Health Care “reform”: My response to Obama (from 3 years ago)

NB: I wrote this quickly on March 22, 2010, after reading Obama’s speech. The ACA had just been passed. I couldn’t listen to his speech the previous night. I think I made it to the third paragraph of his speech before I grabbed my “comfort book” (Epictetus, thank you) and went upstairs to read in dim light.

Good evening, everybody. Tonight, after nearly 100 years of talk and frustration, after decades of trying, and a year of sustained effort and debate, the United States Congress finally declared that America’s workers and America’s families and America’s small businesses deserve the security of knowing that here, in this country, neither illness nor accident should endanger the dreams they’ve worked a lifetime to achieve.

This sounds so good, President Obama.
Does this mean that I can get affordable health insurance for some pre-existing
conditions now?

No? Okay, so I guess I can just keep on dealing with these awful migraines because I can’t afford the $500.00 a month it would cost to get a preventative medication that might work. I won’t find out, because, you know, I have to feed my family first. That’s cool, I understand.

Call this me taking one for the American people. Every time I vomit water or plain bile because I’ve been unable to keep food down for more than 24-hours due to a mere migraine, I’ll just think of it as my sacrifice for the Good of the Country.

So, God forbid (you do invoke Him several times) I get sick, my husband and my daughter would be left without me, or we’d be bankrupt, or…?

That’s so comforting.

Tonight, at a time when the pundits said it was no longer possible, we rose above the weight of our politics. We pushed back on the undue influence of special interests. We didn’t give in to mistrust or to cynicism or to fear.
Instead, we proved that we are still a people capable of doing big things and tackling our biggest challenges. We proved that this government — a government of the people and by the people — still works for the people.

I must disagree, politely but vehemently, with any sort of claim that “we” have “proved” that the “government…still works for the people.”

The government works for some of the people. Hurray for some!

And kudos for us to returning to the failed ways of Ancient Greek oligarchies—this bill has proven more than anything that we are ruled by corporations.
All right, though, I will grant that the Supreme Court recently did rule that corporations are people, too.

Maybe I will change my name and incorporate myself. I could start as an S-corp, sell some stock, and let my investors decide what I should do with my life. That does seem to be one way for me to “get ahead” in America, at this date and time.

I want to thank every member of Congress who stood up tonight with courage and conviction to make health care reform a reality. And I know this wasn’t an easy vote for a lot of people. But it was the right vote. I want to thank Speaker Nancy Pelosi for her extraordinary leadership, and Majority Leader Steny Hoyer and Majority Whip Jim Clyburn for their commitment to getting the job done. I want to thank my outstanding Vice President, Joe Biden, and my wonderful Secretary of Health and Human Services, Kathleen Sebelius, for their fantastic work on this issue. I want to thank the many staffers in Congress, and my own incredible staff in the White House, who have worked tirelessly over the past year with Americans of all walks of life to forge a reform package finally worthy of the people we were sent here to serve.

To those of you who struggled with voting yes, go fuck yourselves. Yes, seriously. You have health insurance. Many of us don’t.

What the hell is wrong with you? Do you think we lack health insurance because we don’t want it?

So if you found doing the RIGHT thing was hard, then maybe you should retire from any sort of public life until you’ve gotten in touch with yourself and let go of some of your financial obligations.

And you should also read “Letter from a Birmingham Jail”—it’s mild, but it’ll remind you (maybe) of what we need. Of what true courage and conviction is.

Today’s vote answers the dreams of so many who have fought for this reform. To every unsung American who took the time to sit down and write a letter or type out an e-mail hoping your voice would be heard — it has been heard tonight. To the untold numbers who knocked on doors and made phone calls, who organized and mobilized out of a firm conviction that change in this country comes not from the top down, but from the bottom up — let me reaffirm that conviction: This moment is possible because of you.

I have never felt like more of a failure with my activism work than when I read this paragraph. I haven’t been heard, that’s clear. I’ve been working for single-payer for years. No, I haven’t been heard. And hundreds of others I’ve encountered during my activism haven’t been heard, either.

