The L.A. Times did a piece over the weekend titled ‘Healthcare reforms’s biggest fans: young adults’. Makes sense to me, we are the least insured age group and more often than not seem to get screwed in the system. From the article, but way too common:
“When Abby Berendt Lavoi graduated from college, she got a job in New York making television commercials as a full-time contractor for one of the largest media companies in the world. She was eligible for health insurance only after she had been working there for a year.
Ten months into the job, Berendt Lavoi came down with painful stomach cramps. Terrified, she used Google to find a hospital that would accept patients without insurance, and underwent surgery to remove an ovarian cyst the size of a softball. The bills came to $12,000. With no savings or assets, Berendt Lavoi turned to her parents, who refinanced their home to pay.”
This story is all too common…I don’t know about you, but I think enough is enough. This is a reform who’s time has come.
~Mary, Rock the Vote
Tags: debt, health care, reform
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Mary Bio: @Rockthevote Email the author at: blog(at)rockthevote.com |
Abby most certainly would have qualified for coverage on her own. She had a full-time job with “one of the largest media companies in the world.” So she should have able to afford a reasonable policy that would have protected her in the case of an emergency, which she sadly had. It seems she made the personal choice not to get coverage, until it was provided through her employer (after a year.) You can purchase coverage without the help of your employer, and she obviously decided against that route.
Hopefully, she is healthy, and got the care she needed. Thanks to the free-market, she will get the benefit of the wonderful technology we have to fight illnesses/diseases, and she should make a wonderful recovery.
Great example! Someone with a well paying full time job that was screwed over by her employer’s policies. This is who we need to protect, young adults that would rather spend their money on iPhones, iPods, internet access, cable TV, XBox games, etc rather than a simple policy, which cost me $150 a month just a year and a half ago. If you know you’ll have no coverage for a year buy a simple policy from Aetna, take some personal responsibility for once in your life, you are a young “adult” after all. If you can’t afford a simple policy, then start asking questions as to why the policy is so expensive, what sort of mandates does your state dictate to private companies that must be covered? Are you an 18 year-old male whose policy has to cover OBGYN visits (happens in some states)? Do you live in a state that only has two private insurance companies selling policies because of the amount of red tape and ridiculous mandates they have to cover for citizens in that state? Would you like to have a policy one of your fiends has in another state but can’t buy across state lines because of federal mandates?
Wake up, blaming your employer or the insurance companies is an easy cop-out for either a lack of responsibility on your part or a failure to demand proper reform from the idiots who started this mess in the first place, Washington politicians and state governments. Insurance companies have to play by the rules set forth in each state and the feds, and don’t get me started about the ridiculous “right” to health care provided by employers.
Think you have it bad? Try working for yourself as a freelance contractor/designer/programmer and you’ll quickly see how bad the feds and the state has their hands in this mess. Sorry if this all sounds rather harsh, but I’m getting tired of hearing those 30 and under – my colleagues – complain about a lack of health care, expecting someone else to pick up the tab (ie employers), while letting government have a pass somehow expecting the morons who caused the mess to fix it yet again.
Hi, Sean!
I wonder where did you get your ‘simple policy’ from Aetna? What did it cover? I think you are in Fort Worth, so after figuring out Aetna’s quote site (IE-only, but they don’t tell you that), I looked at their $150 option — you pay, flat out, the first $1500 you spend a year. After that, they generally pay 80% of your costs. So let’s do the math in Abby’s case:
NO INSURANCE — $12,000 charge, includes prescriptions, office visits, etc.
INSURANCE — $1,800 (premiums, 1 year) + $1,500 (deductable) + $2,400 (coinsurance) = $5,700. This is before the pharmacy and before charging for office visits — which, as I’ve found out first hand, can happen in a hospital — Aetna can bill you every time a doctor comes in to your hospital room and checks you out, but they also include follow-up care. These are covered at %30 after the first two, so let’s say you have eight doctor visits through the whole cyst removal (conservative estimate). $60 for the first two, then an average of $170 for the rest, covered at 30%, is an extra $420. We’re up to $6,120 and we haven’t even been to the pharmacy (which includes all drugs taken during and after hospitalization).
