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Horror story

Tuesday, Jul 31, 2007 - Posted by Rich Miller

The governor told me about this story a few weeks ago. I’m glad to see that it’s finally getting some coverage…

As a press aide to the governor, Annie Thompson helped promote a plan to improve health care access, but didn’t think much about the realities of facing serious illness without insurance.

Now she can think of little else.

In early May, Thompson’s uninsured mother finally agreed to see a doctor for her abdominal pain. The doctors found a softball-sized mass.

Her mother, Pat, underwent surgery for colon cancer and spent about two weeks in the hospital, piling up nearly $100,000 in debt. After a delay over money, she’s starting chemotherapy, with most of the cost covered by a state program she can join only because one of her daughters hasn’t yet turned 19.

“I realized what a struggle it is when you don’t have health insurance. When she was in the hospital, she was turning down pain medications because she knew that every little pill, every little IV bag was going to up the tab,” said Annie Thompson, 25. “It just hit me all of a sudden: It’s a real issue. It’s not just political games.”

There is a valuable lesson in this story, however. It’s very dangerous to drop your health insurance, even if your premiums skyrocket…

Pat Thompson, a self-employed daycare provider in Springfield, said she dropped her health insurance three or four years ago when her premiums tripled to about $300 a month.

“I took the chance and lost,” said Pat, who is in her 50s but wouldn’t give an exact age.

We’ve had innumerable debates about the pros and cons of the governor’s health insurance plan, and over whether or not the state actually should intervene. It’s gotten repetitive and we’ve all gotten the gist by now.

Instead, today let’s discuss your own personal health insurance situations, and any horror stories you might have about yourselves or your families and friends.

       

49 Comments
  1. - Larry - Tuesday, Jul 31, 07 @ 9:42 am:

    My personal horror story is paying premiums for ainsurance all my life and having people drop their coverage. Then I have to pay for part of it in the way of higher cost for medical services.
    We should be concentrating on the many many success stories and not the headline grabbing stories about the few who were without coverage.


  2. - independent - Tuesday, Jul 31, 07 @ 9:47 am:

    I just went to see Sicko, its a good view of what it could be like here if we had a single payer system. Even if you hate Mr. Moore you should see it its makes great discussion about this vital issue.


  3. - BlueByrd - Tuesday, Jul 31, 07 @ 9:48 am:

    Good to see you two becoming fast friends.


  4. - Barry - Tuesday, Jul 31, 07 @ 9:56 am:

    Alas, $300 a month is not unreasonable for family coverage, however unaffordable it might seem. Thankfully, Mrs. Thompson got her needed operation and therapy, and will ultimately not pay the $100,000, (Only $100,000? Sounds like a bargain.) unless she wins the lottery. Personal bankruptcies are way up, in case you haven’t heard, in this wonderful economy we have, and Mrs. Thompson’s problems, uninsured medical expense, is on of the three big reasons. (The other two: divorce and unanticipated unemployment.)

    I repeat: Thankfully Mrs. Thompson got the health care she needed.


  5. - OneManBlog - Tuesday, Jul 31, 07 @ 10:00 am:

    Mrs. OneMan deals with insurance companies when one of her patients needs some care that the insurance company considers ‘not medically necessary’.

    The BS some of the companies try to pull is beyond belief.


  6. - lifer - Tuesday, Jul 31, 07 @ 10:01 am:

    My parents always said you may not eat but you must have health insurance. I have been fortunate to have health insurance my entire working life. The Thompson’s story is heart wrenching and I am sure there are more out there.
    People need some level of care; however the SJR stories of people making in excess of $100,000 and getting health coverage through state plans; essentially choosing self employment and “rolling the dice” health care wise is irresponsible and covering six figure self employed people who choose not to provide their own coverage is not how state plans should work. Most of us have made sacrifices from what we would like to do to what provides reasonable benefits. I have a family member that is uninsurable through no fault of their own and will soon be off the parent’s insurance as school will be finished; the choice has already been made get something that has insurance benefits at whatever cost including a lower income. Something needs to be done that makes everyone accountable. Many people with a low co-pay go to the doctor for every scratch driving up health care costs while many with 80/20 insurance knowing some of the cost is out of pocket are less hesitant to go. A health plan that has a minimum contribution toward care and a cap so that no one is bankrupt sound workable. The minimum contribution can be salary based. Unfortunately as with all things the poor are taken care of and the rich take care of themselves and the middle class continues to struggle.


  7. - Cassandra - Tuesday, Jul 31, 07 @ 10:02 am:

    First, good wishes for complete recovery to Ms. Thompson.

