My opinion letter to the "Chicago Tribune" regarding a public choice for health coverage

terato · June 2009

www.chicagotribune.com/news/opinion/letters/chi-090617kosinski_briefs,0,2232068.story
chicagotribune.com

Insurance companies should prove public option won't work

June 17, 2009

Opponents of a public option for health-care coverage should stop deluding themselves into believing private health insurance companies don't already ration health care when they deny coverage to applicants with pre-existing conditions or disallow a claim submitted by a client for a life-preserving procedure.

Insurance companies are only concerned with their respective bottom-lines, not health-care delivery, and fear competition from a public option having health-care delivery as its sole objective.

Facing competition from a public option might compel private health insurance companies to reduce executive compensation, trim bureaucracies and paperwork, simplify policy language and eliminate exclusions and reduce client premiums.

If private health insurers really believed they had superior products to what the government might offer, they would demand market competition to prove it.

-Richard A. Kosinski, Chicago

Copyright © 2009, Chicago Tribune

MichelleP · June 2009

Seriously? Neither private
Seriously? Neither private nor government insurance is going to take care of us properly! I don't like my private insurance but government run insurance terrifies me! I'll stay where I am thanks. But then, that's my opinion and hopefully my choice.

terato · June 2009

MichelleP said:
Seriously? Neither private
Seriously? Neither private nor government insurance is going to take care of us properly! I don't like my private insurance but government run insurance terrifies me! I'll stay where I am thanks. But then, that's my opinion and hopefully my choice.

And, I wouldn't want it any other way!
Michelle,

However, many are denied any choice because their cancers occurred prior to applying for individual insurance (in my case, it was over 20 years prior to applying!), none-the-less, it is considered a "pre-existing condition". Everyone should have the right to health coverage, be it public or private. Thanks to my employer, I have coverage. Others are not so fortunate.

I am happy that both of us possess insurance coverage and want all Americans to enjoy the same security.

Love and Courage!

Rick

lindaprocopio · June 2009

terato said:
And, I wouldn't want it any other way!
Michelle,

However, many are denied any choice because their cancers occurred prior to applying for individual insurance (in my case, it was over 20 years prior to applying!), none-the-less, it is considered a "pre-existing condition". Everyone should have the right to health coverage, be it public or private. Thanks to my employer, I have coverage. Others are not so fortunate.

I am happy that both of us possess insurance coverage and want all Americans to enjoy the same security.

Love and Courage!

Rick

There is no CHOICE for people now with private insurance.
I have my own business (and had it pre-cancer) and always carried one of the extremely over-priced private insurances that are the only options for small businesses who are not a part of a 'group'. I held my breath when my first 'renewal' came up after my cancer diagnosis and many huge "claims", knowing that no matter how much my insurer increases my premiums, I will not be able to 'shop' for a more-affordable health insurance option now. No other health insurer is going to take me now and cover my 'pre-existing condition'. I was happy that my insurance only (only!) went up another $130/month. And we see people all the time posting here who stay in loveless marriages and horrible jobs JUST to keep their insurance coverage.

All I hope for in the new universal health care plan is the opportunity to buy into a GROUP plan, where the insurer's risk of taking on a cancer patient is offset by the many healthy people who are also paying in, and the insurance company's payouts are financially justified by the many decades I personally paid for health insurance with no claims. My fear is that this new government-directed insurance option will be available only for those who have NO health insurance coverage, rewarding those who were less responsible, and penalizing/excluding people like me who have been paying $12,000 to $15,000/year for coverage by making us ineligible to participate in the government-sponsored plan. I can easily see it playing out like that, in an effort to protect the viability of private insurance companies.

But this country has to do something. We can't allow so many Americans to go without healthcare and still consider ourselves a civilized nation.

terato · June 2009

lindaprocopio said:
There is no CHOICE for people now with private insurance.
I have my own business (and had it pre-cancer) and always carried one of the extremely over-priced private insurances that are the only options for small businesses who are not a part of a 'group'. I held my breath when my first 'renewal' came up after my cancer diagnosis and many huge "claims", knowing that no matter how much my insurer increases my premiums, I will not be able to 'shop' for a more-affordable health insurance option now. No other health insurer is going to take me now and cover my 'pre-existing condition'. I was happy that my insurance only (only!) went up another $130/month. And we see people all the time posting here who stay in loveless marriages and horrible jobs JUST to keep their insurance coverage.