So let’s say you’re 22. Your BEST insurance option is to pay $1800/year (which, in most cases, you don’t have because this is your first job) up front on the chance you’ll get sick and this premium will entitle you to a 50% discount. Why are we complaining about a lack of health care — why are your colleagues (and from your business profile, I think you are actually talking about ‘employees’) suffering? Because insurance companies are straight-up stealing from us, and if we have jobs (=no Medicaid) and aren’t senior citizens (=no Medicare), then we don’t have any other options.
Government regulation tries to keep insurance companies from taking premiums without giving any money back in benefits. It’s CRUCIALLY necessary — if you don’t think so, I’d guess that you’ve never tried to make a non-childbirth claim of $5,000 or more against an insurance company.
Hi Nick,
So are you advocating that all health insurance premiums cover 100% of all procedures, visits and medication without a deductible? Even in the example provided, the employer’s coverage wouldn’t have approached 100% coverage without a deductible. In fact, even the gold plated coverage our members of Congress receive aren’t 100%.
One more quick point about this comment:
“Why are we complaining about a lack of health care — why are your colleagues (and from your business profile, I think you are actually talking about ‘employees’) suffering? Because insurance companies are straight-up stealing from us, and if we have jobs (=no Medicaid) and aren’t senior citizens (=no Medicare), then we don’t have any other options.”
I assume from you last paragraph that your $5,000 claim again the insurance company brought you to the conclusion that “insurance companies are straight-up stealing from us,” however you offer no details as to your plan or the procedures covered by the plan you signup for, nor the incident that caused you to have a $5,000 out of pocket expense. Those facts would help in making your argument, however I find it interesting that you would place the blame wholly on the backs of the insurance company while ignoring that many aspects of government meddling that cause insurance premiums to skyrocket, care to plummet and costs associated with medical practices to become inflated. Using the insurance companies as some boogyman to make you feel better won’t fix the problem.
Now, I’m not suggesting that all insurance companies are run by angels or all hospital administrators are willing to grant discounts on procedures, but insinuating that all insurance companies steal from their customers is a bit disingenuous on your part.
Also, on the part of having issues paying for medical bills, try paying for the hospital bill for your first born when they not only induce, but end up having to perform and emergency c-section, without proper coverage (not all employers have health insurance because the government won’t let us small owners deduct it from our taxes like the corporations). Point is, we all have stories we can tell about large bills, but to claim your problem is that you were fully employed at a large company and that you couldn’t afford insurance is a farce. At some point we need people to stop expecting others to pay for them and take some responsibility for their own lives.
Nick:
I hate to take away from our other thread, but I noticed something in this one.
You gave Sean a quote based on where he lives, but why should where he lives matter. Another regulation that has driven insurance costs through the roof, is the regulation against buying out-of-state health insurance. There is no freedom of choice in limiting which companies you can use. If there were more competition prices would be much lower, and the costs would not be as outrageous as those stated in your above example. However, due to excessive regulations, we are stuck with the next best option, which sadly, is usually higher premiums and higher deductibles.
These insurance companies are stealing from us, we certainly agree on that. The question is how…the answer is ask your representative where his contributions come from.
Note: I am not saying making a profit is stealing!!! I am saying that because the insurance companies/pharma companies are in bed with the politicians in Washington, we are being stolen from by not getting the best value in our health insurance.
As Milton Friedman famously said, “socialism hasn’t worked in 6000 years of recorded history. Why won’t you give up on it?” Making a profit is great, it is American. Socialism doesn’t work in the long-run, everyone ends up broke. The politicians in Washington are the ones making the biggest profits, and yet we want to give them more power? No, thank you.
Hi, Sean!