    My nephew, aged 33, pays $130 a month for an individual BCBS policy with a fairly high deductible. He does get a deduction on his federal income tax as an individual (vs group) policy holder so the real cost is closer to $100 a month. If he were in his fifties, I assume $300 would be a fairly reasonable price, for an individual policy holder, today. Ms. Thompson appears to have dropped some reasonably priced coverage.

    Could it be cheaper. I don’t know. All the French, regardless of income, get cancer care free, according to a recent Business Week article on health care. But their tax burden is very substantially higher, including a VAT (sales) tax that is about 10 points higher than our sales tax.

    There is no free lunch. But one thing Blago could do is ensure community rating and guaranteed access to health care for all Illinoisians. That means everybody pays the same for the same level
    of policy and nobody can be turned down for insurance, regardless of health history. Illinois, despite its strong liberal voter base, has been slow to provide even this basic type of health insurance security to its citizens. Too many pigs at the trough, I guess. And the health insurance industry is no doubt providing a lot of extra feed for those pigs on the side.


  8. - Team Sleep - Tuesday, Jul 31, 07 @ 10:15 am:

    My wife went to high school with Annie Thompson. What a small world.

    I have been very, very blessed. My dad always had great insurance through his company, and since he was corporate he had top-level plans. My wife works for the state, so I have good insurance through her.

    The worst story I can remember is that my aunt, whom I miss very much, was devoid of healthcare for much of her life and wound up dying because of a veritable lack of preventive care. And because Medicaid premiums went unpaid to many Metro East doctors, clinics and hospitals, she had a hard time finding a doctor or clinic in the Metro East that would take her card. It was aggravating to watch one of the best people I’ve known and will ever know succumb to such bureaucratic baloney.


  9. - Capitalist Pig - Tuesday, Jul 31, 07 @ 10:18 am:

    I genuinely feel sorry for this woman. She took a risk and it didn’t work out. I have to think that what really makes this a horror story is that we aren’t discussing her personal choices and taking full responsibility for those choices. I did not read in this story that she was not able to afford the coverage, only that she CHOSE not to partake of it. If you do not wish to pay a higher premium you have a RIGHT to pocket the savings and GAMBLE on your health. I am quite certain that the $300/month was somewhat of a hardship, my question is a) did she choose to be self-employed over working somewhere with benefits? b) Was she eligible for any of the 10,000 insurance programs BEFORE she fell ill? c) Is this really the case that the left wants to make for socialized insurance/healthcare?

    I will pray for Mrs Thompson’s full recovery. I sincerely hope that she can get the care she needs. I am certain, however, that case studies like this one will continue to pop up and will continue to show some of us the great divide between personal responsibility and socialized control of responsibility.


  10. - joe - Tuesday, Jul 31, 07 @ 10:19 am:

    Many hospitals charge the uninsured 3 to 5 times as much for the exact same care as they charge people with insurance–leading to exorbitant profits. Not-for-profit The University of Chicago Hospitals provides no discount to the uninsured, and after just 9 months of their current fiscal year have reported making over $100 MILLION in profits. For the Governor to pass a health care plan that makes no demands for reforms from very very profitable not-for-profit hospitals, is simply giving a blank check to one of his largest donor groups, a blank check that will bankrupt the state in a few years. Saying your for affordable health care doesn’t make it so. By the way, what ever happened with his plan to make drugs more affordable?


  11. - Larry Mullholland - Tuesday, Jul 31, 07 @ 10:20 am:

    When I graduated college, I too, was without insurance for a few months until my parents found out and went nuts on me!

    They explained to me the catastrophic bills that could come my way if I were to simply fall down the stairs. My parents told me I was being completely STUPID for not getting health insurance. But I thought could not afford the insurance at the time. SO my father insisted I pick up a second job to pay for the insurance. SO I started waiting tables one or two nights a week to pay the insurance costs. Fortunately for me, I had my parents educating me about the ways for the world. Fortunately for me, I had the capacity and work ethic to pick a part time job to may my own bills.

    Fortunately for me, I had the willingness to work an extra few hours a week to pay my personal bills.

    I am very sorry for the sickness and financial strain it has caused Mrs Thompson.

    However, it is not the fault of the taxpayers or the Governor that I was uninsured during the brief period before may parents told me how ignorant I was…………..


