Hear my story: COBRA bites

A year ago, I'd have told you that although things weren't perfect, life was pretty darn good. With one kid paying his own way through college, the other adult kid gainfully employed, and our daughter heading into her freshman year of high school, my husband and I were beginning to see a light at the end of the tunnel. We had started thinking about the possibility of traveling a bit, upgrading our townhouse, and socking away more toward retirement. Despite my angst over turning 50, things were looking pretty good.

We're both self-employed, though I had a second full-time job working for a large, solid web company as their blog editor. I was getting rave reviews, our community was growing rapidly, and as far as I knew, things were solid. I'd gone to work for them in 2000 to cover the cost of my health insurance, because it was much too expensive for me to manage as a self-employed person.

That was then. Just a year ago. Things change fast. On December 10, 2008 I received a phone call that I never imagined getting. My newly-assigned supervisor's voice was on the other end, telling me that he was very, very sorry, but the company was making cuts and my position was one of those cut, effective immediately.

My first thought went to our health insurance. Although the company was generous with their severance package, it would only cover the premium for January.  Keeping our health insurance is not optional.

When my middle son was 4, both of us were diagnosed with ADHD. Without going into all of the details, I'll just say that the diagnosis and subsequent search for the right balance of meds, behavior modification, and engagement in areas he had passions for made the difference between his success and failure in school. Because we were able to work with doctors to find the magic mix, he graduated high school with honors, a full scholarship to college, has a part-time job he loves, and a future that's looking pretty bright. Meds were the key that unlocked the door for him, and they aren't cheap, nor do they come with autorenewals. We're required to see the doctor every month for a checkup. Welcome to the world of pre-existing conditions.

The COBRA premium for our family is over $1,700/month. I managed to pay for it for February, but didn't know what we'd do after that. Had the stimulus package not passed with the COBRA subsidy, we'd either be uninsured or tossing money into a high-deductible plan that wouldn't help with the monthly costs of the meds or the doctors' visits.

The subsidy has been a godsend. It's enabled us to keep our insurance and pay the mortgage. The problem is, it ends in November. Congress authorized it for 9 months, and that 9 months will be up on November 30th.

We have a choice to make. Will we pay our mortgage or the insurance premium? (The mortgage is less than the insurance...). We've given up our second car, our office, cut way back on every possible expense, but there is NO cash to pay nearly $2,000 per month for health insurance, assuming they don't increase the premium in December like they have every year for the last 8 years.

I could almost justify opting for the high-deductible insurance and scraping together the monthly meds/visit costs every month, but there's one more twist in our story that just makes me want to scream every time I think about it.

The men on my husband's side of the family have a nasty habit of dropping dead in their mid-50's. One day they're fine; the next they're dead. That fast, from heart attacks. My father-in-law escaped because he had great insurance and was treated for symptoms in time, but he has undergone two bypass surgeries since his 56th birthday.

My husband should have a complete battery of tests -- echocardiogram, regular monitoring, all of it. But we can't. We're afraid to even disclose anything to the doctor beyond a general concern that because of his age, he should be monitored carefully for heart disease. And if we have to drop our insurance and go with the high deductible, there's no chance of us being able to prevent something that's easily preventable.

We're careful. He's nearly at his ideal weight now, he walks 5 miles a day, watches what he eats, doesn't smoke, drink, and stays as zen-like calm as he can. But I'm afraid. Deeply afraid. I have gone to CPR classes, learned about heart attacks, learned what to do, but I'm afraid. It's as simple as that. I don't sleep at night, at least not deeply, because I stay awake to listen for his breathing. It's only when he's up at 5am that I can sleep for a couple of hours before getting up to tackle the day.

This is a fear I live with every minute of every day, a fear I try desperately to control, but one that I shouldn't even have. If insurers cared about prevention, they'd have him in there doing the tests, making sure everything was all right, that there wasn't an undetected blockage (or tendency toward one) that should be treated ahead of a disaster. But that is exactly how you get dropped, or the rates jacked up so high it's impossible to maintain.

Instead, I listen at night to hear him breathe, on guard for anything unusual. I deserve better. My kids deserve better. For $1700 a month, I should be able to sleep at night without wondering if it will be the last time I see my husband. For $1700 a month, I should be able to know my kid can continue with his medication and doctor's visits without a problem. And really, there should be a way to be insured and pay my house payment, rather than risking the loss of our home if he should have a heart attack that he actually survives.

