March 5, 2007 - Gang Member

Several months ago, I wrote of what it felt like to be turned down for supplemental life insurance, due to my recent medical history. An article in today's New York Times reminds me of an even more dire consequence I could have experienced, but – thankfully – haven't: losing my medical insurance.

The story is about a North Carolina woman named Vicki H. Readling, who's exactly my age: 50. She's a real-estate agent, whose income is about $60,000 a year. Even though she works for a large brokerage firm (Century 21), she's considered an independent contractor, and is therefore not eligible for any group medical insurance.

In 2005, Vicki had surgery for breast cancer. Early in 2006, her medical insurance – a continuation of a policy from her prior job at a furniture company, for which she'd been paying the premiums – ran out. She tried to buy a new, stand-alone policy, but found out that – due to her cancer history – it would cost her $27,000 a year with a $5,000 annual deductible.


So, she's doing without insurance. She's supposed to take pills to protect against recurrence of her cancer. These cost $300 a month. She spaces them out, taking a pill every other day, instead of daily, as prescribed. She also forces herself to get by with fewer visits to the doctor.

More than that, Vicki – who was engaged to be married in June – has decided to postpone marriage, because her fiancé could potentially be liable for her medical costs. He owns a house; she does not. If she were to face catastrophic medical bills, his house could be seized to pay off the debt.

Vicki describes how she feels, every time she stands in front of a medical receptionist's window, unable to produce an insurance card:

"When you go to any medical person and they ask for your insurance card, you are so ashamed because you have to say, ‘I don't have insurance.' You just feel like you are dirt.... What did I do wrong? Why am I being punished? I just don't understand how I could have fallen through this horrible, horrible crack."

So, that's how we treat the sick in this country: like dirt. Our broken health-care funding system forces sick people to extreme measures, like diluting the strength of their prescriptions, postponing doctor's appointments and forgoing marriage. It's beyond unfair. It's immoral.

There, but for the grace of God – and the Presbyterian Pension and Benefits Plan – go I. Tomorrow, I go for a PET/CT fusion scan, with an accompanying set of CT scans. I've been having tests like these every three months. The cost of tomorrow's scans will wipe out my 2007 medical deductible in one fell swoop: I'll pay out hundreds of dollars, all at once. But, I'm one of the lucky ones. It could be many thousands (the actual cost of the tests) - unless I were to do as Vicki has been doing, and decide I simply couldn't afford them.

I'm fortunate because, unlike Vicki, I belong to a gang. It's called Highmark Blue Cross/Blue Shield. From time to time, my gang sends some of their muscle over to my doctor, the local hospital and the outpatient radiology place, and "suggests" how much they ought to charge people like me. Fearing the loss of a big chunk of their business, the medical providers knuckle under. Then, they turn around and raise the rates for individual patients like Vicki, who have nobody to do the "negotiating" for them.

It's a corrupt system. That's the only way to describe it. We're so afraid of universal health care in this country, that we've turned the health-care marketplace over to gangs.

It's not the medical providers' fault. It's the whole system.

It's time for a change. Let's all write our Senators and Representatives. And, the next time we vote, let's remember people like Vicki Readling.