Sick With Worry

She is lucky that her husband's company did not cut costs by getting a cheaper plan that may have been no plan at all. The "mom and pop" small business my brother in law worked for did just that, but when he discovered he had brain cancer, their insurance coverage proved to have more holes than Swiss Cheese. Not long afterwards, unable to work due to the disease, he had to quit work and of course that ended what little coverage there was. Faced with exploding bills, his only recourse was to "spend down" his family's assets to a ridiculously low level to qualify for Medicaid. This was a terrible blow to the self esteem of a man who had prided himself on providing for his family, thought he and his employer were doing that, and ended up pauperized by the system.

The article and this story illustrate several points worth deep consideration:

We need to uncouple employment and insurance, so that a change or loss of the former does not make for a loss of the latter. Make coverage a feature of citizenship, more akin to accessing fire and police protection or public education. This alone would eliminate many inequities in the system, where one's quality of care is dependent on which policy they are lucky or unlucky enough to have.

For any public options, we need to make sure that the rich and the poor are served by the same system. The rich will ensure that the system has good quality and does not destroy those it is supposed to be helping. But if only the poor are in the system (think Medicaid), it is vulnerable to shoddy quality and political opportunism ("Cut costs there -- they're just lazy welfare bums anyway.")

Current proposals to mandate either individuals to buy or employers to offer health plans provided through the open market need to prevent the proliferation of low-cost but essentially worthless "Swiss Cheese" policies. They may provide the appearance of coverage and a false peace of mind, but only enrich the insurer.

Finally, remember that any system will have it's horror stories -- some structural, and some the result of carelessness, ignorance, or malice. So don't let the fear of there being horror stories attached to possible solutions prevent us from seeking solutions. Don't let the Perfect be the enemy of the much-better-than-current.

A good many insurance companies will cut you off even in the middle of an operation when you reach a certain "cap"

"And then there was the Canadian on an Internet cancer forum who praised her country's socialized medicine: "We just got a third PET scan machine in Ottawa!" she sang. Three PET scan machines for the entire province of Ottawa? There are more PET scan machines than that in the Manhattan radiology center where I get my scans. And PET scans are now considered the gold standard for identifying the kind of cancer that I had.

This is a significant and deceptive error on the part of the author-Ottawa is a CITY; it is not a PROVINCE--you would need to know how many PET devices are also in Toronto, Kingston, London, Hamilton, and the other cities of ONTARIO--before reaching a conclusion about whether there are too few machines in that Canadian province.