A Young Woman’s Plea: Our Country Must Separate Healthcare from Employment

Yes, we did.

I and a bunch of other apathetic and ambivalent Americans got off our collective butts and voted for a Democrat.

One of the main reasons I compromised some of my closely held principles and voted for you is because you were brave enough – in “The Audacity of Hope” at least – to advocate for socialist leaning universal healthcare.

I sincerely hope your ideas and principles don’t go the way of the Clintons’. Thankfully, you were smart enough to keep Hillary away from healthcare policy – though I’m not so sure about ambassador of the free world. But I digress.

Despite being young, active and healthy, I am afraid to go to the doctor. Don’t get me wrong, I’m not one of those phobic people who hasn’t been to the doctor or dentist in a dozen years. To the contrary, I am a healthy person who believes that the best medicine is preventative, and when problems arise, early diagnosis and treatment are better. I probably don’t need to tell you that one of the glaring problems with our healthcare system has been the trend toward “crisis care,” especially in the uninsured. I’ve been to an emergency room in a crisis situation, and this is a place I never want to revisit.

I’m afraid to go to the doctor because an actual, written, diagnosis of any problem, may preclude me from having health insurance in the future.

A Date to Remember

As I write this letter to you, I’m creeping up on a milestone birthday. And, as you’ve likely experienced, ailments increase with age. First, it was that shoulder hitch that made a funny popping noise when I did pushups. Then there were the achy toes after running a few miles. After months of gulping down anti-inflammatory drugs that masked but didn’t treat the problems, the internal debate began.

Should I seek diagnosis and treatment for my problems while I still have COBRA insurance? Or would any treatment preclude me from getting individual coverage when my COBRA expires? It’s a classic catch-22 of healthcare.

Getting affordable health insurance was one of the best benefits of my marriage, and sadly not much has changed in those 11 years except there are fewer insurance- coverage options even for two married professionals. Many lawyers and writers, by their very nature, are self-employed. If we want health insurance, then we must buy it – on the open market. For several years, my husband and I had individual policies, and these policies were not for the faint of heart.

Because men are less likely to seek out care, in states like California where gender equality in insurance premiums is not mandated, my husband’s individual policy was cheap. He had a safety net for catastrophic care, and the insurer had a premium windfall. My policy options were another story. To make my policy premium affordable, I had to opt out of maternity coverage – swearing on my first-born child, that I wouldn’t give birth on their dime. And I damned my parents for my curvy frame when my height to weight ratio added a surcharge. Despite these limitations, stratospheric co-pays and deductibles, our individual policies were hundreds of dollars cheaper than the $864 per month fee that my husband’s firm offered its lawyers.

Will They Cancel Me?

Every other month, when a bill was expected, I crossed my fingers that I wouldn’t be cancelled. Before the inundation of lawsuits by the Los Angeles City Attorney and others against several health insurers, I zealously consumed newspaper articles about insurers canceling policies after people had gotten sick, based on “application fraud.” If an applicant didn’t include every possible ailment – a cough that should have signified impending lung cancer, a sore knuckle that portended arthritis – then the “dishonest” insureds were kicked to the curb. Every other month when I received my bill, if I’d gone to the doctor, I expected an increase or cancellation. I must have lucked out, because I only had increases.

Many of my colleagues, healthy men and women in their 30s, are living without healthcare because of some “pre-existing condition,” like a sports injury, an abnormal pap smear or a difficult pregnancy. Health insurance, like all insurance, is a for-profit business whose motto is to maximize premiums and minimize payouts. This is an industry America can do without.

Then in a last-ditch effort to save my legal career, I got a job, with benefits. Though it was clear that my career, once on life support, had expired, cheap healthcare was the best part about having a job. For a measly $198 per month, I could have health and dental and vision. I was amazed that co-workers who hadn’t been unemployed in more than 20 years complained about the cost. I thought it was a bargain. Whether it was the final payment on my law school loans or the institution of a punch clock system for all employees, I decided that writing fulltime was much better than fighting the traffic to work for little pay. But without a job, I had no one willing to subsidize my health insurance. I happily elected COBRA’s 18-month coverage – at a mere budget-busting $750 per month – pushing the healthcare decision far into the future – or at least into 2009.

You Can’t be Too Cautious

Even with the knowledge that a healthcare quagmire was just around the corner, my healthier nature overcame me, and I threw myself into testing and diagnosis. Age is not pretty. The bottom line: tendonitis in the shoulder and bone spurs in the toes. Now comes the rush to get it all treated while my employee-sponsored plan can’t drop me. When I fill out that very thorough application 12 months from now, will they insure me as an individual? I think not. The writing is already on the wall. Letters arrive daily looking for liability for my injuries. Was there a car accident, workplace injury or culpable party to sue? my insurance company’s intermediary asked me. No deep pockets here, I answered – just overuse and age.

During the Presidential campaign, one of the things that struck me as particularly out of touch was Sen. John McCain’s $5000 healthcare tax credit proposal. Clearly, neither the Senator nor his multi-millionaire wife had purchased individual healthcare on the open market, or even if they did, the cost for them would not be prohibitive. The only answer is comprehensive health care that covers the well, the sick and everyone in between.

I priced out the only insurer that can’t deny me, my husband’s plan. Inflation has not been kind. Now that unsubsidized $864 coverage is starting to look like a bargain. Less coverage will cost $1044 per month, and that includes high co-pays and high deductibles. Under a McCain-like plan, that would be 4.7 months of coverage. What he had planned for the rest of the year? Thankfully, we’ll never have to find out.

One More Year

I’m keeping my fingers crossed, hoping I remain relatively healthy over the next year. If (and more likely when) I’m denied individual coverage, then I’ll suck it up and pay the thousand dollars. But clearly a system like this is not sustainable over a lifetime. I need that money for retirement – Social Security looks like it won’t provide much of a safety net (but that’s the subject of a different letter). Our country needs to separate healthcare from employment. I can only hope that your election generates change we can believe in. Otherwise, we’ll all be thrown into crisis care.

Best regards,

Jessica Gadsden has been controversial since the day she discovered her inner soapbox. She excoriated the cheerleaders on the editorial page of her high school paper, transferred from a co-educational university to a women's college to protest the gender biased curfew policy, published a newspaper in law school that raked the dean over the coals with (among other things) the headline, "Law School Supports Drug Use"—and that was before she got serious about speaking out. Progressive doesn't begin to define her political views. She's a reformed lawyer, and full time novelist who writes under a pseudonym, of course.This will mark the debut of our newest, and perhaps most charismatic, weekly essayist. A Brooklyn native, she divided her college years between Hampton University and Smith.