months after we moved to Houston I didn’t have huge social life I was accustomed to. All I did was work and go to school.

After a a semester of a lonnnnng commute, in insane traffic, from Katy Texas to University of Houston’s main campus I secured on campus housing where I started meeting people. I was making up for my lack of social activity the prior year or two. My grades showed it. Eventually I secured off campus housing with “Gary the roommate” (another story in itself), who I had met through roommate searches at Uof H. In order to afford this apartment I also got a job as a cook at a major full service Seafood Restaurant Chain.

Was a lot of good, fun people at this Restaurant and my social life once again exploded. I was making up for lost time. Academic probation and then academic suspension followed close behind. In 1982 or 1983 the University of Houston and I mutually agreed I should drop out of college.

So now, at 20 (ish), my Mom was very worried because I couldn’t be on their health care anymore. Apparently I needed Health Care. At a healthy nonsmoking 20 year old who worked a physical job and ran and swam all the time…why would I need such a thing? But to please Mom, I checked and sure enough my job offered health care. I don’t remember what it cost me in 1982? I think it wasn’t much…otherwise I might have not got it. And I believe it was good health care. Though all I can really remember using it for was once when I thought I broke my nose.

That emergency room visit cost me nothing.

At this restaurant in 1983 I met my soon to be wife and oldest son Michael, eventually getting into Management. Still without much thought to healthcare until roughly 1985(?) when my new bride and I decided we wanted to leave Houston to be closer to family in Ohio and Michigan. We settled on Ohio where I tried to get a transfer with the Restaurant (this is a BIG chain) I worked for. I didn’t get it. So the three of us moved anyway. Me without a job and Sheila had a job waiting for her at a restaurant where her mother worked. I don’t remember…but I don’t think we had health care for a month? Was still young and it wasn’t a priority I guess.

After almost a month of unemployment (never occurred to me to try and get unemployment compensation…guess I’m not a good democrat after all) and few months working a couple jobs I hated, while trying to get either a management position at other restaurants or some type of factory job, eventually I got back to working for the same chain I had left as an hourly employee. Hoping to get back into management that way. I had health insurance again. This was late 1985.

Once again…I’m not 100% on this but I don’t think it cost much for the three of us….and uh…. there was a baby on the way too. It MAY even have been a “pre-existing condition”. Though I’m not sure of that either. On May 13, 1986 along came Anthony. Insurance paid for it no questions asked.

I continued working for this company over the next few years. Largely a dead end job, though I was trying the whole time to get back into management. Over these years…my company sponsored health care costs went up a lot. In 1986 I don’t remember what I was paying? Must not have been much to not remember. But I remember clearly by 1988 or so that I was paying $56 a week ($240/month or $2900/year) for me and my new family. Making $10 to $12 an hour….this was quite a bite in my take home pay. Health care was something I never thought about…but all of a sudden the cost was something that was affecting me. Plus the coverage itself was degrading. That free emergency visit wasn’t going to be free anymore.
By 1989, even though I had a LOT of backing from every manager I ever worked with (hell I was doing all of their jobs) It was apparent the ones who make the decision, weren’t going to let me back into a management position (which had cheaper and better health insurance than hourly positions).

So in 1989 I was at a dead end in my job, my oldest was in school and the youngest wasn’t far behind. Working restaurant hours with no future, I was missing out too much of their lives. Not to mention my health care costs were going through the roof. Though in retrospect…$230 month would be pretty good today. I decided it was time to go back to school. I decided on computer science.

My first semester I only went part time and took 2 classes (8 credit hours?). I took the classes I wanted to get behind me the most. Which were Speech and English. In that order.

Much to my surprise I actually enjoyed both and got solid A’s. I actually had a 4.0 my first year and graduated with a 3.7. All while going to school full time (except the first and last quarter) and working full time. Much thanks goes to Sheila, the boys, and my restaurant job for their support and flexibility.

But I digress…..

In 1989, in my English class one of our assignments was to write a “persuasive” paper. I can’t remember if we had a list of subjects to choose or could come up with one of our own. I decided to pick something that was affecting me and I wanted to learn more about. Because my cost had gone up so much, I decided to pick health care. Though I didn’t know what was going to “persuasive” about it. All I knew was in 1989 I was paying a lot more for less benefit.
At the time I wasn’t political at all. I’d never heard of universal health care. I don’t think it was talked about in 1989? At least I’d never heard about it.