All I hope for in the new universal health care plan is the opportunity to buy into a GROUP plan, where the insurer's risk of taking on a cancer patient is offset by the many healthy people who are also paying in, and the insurance company's payouts are financially justified by the many decades I personally paid for health insurance with no claims. My fear is that this new government-directed insurance option will be available only for those who have NO health insurance coverage, rewarding those who were less responsible, and penalizing/excluding people like me who have been paying $12,000 to $15,000/year for coverage by making us ineligible to participate in the government-sponsored plan. I can easily see it playing out like that, in an effort to protect the viability of private insurance companies.

But this country has to do something. We can't allow so many Americans to go without healthcare and still consider ourselves a civilized nation.

Linda, I am frightened by a compromise.
During the spring of 2001, I was seeking an alternative to the high COBRA premiums I was paying since the close of my development and public relations office a few months earlier and on becoming a substitute teacher, an “independent contractor” position affording no health benefits. I applied for a number of popularly advertised individual health insurance plans, only to be repeatedly rejected for coverage, not for some current health problem, but for my previous diagnosis and treatment for testicular cancer (Lance Armstrong's disease), which was successfully concluded in 1982. Despite a letter from my oncologist stating that the medical community recognizes cures for testicular cancers, the largest insurer in Illinois refused to reconsider my application for individual coverage. I should not have been surprised, because the application packet plainly stated that applications from those with histories of cancer, heart disease, diabetes, and other illnesses would not be accepted, and I was still receiving annual tumor marker blood tests and occasional CT scans when specific markers appear elevated. Subsequent applications to competitors were also declined, because it appears that, once one company rejects an applicant for individual coverage, no other company will accept him/her either. Fortunately, I now enjoy group coverage with my employer, for which I am eternally grateful, but who can predict the future?

Why is discrimination because of health history or pre-existing condition any more permissible than discrimination because of gender, race, religion, or ethnicity? Even if the insurance industry agrees to accept applicants with pre-existing conditions now, that does not mean that private insurers will not invent some excuse for abandoning that agreement when their "friends" in Congress are back in power again. REAL terror is suffering a stroke or finding a tumor the day after your COBRA coverage expires.

Love and Courage!

Rick

(Linda, I was notified by a previous employer for whom I had done contract work that a staff position with health benefits had become available on the day of my mother's funeral. Thanks, Mom!)

slickwilly · June 2009

terato said:
Linda, I am frightened by a compromise.
During the spring of 2001, I was seeking an alternative to the high COBRA premiums I was paying since the close of my development and public relations office a few months earlier and on becoming a substitute teacher, an “independent contractor” position affording no health benefits. I applied for a number of popularly advertised individual health insurance plans, only to be repeatedly rejected for coverage, not for some current health problem, but for my previous diagnosis and treatment for testicular cancer (Lance Armstrong's disease), which was successfully concluded in 1982. Despite a letter from my oncologist stating that the medical community recognizes cures for testicular cancers, the largest insurer in Illinois refused to reconsider my application for individual coverage. I should not have been surprised, because the application packet plainly stated that applications from those with histories of cancer, heart disease, diabetes, and other illnesses would not be accepted, and I was still receiving annual tumor marker blood tests and occasional CT scans when specific markers appear elevated. Subsequent applications to competitors were also declined, because it appears that, once one company rejects an applicant for individual coverage, no other company will accept him/her either. Fortunately, I now enjoy group coverage with my employer, for which I am eternally grateful, but who can predict the future?

Why is discrimination because of health history or pre-existing condition any more permissible than discrimination because of gender, race, religion, or ethnicity? Even if the insurance industry agrees to accept applicants with pre-existing conditions now, that does not mean that private insurers will not invent some excuse for abandoning that agreement when their "friends" in Congress are back in power again. REAL terror is suffering a stroke or finding a tumor the day after your COBRA coverage expires.

Love and Courage!

Rick

(Linda, I was notified by a previous employer for whom I had done contract work that a staff position with health benefits had become available on the day of my mother's funeral. Thanks, Mom!)