Most importantly, today’s vote answers the prayers of every American who has hoped deeply for something to be done about a health care system that works for insurance companies, but not for ordinary people. For most Americans, this debate has never been about abstractions, the fight between right and left, Republican and Democrat — it’s always been about something far more personal. It’s about every American who knows the shock of opening an envelope to see that their premiums just shot up again when times are already tough enough. It’s about every parent who knows the desperation of trying to cover a child with a chronic illness only to be told “no” again and again and again. It’s about every small business owner forced to choose between insuring employees and staying open for business. They are why we committed ourselves to this cause.

Tonight’s vote is not a victory for any one party — it’s a victory for them. It’s a victory for the American people. And it’s a victory for common sense.

The only victory I see is that maybe, maybe Rush Limbaugh MIGHT leave the country. [And that didn’t happen, dammit.] But has he not said this sort of crap before and stayed? And honestly, even if he did leave, he’d still go on with his show.

There is no victory, Mr. President and members of Congress. This, if anything, is a time to mourn your failures.

Now, it probably goes without saying that tonight’s vote will give rise to a frenzy of instant analysis. There will be tallies of Washington winners and
losers, predictions about what it means for Democrats and Republicans, for my poll numbers, for my administration. But long after the debate fades away and the prognostication fades away and the dust settles, what will remain standing is not the government-run system some feared, or the status quo that serves the interests of the insurance industry, but a health care system that incorporates ideas from both parties — a system that works better for the American people. <

I don’t give a shit about the frenzied analysis. I want change. I want it NOW. I’m sick and tired of living in fear, Mr. President and members of
Congress. What do I fear? I hate that I live in the shadow of a migraine that will inevitably strike me. I hate that I live in fear of falling down the stairs. How could I pay for a broken bone, never mind something more “serious?”

If you have health insurance, this reform just gave you more control by reining in the worst excesses and abuses of the insurance industry with some of the toughest consumer protections this country has ever known — so that you are actually getting what you pay for.

25994_10100187621531793_2478648_tI am so distrustful of the health insurance industry, and I have total faith that they will find a way to continue to make obscene profit off of sickness.

If you don’t have insurance, this reform gives you a chance to be a part of a big purchasing pool that will give you choice and competition and cheaper prices for insurance. And it includes the largest health care tax cut for working families and small businesses in history — so that if you lose your job and you change jobs, start that new business, you’ll finally be able to purchase quality, affordable care and the security and peace of mind that comes with it.

Wow, great. Our country can pay billions of dollars a day to go to other countries to kill other people, but I have to pay for the basic human right to, you know, live?

Thanks.

This reform is the right thing to do for our seniors. It makes Medicare stronger and more solvent, extending its life by almost a decade. And it’s the
right thing to do for our future. It will reduce our deficit by more than $100 billion over the next decade, and more than $1 trillion in the decade after that.

Anyone else alarmed that extending the life of Medicare by a decade is progress? What the f, people?

So this isn’t radical reform. But it is major reform. This legislation will not fix everything that ails our health care system. But it moves us decisively in the right direction. This is what change looks like.

I cannot argue that this isn’t change. I certainly won’t argue with the first line there, that this isn’t radical reform. It’s not.

Our healthcare situation, as it stands now, is hemorrhaging. And the doctors, the government, have decided a band-aid will do the trick. And I’m not talking decent-sized or even normal band-aids. I’m talking about one of those silly round band-aids that doctors will sometimes put on you after taking blood.

In the end, what this day represents is another stone firmly laid in the foundation of the American Dream. Tonight, we answered the call of history as so many generations of Americans have before us. When faced with crisis, we did not shrink from our challenge — we overcame it. We did not avoid our responsibility — we embraced it. We did not fear our future — we shaped it.

I’ll wait and see what the outcome is, Mr. President. I’ll get back to you in a decade or two.

And maybe, just maybe, I’ll have some sort of health insurance then.

