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That's My Issue: Fixing Insurance

Wednesday, August 15, 2012

That’s My Issue is WNYC’s election-year project to gather stories of how your life experience has shaped your politics. Share your story and createyour custom badge, read all the stories in the archive, record an audio story directly from your computer, and see much more about the project at the That’s My Issue homepage.

About ten years ago, I got sick. Not terminal cancer sick, but sick enough to the point where I needed to be hospitalized for three days.

What I had was an infected epiglottis. It was pretty dire. I couldn’t even swallow my own spit. I have no real idea how I got it, but I’m sure that my life as a drummer in a rock band and my steady diet of coffee, ramen noodles and whatever heinous food was served to us at the clubs we played didn’t form the best defense barrier against the germs and viruses that were floating around.

I did not have insurance. I wanted insurance, but playing drums in a minor league rock band did not give me the sort of financial wherewithal to get any. Back then, I was more concerned with fripperies like rent. A fiber optic tube up my nose, about five x-rays, three days worth of I.V. antibiotics, a liquid diet, codeine crushed up in my apple sauce and bed rest at a hospital in Northern Virginia would have cost me $15,000, but they let me plead financial hardship and very generously slipped the bill down to $12,000.

It took me about three years to pay it off. I was on a first name basis with the lady from the collection agency (Hi, lady! How are you, babe? Hope you found a better job!), who would chide me when I couldn’t send in any money (“You realize that this is a legal debt, right?”) and would also chide me when I could. (“THIRTY DOLLARS? Is that ALL? You’ll be an old man by the time you pay this off!”)

While I was in the middle of digging my way out of this hole with one pathetic payment at a time, I went down to Richmond, Virginia to do a show and ran into an old friend of mine. We used to play music together, but he very wisely went and got himself a real job, complete with benefits and everything, including the best insurance that his employers offered.

I asked him how things were going, and he said not so well, because he just got out of the hospital. I asked him what the problem was, and he said “Do you know what the epiglottis is?”

It turns out that my buddy had the exact same illness that I did, and he got the exact same treatment that took the exact same amount of time. He even got the codeine crushed up in his cup of apple sauce.

The problem was that his insurance that he got from his employer, the best insurance that they offered, the stuff that took a good bit out of his paycheck every two weeks, had quite a bit of unforeseen leeway in terms of what they would actually pay for and what they wouldn’t. It turns out that they thought that most of those x-rays were unnecessary. And why was he there for three days? A day should have been fine. And what’s with the codeine? We aren’t paying for that. You know, just because. "Listen, I’m a guy in a cubicle with really good software. I know what he needs and what he doesn’t." And so on, and so on.

Two guys, the same illness, the same treatment, one has the best insurance that he can afford and the other one has no insurance at all, and they both end up paying $12,000. I was the irresponsible nimrod who didn’t find a way to get insurance, and then I found out that it probably wouldn’t have mattered if I had.

That was about the time that our profit-driven, insurance-based, cruel, sociopathic debacle of a health care system became my issue. It’s a rip off, and it’s a rip-off that leaves people either in crippling debt, flat out broke, or dead. And if you walk up to me and tell me that that’s “freedom” or “liberty,” I’ll tell you to get your head examined, but then I’ll feel bad about it, because I know that there is no way your insurance company will cover that.

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Comments [3]

Heloise Rathbone from Brooklyn

I usually listen to WNYC several hours a day.

I just looked at "Fixing Insurance." I would like to be able to send that by email to some friends. We have been working to get Single Payer healthcare.

Nov. 05 2012 02:09 PM
Hermine Plotnick from Great Neck, NY

Having retired from a NYS hospital job in 1980, and having had enough years of public service, I have had my medical insurance paid for through the State retirement plan (as a supplement to my Medicare coverage, since age 65) because I had accumulated enough unused sick leave time to cover the cost. Fortunately for me (and, of course the state plan), my continuing robust health has not occasioned the need to "draw" on the plan (I am 84 years old.) However, I have seen many of my age-mates (who also retired after many years of employment in upper middle-class jobs) struggle to pay for needed medications and the other costs of chronic illness, not covered by their insurance. This is troubling on an individual level. However, looking at the situation from a large population perspective, when there are comparisons of health outcomes against spending among the developed nations in the world, the USA (the only developed nation WITHOUT a national health plan,) is near the bottom in each category. Spending more and getting less seems to be the what passes for health insurance coverage for older Americans.

Aug. 16 2012 05:59 PM
jean1 from PA

Wow! I was not expected your essay to end that way. Powerful stuff.

Aug. 15 2012 08:16 PM

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