EVERYTHING
FOR YOUR FAMILY
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As insurance and healthcare costs soar, how will your family cope? Perhaps you’re happy with your health coverage, but few can deny the vulnerability most individuals and families feel when considering such a tenuous necessity as costs are skyrocketing. For instance, what happens if . . . > A child or family member is diagnosed with an illness? Even something as common as asthma can have an overwhelming effect on a family’s budget and future coverage. > Children age out of your policy, but are unable to get employee-based coverage (the largest segment of uninsured in California, 30%, are young adults working full time)? If something happened to them, you could end up paying out of pocket for their care. > A parent becomes ill, and Medicare and their supplements do not cover the costs? (An OC Register article estimates a 65-year-old couple retiring this year will need $215,000 to cover medical expenses for the rest of their lives.) > You’re faced with a sudden illness, layoff, divorce or your company can no longer afford your current level of coverage? As a self-employed writer, I have my own health insurance, but I pay a higher-than-average deductible and am vulnerable to arbitrary premium hikes. (After the first year, I received a rate increase of close to 80% for no reason other than “rising healthcare costs.”) Recently, I attended a statewide “town hall meeting” on the issue of health insurance and health-care reform organized by the bipartisan agency, CaliforniaSpeaks.org. Participants were selected at random to reflect the diversity in California. Despite the fact that most participants had health coverage, 82% said California’s healthcare system is in need of major changes; 14% said it needed minor changes; 1% thought it was fine the way it is; and 3% didn’t know. Families in crisis Forrest and Joyce of Riverside have 3 children in their 20s. One is married with a child, 1 is a ballerina in a touring company and 1 has a history of health problems that leave her extremely vulnerable. None of them has insurance. Their married son is working very hard to get a permanent position with Riverside County, but is still working in the Temporary Assignment Pool. “I’ve been employed by L.A. County for over 30 years,” says Forrest. “I’m not worried for me; I’m worried for my children. And if something does happen to them, who’s going to end up paying? My wife and I, of course.” Joyce has been forced to pay cash for her baby granddaughter’s treatment when a MediCal caseworker denied her approval for an illness. The escalating issues Insurance and healthcare costs are at an all-time high and increasing at more than twice the rate of inflation and wage growth. According to CaliforniaSpeaks.org, “In California, spending on health care was $196 billion in 2004; and at this moment, about 4.9 million Californians do not have health insurance and over 6.5 million Californians (more than 20% of the population) had no coverage at some time during the past year.” Most people are shocked to learn that about half of all bankruptcies in the U.S. are due to medical expenses. Seventy-six percent of people with a medical bankruptcy had health insurance when they first became ill, according to a story in MarketWatch. The problem is self-perpetuating. Our premiums continue to soar in order to help cover the uninsured in what Gov. Schwarzenegger calls “the hidden tax” every insured Californian is paying. “More than 60 emergency rooms have closed over the past decade because they didn’t want to keep treating people without insurance. Unpaid medical bills mean billions of dollars in hidden taxes for the rest of us because those services all have to be paid for. So we pay higher deductibles, costs for treatment, premiums and co-pays,” says Gov. Schwarzenegger. “Companies stop offering coverage, which leads to more people without insurance, and the whole cycle keeps repeating. “The ‘hidden tax’ is estimated at $455 for individuals and $1,186 for families.” Why costs are so high > Growth in chronic disease: About 14 million California adults (38%) have chronic illnesses, such as hypertension, asthma, heart disease or diabetes. A child born in 2000 has a 36% risk of developing diabetes in his or her lifetime. > Complex system structure: California has hundreds of insurers and thousands of policies. Poorly coordinated care and excess administration lead to higher costs. > Limited participation in the insurance pool: When fewer people have coverage, the overall cost of insurance goes up because risk is spread over a smaller number of people. > Conflicting incentives: Providers often make more money on specializing, issuing new drugs, and using expensive tests and devices instead of preventive care or other more cost-effective treatments. > High costs of end-of-life care: The high proportion of costs are spent to extend the life of critically ill patients and the aged. What are the proposals? > Schwarzenegger announced in January that he is creating his own healthcare reform plan. It has not yet been introduced as legislation. (Information detailing his plan can be found on gov.ca.gov.) > The Senate has passed Senate Bill 840 (Kuehl), written by Sen. Sheila Kuehl (also known as the California Universal Healthcare Act); however, the governor vows to veto it if it passes the Assembly. Based on a 1-payer system, this plan would cover everyone and people would still have their choice of providers. (Log onto onecarenow.org for a full outline.) > Senate Bill 8 (Nunez/Perata) is currently a compromise bill in the Senate and Senate Bill 236 (Runner) has not been passed by the Senate. In addition to these, there are other bills sponsored by Assembly Republicans that address related issues, which are vast and confusing, but change is on the horizon. Consumers can educate themselves on the plans out there, the plans proposed and the recourses every American has to ensure we get to a place where access to healthcare is not a right of the privileged, but a basic human right. Susan Belknapp is a senior writer for Churm Media. |
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