Healthcare - Upfront and Personal
Ray San Fratello
Posted: 06.22.2009 / 8:28 AM PDT
After going through the ordeal of major surgery for prostate cancer recently, the issue of healthcare delivery is fresh in my mind. Until you have been forced by serious illness to deal with it head on, you can’t appreciate that old saying, “There but for the grace…”
There have been times in the past eight months where I have had the real fear of losing our home, life savings, and most of all my own health – and all while being actually insured here in the State of Florida! What would have happened to me, a guy who has hardly been sick a day in his life, if I would have had no insurance when this disease manifested itself?
What people have said they want foremost as I have told my story, is the security of knowing that if serious illness should befall them or their loved ones, that they would be able get the care they need in a timely fashion in a nurturing environment.
They want an affordable, accessible, understandable plan, AND a quality and customer friendly delivery system.
They want to know for certain that when they are told they have been accepted into a plan and pay their premiums, that IF something should occur that is serious and expensive to take care of, that they won’t have to fight their insurance company nearly every step of the way to have procedures approved in a timely manner, then pay the provider for services and not be caught in the middle of brokering who is supposed to do what to get things done.
I am fairly educated on how health insurance works, after overseeing a 3+ million dollar small business group health insurance program with over 1000 subscribers through the Chamber I worked at in NY. In Florida, unfortunately, there is no such support for small businesses, and the individual markets in both states are extremely dicey.
Being caught in the system here strained my abilities to stay on top of it all, and it all comes at the very worst time, when you are trying to come to terms with an illness, and as you struggle to decide on how to deal with it, and even after you are convalescing from your procedure(s).
You are nearly on your own here in Florida when you have individual, as compared to group benefits, and I shudder to think what happens to the less knowledgeable or the infirm when the system devours them.
There are nearly four million Floridians between the ages of 19 and 64 without health insurance, nearly 1 in 4 people and third worst rate in the nation. This is an appalling indictment on our state (and national) priorities. Most of the uninsured just can not afford the premiums. And so they take the big gamble of hoping that nothing happens to them, or they walk into an expensive emergency room setting for help after a little issue becomes a big one - and they can’t or just won’t pay for the care they get - and so the bill gets charged off to charity care or bad debt and is passed on to all those who do have insurance via higher premiums. This is no way to run the proverbial railroad.
Those over 65 have Medicare to rely on and those living near or below poverty (or who have been driven to it) have Medicaid, both very costly programs at the federal level, as well as the state level with Medicaid, and both political hot potatoes of the highest magnitude.
The challenge of getting health care to over 48 million uninsured Americans is daunting in itself. Couple that with all of us wanting comprehensive benefits that cover everything imaginable, and you have a tsunami of cost far out pacing the revenues to pay for it all, in a system of payors and payees that wreaks of the 1950s. Put this along side the gigantic government infusion of dollars in our slumping economy and it’s not exactly happy time in DC for problem solvers.
Because we are to a large extent an Emptying Nest community here, most retirees have Medicare, medigap, and maybe even a sweet retirement insurance program that they fear losing as they watch the private sector giants crumble. With property devaluation, lost investments, and higher property taxes, many fear having to go back to work just to get, or help pay for insurance.
Younger white, Hispanic, and black families who had moved here for work opportunities during the boom decade have the same pressures on family budgets in this economy, plus a much higher rate of being uninsured than retirees - with most still having jobs!
It is safe to say that everyone agrees the system is broken and perhaps beyond repair. And like Humpty Dumpty there is no consensus how to put it back together, but there are clear battle lines here with catch words flung around like liberal/socialist, bankrupting programs bucking conservative/laissez faire, private solutions.
Mean time you have scenarios like the one I outlined in my personal life playing out every day hundreds of thousand times over, and for those who have not been tapped on the shoulder yet, a conscious fear that they might be next.
Maybe we should all be in Congress. I hear they feel pretty good about their coverage and chances in the health crapshoot that is life, but seriously, I can’t blame them. Peace of mind has no price limit.
