- Posted June 13, 2012 by
This iReport is part of an assignment:
Are you living without health insurance?
Who Can Afford to Have Healthcare?
- stein0726, CNN iReport producer
If not for the fact that I am enrolled in Medicare, I would be uninsurable in today's market or at least if insured, the cost to insure me would be hitting the stratosphere and impossible to make the premiums.
I, like most Americans, took advantage of my employer-offered health insurance while I was still able to be in the workforce. The premiums were fairly reasonable. But in today's market, both under the Affordable Care Act and if the Supreme Court strikes the law down, health insurance premiums are increasing.
For the vast majority of Americans, we pay for our health insurance year after year, seldom if ever use it. Many of us can go for years paying "just in case" and never have a single reason to make a claim. This is good for the insurance companies and good for those who do need to make claims.
Yet more and more Americans are facing the choice of keeping their employer health insurance or dropping coverage. It boils down to finances. With the dollar buying less and less, many are finding that premiums are going up, not down. It's a choice between groceries or health insurance coverage.
Employers are shifting more of the cost to the employee to offset the rising cost. Some employers are even cutting full-time employees back to part-time to keep from having to pay out as much in premiums, since part-time workers are usually not afforded the benefit of health insurance.
Then there is the uncertainty, waiting to see what the Supreme Court will do with the ACA. This uncertainty has employers holding off hiring. If the ACA stands, employers with 50 or more employees must offer health insurance. Many of these small businesses do not currently offer coverage. Not knowing if in 2014 they will be required to provide coverage, expansion of business and hiring is being put off.
Should the Supreme Court overturn ACA, small business employers may breathe a sigh of relief and begin hiring.
This still leaves many without health insurance.
Many who have followed my healthcare saga, from my hospital room to adapting to a new reality with 1 lung, know were I able to re-enter the workforce, without a ban on denial for pre-existing conditions, I could not get health insurance.
Those insurance companies still willing to take on someone with pre-existing conditions, however, would offer coverage at such a high price, that it would be out of reach.
Even with Medicare, my montly out-of-pocket costs for prescriptions runs $50 to $200+ per month. After Medicare paid, for my most recent hospitalization and surgery and all the follow-ups, my out-of-pocket costs are right at $5,000 so far with more bills coming in each week. Before all is said and done, more than half of my income will be paying my healthcare bills.
My rent already runs me around 40% of my income. When you add the medical bills I must pay out-of-pocket, I'm facing 90% gone. From what is left over I have to figure a way to buy groceries and gasoline to go to my doctor appointments. But without Medicare I would be hitting at over $60,000.
Is there an answer?
I believe there can be if the individual state governments are returned the power and right to develop health care coverage and programs for the ciizens in each state, tailored for those citizens and that particular state.
Why do I say each state should be allowed to tailor its own healthcare coverage program?
For example, one of my conditions, presumed occular histoplasmosis syndrome (POHS) is almost exclusively found in Indiana. There are a few cases in the other Great Lakes region, but nil to none in other parts of the country unless someone migrates from Indiana or the Great Lakes.
Is it practical to have a national healthcare program for POHS when the scope is so limited?
This is an example of why I believe each state must be allowed to develop healthcare programs and means to hold down healthcare costs in each individual state.
Have I ever been denied coverage? No, but if I had to find health insurance today, it would either be non-existant or priced so high I couldn't afford it.
From the Cornfield, there is no easy answer.
As I noted in a report earlier today, whether the Supreme Court overturns or lets stand the ACA, healthcare costs and insurance premiums will continue to rise.
There has to be a solution somewhere to contain this epidemic of soaring prices for healthcare.