So with no internet, I hit the library. Remember those? I looked up health care and started reading articles without a clue of what I was actually going to write about. Articles I found were more informative than biased. Most presented both sides of the argument. I learned that a big reason my personal health insurance cost had risen so steeply was the AIDS scare was strong in the late 80’s . Restaurants employ a higher percentage of Gay employees…For that reason health care for restaurant workers and truckers (I didn’t realize was a lot of gays in trucking) was skyrocketing higher than any others. I learned that new technology was a factor for overall costs for health care were skyrocketing. Ie. Hospitals getting a $1,000,000 MRI had a tendency to use it more than probably necessary in order to pay for it. I learned about how dwindling family practices and more specialists have fueled rising costs. I learned about a Universal single payer health insurance that most industrialized countries had adopted. I learned more about our system and the higher quality and innovation attained due to a private sector approach. I learned the positives and negatives of both.

So now I found my angle on subject. I was armed with newfound knowledge but no opinion. I had to decide which way I wanted to persuade? From personal experiences I chose to learn more about the universal approach. I think the two big reasons were:

1. Our family doctor at the time, rarely did any doctoring. You’d go in for things as simple as a sinus infection and he’d sometimes take a look, then refer you to a specialist. Hell…I could do that!! But by then you couldn’t get to a specialist without a family doctor referall. There’s a double cost right there.
   
2. I didn’t think that my sector of business having to pay more due to things that I wasn’t a party to was very fair.

Now…I just wish I could find that paper to post here. I’d be curious to know what I wrote 20 years ago. The assignment required “fair and balanced” arguments to both sides and then an opinion at the end. I got an A on it, so it must not have been too bad. I do know I was convinced a universal health care (buzzword at the time…now it’s as commonly called single payer) approach made a lot more sense to me.

In spring of ’93 I was finishing up my classes, due to the demand for computer professionals and my good grades I had a position waiting for me at a huge insurance company in Columbus Ohio as soon as I got my degree in June, 1992. Working for a huge company like this I can’t really complain about the Health Insurance I had there. We had three options of plans to choose from….all of which were better and cheaper than my restaurant insurance. You could choose the amount of coverage you wanted and what little I used of it, never had any problems with any claims.

Working for a large corporation with well over several 10’s of thousands employees made for good Insurance. These were the good health insurance years.

Even though I liked the job itself, in 96 I got upset with that employer over my slow pay increases due to company policy and the rates at which the fresh out of college new hires I was training were getting. As a result, I decided to look for employment elsewhere. Eventually I decided to change positions (with a considerable increase in pay) to my current employer, closer to my family in Michigan. This was a much smaller insurance company with about 400 employees at the time. In 1996 health insurance was much more important to me than it was in 1982. I asked a lot of questions about my health insurance costs and coverage before accepting this position. While I didn’t have the choices I had at my previous employer, on paper the insurance cost and coverage was acceptable and reasonable. My costs were slightly higher but comparable to my health insurance at the large corporation. That was until my house was already sold, I’d already left me last employer, and I started working here. I found out on day one there was a clause where my wife would have to obtain coverage with her employer if they offered it. Are you kidding me? She worked at the same large seafood chain restaurant I had. They did in fact offer coverage. But by 1996 costs escalated to about $200 a month for just her. Thank God they had pulled the clause about her having to cover the kids too. That would have been 2-3 times that amount. I wouldn’t have been able to afford take this job if that had been the case.

The first year or two I worked at my current employer we had a some minor illnesses. Flu, ear infection, sinus infections and the like. Nothing major or costly. Plus our doctor actually doctored rather than push it off to a specialist. Every single claim made we received a letter denying coverage until I filled out a “pre-existing condition” form. The only medical training I have is studying a Heimlich maneuver chart for a couple minutes once, but even I could tell from the doctors bills these were simple medical conditions and not pre-existing conditions. Thankfully after that first year or two the pre-existing condition forms stopped….but then again, thankfully, we never had any major claims. I’ve heard more than a few stories from fellow employees with major claims about the hoops they had to go through to get them paid.