No, Congress is not exempting themselves from Obamacare

The Affordable Care Act began enrollment on October 1. The site has had many hits, more than anticipated. However, as was expected, there have been glitches in the system—some not so small. The Washington Post’s Wonkblog offers an explanation of why these technical glitches are occurring and what is being done to resolve them. We shall see in the coming months how it all plays out as the kinks get worked out.

These glitches, however, serve as easy ammunition for opponents of the law looking to kill it. Another weapon being used to derail the law and raise the ire of Americans is the claim, mostly in conservative media, that the President and Congress are exempting themselves from Obamacare. This is a falsehood that has been fact checked. But as one knows, if a claim is repeated enough times people will believe it.

This Factcheck.org piece explains all of this exemption brouhaha quite well. I guess it all comes down to who you trust.

Friends referred to me these two articles:

These articles refute the above pieces:

I’ve also heard the claim that somehow these government employees are not contributing to the cost of their healthcare plans at all. That is false. Per Wikipedia:

“Premiums vary from plan to plan and are paid in part by the employer (the U. S. government agency that the employee works for or, for annuitants, OPM) and the remainder by the employee. The employer pays an amount up to 72 percent of the average plan premium for self-only or family coverage (not to exceed 75 percent of the premium for the selected plan), and the employee pays the rest.”

Now, one can make the argument that perhaps they should contribute more to their own coverage; that is legitimate. However, to state they don’t contribute at all is incorrect because they do.

This information can also be found directly from the OPM website. See their latest statement regarding this issue below.

The Office of Personnel Management issued a proposed rule on Aug. 7 explaining that members of Congress and applicable congressional staff will be required to purchase health insurance coverage through the exchanges created by the law. However, according to the proposed rule, the federal government, as the employer, will still be able to make a contribution to health insurance premiums as it currently does. The contribution will be no greater than that now offered to members and their staffs under the FEHB program, and members and their staffs will not be eligible for premium tax credits made available to other persons purchasing health insurance through the exchanges.

A Most Dysfunctional House

So we are experiencing a government shut down.

The last time we had one, I was an adolescent and news via internet, blogs, and the like weren’t popular. (Cue the sound of your modem . . . )

I actually had health insurance 17 years ago, and I was (unfortunately) using it.  (I say “unfortunately” because being sick and in the hospital = not fun).  So yes–I spent one shut-down (1995) in the hospital. I would ask my parents and nurses about the effects, but I gathered from my sources it wasn’t really hurting anyone too much. I still really don’t know, but I gather I was being spoon-fed some information so I could focus on recovering—?

Now, I’m not yet insured (not my choice). I have two children.

And I know what it’s like to be poor.

The shutdown hurts the poor.
It hurts children.
It hurts the barely-existing middle-class.

. . . and more . . .

My friend and fellow blogger found this gem:

“We’re not going to be disrespected, We have to get something out of this. And I don’t know what that even is.”

— Rep. Marlin Stutzman (R-IN)

I know. Sigh. Deep breaths.

WTF!?!?!

Let’s review:

  1. The Executive Branch approves the ACA/Obamacare, which was drafted by the Heritage Foundation.
  2. The Judicial Branch of the government, the Supreme Court, has ruled that the ACA/Obamacare is Constitutional.
  3. HALF of the Legislative Branch has approved the ACA/Obamacare. Sure, some of the members of the Senate may not like it, but they realize that it is, in fact, law.

Could this be the most dysfunctional House in a century? It certainly seems to be in my three decade lifespan.

Olympic National Park, May 2005. (Photo by me)

The National Parks are gated shut. You can look at the nice photograph, but don’t expect to be able to see anything like it in person right now.

Headstart funding is killed.  Meals-on-Wheels and WIC are slaughtered.  Crucial scientific research on all sorts of things–including pediatric cancer–has ceased because the NIH is gone.

And there’s more we’re not investing in because Rep. Stutzman, Rep. Yoho and others have a point to prove.

I’m sure they’ll figure out what their point in a few weeks.  I’m also sure people directly impacted by this tantrum-led shutdown won’t care, won’t get their medication, their food, their education, etc. These aren’t things you just “make up for” with more later.

So while we wait for the House majority to figure out what the hell their point is, we’re hurting our most vulnerable citizens first.

