An unbelievably sad story coming out of Oxford, OH where a 22 year old woman died this week after reportedly suffering from swine flu and delayed getting medical treatment because she did not have health insurance.
The Miami University graduate was working two jobs and put off going to the doctor with her flu like symptoms due to her lack of health insurance. Read more here.
There is no question about it; our system is broken! Young people are not well-served by the current employer-based system AND 59% of young people working full time jobs aren’t provided coverage. Americans between ages 18 and 29 are the most uninsured age group in the country. We need reform that provides options for young Americans.
Visit our Health Care action center to find out what you can to to support reform.
~Chrissy
Tags: health care, Health Insurance, Miami University, Swine Flu
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Mary Bio: @Rockthevote Email the author at: blog(at)rockthevote.com |
Apparently she did not have swine flu, and ignored the symptoms of what was apparently pneumonia. Once has to assume that a double major at the academically competitive Miami University would have the sense to seek medical assistance–and that her parents would have concurred in her decision regardless of the cost. This is not a story about the lack of medical insurance, but about young people lacking the experience to know what do to in bad situations.
If the above signer is Richard Armitage, then what can one say but: “Shouldn’t you be in Prison?”
Otherwise, what an absolutely horrifying sentiment. Is it somehow on the individual to be able to diagnose their own ailment? More to the point, Kimi, who I had the pleasure of knowing, did not have pneumonia as you find so apparent (perhaps diagnosis SHOULD be left to medical professionals).
Kimi had no health insurance and was working several jobs simultaneously, so clearly money was a factor in her ‘choice’ to not incur crippling medical bills. How dare you place the blame on the deceased or on her parents. THIS IS a story about healthcare, it’s about a bright, hard working girl who is dead because she lived in a country where a person can’t count on being bright or working hard as a means to survival, perhaps you are too callous or pampered to see it.
I agree with Armitage. And this is not the only distortion for political reasons a story like this has occurred.
The Prez himself in his Health Care joint session of Congress speech referred to a man that died because he had lost his health insurance.
The next day, the man’s sister said the insurance was re-instated and had the man neeed treatment and went on to live for more than three years. She was very satisfied with the treatment.
Why would the Prez tell such a fib?
It is definitely a sad story. What a shame this had to happen to such a bright person with so much potential…or anyone for that matter. Surely she would have been eligible for medicaid if her financial situation was so bad. Most universities have medical facilities on site that will treat students for a small cost as well. It is also sad that people are using her death to try to further their cause for universal healthcare. I agree that diagnosis should be left to the medical professionals, but those professionals can’t diagnose a sickness of which they are not aware. It really all comes down to personal responsibility. Everyone is always looking for someone else to take the blame.
right now I’m trying to determine coverage for surgery and find a surgeon in my network…instead of just trying to find the best surgeon.
Today in the Senate Finance Committee they’re debating the amendment to add a public option into the Baucus bill — an option that would have been cost-effective for Kimberly Young, and which wouldn’t have played the kind of ‘gotcha’ games that insurance companies play — denying you coverage for treatment after you’ve already had it — that makes people, especially inexperienced young people, so wary of getting necessary medical care.
Basically, to a healthy young person, it’s absolutely clear that most current insurance options are a scam; they’ll only use insurance if they’re either forced to, or if they feel like they’re offered a policy that works for them, not for corporate profits. The Baucus bill with a strong public option would do both.
I wrote a little blog entry on insurance industry overhead and profits this morning here.
Hey Nick when were you appointed as the voice for all young people? I am a “healthy, young person” and I don’t feel like my health insurance is a scam. Nobody forced me to purchase it.
Shane,
I’m not so gung-ho that I don’t think that good insurance doesn’t exist — that’s why I’m in favor of a public option, that would have a place for our current insurance system, instead of a single-payer system which would put most insurance companies out of business. I’m generally a little bit worried about the Baucus bill’s insurance mandate — I don’t like the idea of forcing people to do anything, either — it only makes sense to me if we have an affordable, worthwhile public option as a choice for the people who would be forced into the insurance market.
I have a feeling that you — and this is unprovable, of course — might feel differently about your health insurance if you ever had a critical or otherwise expensive illness. But that’s just a feeling. Your company might be one of the good ones, and that’s terrific. With MILLIONS of young people uninsured, though, it is clear that the system (that means everybody, not just you) is broken.