  12. - Miranda - Tuesday, Jul 31, 07 @ 10:26 am:

    I am one of those that cannot afford health coverage. I am have a chronic heart condition; any insurance company that would insure me charges unaffordable premiums, or they won’t cover the heart condition because it’s a “pre-existing condition”. Why pay for insurance that won’t cover my major medical condition in the first place? With the way the system is set up right now, it is almost better for me financially to save the money that I would be paying in premiums, and if I ever do have a heart attack or other major issue come up, either ask the hospital to take me on as a charity case, as some are required to do so many of those a year, or just file for bankruptcy after the fact. People in my situation really don’t have many other options. And no, I don’t make $100,000 a year, I make less than $20,000 when I was a preschool teacher, a job I just resigned from for various reasons, and I am looking for a new job. Hint, Hint, I have a degree in communications, so if anyone out there knows of a job possiblity for pr or journalism, let me know. Thanks!


  13. - VanillaMan - Tuesday, Jul 31, 07 @ 10:32 am:

    When I lived in Germany I was fortunate enough not to get sick. But as the Student Leader for English Speaking Students, I dealt with exchange students who needed care at our school. I lived first-hand a universal health care system labeled by Democrats as some kind of nirvana - and the honest truth is that it isn’t.

    You have to wait. A long time. One of our students suffered from chest pain. He couldn’t get any attention from the state clinic because they triage everyone. There are more patients than doctors, so the system forces you to deal with cold bureaucrats who make your life or death calls - not you. They took his blood pressure, listened to his heart, and told him he had nothing to worry about. He complained and gave great details about his concerns - they didn’t even listen because they say everyone feels they have needs, so they depend on their tests only.

    So he was sent home, and it was my job to worry about him. He didn’t get better, so we asked and got homeopathic pills. Not real medicine - cheap homeopathic crap. You see, drugs are also rationed in Germany. They cost, so you don’t get them unless a test tells them otherwise. Instead you see a lot of fake medicine in Germany available over the counter and useless.

    Honestly, in all seriousness, whenever we had a student with a medical need, we sent them back to the US. The reason was that there was really NO medical care available under the German system.

    We had a bike accident, which is common when American students try to ride bikes, (we are awful bike riders, btw). Broken leg, bleeding, the whole schmear. We would consider the situation an emergency. Not in Germany. We had to get a taxi to the state clinic, where we sat and wrapped towels around the wound. She was treated as if she was complaining about a cold. The same cold ladies looked at the wound and scheduled a doctor visit after confirming that it looked like a broken leg. Big deal. After the doctors set her leg and stitched up her injury - we flew her back to the US.

    My personal experiences are a counterpoint to all those who believe that universal health care is some kind of an answer. It isn’t. A country as efficient and as cooly analystical as Germany can’t make it fly. Health care is rationed by aides who don’t see you as a person. Instead of dealing with an HMO playing games, you deal with a government acting like an HMO that doesn’t play games. You lose if they decide you lose.

    It is incredible to me that people who demand 100s of different cars to drive are willing to take their most precious asset - their health and lives - and give it up for a one-size-fits-all mentality that never works as promised.

    Anyone out there thinking that their health care situation will improve, that costs will go down, that cutting edge medicine will be available, that surgeries will be timely, that chemotherapy will be available are absolutely stupid.

    I know. Universal health care is a fraud.


  14. - vouchey - Tuesday, Jul 31, 07 @ 10:37 am:

    Irony of ironies, my father used to run community health centers on Chicago’s south and west sides and would rail about how uninsured saw their clinics not as a last resort, but the only resort.

    A few years later, out of work and lapsed COBRA, he was diagnosed with Alzheimer’s. Now he’s 64, not eligible for Medicare.

    While he’s slowly slipping into oblivion, the good news is that his disease seems to blot out bitterness for the system he once tried to fix.


  15. - It's 5 O'clock somewhere - Tuesday, Jul 31, 07 @ 10:37 am:

    First of all I wish everyone good health. We have heard many reports of what is wrong with the health care coverage and many reports of what is right with health care coverage. My question is what is the root cause for high insurance premiums? A few thoughts would be technology, we are living longer and governmnet mandates. Any thoughts on this issue?


  16. - Southern Right - Tuesday, Jul 31, 07 @ 10:46 am:

    Miranda, Beg, borrow, or steal get signed up with ICHIP. A six month waiting period is not a bad option. Get the highest deductible offered and at least protect yourself from financial ruin.


