Peter MacDonald is a computer consultant who works as an independent contractor. Peter and his wife Kirsten have four children. They purchased health insurance on their own through the end of 2007. Here’s Peter’s story about why the family does not currently have coverage.
I had been buying my health insurance since May 2006. The monthly premiums then, were $650 a month for a 35 year old + Spouse and family. No prescription coverage and $25 copay. This seemed high but I could afford it. Then in December that year the premium was raised to $750 a month. Kirsten and I started paying real attention to how much we were using insurance. Over the next year we only had about 15 doctors visits between all 6 of us. In December 2007 my premium jumped to $890 a month. When I called Blue Cross Blue Shield about this I was told that there was a 20% premium increase because they were not offering the plan anymore. The reason for not offering the plan was due to the new Massachusetts Connector plan. That plan would have cost me $905 a month, the only difference was that now it included prescription coverage. At this point my wife and I decided to just put the monthly premium into a savings account just to cover health costs.
The other issue is that the insurance companies pay a different amount for the same services than what I pay for me or my family. They will say it is free market economy, well that is were they are wrong. That is where this system is messed up and the state is just helping it out, towards total collapse. I have a current example of this system at work.
Yesterday my son fell and cut open the bridge of his nose. My wife called and said that she had to go to the ER with him. She was questioned several time about the lack of insurance. They asked if she really wanted the Plastic surgeon to look at and seal the cut. They thought we could not afford the care. When the surgeon came in he told my wife that we could pay his office directly at the checkup in 10 days, $900, because the hospital would probably charge up to twice that. It will be interesting to see what the rest of the bill looks like. I will easily pay for this because I have been saving for such a situation. What would this cost me on insurance, oh $50 for an unauthorized ER visit and the $10,000 for my annual premiums. $900 for 1/2 hours work seems a little steep and the hospital may have charged me double for that same work.
My last point is this is really silly thing that we are doing in this state. While it is a noble idea, it is a bad idea because it goes against many of the founding principles of this country. Freedom of choice. What do I mean by this? This is worse than any tax ever because there is no way to not pay for the insurance. If I do not want to pay property taxes, I just rent. If I do not want to pay excise and fuel taxes I use public transportation. If I do not want to pay income tax I just get a job were I earn less money. I want the choice of whether or not I have insurance. As long as one does not burden society the they should be free to make those choices.
My wife and I are both of a similar mind that to many Americans have lost site of the simple things in life. They have to see a doctor for every little cough they have and have medicine every time they have a runny nose. Here in the United States of America we seem to have lost sight of the fact that we live and die, no matter what we do to intervene, and it is the quality of life that we are forgetting to live for.
Peter MacDonald, Brockton
While I am happy the financial planning abilities of Peter and his family has worked out thus far, I am concerned that this is a dangerously short sighted approach to maintaining his family’s well being.
Imagine his son or wife had not hurt their nose, but instead – like thousands of others across the state – received a cancer diagnosis. While there is a difference between a $900 fee and a $10,000 annual premium, that is nothing compared to a $10,000 premium and the cost of diagnosing, treating, and recovering from cancer – which easily exceeds several hundred thousand dollars without insurance. And that’s before prescription drugs.
Another issue which is often overlooked with cancer is that once you are diagnosed, there is not option to become insured after that (as part of pre-existing look backs). So by deciding to not have health insurance now, Peter is closing that door for his family for some time to come.
The point of insurance is to safeguard against the unexpected; one’s history of health doesn’t mean there will never be a real health problem (or accident or emergency) in the future. There is a vast difference between self-reliance and self-denial.
If having affordable and reliable security against a medical emergency and potential financial ruin does not allow you to “enjoy the simple things in life”, what would? Health reform is not a symbol of people forgetting to strive for a more peaceful quality of life, it is exactly what is enabling us to do so.
Chris,
Spoken like a true insurance industry shill! The fact of the matter is that plenty of folks have health insurance and still end up bankrupt in the event of serious illness. Insurers look for reasons to rescind policies or deny care in the hope that you’ll simply go away, pay out of your own pocket, or die before they have to pay off. Peter appears to have made a rational decision to forgo the purchase of an expensive product of questionable quality and bank his money for eventualities. That seems like truer peace of mind.
Peter,
Thanks for sharing your family’s story
Peter-
It is people like you who say they want the freedom to choose whether or not to have insurance who then cost all of us more and more taxes to cover the care of your children when they get seriously ill, your wife when she has breast cancer and you when you fall off the roof and shatter the left side of your body. If I were sure that people like you REALLY would pay for themselves, or choose not to use the system, then I would agree…you deserve the choice. HOwever, it never seems to work that way.
Peter, you hit the nail right on the head! The reason why there are so many uninsured people is that they can’t afford it! Too expensive, especially if you are older. The older you are, the more expensive it is. It was stated when this mandated insurance first was announced, that the reason why the don’t have health insurance was that they just didn’t want it and had the monetary resources just to pay out-of-pocket. No, even the well-to-do want health insurance and they should be able to have it. The uninsured who don’t have insurance “CAN’T AFFORD IT”! The only choice we have is to purchase health insurance and stop paying for rent, food and vehicles. I am unemployed and have been searching endlessly for employment. No luck yet. I have just about exhausted my IRA from my many years of work. It is very discouraging. Early last month I applied to commonwealth care and have not yet received a response. My COBRA from my last job is up in a month (I was paying 489 a month just for me). My husband has no insurance. He has a job that doesn’t pay health and even if it did, his wages wouldn’t even cover that! The worst part is is that we are being punished by the state for not having insurance.