The expenses I was calculating were those in the original blog post — Abby Berendt Lavoi’s medical expenses. The original post is at the top of the page, above the comments.
The rest of your post confuses me. So — you didn’t have “proper coverage” when your first daughter was born, and therefore incurred large bills, even though you own your own business, and you blame the tax differential between small and large businesses? I’m against the government giving large employers a pass, and charging small employers — I think it’s unfair — but did it never occur to you that the tax is pretty small compared to, say, what you paid due to the fact that your insurance company is trying to make a buck off the birth of your child? Or the extra amount you paid because Texas is one of the least competitive health care markets in America?
Adam:
Just check out real quick — google it yourself, so you don’t think I’m trying to lead you — which party takes more donations from health insurance corporations, and which plans health insurance corporations oppose most strongly. They /hate/ the public option. If we want to break their monopoly power over our markets, we should be doing exactly what they fear and resent most.
PS: Milton Friedman is a kook — and I think you’re both confusing socialist (sharing resources between people for increased benefits for all) and Socialism (an economic system in which government owns many of the means of production). Europe is overwhelmingly socialist when it comes to public health policy — but they’re not really Socialists.
Nick:
I am not a Republican, I didn’t vote for McCain or Bush, so this “which party take more donations” stuff doesn’t mean anything to me. They are all corrupt, you blessed Democrats too. The way to revolt, is against more government, not in favor of more. We agree there is a problem, I just believe you are misdiagnosing the symptoms.
The fact that you say Milton Friedman is a kook tells me all I need to know. It is very dismissive to call someone a kook, or crazy. I don’t agree with everyone Friedman says, but I would never refer to him as a kook. For the record, my thoughts are much more aligned with Adam Smith, F.A. Hayek, Joseph Schumpeter, and Ludwig von Mises. Call me a kook, but those are some of the finest free-market thinkers ever.
As Schumpeter would say, those “social programs” lead to socialism, and that does not end well (See USSR, Argentina, North Korea, the list goes on…)
While i sympathize with Ms. Lavoi’s problem, there are catastrophic personal policies that can be purchased at very reasonable costs. It doesn’t cover the day to day preventive care, but it covers large surgical expenses. Second, regardless of what hospital you go to, insurance or not, they can’t refuse you emergency care, so Googling what hospitals see people without insurance is ridiculus, they all see people without insurance. Third, the hospital can do nothing but send you a bill and try to collect. Fourth, there is no debtor’s prison in the U.S. so the worse they can do is screw up your credit, all of which still does not exclude the person from receiving treatment. Finally, the final bill if you can demonstrate an inability to pay, can usually be negotiated down, then set on a long term repayment schedule so that one can pay what they owe. That is the crux of the matter which is that most who are screaming for a public option, or pointing to stories like this about how the system has failed them leave out the glaring truth and unstated/unknown facts, and that is that it is not a matter of their being no coverage or access to health insurance, there is simply coverage/insurance that one is unwilling or unable to pay the cost of. That comes to the unknown quantity of information which was whether Ms.Lavoi’s lack of coverage was because she did not make enough to secure a policy, or did her style of living leave her without the resources necessary. Loooooooooooooooong before I lose my healthcare coverage for myself and my family, I have frills that can be cut away such as Xbox Live subscriptions, Satellite TV, reduction in cell phone plans, a complete halt to eating out, thrifty smart shopping for groceries and other goods, energy usage reduction at home, and the list goes on and on. The difference is that I know it is my DUTY to secure the health and wellbeing of myself and my family, and that anything that does not directly contribute to providing the basic life sustaining goods and services for us is therefor not a necessity and can be eliminated when necessary. Now if Ms.Lavoi lived a completely frugal life with minimal waste of resources on luxuries, and yet still did not have enough income to secure even the most basic of catastrophic policies, then i sympathize and agree that the system has failed her in a way that should be addressed (albeit by reform, not by overturning an entire system). If on the other hand, she went without simply because maintaining a style of living was more important than securing her own healthcare, well then that is a choice she made, and it is one that should not require me to subsidize her lack of healthcare that she CHOSE not secure herself through her own life choices.