Over there is the rock. On the other side is the hard place. And yet somehow the debate has degenerated into ridiculous allegations about death panels! When I see hysterics waving Nazi signs, claiming that health insurance/care reform is going to mean death panels, I seriously want to yank Sarah Palin up by the hair and ask her how she thinks it would feel to fear every single day that it will be the last one she has with someone she loves. While Sarah spins on and on about nonsense and stirs up every wingnut on the planet, I'm listening to make sure my husband breathes. While Sarah invents ridiculous scenarios about euthanizing Grandma, I'm staying awake, maintaining a vigil, wondering where the common sense in this country has gone.

Here's a picture of us, taken last week on our 20th wedding anniversary. He's a good man. His children adore him. So do I. I truly wonder how the Sarah Palins and Karl Roves sleep at night, knowing they're screwing good, decent, hardworking people with their made-up stories intended to make political hay but without any regard for the people they're stirring and even less for those they're hurting. I wonder how she'd feel if HER child were considered a pre-existing condition.

Instead we're talking about death panels and socialism. Actual people inhabit this issue, despite the cynical manipulators who invent phony monsters to avoid the real ones. We may not have a dramatic story, but it's still our lives and our futures on the line, and we're being extorted to save what little we have left while the Republicans beat their breasts and talk out of both sides of their mouth.

Did I mention that my husband used to be a Republican? Emphasis on the past tense. It's time for the stupid to stop, and common sense to prevail.

Comments

[ozma]

Well, you said it. How do they sleep at night? How? By not giving a damn about anyone but themselves and their cronies. It's the only explanation.

I'm so sorry. This story ENRAGES me. Honestly, I will be the one out there getting hysterical if people like you--or ANYONE--is deprived of health insurance and has to live with this level of fear in a country as rich as ours.

[kgirl]

Oh. My. God.

I can't believe that you and millions of other Americans are put in this position. It is shameful. Shameful.

I just wrote about why your system sucks at Canada Moms Blog. I may sound like a smug Canadian, but when my dad had a massive heart attack, he survived it thanks to our health care system, and MANY medical precautions were taking to ensure that it didn't happen again. All for free.

Seriously, this needs to change. I am outraged for you.

[Mom101]

Am forwarding this everywhere I can.

Thank you.

[Karoli]

Thank you for your support and kind words. I wish beyond all measure that we could have a system like Canada's. Do those idiots out there dissing it realize what I would trade for a night's sleep? Do they think I'd care if I had to wait a few weeks to have him do those tests, to be reassured? They're out there dumping on the Canadians and the British and everyone else because they're OWNED by the same greedy bastards who declare 1 billion dollars in profit for 3 months.

It infuriates me beyond all belief.

[Magpie Ima]

I'm so sorry to hear of your family's worries. If only yours were an unusual story! But I understand all too well.

I have tried to pretend I was OK with my heart rate at 140 for two days just so I wouldn't have to pay the emergency room bills. I ended up going in after all and it took me two years to pay it off.

I have gone without needed tests and monitoring for my Graves disease because I needed to buy food for my kids.

Thankfully, I am now insured through my employer but we don't regularly have the $1400/month to cover the rest of the family. And the cheaper high deductible plan doesn't leave us with enough money to visit the doctor!

Every time one of my boys hops on his bike I say a little prayer, knowing that an accident could lose us our house.

What a country.

[dotlizard]

This is just horrible, and it makes me even more angry hearing the news-rumors that the President is considering giving up the public option. Regulation alone is ... well, something to settle for, and keep fighting I suppose.

We do have a majority supporting health care reform, I just wish that was as well-covered in the news as nutjobs showing up to town hall meetings with assault rifles. Roaming packs of lunatics waving moronic signs might be more "infotainment"-y and ratings-inflating, but they do not represent **the majority**. Real sick and tired of sensationalism getting the airtime instead of the boring old fact-checking and research and you know, journalism (in the archaic sense).

We have to win this. If we have to win it in fits and starts, so be it. We can't give up.

I hope things work out for you & your family.

[Lawyer Mama]

Oh dear god, Karoli. No one should have to live with that!

My hubs *used* to be a Republican too. But he looks at our kids and realizes that everyone deserves affordable health care. My husband, a die hard fiscal conservative, has the ability to empathize with every other parent out there who isn't as lucky as we are. Why can't Republicans do that? I just don't get it.

[susan blatt]

I'm confused about some comments about healthcare in Canada. I am aware they have a government sponsored system, and I am also aware that there are Canadians who are not happy with it. Furthermore, I know for a fact that (twenty years ago) they also had private doctors whom one could pay to see. For severe conditions these private doctors had a huge following, as well as reputation outside of the country.
In some cases well-known Americans consulted with these private doctors and, of course, paid for their visits/treatment out of pocket. I think there's something to be said for the competition of healthcare, as well as competition in all fields.
If I could afford it, I'd chose a private school. Nobody says it's fair...

