Everyone should read the personal story by Kevin Zelnio, a marine biologist and blogger at EvoEcoLab, about his son’s recent medical emergency. Having a six-year-old child whose flulike symptoms turn into a struggle to breathe must be scary enough — but this family’s troubles are compounded by not having health insurance.

Zelnio is self-employed, and he and has wife have been unable to find affordable insurance for themselves and their two children. He cites uninsurance as one reason why they didn’t bring their son to an urgent care facility as soon as his fever reached 103. They did get him to an emergency room the next day, where he was diagnosed with pneumonia and admitted to the hopsital. Zelnio writes about how it could’ve gone differently:

My son could have suffocated from his pneumonia had we not sucked it up and rushed him to the hospital on Tuesday morning. If we were able to see a doctor a day earlier, he perhaps could have been treated at home as an outpatient with antibiotics. I don’t know what our final bill will be when we leave tomorrow morning, right now I don’t care. All I know is my son got better under the supervision of a wonderful team of nurses and pediatricians. My community has income-based charity care which will hopefully reduce our bill to a much more manageable sum. All minor details when the stakes are as high as your children’s lives.

David Kroll of Take as Directed has set up a PayPal account to collect donations to help Kevin Zelnio’s family. While it’s great to see friends and readers coming together to help out those in need, it’s also sickening that this kind of fundraising is necessary at all. Maryn McKenna of Superbug says it well:

I have a bias here, and I’ll declare it freely: I don’t think healthcare should be a luxury product that only a few can afford. I was born in the United States, but I grew up partly in England under the care of the National Health Service, and I spend a fair amount of time in countries where single-payer systems persist. Here’s the thing: They work. They take care of people (even people who don’t contribute to them; see Steve Silberman’s experience in London last summer for one example). They don’t permit families to be crushed, either by fear of bills, or by the thuggish actions of collection agencies.

Zelnio writes in his post that he would gladly buy insurance coverage if he could find one that seemed to offer good benefits at a reasonable cost — but as a self-employed writer, he hasn’t been able to find such coverage. This is a common problem for people who don’t get insurance through their employers, and the Affordable Care Act aims to correct it. Starting in 2014, individuals and small employers will be able to purchase insurance coverage through state-based health insurance exchanges. The plans will have to cover essential health benefits (broadly defined in the law and determined more specifically at the state level), and subsidies to help with premium costs will be available for those earning up to 400% of the poverty level. It remains to be seen how well the system will work and how affordable the coverage will end up being. The hope is that it will allow families like Zelnio’s to focus on recovering from illness, not worrying about how they’ll pay for care in a crisis.

Comments

  1. #1 mandas
    February 15, 2012

    I have lived in America and just don’t get the opposition to a universal heathcare system. Just to give you a personal example about what happens here in Australia.

    Although it is possible to have private health insurance here, I do not have any, and rely entirely in the public system provided by the Government. Just before Christmas I had a bout of appendicitis that involved 3 trips to the emergency ward, 2 GP visits, and 2 stays in hospital, totally 7 days. I had CT scans and x-rays, and eventually had an operation to remove my appendix – all at no cost to me. Not even a co-payment. I walked out the door of the hospital without even seeing or signing anything.

    Last month I had another health scare that involved a stay in 2 hospitals totally 3 days, and ambulance transfer between the two, CT scans and an MRI. This was followed up by a visit to a specialist neurosurgeon. Once again, all this was at no cost to me.

    For all this I pay a small additional ‘levy’ as part of my normal tax (it’s 1.5% of my income). And there is no way I would want to live under the US system. I get health cover for a modest amount, and people on no income or very low wages get it for free. Everyone is covered by the public system, and can take out additional ‘private’ insurance if they want extra (such as for elective surgery). And that’s the way it should be.

  2. #2 Celeste Monforton
    February 16, 2012

    Thanks for pointing me to the Zelnio story. My husband and I are filling out the applications with four different insurance providers. (You don’t just buy insurance, you have to apply for it.) My husband is a master at researching products and doing cost comparisons. He does it for everything from bicycle tires and computers, to washing machines and groceries. Through the process of researching health insurance plans, he’ll be the first to say trying to obtain health insurance is not like buying any other product.

  3. #3 Man of Misery
    February 16, 2012

    Mark Hoofnagle at Denialism Blog had a nice piece on this for Valentine’s day here: http://scienceblogs.com/denialism/2012/02/more_evidence_that_universal_h.php

  4. #4 Liz
    February 16, 2012

    Mandas – I’d love to have a system like that, instead of the constant worries about how everyone is going to get and maintain their healthcare coverage and cover their cost-sharing. I think some people in the US assume that our system is better (or not worse) than those in developed countries with national healthcare for one of two reasons: They think the quality of care here is far superior to that in other countries, or they’ve heard horror stories about rationing.

    When it comes to quality, we may have some advanced technology and procedures, but the extent to which providers and facilities meet quality benchmarks is variable. As far as rationing, we do ration here — just by insurance status and ability to pay, rather than by waiting lists or budgets. And if other developed countries spent as much per capita on healthcare as we do, they might be able to do all the hip replacements, cataract surgeries, etc. without making people wait.

    Man of Misery – Thanks for the link! I’d missed that one.

  5. #5 greg
    February 19, 2012

    And not a word about occupy?? It’s about damn time for a big push back against this shit don’t you think?! And that is exactly what Occupy is.

  6. #6 Rifad
    EhJkkxsw
    July 25, 2012

    If they wanted to bemoce a participating payor in the government plan they would have to agree to the payment formulary outlined by the government. For the companies that chose to go along with the government plan, you’d end up seeing a whole lot more HMO type plans available and the PPO plans would pretty much go away. Those that didn’t participate as payors under the government’s terms would pass their extra costs on to the consumer purchasing the insurance. If doctors are given an option to participate, they’ll refuse to accept the government plans and will jack up their costs to private pay insurance clients (the same as many are doing with Medicaid today). If it’s all nationalized and we fall under one payor, just take a look at how Medicaid works today and that’s what you’ll get. Doctors will also close up shop. Demand will be high and supply of qualified health care professionals will be low.Edit Another thing to consider is that there will be unanticipated levels of enrollment if they leave multiple payors in place and only have the government plan for those whose employers don’t offer coverage. Larger businesses will be required to offer insurance, but businesses with few employees won’t. Those small businesses that are offering it now will stop. Their employees will then bemoce dependent on the government health care system. My mom’s a small business owner and pays part of her employee’s insurance costs now. I can assure you that if this kicks in she’ll drop it. She’s having a hard enough time keeping her doors open as it is and that would save her a ton. This is exactly what happened when Hawaii went to their plan to insure all children in the state. People dropped their private insurance and used the state insurance. The program lasted for about 6-7 months before the state couldn’t afford it any more.@ bob k If you think the greedy insurance companies are bad about determining what care you will and will not receive, wait until the government decides that for you. Ask any Medicaid patient about how much say they or their doctors have in the care that they receive, and you’ll love your greedy insurance company.