Arts & Entertainment, etc. and Opinion and Health Care Reform and Health Insurance and Notions

HETRICK: A health insurance beneficiary pleads for reform

August 10, 2009

As a hearing-impaired, migraine-suffering, diabetic cancer survivor who’s also the father of a cancer survivor and the widower of a cancer victim, I’ve experienced more than my fair share of American health care.

As a professional communicator with a passion for human services, I’ve also spent decades working for health educators, nurses, doctors, hospitals, health advocates and the people who fund all the above.

And as a small-business owner, I’ve evaluated, purchased and paid for health insurance for my employees and our families.

So as yet another health-reform debate rages, I watch and listen with a vested interest and broad perspective.

Despite my and my family’s health problems, I count myself lucky. I’ve had health coverage for myself, my spouse and my kids throughout my 30-year career. For the most part, the policies have covered what they promised to cover, little haggling required. And when the need was greatest (during my late wife’s cancer battle), our insurance company sped approvals and denied not a single claim.

On the other hand, I have frustrations.

First and foremost, health-care and health-coverage inflation is small-business enemy No. 1. I know, because I buy a lot of it. My company pays 80 percent of employee premiums and 50 percent of dependent premiums. That’s higher than typical for firms like ours, but it helps us attract and retain good people. It also leaves us with a painful choice: Either the cost of health coverage cuts into our profits or, if passed along to our customers, renders us less competitive.

Second, while insurance covers all kinds of health problems people bring on themselves (through smoking, driving while texting, overeating, lack of exercise, etc.), it won’t cover the not-my-fault hearing aids that allow me to function as a wage-earning, tax-paying, job-creating contributor to the economy.

But mostly, I’m irked by rate inequities. While big business gets pricing based on giant risk pools, a lone staff health crisis can send my small company’s rates into the stratosphere.

To wit: My late wife Pam was also my business partner. As such, she was covered by our company’s health insurance.

In the last year of her life, billed charges for Pam’s cancer care totaled $300,000. At renewal time, our company’s health premiums were scheduled to jump 28 percent, a price hike that would seriously affect both the firm’s and employees’ incomes.

But when Pam died just shy of that renewal date, I had our rates requoted. With Pam out of the mix, the increase was cut by half.

The biggest inequities of all, of course, are the have-and-have-not chasm caused by our country’s overdependence on employment-based health insurance, and the denial of coverage to those with major maladies and “pre-existing conditions.” One lost job paired with one serious or chronic ailment and you’re a fiscal goner.

Certain politicians and commentators (most of whom, I’d wager, enjoy employer-paid health benefits), argue that we can’t afford to cover everyone.

I’d counter that we can’t afford not to. I’d also predict that the fiscal shock of universal coverage won’t be nearly as great as feared because we’re already paying for everyone—but in the least-effective, most-expensive ways.

Working years ago for a generous, don’t-turn-patients-away-because-of-money, church-founded urban hospital (Methodist), I saw firsthand how few people go without health care. Lacking insurance, they simply get their care in the costliest settings (e.g., emergency rooms) and at the worst possible times (when illnesses and injuries have become far more serious and dangerous than they might have become with timely, appropriate care).

And we all end up paying. Through higher premiums to offset the cost of non-payers. Through charitable contributions to health organizations. Through higher taxes, bankruptcies, lost productivity and more.

There’s an old Fram oil filter commercial that sums up the situation well. Comparing the cost of a new filter to an expensive engine repair, an auto mechanic warns, “You can pay me now. Or you can pay me later.”

In American health care, we’re paying later. And we’re paying through the nose. Our costs, quality and outcomes—compared to other advanced nations—are an embarrassment to the world’s richest economy. Heck, they’d embarrass any civilized society.

As Pam sat in renowned cancer centers and elaborate infusion rooms in Indianapolis and Houston, getting pricey chemotherapy and sophisticated scans, we were grateful for the caregivers, the coverage, the clinical trials, the mere chance at survival.

But we also felt guilty. That we were getting all this because we had money, connections and jobs. Yet all the while, in the greatest nation on earth, others facing the same predicament—citizens with the same right to life and health—were growing sick and dying with no chance whatsoever.

We need health coverage for all. We need it now. No water added. No more excuses. No more delays.

Tens of millions are literally sick of waiting. All the rest are paying the skyrocketing price of procrastination.•

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Hetrick is chairman and CEO of Hetrick Communications Inc., an Indianapolis-based public relations and marketing communications firm. His column appears twice a month. He can be reached at bhetrick@ibj.com.

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