No high expectations here
We all know the horror stories of those without insurance. Some of us have family members or children without insurance. And even with good insurance we watch people lose everything while fighting cancer. I have no expectation that our politicians in Washington can do anything right. If that was the case we would not be in a recession over the banking fiasco that everyone turned a blind eye too. And our veterans would not be having issues with the veterans hospitals.
Common sense would tell you that we should look at every other country and see what has worked and what does not work. And we are going to pay one way or another. I am not impressed by Germany and its 50% income tax rate my cousin was paying. Along with the taxes on every water tap, radio and T.V. in a home. Or France that is billions in the hole. Or Canada with its waiting list so long that people are dying before they get needed surgery.
If health care in going to be reformed then slow down and do it right the first time. Put every politician and their families on it and problems will be fixed faster. Slickwilly

soccerfreaks · June 2009

slickwilly said:
No high expectations here
We all know the horror stories of those without insurance. Some of us have family members or children without insurance. And even with good insurance we watch people lose everything while fighting cancer. I have no expectation that our politicians in Washington can do anything right. If that was the case we would not be in a recession over the banking fiasco that everyone turned a blind eye too. And our veterans would not be having issues with the veterans hospitals.
Common sense would tell you that we should look at every other country and see what has worked and what does not work. And we are going to pay one way or another. I am not impressed by Germany and its 50% income tax rate my cousin was paying. Along with the taxes on every water tap, radio and T.V. in a home. Or France that is billions in the hole. Or Canada with its waiting list so long that people are dying before they get needed surgery.
If health care in going to be reformed then slow down and do it right the first time. Put every politician and their families on it and problems will be fixed faster. Slickwilly

Look before you leap
Your last sentence says it all, slickwilly, at least with regard to politicians at the national level. Those boys and girls enjoy the best health package that the people can pay for. And pay we do.

Beyond that, your reference to programs in other countries strikes a chord as well. I recall my friend cheekymonkey (Helen) trying anxiously, aggressively and ultimately to her dying day (she was a member here) to get drugs prescribed to her, fighting through a UK bureaucracy that moved just ever so slowly. Another UK friend indicated to me that had Helen lived in HER neighborhood, a tad more upscale, the red tape would have moved much more quickly.

Helen died.

And I hear all the time from friends in Canada and elsewhere who complain of poor practice, poor manner, poor treatment.

This is all second-hand, of course, and I would not suggest that public health care is not a necessity in this country (nor around the world). I would, however, ask what those who use the VA (Veterans Affairs) medical system think of that gem? Living in what is considered THE military town if there is a single one in this nation, I read every day about the nightmares that our veterans must become accustomed to -- both new veterans and elderly ones -- if they are to use that system.

It is an atrocious system, beginning with infrastructure and ending with care at the topmost levels.

And it is government run.

I happen to think a great deal of Rick and point people to his posts and responses whenever I think they are appropriate. He does good for all of us, and if he ever gets his license to practice law, I am going to ask him to represent me, and I mean that sincerely (so get on it, Rick), but I am like you on this one, willy. Show me an alternative that works.

I want one. Show me.

Take care,

Joe

terato · June 2009

soccerfreaks said:
Look before you leap
Your last sentence says it all, slickwilly, at least with regard to politicians at the national level. Those boys and girls enjoy the best health package that the people can pay for. And pay we do.

Beyond that, your reference to programs in other countries strikes a chord as well. I recall my friend cheekymonkey (Helen) trying anxiously, aggressively and ultimately to her dying day (she was a member here) to get drugs prescribed to her, fighting through a UK bureaucracy that moved just ever so slowly. Another UK friend indicated to me that had Helen lived in HER neighborhood, a tad more upscale, the red tape would have moved much more quickly.

Helen died.

And I hear all the time from friends in Canada and elsewhere who complain of poor practice, poor manner, poor treatment.

This is all second-hand, of course, and I would not suggest that public health care is not a necessity in this country (nor around the world). I would, however, ask what those who use the VA (Veterans Affairs) medical system think of that gem? Living in what is considered THE military town if there is a single one in this nation, I read every day about the nightmares that our veterans must become accustomed to -- both new veterans and elderly ones -- if they are to use that system.

It is an atrocious system, beginning with infrastructure and ending with care at the topmost levels.

And it is government run.

I happen to think a great deal of Rick and point people to his posts and responses whenever I think they are appropriate. He does good for all of us, and if he ever gets his license to practice law, I am going to ask him to represent me, and I mean that sincerely (so get on it, Rick), but I am like you on this one, willy. Show me an alternative that works.

