BY SUSAN ESTRICH
My friend Ethel is mad as hell, but she has no choice but to keep taking it. She’s mad at her health insurance company, and she’s mad at the administration and Congress. She’s equally mad at Democrats and Republicans. It’s not partisan; it’s personal.
Ethel had breast cancer five years ago. Knock on wood and keep the evil eye away, she is doing fine. Health-wise, that is. Financially, it’s a completely different story. Financially, it’s a disaster.
Ethel is not one of those people who doesn’t have health insurance. Actually, she’s kind of tired of all the attention Democrats have been paying to the folks who don’t have health insurance, who show up at the emergency room and expect to be taken care of, and then have someone else pay the costs. She’s the someone else, and she knows it.
But she’s just as tired of all those Republicans who claim they’re the party of small business and say the market will take care of everything. She knows better. It’s not taking care of anything.
Ethel owns a small store. You can find her there seven days a week. She works, and she worries. She pays more than $900 a month for individual health insurance. It’s a lousy policy: huge deductible, huge co-pays and a very limited network of doctors.
Excuse me – she paid $900 a month. If Anthem Blue Cross [That is what they are called here in California. Ethel has another name for them, but it can’t be included in a family newspaper.] has its way, she’ll be paying 39% more every month. Anthem has just announced a rate increase for its individual policyholders, the people who don’t work for big companies and don’t belong to any groups. Individual coverage is the most expensive you can buy – if you can buy it.
Ethel keeps paying every month because she knows darn well that the company would like nothing better than the chance to drop her. If she didn’t already have insurance, they wouldn’t sell it to her. She can’t change policies or companies. So she sold her car to pay for her insurance.
For two years, after having breast cancer no less, she didn’t have a sonogram – even though the doctor said the mammogram wouldn’t work with dense breasts – because her insurance wouldn’t cover it and she couldn’t afford it. She gets teary as she tells me. So do I.
Who is helping me, she asks. She has written letters to her senators. In return, she gets form letters telling her how hard they are working to make sure every American has access to health insurance. Right.
An increase of 39% on top of the $900-plus she is already paying is beyond the pale. But there is a reason for it. My sister has worked in the field for years. Much as I’d like to chalk it all up to greed, much as that might make for good raw meat in a liberal crowd, she taught me long ago that it’s a whole lot more complicated than that.
Ethel can’t drop her insurance because she’s been sick once. But what’s happening in the individual market, in the midst of this continuing recession, is that the healthy people in that pool are deciding they can’t afford it anymore and are going uninsured. As the younger and healthier people drop out, the pool of individuals gets older and sicker, meaning it costs more to provide the same coverage. Could it be as much as 39% more? It could.
I tried to tell Ethel that the president’s plan would help her, but she just laughed. All he cares about are the people with no insurance, she said. I don’t think that’s true, but what can I say? I still don’t know exactly what’s in – or out – of the Democratic plan, and we both know it isn’t going to pass in its current form anyway. I told her she’ll be worse off without the Democratic plan, whatever it is, but she doesn’t believe that, either. Now that Anthem has announced the increase, I might be right, but that’s hardly a victory for anyone.
Republicans may be crowing now about defeating health care, but they should beware what they wish for. Saying no when the other side has 60 votes is one thing. Just saying no doesn’t work anymore. Live by the sword, die by the sword. If Republicans don’t find a way to work with Democrats in creating a bigger and healthier pool for Ethel, she might decide that the plague belongs on both their houses. And she’d be right.
– Susan Estrich’s columns appear regularly in The Oklahoma Observer