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Hi, Shing.
I have no idea how you can sneer about public responsibility and advocate that people refuse to pay their medical bills at the same time. “There’s no debtor’s prison” is NOT a health care policy that takes care of our communities or supports people.
Your policy of assuming that others enjoy the honestly startlingly long list of creature comforts you’re ready to ‘cut back on’ shows that you have little experience in the real world, where the average American income per household member is $26,000.
The public option doesn’t ‘overturn the whole system’. It provides a government insurance option for those who make too much to qualify for Medicare, but too little to buy expensive and exploitative private insurance. It IS the reform we need in a system that is failing the hardest-working Americans.
Just graduated???…..99% of colleges offer a temporary medical insurance plan called “Grad Med”. You can purchase it in 3, 6, 9 month increments with renewable terms which potentially covers 18 months to 2 years.
Cost is minimal because the universities get group rates. Depending on the state, it could be as low as $300-$400 for 3 months.
$12,000 lesson learned. Ignorance is not an excuse nor is immaturity, irresponsibility or inability to do her homework.
Nick -
Why should I believe Obama when he says I can keep my private insurance? Why should I believe Obama when he says we won’t ration health care?
Here is an article about Ezekeil Emanuel, and it paints a dreary picture of a guy who very close to the President. He is Special Advisor the Health Czar, and brother of Rham Emaunel, White House Chief of Staff.
http://online.wsj.com/article/SB10001424052970203706604574374463280098676.html
Scary stuff. He wants to use mathematical formulas to decide who lives, and who dies…sorry, I mean who deserves treatment, and who doesn’t. Dr. Emanuel believes doctors care too much for their patients, and that is why costs are so high. Yes, that must be the problem, doctors care too much.
Obama has already broken many campaign promises, and very important ones. He said we were going to close Gitmo, and give fair trials to those being held unconstitutionally. Not only has that not happened, but we are expanding Gitmo. This doesn’t sound like a base that will be closing in January. He said we would scale down on our pointless occupation in Iraq. Not only is that not happening, but he is sending more troops to fight in another pointless war in Afghanistan.
Here is a lovely article about Gitmo:
http://naomiwolf.org/2009/07/guantanamo-bay-the-inside-story/
Why should believe Obama on Health Care, when he has already lied to us about closing Guantanamo Bay, and getting us out of Iraq?
Lynn,
Gradmed is not offered by universities or colleges. It is a private insurance program that has affiliate marketing programs with alumni associations, which it renumerates with cash payments.
Additionally, in California, every 180 days (that’s SIX MONTHS) they have the right to recheck your health, and can delist you if it changes considerably. This is /the/ most exploitative and dishonest profit extraction device I have ever seen. It literally insures nothing, and is marketed to the unemployed who have no money to pay for it.
I think you work for an insurance company. I encourage you to carefully read the policies of your employer, and really think about how they affect real people.
Young adults find it so seductive because of their limited experience in dealing with government and their total lack of education on the inevitable repercussions of a socialist government (and yes, despite what the people who think for you may say, Obama’s admin is socialist by definition).
Johnny,
I think for myself. Your assertion is flat out wrong. Socialism, noun:
1. a theory or system of social organization that advocates the vesting of the ownership and control of the means of production and distribution, of capital, land, etc., in the community as a whole.
2. procedure or practice in accordance with this theory.
3. (in Marxist theory) the stage following capitalism in the transition of a society to communism, characterized by the imperfect implementation of collectivist principles.
A government plan to offer fixed- and low-cost health insurance to individuals is not ‘ownership and control’ of ‘production and distribution, capital, land, etc.’ You know what is? The water company. I’m sure that like a good free-marketer, though, you shower in bottled water.