  17. - Lainer - Tuesday, Jul 31, 07 @ 11:12 am:

    In the fall of 2004 I lost a private sector job which had a fairly good health insurance plan with family coverage. In January 2005 I started working for a daily newspaper which paid considerably less than what I had made before. Its health coverage didn’t start until you had worked there 90 days, and family coverage would have cost nearly a third of my pay, so I tried shopping for something more affordable in the meantime.
    Three weeks after I started working at the newspaper, my daughter had a grand mal seizure for the first time in her life and had to be rushed to the hospital. I had to tell the hospital people we were uninsured because I had just changed jobs. One of their caseworkers helped us apply for Medicaid for our daughter.
    Since my daughter had had a seizure, she now had a “pre existing condition” which my employer’s health insurance would not cover and no other private insurance would cover for at least a year or more. So she stayed on Medicaid for two years, while I went without insurance and kept my fingers crossed trying to find something affordable.
    I hated having my daughter on Medicaid mainly because it was nearly impossible to find a doctor for her. We ended up having to go to a low-income clinic where the staff was obviously overworked and underpaid. Nothing against them, and thank God they are there doing what they can, but I knew we had to find something better, and eventually I did get a state job with a reasonably affordable (not free – hope you’re reading this Cassandra) HMO plan.
    Believe me, I understand people’s frustration with the cost of private health insurance, but my experience with Medicaid/All Kids did NOT endear me to Blago’s grandiose health insurance plans. What good is “universal coverage” when doctors won’t take it?
    Now, if Illinois (like 40 other states) had a budget surplus, and its current Medicaid program were well-managed and paid its bills on time, and our governor were more trustworthy, it would be different, and I would not object to expanding state funded coverage. But not now, and not with this governor!


  18. - VanillaMan - Tuesday, Jul 31, 07 @ 11:14 am:

    These posts are allowing for a “grass is greener” analogy. We are getting a one-sided discussion.

    Naturally, most posters have had problems with the current system.

    But what we need to ask ourselves is whether or not the proposals being sold to us would really have solved those problems.

    The answer would often be “no”.


  19. - Rich Miller - Tuesday, Jul 31, 07 @ 11:20 am:

    VM, as I noted above, we have had that particular discussion here more times than I can count. Stick to the topic, please.


  20. - 45 - Tuesday, Jul 31, 07 @ 11:38 am:

    Wow, talk about a one-sided QOTD.

    Let me tell you about my story. My wife fell deathly ill and was rushed to the hospital in the early hours of the morning. She was in the hospital for 2 weeks and on home care for 4 months. The doctors were great, nurses outstanding, and the insurance company paid their fair share.

    I also feel bad for Ms. Thompson and wish her a speedy and full recovery. However, as unfortunate as it is, she made a conscious decision to cancel her insurance and now must live with the ramification. $300 may be alot of money but did she cancel her cable TV, get a smaller car, eat at home more often or make other lifestyle changes that would have allowed her to pay for insurance.


  21. - Fiscus - Tuesday, Jul 31, 07 @ 11:39 am:

    The Significant Other is a state worker, and our problem was that on the state’s cheapest health care plan, you didn’t pick your doctor, you were assigned to one. She had the same OBGYN since she was a teenager, and the plan insisted we change docs or pay extra. As to our G.P., we rotated thru about five of them in three and a half years, never seeing the same one twice. What kind of continuity of care can you get when every time you go in for even a regular checkup, it’s essentially for the first time? It’s settled down a little bit in the last year or two, thank goodness.

    Dad had a lot of trouble getting full coverage because just as he’d be working somewhere long enough to be fully vested in their plan, they’d let him go and he’d have to start all over again at another place. Portability of benefits is a big deal.


  22. - Cassandra - Tuesday, Jul 31, 07 @ 11:59 am:

    Actually, Lainer makes my point (best of luck to your daughter, by the way). He had to get a state job to get reasonably priced private coverage (around $200 a month for employee and two or more dependents in HMO). Now, Illinois state government can’t employ everybody in Illinois although it often seems that way. And it doesn’t seem right that Lainer as a private sector workers subsidizing state workers couldn’t get reasonably priced private health insurance (until he became a state worker). We are. after all paying state taxes.

    Community rating, guaranteed access, and
    subsidized health insurance premiums would take care of most of these problems. Everybody doesn’t have to go on Medicaid. But every taxpayer should be eligible for the subsidies and should have the access to care guaranteed.

    My nephew (see post above) by the way is a starving filmmaker and probably would qualify for some type of public assistance Medicaid/free care. But the family wouldn’t hear of it. To keep him out of that system, we’ll pay the premiums and the co-pays. No way would we go public.


  23. - steve schnorf - Tuesday, Jul 31, 07 @ 12:11 pm:

    Rich, government by anecdote is sort of Reaganesque.


  24. - Rich Miller - Tuesday, Jul 31, 07 @ 12:14 pm:

    This isn’t government, Steve, it’s a blog.


  25. - plutocrat03 - Tuesday, Jul 31, 07 @ 12:23 pm:

    First of all I wish the best outcome for Ms. Thompson and family.