Investing in the future of this country is clearly not a priority.

Be sure to thank your Representative if they did their best to prevent this.

If you’re in a situation like me, then make your voice heard and call/email your Representative of this sad, dysfunctional House.

I posted the what follows earlier this week. Sadly, it bears re-posting:

(transcript below video):


[clip begins partway through former Vice-President Al Gore’s speech at the Brookings Institution this morning] …I will have more to say about this [climate change report] on many other occasions, but, because this report was released just hours before we gathered here, I would not have felt right about not addressing it.

Now, I’m gonna talk about the potential for a shutdown in just a moment, but, uh, I think the only phrase that describes it is political terrorism. “Nice global economy you got there. Be a shame if we had to destroy it. We have a list of demands. If you don’t meet ’em all by our deadline, we’ll blow up the global economy.”

[pause] Really? Um. Where are the American people in this? Why does partisanship have anything to do with such a despicable and dishonorable threat to the integrity of the United States of America?

Obamacare enrollment begins today, despite government shutdown

Despite House Republicans’ forty plus attempts to repeal and defund “Obamacare,” the six-month enrollment period starts today. House Republicans dead set on making sure this legislation fails have used the ACA as leverage to threaten a government shut-down. Mission accomplished. However, the President, Democrats, and some Senate Republicans are refusing to use the ACA as a bargaining chip. Good. The law was passed by Congress and upheld by the Supreme Court. Forbes.com reported yesterday that recent polling shows only 33% of Americans think the federal law should be repealed, delayed, or defunded, and the majority definitely don’t want a government shut-down over it.

The Affordable Care Act (aka Obamacare) is essentially health insurance reform. It is a far cry from the “socialized medicine” its opponents claim it to be. While the state health insurance exchanges become effective January 1, 2014, other components of the law have been postponed until a later date and therefore full implementation will not occur until 2015 or later.

If you don’t want to read about the Affordable Care Act, watch this YouToons Video for information about the law. I urge you to check it out. It’s comprehensive and easy to understand.

Opponents who make claims about ACA’s negative impact are not being honest because until it is fully implemented an accurate assessment of the legislation cannot be made. (The same can be said about those making overly optimistic statements about the law’s benefits and cost-containment.) Some people may see higher insurance premiums, others will see their costs decrease; some health care costs will be contained, others likely will not. However, what the ACA will do is bring millions of uninsured Americans into the system. It is the first serious attempt since the Clinton administration to provide affordable quality health care to all Americans, though sadly, it is estimated that 30 million Americans will still remain uncovered, for various reasons.

Over a quarter of uninsured Americans are unaware of ACA enrollment. This is a problem. One reason for this is that the Obama administration, HHS, and supporters of the ACA have only recently begun disseminating information through advertising campaigns, social media, and community networks. Another reason is that there is much misinformation out there about the ACA. Most people cannot tell you the provisions in it or the benefits they will receive, or why they hate it so much, except for the mandate that requires they must now purchase insurance coverage.

Recent polls have found that 46% of people disapprove of Obamacare, but only 37% disapprove of the Affordable Care Act. It’s one and the same. Still, Americans are largely supportive of its main provisions. There is a major disconnect between the perception of Obamacare and what it is in reality.

So what is in it? Since March 2010, pre-existing conditions for children have been eliminated; come January 2014, that will be extended to all people. Young adults can stay on their parents’ plan until they are 26 years old. Mammograms have been covered in full and will continue to be. You can read more about the benefits and provisions here on the timeline.

Full implementation of this legislation is further imperiled by GOP-led states or states where the legislatures are dominated by conservatives who have refused to set up their state exchanges (Nevada being one exception) but are deferring to the federal government do it. Some states have refused to expand Medicaid, which would allow more low-income Americans to have medical coverage, even though the federal government is paying for it initially, and by 2020 would still be responsible for 90% of state Medicaid funding.