I want one. Show me.

Take care,

Joe

That is why we need to test a public option!
Slick and Joe,

That is why we need to put a public option against private insurers to learn which performs better for patients. Linda is correct when she states that we really have no choice with what we have now. Why can't we have both a public option for us "uninsurables" and commercial options for everyone else? The private insurers don't want us anyway, I have their rejection letters to prove it!

If you ask Janet to the prom and she turns you down, don't you have the right to ask Elizabeth? I' just sayin'!

Love and Courage!

Rick

P.S.: Joe, I was ready to begin law school in 1985 (three years after concluding treatments), but never showed up for my first day of classes, after taking a job with health benefits.

slickwilly · June 2009

terato said:
That is why we need to test a public option!
Slick and Joe,

That is why we need to put a public option against private insurers to learn which performs better for patients. Linda is correct when she states that we really have no choice with what we have now. Why can't we have both a public option for us "uninsurables" and commercial options for everyone else? The private insurers don't want us anyway, I have their rejection letters to prove it!

If you ask Janet to the prom and she turns you down, don't you have the right to ask Elizabeth? I' just sayin'!

Love and Courage!

Rick

P.S.: Joe, I was ready to begin law school in 1985 (three years after concluding treatments), but never showed up for my first day of classes, after taking a job with health benefits.

Options
Rick. Right now I am sitting on the fence with the health care issue. Its hard to be for or against something we have not seen. I am one of those people that wants to know all the information and what the ramifications are going to be. I am not against an overhaul of our health system with reductions in the huge costs. I am not against some sort of insurance my children can afford. But at the same time I don't want to lose what I have because it saved my life. In a perfect world everyone in Washington would work together for the common good of the country. Without outside influence from special interest lobbies or some hidden agenda. They would think every part of this bill through and help the people that needed help. They would come up with a plan that is less costly for business without taking away our ability to get medical tests, procedures ect in a timely manner. At the same time I realize that big business has the larger voice in Washington. I am just a taxpayer that didn't contribute to any political party so Slickwilly is not mentioned during the daily Whitehouse briefings. If I was sinking in a boat and put in for a bailout the government would proubly take my bailing bucket. So I guess we will all wait and see and hope that something good comes out of all of this. Slickwilly

terato · June 2009

slickwilly said:
Options
Rick. Right now I am sitting on the fence with the health care issue. Its hard to be for or against something we have not seen. I am one of those people that wants to know all the information and what the ramifications are going to be. I am not against an overhaul of our health system with reductions in the huge costs. I am not against some sort of insurance my children can afford. But at the same time I don't want to lose what I have because it saved my life. In a perfect world everyone in Washington would work together for the common good of the country. Without outside influence from special interest lobbies or some hidden agenda. They would think every part of this bill through and help the people that needed help. They would come up with a plan that is less costly for business without taking away our ability to get medical tests, procedures ect in a timely manner. At the same time I realize that big business has the larger voice in Washington. I am just a taxpayer that didn't contribute to any political party so Slickwilly is not mentioned during the daily Whitehouse briefings. If I was sinking in a boat and put in for a bailout the government would proubly take my bailing bucket. So I guess we will all wait and see and hope that something good comes out of all of this. Slickwilly

"Death by no insurance"
Slick,

I would not want to lose the coverage I Presently enjoy because of my employer either, but I understand that my job status could change and I could be uninsured, following a COBRA period, with no ability to become insured because I have a cancer history and am ineligible for individual health insurance. Both of us could wind up like Shirley Searcy in the following article. You may want to check out the website at the end of the article to learn what this physicians' group has to say about why the present system fails so many patients. Slick, I have made advocacy for cancer patients' rights a personal crusade since the 1980s and have examined reliable arguments from both sides. United States pays more, yet receives poorer outcomes than most other western nations.

"Health Care Spending in the United States and OECD Countries
January 2007

Health spending is rising faster than incomes in most developed countries, which raises questions about how these countries will pay for future health care needs. The issue may be particularly acute in the United States, which not only spends much more per capita on health care than any other country, but which also has had one of the fastest growth rates in health spending among developed countries. Despite this higher level of spending, the United States does not achieve better outcomes on many important health measures..."
http://www.kff.org/insurance/snapshot/chcm010307oth.cfm

Death by no insurance?

