IT'S A GOOD thing I have health insurance, because I thought my ticker was going to give out when I read this: Health insurance companies will not sell policies, at any price, to hale and healthy people who have, or had, some pretty trifling ailments. Hemorrhoids. Varicose veins.
A woman who'd gone to a psychologist after breaking up with her honey was denied. So was a guy with jock itch, and a 40-year-old man with asthma.
Lisa Girion's front-page Times article the last day of 2006 leaped off the page and grabbed me by the throat, which is pretty much what health insurers are doing to millions of Americans — strangling them. If they don't work for a company with health benefits and they want individual health policies, they pay huge premiums for skimpy benefits, if they can get a policy at all. For health insurers, it's a seller's market, and they ain't selling.
Congress and the state Legislature settle down to business this week, and that business had better include some solution, finally, for the healthcare crisis. We aren't dumb enough today to fall for the boogeyman phrase "socialized medicine" that's been used to scare the public for decades. In the first Times article I found using that phrase, in June 1934, the American Medical Assn. told "advocates of socialized medicine" to keep their hands off the system. (At the same time, the AMA condemned free hospital care for veterans but refused to condemn free medical care for "Cabinet members, congressmen, senators, their families and their servants.")
Business, which has a firm grip on the legislative joystick, hits the panic button at talk of single-payer healthcare or universal healthcare, and it hauls out its own boogeyman phrases, such as "job-killer" and "drag on the economy."
I'll tell you what's a drag on the economy. Healthcare insurance that's impossibly expensive, or impossible to get. If the United States wants a vital economy of personal enterprise and risk-taking, then it needs to guarantee health coverage, period. Americans are willing to take chances in business and careers, but not with their families' health, or their own.
Dan Luke is an Oregon insurance broker. He told me that he runs into this "all the time — people staying in jobs they don't like. People have dreams about going into business for themselves that they can't fulfill because they don't want to lose medical coverage, and they can't pay a lot of money for [individual policies] even if they are healthy."
I gave him a professional for instance: Say there's a man who wants to switch careers, start something on his own. He's 59, married, four kids, comes to you for health insurance. He smokes cigars. ("Mmmmm," I heard Luke say.) And he had heart-valve surgery almost 10 years ago.
Luke stopped me right there. The man would never get coverage. I didn't even get to ask Luke about the risk factors of riding motorcycles and skiing.
My "for instance" is Arnold Schwarzenegger. If the governor weren't a rich man, if he were just a guy with a bold idea who wanted to give it a shot, as Schwarzenegger did when he abandoned acting for governing, he couldn't get health insurance. He'd be stuck in his old job instead of bringing something new to the economy and to his life.
A 2004 health industry survey Girion cited said 12% of applicants for individual policies were turned down. Luke believes it's closer to 40%. "I can't think of any other business," he said, "where people have money in their hand to buy a product, and you can't sell it to them."
Girion's story generated e-mail from people such as Shari, a consultant in Ventura County who couldn't get an individual policy. She's not taking meds, has no health problems, but she did have bunion surgery once. She can only guess that's the reason she couldn't get insurance because, like the FAA's "no-fly" list, the insurance companies told her no but refused to tell her why.
When Jennifer, in Santa Barbara, wanted to start her own bookkeeping business, she checked on whether she could get healthcare coverage. She has a tendency to get benign ovarian cysts, but that's her only health issue. She found out nobody would cover her — unless she'd have a hysterectomy. She stayed at her old job.
This year, the state will spend about $10 billion on healthcare for the 6 million or so uninsured Californians. And what's the worst-case state budget deficit predicted for the coming years? About $10 billion. Some coincidence. The uninsured are nobody's bargain. Businesses, individuals — we all pay, one way or another.
Schwarzenegger — on crutches because of his broken leg — gives his State of the State speech Tuesday. In October, at a meeting at The Times, I asked him what he'd do in a new term, and what he said then is what, it turns out, he'll be promoting next week: "Find a way of providing healthcare for the people of California." Now, with screws and cables holding his leg together, he can contemplate the pickle he'd be in if he were just Arnie S., a desk jockey dreaming of making something more of himself — and uninsurable at any price.
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