Young adults are smart enough to know that the current system of private insurance is an unregulated monopoly that takes money up front and then breaks their promise to provide benefits. The system is broken, and you’re still fighting the Cold War!
We need reform, but the governement is not the answer. Abby would have waited a long time under a govt. plan. The only way the govt option will reduce costs is by rationing. No way around it. Seniors who have been paying taxes all their lives will be denied when they most need it. We all will be affected with lower quality care. What makes this administration think we can do it bette than the Brits, Canadians, Swedes, Cubans, Russians, etc…??? Companies will drop their coverage and you will have 150-200 million on the govt plan. With the Dr. shortage in this country (about 16,000 short of Gen. Practitioners) good luck trying to find a doctor.
Let’s remove the regulation of having to get healthcare in just your state, that will increase competition big time amongst the 1000+ companies that offer it. Adding the one more in the govt. will just put them all out.
Yes to reform, but the government is not the answer unless you want to take another step towards a Marxist state, which is exactly what BHO and his minions are trying to achieve. thank you.
Nick,
Do you prefer the term Fascism? I will agree Bush/Obama are as much as Fascist’s as anything else.
You are so consistently inaccurate it is remarkable. You continue to spew that we have a free-market health care system, while being shown fact, after fact, as to the contrary.
As Joseph Schumpeter has already described our slow demise (via WikiPedia), “Schumpeter’s theory is that the success of capitalism will lead to a form of corporatism and a fostering of values hostile to capitalism, especially among intellectuals. The intellectual and social climate needed to allow entrepreneurship to thrive will not exist in advanced capitalism; it will be replaced by socialism in some form. There will not be a revolution, but merely a trend in parliaments to elect social democratic parties of one stripe or another. He argued that capitalism’s collapse from within will come about as democratic majorities vote for the creation of a welfare state and place restrictions upon entrepreneurship that will burden and eventually destroy the capitalist structure. Schumpeter emphasizes throughout this book that he is analyzing trends, not engaging in political advocacy. “If a doctor predicts that his patient will die presently,” he wrote, “this does not mean that he desires it.”
In his vision, the intellectual class will play an important role in capitalism’s demise. The term “intellectuals” denotes a class of persons in a position to develop critiques of societal matters for which they are not directly responsible and able to stand up for the interests of strata to which they themselves do not belong. One of the great advantages of capitalism, he argues, is that as compared with pre-capitalist periods, when education was a privilege of the few, more and more people acquire (higher) education. The availability of fulfilling work is however limited and this, coupled with the experience of unemployment, produces discontent. The intellectual class is then able to organise protest and develop critical ideas against free markets and private property, even though these institutions are necessary for their existence” (Capitalism, Socialism and Democracy)
Hmm…Sounds pretty much like our current playbook? Kill the free-markets (in the name of free-markets, of course), create a welfare state (Free Health Care, Free Money, Free Food – none of which is free) and we will all lead happy lives on the road to serfdom. Oh happy day Nick!
For a fantastic look at how much of a free-market health care system we do not have, please watch the following segmant from 20/20.
http://www.youtube.com/watch?v=3WnS96NVlMI
Rock the Vote is a Joke! RTV loves you as long as you go along with obama’s Liberal Communist Agenda. Where’s my Tarp funds. I want a lucritive NEA commission to push an illegal agenda. Where’s my money? Can Soros send me some money? -This is from a Democrat blog-pirate looking fo’ mo’ free money. I never liked Mao, Lenin, or Hitler anyway.
Cosmo,
I don’t think you’re super clear on what the government does in the current system. Medicare is a government program: by threatening seniors with rationing, you’re basically accepting the effectiveness of this large, government entitlement program (I would add that Medicare is considerably more socialist than the public option would be). With the exception of Russia, every state you mention promises basic health insurance at cost (no industry profit) to every one of its citizens, and every one of them gives better care at lower cost to more people than the United States. Sure, health care costs are high in other countries, and can be difficult to pay for — but not as high as they are here, and they certainly don’t have the number of bankrupt citizens we do who lost their homes to health care bills.