To make matters worse, these states are obstructing the enrollment process and making it harder for navigators to assist residents in their states to access information and to enroll. This is reprehensible. Even in the reddest of states there are people who need health insurance that may save their lives—even conservative lives. This is not an ideological issue, it is a human issue. I expect the fact that these legislators are actively working to make it more difficult for their constituents to receive health coverage will at some point come back to bite them—hard—and it should.

Currently, we are seeing in states where implementation has been going on for months, the exchanges are not perfect, but they are ready for enrollment and these states are willing to assess where the challenges lie and address them on an ongoing basis. We also see that in many states premiums are coming in lower than expected. A Rand Corp analysis of 10 states and the United States overall predicts that there will be no widespread premium increase in the individual health insurance market. However, in states like FL, TX, LA where they are not expanding Medicaid under the ACA, premiums could increase 8-10%.

Arguments against the ACA include: the mandate is too coercive, it goes against our idea of “freedom,” that Obamacare is already causing insurance premiums to increase, or it is the biggest job-killer right now. First of all, the fine for foregoing insurance coverage is not highly punitive. In the first year, it is $95 or 1% of  income, whichever is higher. Furthermore, if you are too poor and still cannot afford coverage, the fine will be waived.

The penalty for not purchasing coverage should be high enough to at least make people stop for a moment and ask if it is worth the cost to not be insured. The idea of the mandate, is to increase the risk pool, including old and young and sick and healthy. Spreading the risk this way brings down/contains the cost of coverage. Right now, those of us with insurance, subsidize those who do not have it when they need medical care. That’s unfair. Furthermore, it’s the freeloader issue that conservatives are always bemoaning, so one would think this would be an element of the law they would like: everyone taking personal responsibility for their medical coverage.

Providers will offer four plan-levels in the exchanges: bronze, silver, gold, and platinum. Anyone with income up to 400% of the poverty level—$45,960 for an individual, $94,200 for a family of four—will get subsidies to help cover the cost. Disclosure: I am not eligible for subsidies. I make too much money, which isn’t a lot for the NY/NJ area, but even though I do not qualify for them, I do not begrudge those who do. I know how important it is to have decent coverage. I am a leukemia survivor and my healthcare story is a cautionary tale. I was one of the lucky ones.

The second criticism above about increased premiums that people want to assign to solely to Obamacare is also false. Think about it, health care costs have been increasing steadily over the past decades, much higher than wages. This is nothing new. From 2003 to 2011, family premiums for employer-based coverage increased 62% while average median incomes grew only 10%. Some insurers, guaranteed, are setting huge premium increases to fatten their bottom line and blaming it on Obamacare because it’s a great excuse, and most people won’t look for information to refute this subterfuge.

Not only have healthcare costs gone up over the years, but employers have also made employees share more  of those costs. Employers have also decreased pensions as well as their contributions to employee 401K plans. All these costs placed on the American worker have been happening for years, not only in healthcare. The entire system is pushing more costs onto workers.

As for the ACA being the number one job-killer in America—not so much. Read it here, here and here.

No matter what you think of Obamacare the one thing you should remember is that it gives American people choices. If you are fired, or laid off, or want to leave your job, you can do so without the fear of having no affordable health care options for you and your family. That’s liberating. People stay in jobs they hate because they need health insurance. That is ridiculous. Healthcare should not be tied to employment. Furthermore, if businesses did not have this expense they would be much more competitive, globally and domestically. Getting healthcare out of the employment equation is a positive goal because it makes American businesses more competitive and provides Americans the choice and freedom to move to a different job or to start their own business.

The ACA is far from perfect; it is not what I would have designed. However, it is a start to providing universal healthcare to the people of this country. Its implementation will not be complete until all elements of it are in place. And as stated previously, some components have been postponed. The initial enrollment period is for six months (October 1, 2013 – March 31, 2014). In subsequent years, it will be three months (October 1 – December 31).

Furthermore, if Obamacare is delayed for a year, as House Republicans want, it will never get implemented. That is their goal because they are hoping that in the near future there will be a Republican President and a Republican Congress then they can obliterate the law. Our current system is broken, it’s costly to American taxpayers, there are already “death panels” and “rationing” going on in the insurance industry, and have been for years. It’s time to try a different approach, and if that doesn’t work, try another one. The status quo is not an option; our healthcare system is unsustainable.