Doctor and patient had colon cancer. She was uninsured and died. He is alive, convinced she could be too.

By Lindsey Tanner
Associated Press
Published April 4, 2007

Dr. Perry Klaassen lived to tell about his frightening ordeal with colon cancer.

His patient did not.

Same age, same state, same disease. Striking similarities, Klaassen thought when Shirley Searcy came to his clinic in Oklahoma City. It was July 2002, a year after his own diagnosis.

But there was one huge difference: Klaassen had health insurance, Searcy did not.

His treatment included surgery two days after diagnosis and costly new drugs. He is alive six years later despite disease that has now spread to his lungs, liver and pelvis.

“I received the most efficient care possible. I was 61 years old and had good group health insurance through my workplace,” he wrote in a medical journal essay that contrasts his care with that of his uninsured patient.

The doctor didn’t name Shirley Searcy in his March 14 article. After all he’d been through, he couldn’t remember her name. But he dug for days through old medical files searching for her identity after he was interviewed by The Associated Press, hoping to shine a more powerful light on the plight of the uninsured.

The widowed mother of eight grown children, Searcy had little money. When she began to sense she might be sick, she put off going to the doctor for a year because she knew she couldn’t pay the medical bills. Deeply religious, she put her faith in God, according to her family.

By the time she saw Klaassen, her cancer had spread from her colon to her liver. She had surgery but rejected chemotherapy.

“She just really didn’t feel like she wanted to endure what that would cost physically or financially,” said her daughter-in-law, Karen Searcy.

Shirley Searcy died Dec. 22, 2003, about 18 months after her diagnosis.

Searcy’s is a story that’s far from unique. An estimated 112,000 Americans with cancer have no health insurance, according to Physicians for a National Health Program.

Klaassen’s essay in the Journal of the American Medical Association illustrates the issue “close and personal,” said the publication’s editor, Dr. Catherine DeAngelis.

It underscores that insurance can be a life or death issue, said Paul Ginsburg, president of the Center for Studying Health System Change, a non-partisan policy research organization.

Klaassen, now 67, no longer sees patients but works part-time as medical director of an Oklahoma City group that recruits doctors to give free care to needy patients.

Always healthy and vigorous, his diagnosis in 2001 came as a shock.

Klaassen had a colonoscopy within two weeks after seeing his doctor for pain in his lower abdomen. When the specialist with the results asked, “Is your wife with you?” Klaassen wrote, “I knew immediately that I had colon cancer.”

Surgery two days later showed the disease had spread outside the colon wall and to nearby lymph nodes. It was not as advanced as Searcy’s, whose disease had spread to the liver.

Searcy married young and had her first child in her teens. Her mechanic husband died in a 1978 car crash, leaving her to raise the family alone. Social Security helped, but the Searcys never had anything extra, family members said.

“Life dealt her more I guess than some people have been dealt,” Karen Searcy said.

She didn’t work outside the home, didn’t venture often beyond her 4 acres and the ranch house where she raised her children in Blanchard, about 30 miles from Oklahoma City. In her later years, reading stories to her dozens of grandchildren was a favorite pastime. She’d figured she’d live long enough to qualify for Medicare at age 65, family members said; she missed it by a year.

“She put off [seeing a doctor] because of no health insurance, and she wanted to trust the Lord. She was hoping to be healed,” said her daughter, Melba Spalding.

Klaassen knew immediately that it was colon cancer when she saw him. A colonoscopy weeks later confirmed the diagnosis and that it was incurable.

It was “heartbreaking to all of us,” Spalding said. The family had always been close, and Searcy “was pretty well the hub of it,” she said.

With insurance, Searcy would have sought treatment sooner, family members said.

“I believe with all my heart that if she had gone to a doctor early on, that she would still be living,” Karen Searcy said.

Klaassen also thinks things would have turned out differently if she’d been insured.

“If she had survived at least a year more, she would have had new pills available to her,” the same ones that have helped control his disease, Klaassen said.

“People say … nobody ever dies because they don’t have insurance, and I say, ‘Yeah, they do.”

Copyright © 2007, Chicago Tribune

http://www.pnhp.org/news/2007/april/death_by_no_insuranc.php
____________________________________________________________________________

The United States must provide a practical option for people like Shirley, and possibly, for people like us.

Love and Courage!

Rick

Unknown · August 2009