My wife and I both work, but we don’t have insurance through employers.
Our family had a major medical issue last year. And so, after my wife went from working as a school employee to a private practice as a speech therapist, we sought quotes on single-family premiums. I couldn’t believe when the first monthly quote we received was over $3,000. You mean $36,000 a year?! I screamed.
Because of the crisis last year, which now counts as a “pre-existing condition,” we were basically priced out of insurance for single-family coverage, at least as far as we could tell. After that absurd quote, we contacted an insurance agent to help us find something. She told us that the Affordable Care Act offered one option for us in Madison County — Ambetter. We saw several plans, with one for $1,772 a month or $21,264 a year. But if we didn’t cross a certain pay threshold with our combined incomes, we could get it for $877 a month or $10,524 a year.
Maybe this is already sounding like an annoying commercial to some of you. But this isn’t fiction for us. It’s a matter of getting by or not.
Without the Affordable Care Act or “Obamacare,” the pre-existing condition in our family could keep us from even getting the outrageous $36,000-a-year insurance. But at least for now, pre-existing conditions can’t keep you from getting some form of coverage. With the Obamacare plan, we currently have a $10,524 a year premium, hardly cheap, but at least it’s protection against financial ruin that can come with being uninsured. But for us, a $36,000-a-year plan is also financial ruin. A $21,264-a-year plan is close to ruinous, too. If premiums reach a certain level, we just have to go uninsured, which is a reality for so many people.
I’m a long-time newspaperman and my wife is a speech therapist. We have two kids. We are not in poverty, but we are certainly far from rich. But the insurance premium squeeze is on. We feel it. And we had one affordable option this year, one life raft. We certainly weren’t presented with competitive options. Not that anyone would or should care for us in particular. But I know we’re far from alone. This is a significant national issue.
When there’s talk of repealing “Obamacare,” I’m not just thinking in terms of the political hate that plagues our country like severe head lice. No, I’m thinking of our own bank account and what escalating health insurance premiums can do to it — or what the lack of insurance might do to us. When you start thinking about $36,000 a year versus $10,500 a year, this is serious territory for a family. This is not a hypothetical or a fire alarm. It’s a fire.
And without any further reform, those premiums will only go up — because insurance companies are in the business of profits first, not health. Shareholder price matters more to them than your heart beating or mine. That’s just the cold fact. It’s just business.
Health insurance is, in theory, a protection. But for too many Americans, it is becoming more and more just a punitive tax on being alive. In a healthy private insurance market, a family that is healthy for a year would see a reduction in premiums. But, of course, that never happens. The rates go up every single year, no matter our health. That’s because in any publicly traded business, growth is what matters. Insurance companies are healthy when expenses and premiums go up together, and share prices go up, too.
This arrangement is crippling millions of people financially. And small businesses suffer due to their lack of scale. Bigger companies can get lower rates. Middle-class workers with the most health insurance stability tend to be those who either hold a government job or work at a major company in a management position. That’s all because the economy of scale matters. That’s why a government plan makes sense. It can have the largest scale, since risk can be shared between the most people. Bills for one quadriplegic patient will cripple a home, but not a nation.
The retort to this comes with one word, “socialism.” I hear the word used in fearful ways all the time, but I’m legitimately confused about what exactly is envisioned. The word is deemed argument enough to end all discussion. But it’s not because it’s too broad. Here’s what I see: we are each a blend of personal and collective responsibilities. We have a duty to try our best to take care of ourselves, as well as our immediate community, state and nation.
I believe that “socialism” is basically a stand-in term for “giving money to free loaders.” We don’t want our hard-earned money to go to those who seem eager to cheat the system. I get that, and I agree with it. Cheating can happen on both ends of the financial spectrum. I don’t like either.
But malignant socialism as a government construct would be the seizure of all of Walmart’s or Target’s profits. It would be the forced takeover of farms by the government. It would be private business not just taxed, but controlled as state property. That would be worth fighting against. That would be a horrible.
But I don’t see that happening. Consider that online behemoth Amazon paid $0 in federal taxes in 2017 and 2018. Meanwhile, many big businesses employ people and then expect them to have insurance through government assistance. How is that financially healthy for the country? This protects corporate profits, but it hurts the taxpayer.
What I see is the complete breakdown in America of any social policy so that we can adequately maintain normalcy for the middle class. I see the fear of “socialism” — the fear of helping the “bad people” —prohibiting us from taking any substantive action on a health care system that bankrupts too many people simply trying to work and get by and live a regular life. This system is not priced with any sanity, and this hurts everyone since it threatens the health of our nation.
Whether you are Republican or Democrat, you should be able to look at health bills, admit that they are insane and demand action. To demand legislative action for fiscally sensible health care system is not “socialism.” No, I see it as a civic duty, a moral duty. I find the socialism retort infuriating, because the person who says that word to me when I speak of health care pricing and needed reform is usually not looking at the same kind of premium issue that so many families face. To be willfully blind to this is a political liability, and it’s also a moral duck and run.
My wife and I want to insure our family without facing financial ruin. I don’t think this desire makes her an extremist or a socialist — me either. We’re looking at $36,000 alone versus a $10,500-a-year with a plan through Obamacare, which needs improvements, not destruction.
I don’t want to hear any health pricing retorts rooted in fearmongering. I want to hear specific plans — no matter what party is in charge. I haven’t seen any real talk about this in quite some time with our federal government.
The insurance catastrophe of this nation is treated like a joke by those who want to overturn the Affordable Care Act. But it’s no joke for many of us and you shouldn’t have to be employed by the government or a management level employee at a big business to have decent, stable coverage as a middle-class family. This matter needs to transcend partisanship.
Speaking of jokes, that last line sounds like one, doesn’t it?
How do I even dare to use the infinitive verb “to transcend” in 2020?
I guess I can dream of the stars — then bounce back to earth as I wait for the next premium hike.