[Karoli]

Susan, I'm not sure if you're referring to my comments, but Canadians overall are quick to say they wouldn't give up their system for anything, because it's a safety net. That's all I want. A safety net. A way to get the diagnostics, get on a pathway to wellness, preventive medicine. I'm not asking for a bypass here, I'm asking for reassurance that he has a healthy heart and guidance on ways to keep it that way. These men just drop in his family. It's a very real genetic concern, but I can't fathom the disaster we'd have if I tried to actually use the insurance I pay for.

I'm not asking for a private school. I'm asking for a safety net to keep a roof over my head and the head of my children.

[Karoli]

Lawyer Mama,

My husband is still a fiscal conservative. He's gobsmacked by the refusal of the Republicans to acknowledge the financial disaster that looms large for millions of responsible Americans, liberal and conservative alike. It's unlikely that he'll ever be a "big D" Democrat, but he won't be a Republican either. He'll stay centrist and independent. However, he's made it clear that if Dems can't get this done without watering it down, he'll hold them all responsible, starting with Obama. I think we will get it done, and hopefully the way it should be.

[Aviva Gabriel]

Karoli, I'm also sorry to hear of your situation. I wish I could say I was surprised by it, or that it was unusual, or rare. You are not alone in your woes, unfortunately.

I won't go into too many personal details right now, or narrate the stories of friends, neighbors, and family -- suffice it to say that many of us have have little or no coverage for illness -- whether we are lucky enough to have medical insurance or not -- and cannot afford to visit doctors for preventive and routine care.

Many of us have recently begun concealing or minimizing as much of our medical histories as we can, for fear that we'll be denied coverage or dropped from our plans. Many of us have insurance contracts that appear to promise coverage for medical care -- but are actually under no real obligation to honor those comittments.

In my case, I lost my insurance after being laid off in March 2009; my employer of 3.5 years had to terminate 50% of his employees between October 2008 and March 2009, after the 2008 global economic crisis took its toll on his business.

Even with a fairly generous COBRA subsidy that helped me to pay group insurance premiums for April and May of 2009, by June 2009 I found it impossible to maintain participation in my ex-employer's high-deductible insurance plan. I was faced with a dilemma: pay my insurance premium but stop taking my medication, or pay full "retail" price (as usual) for my monthly medication and the requisite doctor's office visit for a prescription renewal.

I know many people in my state who lack access to medical care -- fully-employed folks with advanced degrees, folks who've been purchasing insurance for a decade (or three), folks who are allegedly "insured." For a variety of reasons, their "insurance" doesn't cover them for the medical care that they actually require -- or puts them at risk of being denied coverage for future illnesses.

In Vermont, certain sectors of the population have access to fairly reliable medical coverage.

__________(1) If you're poor, you're covered by Medicaid (which generally doesn't refuse payment for medically-necessary treatment, at least not to the extent that private insurers do).

__________(2) If you're over 65, you're covered by Medicare, which most recipients feel is adequate, or provides superior coverage to that which they had under employer-sponsored health care plans.

__________(3) If you're upper-upper middle class or wealthy, you can generally count on coverage by your insurance company for medically-necessary treatment, or have access to private funds that enable you to purchase medical care (without becoming homeless or destitute).

Otherwise, for all of us who are 'working poor,' lower middle class, middle class, or upper middle class, there is either (a) NO access to medical care, or (b) only limited access, or (c) unreliable access where we can almost certainly predict that we will one day find ourselves "dead out of luck" in the event of actual disease or significant illness.

This week, I've read countless numbers of largely happy stories from folks living in the U.K., Thailand, Sweden, Turkey, Canada, Italy, France, Germany, Switzerland, and Cyprus.

Not once, in all of my research, could I find a case someone was denied coverage for medically-necessary treatment. Not once did I find a case where someone was told they must go home and die, or face a lifetime of untreated disability, because their health care system refused to pay for essential medical care.

In my countless hours of reading, I failed to find a single case where someone was abruptly denied medical care that they had previously been led to believe was available.

Not once did I read a story of someone who hadn't seen a doctor in years because their employer only offered a "high deductible insurance plan" or some other sort of inadequate insurance. In all my hours of research and reading, I never encountered a report where someone was afraid to disclose a familial medical background that placed them (or a family member) at greater risk for diseases like prostate cancer or atherosclerosis.

To the contrary, most folks living in industrialized countries (outside the United States) write that they would be loathe to give up their own country's health care system for the U.S. health care system.