Why We Need the Public Option

A personal acquaintance sent the following letter (behind a cut, for length) to her Representative and Senators, and to members of the Congressional committees working on health care reform.

I am writing you concerning the health care crisis that is affecting us, Americans, currently. I feel we, Americans need something to help with health care costs. Whether it is a single payer system, a government provided health insurance or mandatory insurance with a government option does not matter. We need something to fix the current system. The biggest requirement I have is that any insurance can not deny anyone coverage for a pre-existing condition nor can it be canceled at the first sign of a medical problem.

I have no problem with a short waiting period on certain pre-existing conditions if you did not have insurance with in the past 6 months. Nor do I have a problem with insurance being canceled due to outright fraud.

This is very much a concern to me as the thought of losing my family’s health insurance scares the hell out of me. Right now we are currently on my employer provided health insurance. Our children qualify for Healthy Start/Healthy Families through the county Job and Family Services Department. If I get a raise they will lose that secondary coverage. We have a standard co-pay of $25 per doctor visit and $30 per non-generic drugs for prescriptions.

Now let me tell you why the thought of losing our health insurance scares the hell out of me.

I am an asthmatic. I am lucky I have a fairly mild case and it is considered under control as I haven’t had a flare-up since Spring 2005 that wasn’t due to illness. I take 1 daily maintenance medication, 1 allergy medication, I have a rescue inhaler and eye drops for when my allergies flare up. In addition to seeing my primary care physician or ob/gyn yearly I see my allergist/asthma specialist twice a year. My daily medication is $90 per month.

My husband is a type 1 diabetic. This means through no fault of his own his body stopped producing insulin. He’s on two different types of insulin, one long-acting taken once per day and one short-acting taken anytime he eats or his blood sugar spikes. His doctor has prescribed several medications to help control some of the side effects of living with this for most of his life. My husband checks his blood sugar several times a day. He sees the doctor a minimum of twice a year and is suppose to have his hemoglobin A1C tested every 3 months. He also needs to see an ophthalmologist once a year. His monthly co-pays on his medications are approximately $120 per month.

We are thankful our children are fairly healthy. We have 4 children ranging from 1 year old up to 13 years old. The oldest rarely gets sick. The youngest just finished her immunizations until she is 4. So far nothing abnormal has shown up in her development. Our 8 year old has had several sets of ear tubes. It looks like he has finally matured enough for his ears to drain properly so he is no longer having hearing problems or getting ear infections. However he was recently diagnosed with ADD. He is on a medication that is helping him focus and hopefully we will be able to get him into a program that will help him manage his ADD and provide him with additional coping skills. Our 3rd child has asthma. Until recently the doctors were calling it Reactive Airway Disorder. They were hoping she would grow out of it. It doesn’t look like that will happen. She is currently on 3 daily maintenance medications, 2 for her asthma and 1 for her allergies. She also has a rescue inhaler and Albuterol for her nebulizer if she needs it. When her asthma flares up the doctor has also prescribed 2 additional medications to help control it. She sees the allergist/asthma specialist 2 to 3 times a year for normal care and controlling of her asthma. Recently this spring she saw the doctor 4 times in 7 days, because her asthma wasn’t staying under control.

As I mentioned before our children currently have Healthy Start as their secondary insurance. So their co-pays are covered. However if we lose that coverage we will need to pay for those co-pays. While researching my insurance’s website for the co-pays on my children’s medications I discovered that all my children’s medications are either considered Tier 2 so a $30 co-pay or not covered at all. The allergy medications are available over the counter now so the insurance company does not pay for them. For a month’s supply of our children’s medications we would spend a minimum of $169.48.

I am very thankful my employer provides health insurance to us. I do have to pay my portion and I have no problem with that. I am also very thankful they have chosen a good company. Compared to the insurance coverage we had through my husband’s previous job we are paying almost nothing. We had to pay out of pocket for the cost of the immunizations for our 5 year old when she was a baby due to that insurance company only paying $100 for preventive medicine per year. Luckily we were able to find out before we got to the 6month shots. We qualified for Healthy Start at that point but due to my husband’s pay schedule that year those earlier immunization were not covered.

I have priced all the medication we need to stay alive and to maintain a good standard of living and the cost is $1280.75 per month if we did not have insurance. My husband needs his medication to live. I can get by without if I need to as long as I remember to take allergy medicine during the peak allergy season. I will not let my daughter suffer and risk death by not giving her medication.

I should also give you some background on us. I am a college graduate with a BS in Mechanical Engineering. My husband worked as a manager for 10 of the 15 years he worked for the same company. Recently he resigned so he could go back to school fulltime to obtain his BS in Environmental Engineering. Our income places us squarely into middle class.

I would like you to work diligently to create a better way to pay for our health care. The public health care plan must be accountable to all Americans and to Congress. This option needs to have a true bargaining power to be able to control costs and to compete against private healthcare. Also private insurance companies should not be able to deny coverage arbitrarily nor should they be able to cancel coverage without proof of fraud.

Without insurance my husband’s insulin and diabetic supplies would cost us $397.57 each month.

In the last 2 weeks our daughter has seen the asthma specialist 5 times and the sixth time will be in two days. Let us review the costs if we were uninsured, each visit cost $200. The doctor prescribed Prelone, which was filled 3 times, to help her breathe at $97.86, an antibiotic at $32.46, two x-rays at $145.00 each, Albuterol ampules at $8.00, Mucinex for the cough at $10 and an Advair 115/21 inhaler at $219.46. Without insurance or $1857.78 our daughter would have died.

The letter writer isn’t exaggerating her family’s health needs, nor the serious risk if the lose the ability to get the medication they need.

It’s unacceptable that people’s lives are at the mercy of the bean counters who decide how much their corporation will spend on health care. We need a system in which no one who needs medical help is denied that help, and no one faces bankruptcy because they didn’t want to die.