(MG) My son's health insurance premiums doubled to about $8,200.00 in 2003, the hear he turned nineteen. That's more money than I've made in the last several years combined. Couldn't afford it. He's self-insured now. Stay well son.
(MG) To add injury to injury, the premium increase notice came with the following "good news": Because you have been claim free for the past three years, this insurance premium has been reduced by 15%.
(MG) I sighed, with deep regret, for my own tenure in the individual health insurance pricing field, and for all the policies I had priced exactly the same way. (Which was the way we always used to do it, back in the day. If it's not broke, don't fix it!) Actuaries have a certain mind set. We were trained (it's been 24 years since I last practiced, and so cannot speak to contemporary practices in the matter) to address the issue of escalation of health care costs by either: (a) Increasing the premium rates, (b) reducing the benefits, or (c) both.
(MG) When a product line started losing money, however, neither (a), (b), nor (c) above was sufficient to "rehabilitate" (restore to profitability) the situation for very long. We eventually learned to price for "shock lapses", a term we used to reflect that when you increase the premiums, the healthiest of the cohort will look elsewhere for coverage, or, decide to go without. IT is the least healthy, the ones who can't afford to NOT have health insurance that will scrape to find a way to deal with premium increases of 40, 50, 100% (or more).
(MG) A significant factor in my choice to leave the actuarial profession, and all the financial rewards there attendant, to ultimately take on a number of low level, sometimes minimum wage-paying (and sometimes less) jobs was linked the the empathy I could feel for people on fixed incomes who got the revolting news ... gonna cost you more, more, much more than before, to have health insurance.
(MG) However my background in the field serves me well. There are options other than (a), (b) & (c) above. I'm blessed that a nearby health clinic with seven full time doctors and a support staff of about 35 nurses, technicians, clerical and support workers offers their services on a generous basis. They do so out of love, and could all be making much bigger bucks in another venue. I invariably arrive early for my appointments, and have discovered that they process patients at a rate of about one ever 90 seconds. They practice preventative medicine. I went in to have a persistent upper respiratory infection checked out. They discovered Type II diabetes. They gave me a two week supply of medication. I slept soundly through the first night, for 8 straight hours. Awoke, and drifted through the next 12 hours like a zombie. Good by medication. But I also changed my eating habits and exercise habits, improving them both measurably. At my follow up check in two weeks later, my blood sugar had dropped to 95, and my albuminium was at 5.6. My diabetes went away. Hallelujiah.
(MG) And all that story proves is the importance of early detection. Without the option, I would have endured the infection (which recurs three or four times annually) and the diabetes would have gotten worse.
(MG) I have so much empathy for "Bob" in this article below. Wake up, America! Most of us are about one serious illness, or one unexpected employment termination away from being Bob.
(MG) Fury is the appropriate response to the system. The system is oppressive, racist, sexist, murderous. And that is just the pricing and the distribution. (I'm speaking of the health insurance system specifically, Mr. Fletcher addresses a far more menacing system that countenances the discrimination, the outright abandonment of decent, hard-working people of color, and also people of low income. The poor in America frighten middle and upper-middle class white folks even more, I suspect, than peoples of color. But in the cowardly new world of managed health care, medical decisions are routinely made by numbers crunchers. Even those WITH health insurance are likely to be given treatment below levels that at least some doctors would consider prudent.A Guy Named "Bob":Over the years I have gotten to know a guy named “Bob” [not his real name]. The government would probably classify him as an independent contractor, but he works for this company that does what can broadly be described as home maintenance. “Bob” is a 40-ish, African American. Very personable, he is equally reliable in his work ethic and performance. A bit overweight, “Bob” has been fighting high blood pressure, having recently experienced two incidents that landed him in the emergency room of a local hospital.
Life In This Brave New World
Without Health Insurance and Job Security
By Bill Fletcher, Jr.
BC Editorial Board
“Bob,” like 47+ million other people in the USA, has no health insurance, and receives an insufficient salary to pay for private health insurance out of pocket. He also has little job security, and he lacks a labor union, a fact very relevant to this overall situation.