Shane –
Sorry, I responded to your more trollish, later comment instead of your earlier, substantive comment.
1) You have to be very poor — surprisingly poor — to qualify for Medicaid. You say “surely” she must have qualified — but if she was working 55 hours a week at minimum wage (or less for more per hour), she wouldn’t qualify.
2) Almost every university will refuse to treat non-students, which includes recent alumni. I’ve been turned away myself.
You say ‘everyone is always looking for someone else to take the blame’. I think it’s a convenient excuse for you to blame Kimberly — it prevents you from taking responsibility for your community, the group of people that support you and allow you to live with the freedoms and privileges you enjoy. Responsibility is bigger than self-responsibility.
Medicaid is different in each state, because it is regulated by the states. Therefore, Nick, your assumptions of qualification are based on the state in which you live, and are likely different than the state where Kimberly lived.
And I agree with Shane, I don’t think my medical care is a scam. I have been covered by three different companies since I turned 18, and all were well worth my money. However, I do know that your experience is often based on your medical condition. My mother, who has a pre-existing condition (childhood epilepsy) was denied coverage as a young parent and now has suffered other medical problems because of lack of good medical care (she can’t afford to pay for everything she needs out of pocket).
Therefore, if I were at the negotiating table, I would focus my energy on fighting for closing the gap in Medicare reimbursement rates (rural vs. urban), tort reform, and insurance company regulations. I think it’s rather ridiculous that people are denied coverage for medical conditions beyond their control. My mother was born with epilepsy, it was nothing that she did wrong. Yet now she can’t get the medical care she needs. Forget about the public option and focus directly on the insurance industry we have. There are many things that are great about our present system. Fix the problems, don’t change the system.
Amy –
You’re right. I was estimating off a mental average, which is sloppy. I should have looked at the eligibility page for Ohio Medicaid, which shows that they only cover children, parents of children, the disabled, refugees and the elderly. That’s right — there is no Medicaid for the childless poor in Ohio. Shows the gravity of the problem.
But you make some really strong points anyway — about how destructive it is to exclude pre-existing conditions, and how Medicaid doesn’t usually cover the working poor. The only thing I’d quibble with is that the creation of a strong public option isn’t ‘changing the system’ — it’s adding to the system, an incremental reform that will give some people the ability to choose standardized, transparent, affordable, publicly operated medical insurance.
If the public option is as bad as its opponents say, it’ll just dry up and disappear: nobody will use it. If it’s better, though, if it can control costs, if it can help insure uninsured young people, then we have a responsibility to put it into place, just as they’ve done in Germany, and in France, and in Belgium, and Switzerland, etc.
The system we have, as I understand it, costs more every year, insures fewer people every year, and gives less care to those who are insured every year. Why not add a strong public option? What’s there to lose?
Creating a public option is not going to keep the costs of medical care from increasing every year. Take a look at two of the government run “insurance” programs currently in existence, medicare and medicaid. The costs of those programs increase significantly every year. I don’t think you can blame Americans if they don’t trust our government to properly run a public option. It is a scary proposition to me and I assume a lot of other Americans. It really seems like a first step on our way to a single payer system. Once they get their public option, they will be back at the trough a few years from now to expand it. Maybe that is not the reality of what would actually happen, but history tells us that it is likely. Social Security is a good example.
The public option could put the private insurors out of business because the same people who would be running the public option, would also be regulating the private insurors. That’s not fair competition. The system we have now is fair competition. Why not regulate our current system more closely?
This is a sad story. But I fail to see how providing insurance for 18-29 year olds is my responsibility. Perhaps these young un-insured should purchase insurance and maybe go without their cellphones, cable TV plans, and internet access. The fact is they make a rational choice not to purchase health insurance. That is their right. The 18 year olds who expect government health care should be more concerned with all the other government obligations they will eventually be responsible for. The current unfunded liabilities of the Federal government (social security, medicare, medicaid, federal pensions and retirement benifits) is 52 Trillion dollars. To pay for these obligations they will be facing in their lifetime a top marginal tax rate of 85%.
Shane –
The government would make no profit from the public option, and would have no reason to run insurers out of business. Germany’s system, in which private and public insurance coexist, is considerably more effective than our current system. Our university system, in which we provide public secondary education, and private non-profits (and some for-profit options) offer advanced degrees as well, works pretty well too — our secondary education (unlike our health care!) is still best in the world.
