Sunday, January 23, 2011

Dear Marcy: A Letter to My Congressperson





Congresswoman Marcy Kaptur
1 Maritime Plaza # 6
Toledo, OH 43604-1881

Dear Ms. Kaptur:

I am writing to ask you to do everything in your power to make sure the healthcare bill is not repealed. More accurately, I’m writing to ask you do everything in your power to make the bill stronger, to work our way toward a single-payer, not-in-it-for-profit system.

I am a fit, healthy middle-aged woman. It takes 500 hours of work-income for me to cover my healthcare premiums and deductible.  This is my story:

Because of divorce and a bad economy, I recently lost employer and group coverage, and experienced a deep income drop. I am presently employed on an hourly basis at Owens Community College. Owens offers no benefits.  As a writing and ESL tutor, a job to which I bring two Masters degrees, I make slightly over $16 an hour.

In an attempt to defend against potential financial emergency, I asked my insurance agent to search for a reasonably priced healthcare policy. The least expensive plan she identified is an HSA product offered by Anthem Blue Cross, for which I must pay premiums of $315/month plus a $2500 deductible. Based on experience with former providers, I expect that when I actually try to “use” my policy, there will be plenty of non-covered exemptions.

But to step back, let me point out that the rate originally quoted by Anthem was $253/month. Then my medical records were scoured, and I was determined to have “Hyperlipidemia,” high blood cholesterol. Indeed, by current standards, my "bad cholesterol" is three points below "target." That said, I exercise daily, weigh at or below my target weight, have never smoked and could be the poster child for healthy eating.

Dare I suggest that my diagnosis of Hyperlipidemia is based more on profits than proof? About four years ago, according to my physician, the JNC 7 lowered target lipid levels. This opened up a huge new market for the manufacturers of statin drugs and put doctors at malpractice risk for not prescribing them. That said, many studies contest the correlation between statins and heart disease, especially for people with no other risk factors.

For a short period, I let my physician prescribe a statin, but since my lipid count before JNC 7 would have been considered “normal,” and because I have no other risk factors, and because the fewer drugs a person needs, the better for her body and her wallet, with my doctor’s agreement, I decided not to continue these pills.

Still, even though I am not on a statin (or any other drug), Anthem continues to deem me a risk. Or at least Anthem uses that reasoning to justify the upcharge to my premium.

Dare I also suggest that the pharmaceutical companies and insurers are the reason healthcare is so expensive?  That said, insurers rates are, in theory, “regulated” by the government, as are many other costs relating to healthcare.

Another story: In order for me to even apply for this (or any) insurance policy, I needed to submit five years of my medical coverage. To do this I was forced to pay $62 to have that record copied and mailed to Anthem. Because this is an even longer story, I will leave the enclosed letter to Dr. Lee Hammerling, the CMO of Promedica, to speak for itself. Please note that the Ohio legislature has been blamed by at least one Promedica employee for these excessive copying charges.

Ms. Kaptur, I am outraged at the state of healthcare in this country. I am outraged at the cynicism and greed of insurers, pharmaceutical companies, and so many other auxiliary “providers” of health care products and services.  I am outraged that healthcare is a profit-driven business and that the executives of so many of these businesses (not to mention their lawyers, lobbyists and affiliates) make millions of dollars while refusing and reducing services and coverage. I am aghast that so many Americans worry about the “socialization” of healthcare, and think the system is working. I used to live in Germany; the healthcare was straightforward, caring and effective. What I would do to be under a “socialized” system again.

Soon only the elite–as in how much money one has, not how much education or talent one possesses--will have sufficient healthcare.  I used to be elite. It does not take long to lose that status.

As Martin Niemoeller said:

First they came for the Socialists, and I did not speak out --
Because I was not a Socialist.
Then they came for the Trade Unionists, and I did not speak out --
Because I was not a Trade Unionist.
Then they came for the Jews, and I did not speak out --
Because I was not a Jew.
Then they came for me -- and there was no one left to speak for me.

Please. Do what you can to assure that we are on the road to a single-payer healthcare system. Get the greed out of the system. Educate those individual who think what we have works. I will do what I can to help.

1 comment:

  1. Good story. Not only do we need a single payer plan, we need to reduce our costs to what other public plans are in other Western nations, which average about 1/3 to 1/6th the cost of ours . . . which of course would go a long way toward making many of our businesses and services more competitive globally. Why the non-insurance, non-medical, businesses don't push for this is beyond me. Perhaps they are afraid that this will further undermine the credibility of the free market concept.

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