    One can always find examples of how a system designed to protect us fails. There are examples of utter failure in the current system as well as examples of the single payer system. Mr. Moore’s mocumentary is another example which points at our system’s failures without consideration of the daily miraculous successes.

    Now what to do? To transfer the health care portion of our economy to the government is likely the most inefficient thing we can do. Without the free market system mechanisms in place we will watch what happens in each and every governmental entity. Waste fraud, inefficiency, etc.

    Opposition to governmental takeover aside, the rational approach is to whittle away at the problems. Corporate benefits aside, small businesses provide the largest percentage of jobs in our economy and have the largest challenges in providing health care to their employees. A decent health insurance plan will cost approximately 4.00 per hour based on a 1750 hr work year. A lot of money for those at the lower end of the pay scale.

    Let’s get to work improving our system, rather than using the governmental catch all.


  26. - Healthcare Worker - Tuesday, Jul 31, 07 @ 1:09 pm:

    Joe wrote, “Many hospitals charge the uninsured 3 to 5 times as much for the exact same care as they charge people with insurance–leading to exorbitant profits.”

    I work for one of those “not-for-profit” hospitals and, let me say, “No, we don’t make exorbitant profits.”

    Here is how it all works from the inside:

    1) In order to meet our OPERATING BUDGET (salaries, healcare, electricity, training, cleaning supplies, …) we need to charge patients $X per day per bed for inpatients.

    2) In order to meet our CAPITAL BUDGET (improvements, regulatory needs, …) we need to charge patients $Y per day per bed for inpatients.

    So, to function as a hospital, we need to charge $Z ($Z = $X + $Y) per day per bed.

    Now lets look at re-imbursements:

    1) Health insurance companies, being the capitalist that they are, NEGOTIATE a re-imbursement plan for services. This is based on what THEY are paying throughout there service area. For a national company, this is about 1/2 of $Z.

    2) Medicare/Medicaid/Public Aid pay on a fixed plan that hasn’t changed in YEARS. This also amounts to about 1/2 of $Z. They also tend to pay 90-180 days after service….

    So, from insurance we get anywhere from 1/2 to 3/4 of $Z. From the gov’t. we get 1/2 of $Z. And lets not talk about the “compassion care” which contributes $0 to the mix.

    We use investments to help offset some of the extra costs, but to make up the difference, the non-insured pay the price.


  27. - Capitalist Pig - Tuesday, Jul 31, 07 @ 1:21 pm:

    Steve,
    Great Idea!!! A dose of “Reaganesque” capitalism would be a huge improvement in this state. Thanks for thinking of it :c)


  28. - Fan of the Game - Tuesday, Jul 31, 07 @ 1:29 pm:

    I have good health insurance and have used it only for minor surgeries and scrapes. No insurance nightmares here.


  29. - Southern Right - Tuesday, Jul 31, 07 @ 1:45 pm:

    Healthcare Worker 1/2 to 3/4 payment of an inflated rate is still too much. Your industry has dodged the issue of transparency for decades.


  30. - Health Care for All - Tuesday, Jul 31, 07 @ 1:52 pm:

    Let’s stand up for our great insurance system.
    We are number one in spending - per capita. The closest per capita costs of the next country to the U.S. is nearly half on what we pay today.
    We are number one in administrative cost than any other country in the world. Let’s hear it for the effeciency of our private sector. As a fiscal conservative I like giving my insurance company 21% of every dollar that my small business spends on health care. Do not forget the bokers 5-7% fee. The sicker you are the more they make. Now that is the American way! Profit and greed is what makes this country great. How dare the Medicare program’s bloated bureacracy is only 3% and they only pay their Director $185,000 versus the tens of millions that the CEOs of our finest insurance industy CEOs make. How un-American
    Let’s hear it for the many different ways that I pay for health care: $1,100 in additional costs a year from cost-shifting due to the growing number of uninsured. This will only continue to grow; $642 a year for health care coverage on my auto insurance and another $72 a year for health care coverage for my homeowners policy; another $100 in this year’s property tax increase to pay for health care coverage (9.4% increase) for city, school and county workers; smaller wage increases due to the year 11% increase in my small businesses health care premiums, and the list goes on. It is great to see how effecient the insurance industry is in taking money from from us.
    Lets hear it for the good ole private sector - where the private health insurance industry is number one in their creativity and ability to ration care so much better than all those god-less communist western-industrialize countries who health care indicators are better than our 37th standing. What is wrong with 37th?
    I think it is time to have our postal system be run by the private health insurance system: 47 million Americans would not receive direct mail service; 85million Americans would only receive some mail service since they would be undermailed (underserved).
    Stay the course. Pay more and get less and cross your fingers that you do not get sick.
    As a fiscal conservative not only are all stories shocking and should not be happening in the greatest country in the world, but it is an economic imperative to eliminate the fraud and waste in the private sector and get those free-loading businesses to share in the responsibility in contributing to the cost of health care insurance to their workers.