Craig — your argument shows me that we need to vastly decrease the cost of health insurance. Unlike the cost of cable tv, cell phones, and the internet, health care costs have had double-digit increases every year for the last ten years. The public option is our best — really, on the floor of congress right now, our only — method to control costs. Group negotiation with providers, and negotiation in large enough numbers to make our negotiations stick, has been every industrialized nation’s response to their citizenry’s health needs — except for us.
You may not feel responsible for the health care of 18-29 year olds — I think that is stingy and mean, but it’s certainly an attitude you have a full right to — regardless, the fact remains that you currently cover their care through emergency room cost shifting. Nobody is turned away from an American emergency room: hospitals cover those costs by charging paying hospital patients large amounts over the real cost of their treatment. This is why simple hospitalizations cost exorbitant amounts of money. This is also why even the stingy and mean among us should support an expansion of health care benefits to the poor and unemployed — because the more of them we insure, the less we have to pay in wasteful emergency room spending.
Craig —
I hit ‘submit’ and then remembered — the top marginal tax rate, or the tax levied on the richest Americans, is perfectly reasonable at 85%. In the 1950s, it was at 92%. This tax rate affects a tiny, tiny minority of actual people, and just plain doesn’t make sense as a metric for how much real people will owe the government in the future.
My health insurance costs me $248 a month. I have a $1000 annual deductible and I have copays for doctor visits and medications. My cable/internet costs me $140 a month, my cell phone is $90 a month. If I were really that hard up…I would cancel my cell phone and cable/internet because I don’t feel so entitled as to think someone else should provide for my healthcare. Some people are responsible enogh to take care of themselves and some feel it is someone else’s responsibility to take care of them. Apparently Nick is one of those who feels like his welfare is someone else’s responsibility. Everyone is entitled to have their own ideas about how they want to live their life, but don’t get upset with people if they don’t want to work to provide for those you are too lazy to provide for themselves.
No idea why you would assume that I’m not fully insured or financially self-sufficient, Shane. Maybe someone who is trying to help other people, and wouldn’t personally profit from a change, is strange to you?
Regardless, suffice to say that I happily pay my own way in all matters. I’ll spare you my household budget.
And I’m not upset with you. I just think that you might find — just might find — that when you get sick, that insurance that you pay for might not cover what you expect it to. I want you to have all the insurance you deserve — and competition between private and public options is the best way to get that.
In situations where lower income people are concerned, we’ll have to agree to disagree. The majority of the people I know who can’t make ends meet, both young and old, are trying very hard, but you call them lazy. In any event, all people (whether you dislike them or not) are currently covered under the American emergency room mandate, and Medicaid and SCHIP are simply more humane, cheaper ways to serve the same population.
You assume as if I have no experience dealing with health insurance companies and that is very far from the truth. I sat in a hospital room for 6 months watching my mother die of cancer. Through that whole process I got very familiar with health insurance and how it works. I’m not going to say all of my dealings with the insurance company were pleasant, but everything that should have been covered was covered. She did not have a low deductible plan and the costs, even with insurance coverage, were still significant. The difference between me and you is, I realize that sometimes bad things happen to good people. Instead of dwelling on why it has happened and feeling sorry for myself, my family and I dealt with it and moved on with our lives. I didn’t feel it was necessary to cry to my local representative and ask for other people to pay for my family’s misfortune.
I consider myself pretty liberal but I, unlike you, wouldn’t expect anyone to think that an 85% tax rate is reasonable.
An 85% top marginal tax rate is not an “85% tax rate”. I encourage you to look up a definition and chart of the American top marginal tax rate in the 20th century: it’s fascinating, although pretty much beside the point for this discussion.
The point is: nobody’s whining. Insurance companies taking 15-50% overhead, though, is something that we should all be dwelling on: for every family like yours that managed to pull through, there is one that just couldn’t get the money together, no matter how hard they tried. Imagine if you’d lost your job during your mother’s illness, if your employer had gone bankrupt: what the insurance company skimmed off the top of your health costs would have been really useful. The federal government can provide insurance for something on the level of 8% overhead — the difference would be money in the pocket of working families — money they earned, and money that they deserve.