0006_health-care-oecd-full

SOURCE: Data from OECD, Health Data 2013, June 2013. Compiled by PGPF.

Once we see what is working and what isn’t then we can put policies in place to improve it. But trying to prevent people from accessing a system that though imperfect may help them, possibly even save their lives, is a bad strategy.

There will be obstacles and glitches initially with Obamacare, but perhaps many will be minor. We will never know how a different health care system will work if we don’t try, and even if there are problems, we can improve upon it. We’re Americans. We can meet these challenges. The Affordable Care Act will not affect the majority of Americans or their current coverage. However, if you are uninsured, enroll. The exchanges are open.

Cross-posted at The Feisty Liberal

Get Ready, Enrollment for “Obamacare” begins October 1

Despite House Republicans’ 37 attempts—yes, 37— to repeal the Affordable Care Act (ACA), it will be fully implemented on January 1, 2014, including the state health insurance exchanges, the mandate to buy insurance, and no more pre-existing condition clauses in insurance policies. Congressional GOPers have worked diligently over the past couple of years to undermine the law. You must give them credit—they are persistent. Now, instead of trying to make it fail, they should help Democrats try to make it work and even improve upon it. I know, that’s asking a bit much, but I am an eternal optimist.

My last post about the ACA bemoaned the fact that the Obama Administration and the Health and Human Services (HHS) Department had done very little to raise awareness for the open enrollment period that commences October 1. Participation is important to the success of the exchanges. A Kaiser Family Foundation poll in April found that 42% of people were unaware that the ACA was still being implemented. Since then Organizing for Action, HHS, and healthcare advocates have begun a campaign to raise awareness and set-up a platform for enrolling Americans in the health insurance exchanges and answer questions.

This effort should have been initiated well before now, so timing is a concern for many involved in operating the exchanges. As of June 14, only 26 states have committed to expanding Medicaid, so many low-income people will remain uninsured. Further complicating the roll-out is how the exchanges are being established: some states are handling the exchanges themselves, some are working in tandem with the federal government, and others, like New Jersey (my state), are leaving it up to the federal government to organize.

DB_medicaid_map

Guaranteed there will be confusion and systemic glitches in the beginning, but hopefully not so many that healthcare reform opponents can fan the flames of opposition more than they already do. Healthcare advocates are hoping, as with Medicare Part D after its problematic roll-out in 2006, once the initial ACA problems are resolved, people will discover not only do they benefit from the program but they like it.

Steps are being taken to increase awareness and assist with the enrollment process. Organizing for Action and other pro-healthcare reform groups are spending millions of dollars on an advertising and public relations campaign, “Get Covered America,” and Doctors for America is training 500 doctors and medical students to educate patients about the enrollment process. The Enroll America website is a comprehensive resource for information about the healthcare law and provides enrollment assistance.

It is important for people to educate themselves about the provisions included in the ACA because there is much misinformation floating around about it. It is shocking the number of people who do not know what is in this legislation. There is a health reform quiz on the Kaiser Family Foundation site. I encourage you to take it. Knowledge is power and you may find that knowledge to be quite beneficial in making insurance coverage decisions for you and your family, especially those not covered under an employer-paid plan.

Wendell Potter, author of Deadly Spin and a former health insurance industry insider turned watchdog, has been writing extensively for several years about the topic of healthcare reform and how insurance companies manipulate the American public against reforming the system through media and public relations spin. Visit his site for articles that will help you separate fact from fiction. There is a lot of fear mongering about the ACA; Mr. Potter alleviates many of those fears.

The healthcare  reform legislation is far from perfect. However, there are many benefits people have already been receiving since March 2010. Sadly, the ACA won’t cover everyone—there will be people left out. Some individuals will have higher premium costs but with those costs should come better coverage as opposed to the “junk insurance” that is akin to having no coverage at all.

So, ready or not, Obamacare is happening. Are you informed and prepared for it?