  31. - manny - Tuesday, Jul 31, 07 @ 1:54 pm:

    the thompson woman lives on the southwest side of springfield in her own home, paid tuition to send her kids to private high school paid to send them to collee—chose to baby sit for kids in her home rather than go out into the workforce—dropped what sounds like fairly ordinarily priced insurance doesn’t seem to have a plan to pay her bills and wants the government to help her—talk about the nanny stae—there are consequences for bad decisions and the taxpayer shouldn’t be responsible for them


  32. - Rich Miller - Tuesday, Jul 31, 07 @ 1:57 pm:

    HCFA, nice rant, but let’s stick to the topic at hand.


  33. - Jeff - Tuesday, Jul 31, 07 @ 2:12 pm:

    My experience is nobody wants to pay for health insurance. 13 years ago I was denied coverage due to a preexisting condition that I did not want to disclose to a new employer. I did some research and found some affordable $200 a month catastophic policy. I was ready to sign up when my next employer found a way to cover me.

    Whenever friends who had the same condition complained they could not get insurance, I would show them what I had found. They all refused to sign up because it was too expensive.

    I am extremely sorry when anyone gets sick. But what I do not understand is how single payer will be any cheaper than most policies in effect today. Just because you pay for it in taxes does not make it free. Does anyone think that Ms Thompson would have paid less than $300 a month in a single payer system? She just would not have had the choice.


  34. - HMO Fighter - Tuesday, Jul 31, 07 @ 2:23 pm:

    I had cancer, a very, very rare form of cancer. I was insured by an HMO. I went to the only doctor in the Midwest who had dealt with my form of cancer. The HMO decided this was not medically necessary, that I see this particular doctor. I had to threaten them with a lawsuit to get them to continue to cover my treatment with someone who actually knew what he was doing. Thankfully I prevailed in my fight with the insurance company and with the cancer, as I am OK now.


  35. - Capitalist Pig - Tuesday, Jul 31, 07 @ 2:48 pm:

    Unfortunately, the HMO is the closest example we have to state managed insurance. It get’s worse…not better.


  36. - ZC - Tuesday, Jul 31, 07 @ 3:24 pm:

    I have been blessed to have had health insurance my entire life, and much better, just to be a very healthy individual. As such, my interactions with the health care system have been mercifully few.

    I do find our health insurance system odd. I have bad eyesight and an eye condition that might eventually degenerate, so I get yearly checkups to see how it’s doing. Each time I get out of the clinic, they say they’ll send me a bill for the parts of my checkup Blue Cross won’t cover. I ask them what those are and they don’t want to tell me. I ask them what amount I am going to wind up paying, for a simple check-up, and they don’t want to tell me. I imagine if I blew up and DEMANDED the truth, they would have to explain to me the cost of my visit, and how my coverage is or is not adequate to the routine procedures performed. But everything about the experience is aimed at getting me out the door with as few questions about that as possible. They are good people but clearly they like me as uninformed about the financial underpinnings of their business as possible. I worry someday that, even WITH insurance, I’m going to be mailed me a $1,000 bill, with minimal explanation, and told that’s what I need to pay.

    It is a weird system, and I say that having been very fortunate within it. I wish there was a lot more transparency about the true costs and more info upfront about what insurance does and does not cover, so I could be more educated as a health consumer. But my health remains excellent, and my medical costs minimal, so I don’t put in that work.


  37. - The Horse - Tuesday, Jul 31, 07 @ 4:07 pm:

    She gambled, she lost, she was treated… what is the horror?

    I go to the Paradice…I gamble.. do I eat at Jonah’s? or do I go hungry. Most restaurants I know won’t give me a meal I can’t pay for.

    Its all a matter of national, sociatal priorities.


  38. - liberal louisa - Tuesday, Jul 31, 07 @ 4:38 pm:

    I used to work taking medicaid applications and it was always horrific to have to tell someone that they didn’t fall into a “category” so they didn’t qualify. This was after AMI(Aid to the Medically Indigent) was done away with. I felt so strongly about it that I called the Governor’s office about it(which was Edgar it was back in 91) I told the person who I spoke to that I didn’t think it was right that although a person didn’t have children in the home or was disabled or elderly that they didn’t qualify. He sputtered and said something about people with kids getting sick more, but the thing was that I was turning away people with cancer who weren’t necessarily considered disabled. I don’t think it’s right that someone has to fall into a “category” as in the case with Ms. Thompson, who still had a child in the home. Disease doesn’t discriminate as to whom it strikes and one person’s life isn’t worth more than another’s.