The idea of the public option isn’t that someone else pays for your family, it’s that more of your family’s premium money is returned to you in the form of benefits. Your anger and your opposition seems to be focused towards redistributive programs like medicaid, medicare, and SCHIP — but Kimberly (the original post seems like such a long time ago!) didn’t need a handout, she needed a reasonable, affordable policy that she could trust. It costs young people who work for small businesses a /lot/ more than it costs the employees of large businesses to get health insurance: this is unfair and needs to stop. A public option — a large group made of all the people who haven’t been able to find insurance in other ways (paying customers of a government service) — would restore fairness and parity to the current system, in which the people who can afford it least pay the highest premiums for the worst care.
I just don’t see how you think that improving our system is “feeling sorry for ourselves” or “crying to a local representative”. The government made the laws in which our current system of insurance operates — we can’t change that system without changing government and law. I know bad things happen to good people. I hate it when bad things happen to good people. I want to stop as many bad things from happening to good people as I can, and the strong public option seems like a great way to start.
Any educated person knows what an 85% marginal tax rate is…and yes it is excessive. Just because at one point we had a higher one, doesn’t make it right.
You are delusional if you think the government can run a public option with 8% overhead. The estimated fraud in medicare is $80 Billion. That’s about 20%. What makes you think that a government that can’t efficiently run medicare, medicaid, or social security would be able to run a public option efficiently? Obama himself has said that the 8% is just an estimate and that it may be higher.
15-50% profit for insurance companies? Really? You care to back that statement up with any facts or sources? Which insurance company specifically had 50% profit? I would like to know so I can go buy their stock.
Top marginal tax rate. Different from a marginal tax rate. Also different from a ‘tax rate’, because the top 1% have ample ability to shield their assets, and tend to keep their effective tax rate below 30%. I really suggest you look into this if you want to talk about it: it’s not something that ‘every educated person’ understands. They don’t teach about it in Civics.
Insurance companies experience fraud too, and it’s not recorded in their overhead numbers — I would be very wary of anyone who is telling you that they can ‘measure’ fraud (survey question 1: are you defrauding the government yes/no?). Medicare, medicaid, and the VA all have a higher satisfaction rate, serve all those they are instructed to serve (they don’t get to pick and choose like private insurance) AND do it for less money per person, with costs increasing more slowly, than private insurance. Just try walking into Congress and saying ‘Medicare doesn’t work, let’s replace it with a…” You won’t be allowed to finish your sentence before getting clubbed to death by cane-wielding Medicare recipients. Seniors know this program is good for them, and they don’t want it changed. For the rest of us, the public option wouldn’t be a silver bullet, but it would be a huge improvement.
If you keep confusing profit and overhead, we really can’t continue this discussion. Profit is the money that insurance companies pay out in stock dividends. Overhead is the money that insurance companies spend on everything other than paying for our health care, which includes salaries, marketing, cost containment (legal struggles over what they’re allowed to refuse coverage for), rent, etc. Overhead really does hit 50%, especially for plans that cover individuals and not groups:
http://economix.blogs.nytimes.com/2009/10/02/what-portion-of-premiums-should-insurers-pay-out-in-benefits/
The situation really is this bad, and it’s getting worse as insurance companies combine into extremely large conglomerates (Wellpoint has a 10% market share nationwide, which is astonishing considering that it’s illegal for a company in one state to sell insurance in another) and gain monopolies in individual regions. Tort reform or interstate trade won’t fix that — we need to compete with these big companies, not make their growth easier.
Top marginal tax rate. Different from a marginal tax rate. Also different from a ‘tax rate’, because the top 1% have ample ability to shield their assets, and tend to keep their effective tax rate below 30%. I really suggest you look into this if you want to talk about it: it’s not something that ‘every educated person’ understands. They don’t teach about it in Civics.
Insurance companies experience fraud too, and it’s not recorded in their overhead numbers — I would be very wary of anyone who is telling you that they can ‘measure’ fraud (survey question 1: are you defrauding your insurer yes/no?). Medicare, medicaid, and the VA all have a higher satisfaction rate, serve all those they are instructed to serve (they don’t get to pick and choose like private insurance) AND do it for less money per person, with costs increasing more slowly, than private insurance. Just try walking into Congress and saying ‘Medicare doesn’t work, let’s replace it with a…” You won’t be allowed to finish your sentence before getting clubbed to death by cane-wielding Medicare recipients. Senior know this program is good for them, and they don’t want it changed. For the rest of us, the public option wouldn’t be a silver bullet, but it would be a huge improvement.
