I don’t know what the solution is. If I did I would have called this thread “The Case for Single Payer Health Care” “Universal Health Care” or “Socialized Medicine”.
But I don’t know the answer.
But I have some friends, Kevin and Beth. They have 2 gorgeous little girls and a boy who is a blast! The kids are 10 years old down to 11 months.
Beth has MS. It is mostly under control now but she does struggle, probably more than she lets on.
Kevin works for Circuit City who just filed Chapter 11 Bankruptcy. That’s fine, he keeps his health care. But conventional wisdom is that they will move to Chapter 13 after Christmas.
Chapter 13 means no more healthcare and no COBRA option.
No company will write a policy for a woman with advanced MS. Her medicines will break them. They will run through their savings, then his 401k, then what? A couple thousand a month for meds and more for doctor visits.
So what do they do then? Medicare? So she WILL have socialized medicine, but just after they blow their retirement and their kids college money.
A minor point of fact. Medicare eligibility is dependent on the extent of the disability, not on income. Medicaid is dependent on income and assets. In your scenario, if her disability is not severe enough for Medicare, they could wind up exhausting their assets and then getting Medicaid. If she is too disabled to work, she should be looking into Social Security Disability and Medicare eligibility ASAP. Also, sometimes drug companies have subsidy programs for those unable to pay.
I wish Kevin the best of luck in finding a new job with benefits right away.
My state, Indiana, has a program for people who don’t or can’t get health insurance through an employer, and they covered my husband (spina bifida, diabetes, carpal tunnel) including pre-existing conditions for an insanely reasonable price. Once we qualified.
I STRONGLY suggest these people look into state and local programs. There may be something out there for them, even if they have to jump through a lot of hoops. A lot of states have coverage for kids, too. They need to do some research. There’s no guarantee they will get anything, but they really need to look and see.
Since this is IMHO, I can argue strongly in favor of universal health insurance. Here in Canada, there are no eligibility conditions. There is no massive bureaucracy whose main job is to weed out bad risks and to find reasons to deny claims. Their administrative expenses are very low (a few per cent) and when you are in the hospital they spend no time itemizing every single service. Although not part of universal coverage, there are, I believe, no proprietary hospitals; they are all government financed, although locally operated. Doctors are paid on a per act basis. Globally we spend per capita about 2/3 of what the Americans do, and that covers everybody. Incidentally, one of the costs that is not usually accounted in the US is the time physicians spend fighting with insurance companies over treatments. Every minute my daughter-in-law (a family physician in NYC) spends on the phone arguing with an insurance bureaucrat is a minute she is not spending on caring for patients. Here, as far as I know, doctors are pretty much autonomous.
The main problem here (Quebec to be precise) is a shortage of doctors and nurses. The latter because the government stupidly bought out a few thousand nurses some years ago to solve (in the short term) a budget problem. Now they can’t get nurses and are trying to enforce obligatory overtime. There is a shortage of doctors, which could be alleviated if foreign doctors (some one whom are driving taxis) were permitted to practice. (The problem is that they are required to go through internship and only 20 are permitted to enter internship every year.) They also keep the med schools from expanding. If, however, they were to spend 3/4 per capita, instead of 2/3, all these problems would go away.
Of course, all this is paid for by hefty taxes, worth every cent. Americans are famously averse to paying taxes and would prefer to do without government services.
One other thing I’ll mention is that, while he may not be eligible for COBRA in the worst-case scenario, he should also look into something called conversion of his health insurance. The premiums are higher than COBRA, but the insurance company has to issue the policy. Essentially it is a requirement to issue an individual policy.
Beth should contact the MS Society. They will probably have some ideas. I also have MS but am Canadian so can’t help with insurance questions but will try with anything else.
I would also recommend that the OP’s friends look into SSDI and Medicare; however, they will need some help in the interim. SSDI can take up to 2-3 years to start awarding participants (it can take that long just to get through all the levels of appeal necessary to get reimbursement) and after that, you’re only eligible for Medicare on the 25th month after you’ve started collecting your SSDI.
I’d strongly recommend that your friend contact a SHIP program (state health insurance and assistance program) and their local chapter of the MS society. To find SHIPs, you can use Medicare.gov’s search engine. Just type in SHIP and it should the the first or second link under your results.
Good thoughts for your friends - I actually work in SSDI and Medicare and the way the system works is obscene. I hope your friend can find another job, and fast.