In the last two two years we are a larger company (600 employees) and have switched to a better administrator (I hope) for our health insurance coverage. Though I haven’t had a chance to use it much yet. But at the same time, I’m now divorced and kids are grown with their own insurance. My costs are about the same for just me , as they were when I covered the whole family 13 years ago. Which I have to admit are still reasonable. Though coverage has decreased some. My biggest complaint to “save costs” a $200 individual and $400 family yearly deductible was implemented a few years ago. $200 is doable to me. But somebody making much less, I’m afraid would forgo a doctor until it was an emergency to avoid the $200 out of pocket costs. I know I have cut back on my yearly physicals to every other year due to this added deductable cost. Incorporating this deductible contributes to sick care system as opposed to health care. It saves money costs by discouraging people from going to the doctor. A $7.70 increase in my bi-weekly payments equals $200 a year deductible. But that wouldn’t cut costs, because I may have a tendency to actually use my insurance.

In roughly 2005-2006 I started doing photography on the side. Weddings, portraits….I was doing pretty well financially at it. Not quite enough to quit my day job, but I was getting damn close. Crunching numbers I had thought maybe I could actually quit my job. Business was good, and not having a full time job I would have the time to market myself more, and have more flexible schedule to do this and pursue other endeavors full time. It looked to be doable. That was until I called around and researched getting my own health insurance. This cost stopped me cold. Plus the horror stories I heard from self employed individuals when they actually needed to use these high costs individual plans. When you need them most the coverage is disputed, then rates immediately become unreachable. Good chance you will be dropped after a major illness too.

Saddens me to have to say goodbye to that dream of self employment, because of health insurance.

I have good insurance. I should be happy. But I have an entrepreneurial sprit and I’m stuck in a job for this reason above all others. I don’t have a problem paying for a product. But only if it’s there when I actually need it. I realize there is a fairness issue about controllable things like with me being overweight and a smoker (continuously working on those). I agree I should have to pay for those things. But there are issues that would cost me more in the free market I can’t control. My age is the best example. As much I would love to be able to stop that from progressing. Should I have to pay more for things beyond my control? For someone born with allergies, asthma or a host of a million other things beyond their control , why should they be denied or have to pay more? With DNA research will genetic predispositions soon be charged a premium in the free market?

Our current Health care is broken. It’s not even health care. It’s sick care. Premiums increase for the individual or the small company when they are needed most. A pre-existing condition could make you uninsurable in the free market, where you would have no choice but be stuck in a employment position. Health care shouldn’t be a factor in these things….

Our current system has destroyed small and medium employers. Individual’s accomplishment is impossible with our current system. Those brave (or stupid) enough to do so without health insurance and something happens….it’s us hard working Americans who end up pay for those individuals anyway.

One of the largest contributors of Bankruptcy are Health related expenses. When you are sick…this should be one of the last things you have to worry about.

Are we all meant to work for nameless corporations our whole life? An obtainable health care system is needed. And is needed now. It’s no secret I’m in favor of a single payer system. I have been since 1989 before most people even heard of such a thing. Before I knew such a thing existed and all I knew was health care was costing me more than I could afford. I am once again researching this. I find mostly biased information in favor of it.

Though one program on PBS was pretty informational, and while I feel there is a biased theme it explores private enterprises states have tried.

http://www.pbs.org/wgbh/pages/frontline/sickaroundamerica/view/

I can’t seem to find any solutions or things in favor of our current system. Other than throwing “socialism” at the problem with no solutions. Do these grassroots movements think our health care system is fine the way it is?

Few Americans in the early years of the 21st century would argue that the country's healthcare system is healthy; however, fewer still would be likely to agree about how to fix it. I don’t have a #$!@#$ clue what the plan in congress is now, because they are trying to please everyone. While I’m still a fan of the Universal single payer system, I realize it wouldn’t be perfect. But it would be damn site better than what we have now. As far as costs being a factor…we already paying for it. Health Insurance/Care needs to be obtainable for everyone I’m open to learning real private solutions beyond throwing the word “socialist” at it. Which is not really an argument at all.

I would love to hear some real solutions to health care. Or if you think our system is fine the way it some defense to the current system.

While I’m a fan of a single payer system for 20 years, I accept and acknowledge it won’t be perfect. There is no perfect solution. I’m not looking for perfection just reasonable care with reasonable obtainability.