  39. - getting too old for this - Tuesday, Jul 31, 07 @ 6:14 pm:

    First, best wishes to Ms. Thompson for a speedy recovery and return to good health.

    As for me, I had health insurance until late last year when the premium started to get close to my mortgage payment. Last week, on the advice of a friend who knows an insurance broker, I spoke with the broker about resuming coverage with BCBS. Apparently, the county you live in has much to do with your premium.

    I live in Cook County, but not far from Kane County. He mentioned that Kane County is much cheaper, so I asked him to compare the plan we were discussing. By moving to Kane County, I could save about 35% on premium coverage to the point where it would actually be affordable for me. I asked why the difference, and he replied “Chicago.”

    With that point alone, he’s speaking volumes about the way insurance companies operate and the use of the system. By the way, I live more than 30 miles from the Loop and about 20 miles from the Chicago city limits.

    In the meantime, after reading some of the comments here, I’m going to resume my search for a good catastrophic health plan. The little aches and pains can come out of my pocket.


  40. - Esteban - Tuesday, Jul 31, 07 @ 6:33 pm:

    I think we miss the point somewhat when we get
    into these arguments. I think the really
    important question is this: Is decent medical
    care a fundamental human right? If a majority
    says “yes”, let’s figure out how to bring it about.


  41. - Anon - Tuesday, Jul 31, 07 @ 7:09 pm:

    To all of you, especially the younger people that are posting on this site, are you aware of the ICHIP program? It is the high risk health insurance plan for the state of Illinois. It often is cheaper than people are paying in the private sector, and is for people who have pre-existing conditions…there also is a plan for people under 65, diabled and on Medicare


  42. - Lainer - Tuesday, Jul 31, 07 @ 7:57 pm:

    Thanks Cassandra. (By the way, I’m a “she.”) My daughter has been seizure free and healthy for over 2 years now.

    Something else I would like to point out is the fact that many hospitals have charity care programs, or can work out payment plans with you if you are uninsured or underinsured.
    My husband had to have an operation for an injury while he was on the student insurance plan of the university he attends. (This was before I got hired with the state and put him on that insurance). Since the plan is designed for young, healthy college students, it doesn’t cover surgery very well. Thankfully, Memorial Medical Center in Springfield encouraged us to apply for their Community Care program, and they ended up forgiving his entire hospital bill! If you’re uninsured or underinsured and need help paying the bill, don’t hesitate to ask your provider for help.


  43. - joe - Tuesday, Jul 31, 07 @ 9:15 pm:

    response to supposed healthcare worker. What’s your CEO make this year compared to 2 or 3 years ago? What is your hospital and does it belong to a system? Why no mention–stand tall stand proud. How much does your hospital make off arbitrage, how much did they make on interest on their investments? Your last sentence proves my point, to make it up–your hospital screws the uninsured–something Blago won’t address.Have a good day compassionate healthcare worker.


  44. - steve schnorf - Tuesday, Jul 31, 07 @ 10:00 pm:

    After hearing all this I believe health care should be free to all but the very wealthy. Hospitals may have to operate at a loss, but they can afford to do that, right? Most of then are non-profit anyway. And I see no reason why doctors should get paid so much more than teachers, and doctors usually golf on Wednesdays, not work. No one should have to pay health insurance premiums unless they are high salaried, because insurance companies are nothing but grave robbers, and they pay their executives way too much. The idea that people don’t adequately value something they get for free and overutilize it is absurd. And don’t try to tell me that we’ll have to raise taxes to pay for this. Get rid of some of the waste in government and get rid of all the slackers and quit flying the Governor around everywhere and there will be plenty of money to pay for health care for everyone who needs it. And, by the way, there’s a lemonade spring over by the big rock candy mountain.


  45. - Extreme Wisdom - Tuesday, Jul 31, 07 @ 10:58 pm:

    As a better-than-average-health 46 year-old with a gold plated health plan (through wife’s company), my only complaint about the health system is the utter and complete waste of time focusing on ‘insurance’ over ‘health care.’

    My recent visit to address some preventative concerns got me a ream of suggestions for all kinds of tests that I know I don’t need. I was assured that it wouldn’t ‘cost’ me anything. I declined, figuring the resources should go to some one who needs it.

    Group Insurance AND Single Payer create over-utilization. Placing the consumer in charge of all but the most catastrophic spending dramatically reduce over-utilization.

