For the first time in my life, I am without health insurance and it is a terrible feeling.
In the past, I paid attention to the health care debate as a speechwriter who prepared speeches, talking points, op-eds, and debate prep material on the topic at different times for John Edwards, Barack Obama, Hillary Clinton and others. Now, I’m paying attention because I’m a citizen up the creek without a paddle.
Throughout my life, I have been very lucky because my insurance has always been there whenever I had a crisis. When my 10-speed hit a patch of leftover winter sand, and I went flying into a telephone pole, it covered the x-rays and stitches and concussion diagnosis. When a half a ton of sheet rock fell on me, my insurance paid for the cast on my foot. When my depression kicked in and I was hospitalized and painting ceramic pieces in art therapy to boost my self-esteem (sheesh), it made sure that when I got home my medical bills didn’t make me reach for a razor. And when there were growths in my uterus, it covered that medical procedure and every regular check-up, lab test, broken bone, sports injury, and antibiotic prescription in between.
Since I care more about my country than my personal pride, here’s how I lost my insurance: I moved. That’s right, I moved from Washington, D.C., back to Massachusetts, a state with universal health care.
In D.C., I had a policy with a national company, an HMO, and surprisingly I was very happy with it. I had a fantastic primary care doctor at Georgetown University Hospital. As a self-employed writer, my premium was $225 a month, plus $10 for a dental discount.
In Massachusetts, the cost for a similar plan is around $550, give or take a few dollars. My risk factors haven’t changed. I didn’t stop writing and become a stunt double. I don’t smoke. I drink a little and every once in a while a little more than I should. I have a Newfoundland dog. I am only 41. There has been no change in the way I live my life except my zip code — to a state with universal health care.
Massachusetts has enacted many of the necessary reforms being talked about in Washington. There is a mandate for all residents to get insurance, a law to prevent insurance companies from denying coverage because of a pre-existing condition, an automatic enrollment requirement, and insurance companies are no longer allowed to cap coverage or drop people when they get sick because they forgot to include a sprained ankle back in 1989 on their application.
Even if the economy was strong and I was working more, I still couldn’t afford my premium. I am not alone; I’ve got 46 million friends in a similar situation. We wake up every day worried that a bad cough, an accident while walking the dog, or that dreaded pain on the right side of the abdomen will send us into complete financial ruin.
As luck would have it, I didn’t schedule a physical before I left D.C. I thought I could get that taken care of when I moved — after all they had reforms, automatic enrollment, and universal coverage in Massachusetts, all the things I’d written about for politicians. Health care would be affordable. It didn’t dawn on me that it would just be affordable for other people.
Now, sharing my experience doesn’t make me an expert in health care policy anymore more than my knowledge that Kajagoogoo sings “Too Shy” makes me an expert in music. What my story does is serve as a cautious reminder that we need to get this right, not right away. A rushed bill will have consequences. Reforms will not be cheap and some people may be priced out.
How could all of these weeks and months go by and no one is examining and talking about what has worked and what hasn’t worked in Massachusetts?
While the state has the lowest rate of uninsured, a report by the Commonwealth Fund states that Massachusetts has the highest premiums in the country. The state’s budget is a mess and lawmakers had to make deep cuts in services and increase the sales tax to close gaps. The number of people needing assistance has at times overwhelmed the state. The mandate means that some people who can’t afford insurance are now being slapped with a fine they also can’t afford. There is no “public option” in the way the president describes it, no inter-state competition, no pool for small businesses and self-employed individuals like me to buy into groups that negotiate cheaper rates. So far I haven’t found any “death panels,” but if I get sick and need a hospital, I sure hope I can find one and a feisty granny to pull my plug.
What makes this a double blow is that my experience contradicts so much of what I wrote for political leaders over the last decade. That’s a terrible feeling, too. I typed line after line that said everything Massachusetts did would make health insurance more affordable. If I had a dollar for every time I typed, “universal coverage will lower premiums,” I could pay for my own health care at Massachusetts’s rates.
So far, the most informed and civil discussion I’ve had about this issue has been with some of the sales representatives with the top providers in Massachusetts as I searched for an affordable plan. Each person I talked to was kind and considerate and truthful. One man said that he prepares everyone for the “sticker-shock,” whether they are a family of four or an individual.
Right now, the truth is if I could buy my health plan from D.C., then I would. If I could buy into a public option, co-op, or trigger plan, whatever they want to call it, then I would. If I qualified for the new exchange, then I’d get into that, too, but four years is a long time to go without a physical, pap smear, and to have this mole checked. If someone were to put Medicare for All back on the table, then I would be fine with that too. Honestly, it’s starting to make the most fiscal sense: $450 billion we pay to insurance companies could be redirected to Medicare, $350 billion in savings in paper work, and of course that $500 billion in savings for “waste, fraud, and abuse.”
If this country is about to gamble a trillion dollars plus — and it will be a big plus no matter what the Congressional Budget Office projection is — then why not use a system that already exists? My experience in politics has been any time a politician says $500 billion will come from “waste, fraud, and abuse” that’s a fancy way of saying, “Hold on to your wallet; we’ll pay for it later.”
We have to be careful about how we spend this trillion dollars. Right now, we are $1.4 trillion in the hole and the Senate has been asked to raise the country’s debt ceiling to $12 trillion. We are fighting two wars and may increase troop levels in one. We have 250 new Iraq and Afghanistan veterans seeking care from VA facilities every day, and unemployment is headed north, past 10 percent. Has anyone else thought, “Hey wait a minute? Why are we proposing to spend so much on a mess of a plan?”
Why can’t Washington look north to Massachusetts? What’s the lesson for the nation in its successes and failures: universal coverage first or cost reductions? If health care is a right, then why aren’t we starting over with Medicare for All? If health care is a responsibility, then why aren’t we changing the system to address that? There is a big red flag planted in the middle of this state and it looks like everyone’s just pledging allegiance to it rather understanding the warning in its wave.
For now, I’m going to have to get used to this terrible feeling. I’ll eat right. I’ll drive 55. I’ll keep my dog on a tight heel and pet her to keep my blood pressure down. And I’ll hope the economy turns around soon and $6,600 or so a year for health insurance doesn’t seem so unaffordable.
I want health care reform. I need it, but I want Washington to start over. It doesn’t make me “un-American” or “astroturf” or “racist.” I’m a critic because what Washington is talking about doing has made health insurance unaffordable in Massachusetts.
If Washington won’t go for a simple clean move to a system like Medicare for All, then it needs to do one reform, one new law, at a time — not with a 1,000 page bill where strange things can hide. Line up the 80 percent of things we agree on and vote one at a time to change pre-existing conditions, cut that $500 billion in Medicare’s “waste, fraud, and abuse,” create meaningful lawsuit reform, and add some real competition to insurance companies whether it’s a public option or a pilot exchange program. Show the country that this is possible with lower premiums and more efficiency and then go for the tough stuff. Critics like me want something done right because we actually are up the creek without a paddle.
If Congress and the president want to fix health care, then it is time to start over. They need to look at what’s worked and what has failed in Massachusetts. They are going to have to actually take former Gov. Sarah Palin’s advice and “look north to the future.” Who knew that would ever make sense? But if we continue on this current path without looking, it’s easy to diagnose what’s coming to the country when a health care bill passes.
Wendy Button has written for John Edwards, Hillary Clinton, John Kerry, Barack Obama, and Mayor Tom Menino of Boston as well as other national and international leaders, and is working on a book.