Cross-posted at The Feisty Liberal

A Medical Nightmare: Unemployed, COBRA Ending, and a Cancer Diagnosis

On December 18, 2003, I was diagnosed with adult acute lymphoblastic leukemia. At that time, I was unemployed, my savings was nearly depleted, and my COBRA coverage was set to expire on February 29, 2004. I was thirty-seven years old, and up to this point, I had always been a very healthy, active woman. My biggest fear, aside from dying, was that I wouldn’t have medical coverage after February.

My cancer protocol required four to five days of hospitalization for each round of high-dose chemotherapy, which was completed by the end of March. I checked into the hospital on May 26 to begin four days of total body irradiation followed by two days of chemo before my bone marrow transplant on June 1, 2004. I then spent three weeks recovering in the hospital after BMT.

Following my December 18 diagnosis and ten-day hospital stay, I had moved into my sister Barbara’s home. She and her husband, Dan, took over paying my medical bills, health insurance premiums, and all other expenses.

I applied for Social Security Disability benefits in January and was approved, but my payments would not begin until I’d been disabled for five months. I received my first disability payment in July 2004. Meanwhile, I was researching individual medical plans and discovered that I was eligible for coverage since I’d been insured under a group plan for at least 18 months without any lapse in coverage prior to my intended March 1 effective date.

Once I received the insurance information packet, I was beyond depressed. The insurance premiums were unbelievable. I’d been paying $273 per month for my COBRA coverage—which at the time I thought was expensive—but now I’d be paying $659 per month for an individual plan. I had to have coverage, so my sister and her husband paid for it.

Me with my nephew Andrew, September 2004 – 3 months after BMT; 1 month after he was born.

It is vital to have good medical coverage; it is so important to find a way to pay for it because if you do not have it, it can be catastrophic. My initial hospital stay cost $82,000, of which my insurance company picked up around $15,000, and I paid $550. My entire treatment including hospital stays (one 10-day; three 4- to 5-day; one 3-day due to increased fever after chemo; and a 4-week stay for BMT), chemotherapy, total body irradiation, medications, x-rays, CT and MUGA scans, and BMT probably totaled between $750,000 and $1,000,000 (this based on initial bills of which I saw the price tag and what I know to be the cost of BMT). My caregiver sister was also my bone marrow donor and 28 weeks pregnant—a whole other story in itself and an amazing one. My insurance company covered all her associated medical expenses.

Had I been without insurance, I may not have gotten the treatment I needed to save my life. Had I not had family that was financially capable of covering my expenses, I would not have had insurance coverage and the excellent level of care that accompanied it. I know first-hand how exorbitant medical costs are and how important good medical coverage is to ensure proper treatment.

In the following years, my health insurance premium rose to $759 then to $835 per month. By this time, I’d moved out of my sister’s home and into my own apartment where I was paying $1,000 a month rent. On the salary I earned as a temporary employee, I knew I could not survive if I had to pay $1,000 in rent and $835 for insurance premiums on a monthly basis.

I searched for other health plans and found one costing $453 per month with almost identical benefits, co-pays, and coinsurance. It was still expensive, but at least manageable within my budget. I accumulated some savings post-cancer while still residing with my sister’s family because I was able to work full-time and still collect my disability payments during the nine-month trial work period. This savings allowed me a small safety net post-cancer until I was again on solid financial footing.

My healthcare story had a happy ending, yet many people who are in the situation in which I found myself that December of 2003 may not be so fortunate. My heart breaks for those who go without treatment because they are uninsured, or those who are insured but have limited plans and have to make tough choices between their own and their children’s care.

I am a single woman and it was hard enough coping with my own cancer experience. I can’t imagine factoring a child and/or a husband into those concerns. It must be agonizing. Excellent medical care should be the right of everyone in this country, not only those fortunate ones covered by an employer-paid plan or who can afford an individual one.

Check out two other healthcare-related posts by fellow Evergreeners here and here.

Ms. Ludwig is the author of Rebirth: A Leukemia Survivor’s Journal of Healing during Chemotherapy, Bone Marrow Transplant, and Recovery