    While we are at it…if we are going to have the government pay for health care, an investment in numerous free clinics and follow-up care centers will be far superior to governmental insurance schemes. Arguing otherwise makes the “Michael Moore Mistake” - forgetting (or ignoring) the fact government is nothing more than the worst HMO…on steroids.

    Piling on…if we are serious about taxing something to pay for “health care,” then institute a tax on EVERY pound on EVERYONE is who is overwieght and collect it with forced driver’s licence renewals or pension check “pick-ups” at the government scales.

    Health care costs would plummet.


  46. - Steve Forbes - Tuesday, Jul 31, 07 @ 11:02 pm:

    For years at Forbes we have provided what have been, in effect, Health Savings Accounts. The insurance itself is a bargain (relatively) because the policy deductible is high. What makes the plan so attractive, though, is that we give everyone who works here $2,000 each year, which covers most of the deductible.

    Money that isn’t used is rolled over. If medical bills exceed both that $2,000 and the employee portion of the deductible, traditional health insurance kicks in. Our premiums last year went up only a fraction of the national average. When companies initially put such a plan in place, they often see a decline in premiums. Now that employees will have “skin in the game,” employers rightly figure that those dollars will be spent more carefully, more wisely. For instance, why get an MRI when, in certain situations, an X ray would be just as good?

    The virtue of HSAs, however, goes well beyond this semi-zero-sum mentality: The way health care is delivered will change as providers find it in their best interest to come up with inno-vative breakthroughs. The traditional cost-plus mind-set will wither away. We truly will get more for less.

    http://members.forbes.com/forbes/2004/0726/029.html
    [Forwarded and linked by Extreme Wisdom]


  47. - From the Sidelines - Tuesday, Jul 31, 07 @ 11:20 pm:

    My mother has worked at the same job for 36 years with no health coverage. She has always been covered under my dad’s plan. My dad retired earlier this year and my mom will remain covered under his plan for 4 more years, until he turns 65. At that time they will both lose coverage and he will go on Medicare. My mother is six years younger than my father and will be without health insurance until she turns 65. She has severe heart problems that have required multiple surgeries, and will most likely require future surgeries. In the past she has attempted to get health insurance coverage and been denied. Later when she explored coverage, she was quoted a price that was higher than her current salary and had exclusions for pre-existing conditions. Needless to say, she is terrified of the possibility of life without health insurance.

    On one hand I am extremely concerned about the health and welfare of my mother, and for her sake would like to see smoe reasonable plan that would give her and my father some peace of mind. At the same time, I am also concerned that a state sponsored system would have approval delays, not be accepted by her current doctors and place restrictions on what brand of medications she must take.

    I don’t know if there is a solution to this problem. The proposed health plan may be better than nothing, but somehow I doubt that any health plan developed and run by the current state officials is going to be timely and effective.


  48. - joe - Tuesday, Jul 31, 07 @ 11:39 pm:

    steve schnorf - how ignorant or misleading you are, many not-for-profit hospitals compared to pharmaceutical companies and insurance companies are enjoying bigger % increases in their profits. And many of their not-for-profit CEO’s compensation is inreasing by hundreds if not millions of dollars a year,go to www.wherethemoneygoes.com. The 11 largest not-for-profit Catholic health care systems reported sitting on over $32 BILLION in cash and investments last year, while the 13 largest not-for-profit Catholic systems reported making a profit of over $4.3 BILLION last year (3 times as much as 4 years ago). That’s after losses on Medicaid, uncollected bills, community benefits etc. The 13 most profitable not-for-profit health care systems reported making a combined profit of over $6 BILLION last year and had over $35 BILLION in the bank. Try again selling your stuff, this time with facts.


  49. - AliceBlue - Sunday, Aug 5, 07 @ 5:29 pm:

    Saying Mrs. Thompson made a “bad choice” is counter to free market thinking. If there were a free market, there would be no need to make a choice between insurance and a business she finds satisfying.

    Instead, we have 6 health insurance markets, and the only one that works well is Medicare. That has started to unravel since Bush introduced privatized HMOs which have increased costs to taxpayers and greatly reduced services.

    Don’t forget that Medicare isn’t free – base premiums are $93 per month, plus optional supplements starting at $120 and Part D Rx at $25 per month. But it is the same price for all but those at the highest income levels, no one can be denied Medicare, and pre-existing isn’t a condition for obtaining it.

    Why shouldn’t everyone have this type of access to health care?

    Currently there are few protections for people with insurance. Illinois Covered, if it passes, will introduce several features including a right to “an independent external review upon denial of a claim.” That doesn’t exist now, while other states do give this protection. Another feature will prohibit (insurers) “from raising premiums on individuals just because they get sick.”

    Take a look at the features for everyone in the bill - they’re worth it for all.


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