A recent article in, of all places, Parade magazine [Lynn Brenner, “How did you do?” April 15, 2007] helps to put “Bob’s” story into context. Despite the fairly conservative bent of Parade, they put their finger on critical issues of the day:
* Workers’ productivity has grown 18% between 2000 and 2006, yet people’s real wages (factoring in inflation) have grown only 1%.
* 2/3 of those polled said that despite an allegedly booming economy, they do not believe that their children’s generation will be better off than they are.
* 47+ million people lack healthcare.
* There is a declining living standard for the working person, in part because employee benefits have been steadily shrinking.
* In 2005, the average CEO made 369 times as much as the average worker, whereas in 1993, it was 131 times.
So, for the average working person, [life] is unraveling and a tremendous amount of wealth is being captured by those at the top of the wealth pyramid.
The only things that the article failed to mention were that:
(1) the attack on labor unions by the corporations and their right-wing political allies helps to explain part of the decline in the living standard, and
2) for those of us of color—and particularly for African Americans—in every category, we continue to be hit harder than the white population.
“Bob”, like too many other people in the USA, recognizes that he is being stepped upon. After years of denial of the health issues he confronts, he is finally trying to come to grips with them. Yet, in one of our discussions, it was very clear that he had to weigh paying for medical treatments—which might prevent a stroke or heart attack—against his other survival costs. For “Bob,” however, the choices he confronts are choices he believes he must make on his own.
My fury with the system rose after my last discussion with “Bob.” He, like millions of others, finds himself being squeezed on all ends and he also feels very much alone. I asked him whether he had ever thought of unionizing his company. He sighed and not surprisingly said that he wished that there was a union at the company.
But that was not quite answering my question. There was no union at his company, so in order to get one, he and his co-workers would need to join together to form one. “Bob” had not a clue about how to do this, which affected me as well, since it spoke volumes regarding the state of workers today and of the union movement. Opinion polls over the last ten years have repeatedly noted that more than 50% of non-union workers would join or form a union or employee association if they could. These workers generally do not do so because of:
(1) fear of employer retaliation, since employers regularly ignore the National Labor Relations Act [which gives workers the right to form or join unions], and
(2) the union movement is largely stuck and has not developed the internal political will, strategies and organizational forms to address workers like “Bob”, who fall into the category of being members of a growing unstable, insecure workforce.
The fact that “Bob” is not alone in his experience should make it clear that a potential constituency of millions exists upon which a new union movement can be built. Such a movement is necessary to address the issues of gross social and economic injustice people such as “Bob” confront each day. This cannot happen unless “Bob’s” voice is part of shaping such a movement. In other words, a service cannot be delivered to “Bob”. Energy and organization can, however, be a vehicle for giving the millions of “Bobs” [men AND woman] a megaphone to amplify their voices.(MG) My father taught high school mathematics. For many years, he was the lead negotiator for the teachers' union. He understood the importance of compromise, but he also understood the importance of principal. Republicans have wanted to break up the teachers union forever. Unions have two traps to avoid - the corruption trap, and the comfort trap. The comfort trap is the more insidious. Many area teachers take their very nice salaries and benefits for granted. A terrifying number of them are unapologetic republicans. It's part comfort zone, but it's a lot racist. Ours is a VERY white community, and black or hispanic kids make some of the residents nervous; but then, so do white kids with spiked hair, and so do I.
(MG) My dream is for a third political party to arise out of the minds, hearts and souls of its logical constituents: Blacks, Hispanics, single women, unions, socially liberal anti-war Christians, Muslims, single mothers, the chronically unemployed, the marginally employed, and the barely-getting-by working class. Note well, the faces of such a political movement are severely underrepresented amongst our nationally elected officials (who are all to often anything BUT public servants).
Each time I see “Bob”, I wonder whether it will be the last. On the one hand, he may leave his employer and engage in the horizontal job mobility of so many US workers: going from one bad employer to another bad or semi-bad employer, but not really improving their overall economic situation.
On the other hand, I worry about “Bob’s” health and whether he will have to continue this game of Russian roulette, where he is making the choice between blood pressure medicine and feeding his family.
Why should anyone have to make such a choice?
BC Editorial Board member Bill Fletcher, Jr. is a long-time labor and international activist who currently serves as a visiting professor at Brooklyn College-CUNY. He is the immediate past president of TransAfrica Forum.
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