If you keep confusing profit and overhead, we really can’t continue this discussion. Profit is the money that insurance companies pay out in stock dividends. Overhead is the money that insurance companies spend on everything other than paying for our health care, which includes salaries, marketing, cost containment (legal struggles over what they’re allowed to refuse coverage for), rent, etc. Overhead really does hit 50%, especially for plans that cover individuals and not groups:
http://economix.blogs.nytimes.com/2009/10/02/what-portion-of-premiums-should-insurers-pay-out-in-benefits/
The situation really is this bad, and it’s getting worse as insurance companies combine into extremely large conglomerates (Wellpoint has a 10% market share nationwide, which is astonishing considering that it’s illegal for a company in one state to sell insurance in another) and gain monopolies in individual regions. Tort reform or interstate trade won’t fix that — we need to compete with these big companies, not make their growth easier.
You still didn’t give an example of a company with 50% overhead. That’s because it is easy for you to throw numbers out that benefit your arguement. Coming up with the sources to back up your assertions is not quite so easy. Even the source you list doesn’t give an example of a carrier with 50% overhead. Not only that but it is talking specifically about individual health insurance policies which cover a much smaller part of the population than group sponsored policies.
It’s funny you choose to lecture me about differentiating between profit and overhead. I’ll just reference your own words: “What seems absolutely true to me is that even if these costs aren’t considered profit on the company’s 10-K, they are profit: the company investing in its own future enrichment through advertising, and directly profiting the people who make up the company through salary and benefits.” This is from YOUR article YOU posted a link to earlier in this thread. So which is it Nick? Who exactly is it that is confused about profit and overhead?
I never said I wanted to replace medicare. I simply said that anyone who thinks the government can run a public option with 8% overhead is delusional. My example was that the estimated fraud in medicare is roughly 20%. Wouldn’t fraud be included in “overhead”? So what would that make “overhead” on medicare? So I ask you again…How do you expect Americans to trust the government to run a public option when they clearly can’t efficiently run medicare?
The majority of Americans support healthcare reform. What I don’t understand is why a few people latch on to this public option rather than talk about reforming the system we already have in place. If they would just drop this public option, the reform would pass and we would all be that much better for it. Even Obama has waivered on the public option issue. Just drop it so we can get on with fixing the system.
From the article I cited, quoting an insurance industry lobbying group:
“Insurers need to have enough money to pay claims. In most states, individual coverage faces [medical] loss ratios between 55 and 65 percent.”
That’s the industry itself admitting that in MOST places, insurance companies have between 35 and 45% overhead when providing individual insurance policies. No insurance company directly publishes its ‘loss ratio’ — the fraction of their income that they spend on their patients, which they consider a ‘loss’. That’s bad business, because it always leads consumers to ask the question, what are we paying so much for? What do we get from insurance companies, anyway? The answer: not much.
Fraud is not included in measurements of overhead — not for the insurance industry, not for Medicare, not for anyone. Nobody can measure it: if we knew who was perpetrating fraud and how much, we would simply lock them up for it. Opposition to Medicare and the public option often centers around fraud because it’s an easy thing to make up numbers about. It’d be great to decrease fraud — it’s a constant battle, and one worth fighting. It is EASY, though, to decrease overhead: force wasteful insurance companies to compete against a government-run health insurance option. They’ll cut costs. Even the threat of a public option has caused insurance companies to treat patients better: imagine what we can do once we have one.
Finally, the majority of Americans do support a strong public option. Almost two thirds of us do.
http://prescriptions.blogs.nytimes.com/2009/09/25/times-poll-americans-strongly-favor-public-option/
The public option is our best way to fix the system. Health insurance reform without it is just a giveaway to insurance companies, and won’t decrease our costs. There are other ways to do it, and maybe there are better ways nobody’s suggested, but this is by far the best policy on the table right now, better then the Baucus bill, better than the Republican subsidy for the insurance industry, a dozen times better than the status quo. Get on board! If you care about costs and efficiency as much as you seem to, I can’t think of a reason not to support this policy.
What you quoted was an exerpt from an article where the author was quoting information he found on CAHI’s website. The funny thing is, if you read the info on CAHI’s website, they are just speculating on what they think those loss ratios are. It’s really not a good source. You still managed to exaggerate that information by saying 15 to 50% loss ratios. The last time I checked 100 minus 55 is 45. So I ask you again…where is that insurance company with the 50% loss ratio?