We pay the most, we get the least. Where’s the money going? This is from Physicians for a National Health Program:
“The United States has the most bureaucratic health care system in the world. Over 31% of every health care dollar goes to paperwork, overhead, CEO salaries, profits, etc. Because the U.S. does not have a unified system that serves everyone, and instead has thousands of different insurance plans, each with its own marketing, paperwork, enrollment, premiums, and rules and regulations, our insurance system is both extremely complex and fragmented.
The Medicare program operates with just 3% overhead, compared to 15% to 25% overhead at a typical HMO. Provincial single-payer plans in Canada have an overhead of about 1%.”
I do not want a useless middleman industry to PROFIT OFF MY BODY. You will feel the same way, too, the first time you find yourself ill and reliant on a health insurance corporation that is out exclusively to make a buck.
Really, though, past the libertarian stuff government good/bad that a lot of people here are angry about, I am still waiting to see if Lynn will come back. I feel pretty ticked at a lot of people’s shortsightedness, but there is not one person who seems more like an insurance company shill than Lynn.
I’m calling you out, Lynn. How much do you gain personally off the suffering of young people? Are you ashamed of yourself? What happens to someone who signs up for GradMed and then gets sick during the coverage period? What happens during the 180-day review?
And for you, Cosmo or Johnny or Shing — go look at the gradmed site, punch in a school somewhere, and read the terms. Would you buy this? Do you think that this should be a legal product to sell unemployed 21 and 22-year olds? Is this the health insurance that Americans deserve?
Rock The vote is a JOKE! since when does rock the vote involve bill, and policy? you know the things WE CANT VOTE ON! Rock the vote was supposed to be about getting people out to vote, but it turned into a Democrat PAC.
Never heard crap from RTV during the Bush years, but as soon as vote time came they went around throwing out “CHANGE” buttons and shirts to all the “hip” areas, like colleges and Mtv functions.
Now this joke committee is gonna kiss the Obama butt more and push the Health care reform???
And now we have the typical Lib. Nick who spouts off every little Government okay-ed press release and runs with it over and over and over again without any REAL research, and then when someone blindsides him with TRUTH and REALISM, he can only re hash the SAME THING HE ALREADY SAID, OVER AND OVER AND OVER again, and when he can’t win he tucks tail and goes back to the same rhetoric again and again… look above, Nick stops going after Adam, because Adam is to smart for him, so he’ll call out Lynn who only posted once, the day before. Cosmo, Johnny and Shing also only posted once, and you have NO comeback to them.. you never addressed Teabagger… Nick, you and your party is a JOKE no wonder you subscribe to the Rock The Vote campaign
Here’s some REAL EDUCATION FOR YOU!
As recently as the 1960s, low-cost health insurance was available to virtually everyone in America – including people with existing medical problems. Doctors made house calls. A hospital stay cost only a few days’ pay. Charity hospitals were available to take care of families who could not afford to pay for health care.
Since then the FEDERAL GOVERNMENT has increasingly intervened through Medicare, Medicaid, the HMO Act and tens of thousands of regulations on doctors, hospitals and health-insurance companies.
Today, more than 50 PERCENT OF ALL HEALTH CARE DOLLARS ARE SPENT BY THE GOVERNMENT.
Health insurance costs are skyrocketing. Government health programs are heading for bankruptcy. Politicians continue to pile on the regulations.
the only health care reforms that will make a real difference are those that draw on the strength of the free market.
Establish Medical Saving Accounts.
Deregulate the health care industry.
Remove barriers to safe, affordable medicines. (The dangerous FDA that makes drug companies spend millions to get approved who then pass the costs onto customers to recoup their losses. and then if the drug which the FDA approved should cause bad side effects or death the FDA runs and hides but shouts “sue the drug maker not us!” )
Now Nick… who’s shortsighted? Your ignorance is laughable!
No wonder you support RTV