A Tragic Tale -- Of A Lack Of Parental Responsibility
Remember all those stories of men back in the 50s who sacrificed to feed and care for their families? They didn't think they got to sacrifice earning power to have the most fulfilling jobs -- and I don't think you get to if you have kids...if you can't pay for those kids on it.
Of course, a big part of the problem, as I've written before, is that health care is tied to the workplace. As soon as I no longer worked in a company (in my early 20s), I got my own health insurance (Kaiser HMO rather than Blue Cross, because once you're in, you're in, and the price goes up based on age, not on whether you get sick).
Read the tale of the here of the guy's kid in the hospital after he took his chances on having no health insurance (but, yay, he "works full time as a self-employed consultant and writer"):
He wasn't eating and his fever was getting pretty high, up to 103. I drugged him the best I could with kid's OTC meds and on Monday my wife and I attended to his needs however we could.We should have taken him to the Urgent Care right then and there. But we didn't.
My poor decision-making capabilities in this regard was influenced by my lack of experience with any major disease (I have an immune system of steel, fortified by coffee and whisky), and our lack of insurance. My family includes four of the 49.1 million uninsured people in the United States. I've comforted myself that we couldn't afford private insurance, which we can't, but at least we were all relatively healthy and never seemed to have problems.
...When I started my family 6 years ago, I was on a path to a career in research and teaching. We had amazing health insurance through my institution and my wife and children-to-be were generously covered, no-questions-asked by the state of Pennsylvania during, and a year after, the pregnancies. We never saw a bill. After I got "real jobs" upon completing my Masters degree, I entered a grey zone of contract teaching and research employment at universities. With a decent, regular salary we were ineligible for state aid, yet didn't make enough to afford extra costs. Furthermore, the quality of the insurance kept lowering until I wasn't even sure what I was paying for - even as the premium costs were rising.
It reached rock bottom last Spring when we attempted to actually use our insurance that I bought for $1400 every six months while a contract lecturer and beginning PhD student at a North Carolinian university. My boy was starting Kindergarten and needed to be current on his vaccines. Of course, both kids needed to be current, so we took them in one-by-one, got their shots and check-ups, handed over the insurance information, paid our co-pay and went on our way. Never thinking about it, assuming that insurance would do the job we paid them to do.
Exactly 6 months later we received bills, after I no longer had insurance (I had to leave my phd for variety of reasons), and addressed to our kids' names and not mine, the policy holder, for substantial amounts. Apparently, my daughter owed over $400 and my son owed over $1600 to the doctor office, which was the net left over after the insurance contributed about $200 for each visit.
Naturally, I was dumbfounded. I already paid $1400, which I had to ask my department head for an advance to cover their own insurance (there were no monthly payment plans offered by the way), but they only covered about 20% of the medical bills? Ironically, as an uninsured I would have been able to get a discounted rate and probably pay less than the amount I actually owed after the insurance company gave their dues.
I still don't understand it and they are unwilling to work with me. Hence, the bills have gone to a collection agency. I'm refusing to pay for the time being and my kids, at 4 and 6, have their first negative credit rating. Presumably, anyways, since the idiots never fixed the billing information.
This burn, though, has contributed to a deep mistrust in the insurance industry, further feeding my indignations about acquiring individual care - of course we couldn't afford the monthly premiums anyways so the point is moot.
This commenter's right on:
20. Eowyn
Mr. Zelnio's story is sad indeed. But I'll be the lone dissenter among the commenters here.Throughout his tear-jerking account, not once did Zelnio admit that his behaviors and his choices have consequences. It is Zelnio who chose to support a wife and 2 kids on a M.A. graduate student's salary -- which is not meant to support an entire family. It is Zelnio who chose to discontinue his Ph.D. studies and so forfeited even that salary. It is Zelnio who chose to get "renter's or home, wind and hail, flood, car, life" insurance, but not medical insurance, although he knows full well how expensive medical care is. It is Zelnio who chose to gamble that he and his family would not require emergency care or hospitalization.
He gambled and lost. So now he wants other people to pay for his family's medical insurance via a "single payer" system. Though some of the commenters deny it, that is socialism.
This person's dad got it, too -- although the commenter's mocking his dad, who was right:
32. DSchultz
My late father would have explained it to me as follows:"When you chose to have children, you forfeited the right to follow your "dream job". Your satisfaction with your job is not as important as your ability to provide necessary support and protection for your children. Therefore you must abandon your present job and find a responsible middle management position in a major corporation that will provide your family with group health insurance. Your pay and benefits are all that matters, job satisfaction is for hippies."
Bio of the writer:
Kevin Zelnio is a marine biologist by training and is now a freelance science writer, independent scientist and science communications strategist living in beautiful coastal North Carolina. He has studied the ecology and evolution of animals living around underwater volcanoes and described several new species of deep-sea invertebrates.Kevin is the assistant editor for Deep Sea News, where he contributes articles on marine science. Outside of science, Kevin is a songwriter and enjoys spending time with family in the long-leaf Carolina pines!
While all this is going on, remember that the sole purpose of "insurance" (quotes because it's NOT insurance, everyone is going to need care) is to pay doctors.
If the system you envision doesn't do that to the exclusion of all else, it's a failure.
Office-building occupants at an HMO, BCBS, Kaiser, whoever, are parasites diminishing your medical dollars, and Federal involvement can only make that worse.
Radwaste at February 21, 2012 2:55 AM
After I'm super rich, I'm going to start my own insurance company.
My model would be simple:
You pay a fixed rate constantly. Routine stuff like vaccines wouldn't be covered, its there for emergency use. That means no fertility treatments, no birth control, no cosmetic surgery. But any emergency care, a sudden illness, a broken limb, cancer, you'd be covered without limit. No "Co-pays" or any other horseshit.
Discounts would apply to those who chose to take care of themselves, and proved it by taking a physical fitness test once per year.
That about sums it up.
Robert at February 21, 2012 3:20 AM
Robert, isn't that called "Major Medical Insurance?"
Somehow, though, I think the government would still force you to pay for everything, up to and including Preparation H, which will be needed in greater and greater quantities.
Old RPM Daddy at February 21, 2012 4:31 AM
Except, "Dad," that responsible middle-management jobs in respectable corporations are few and far between these days... and even if you obtain said responsible job, it ain't necessarily going to come with the health coverage it did back in Dad's day.
I've made sure to have employment that offers coverage for as long as I've had children. In one job, my "employer-provided" coverage was taking a bite of $700 a month from my paycheck. In the one I have now, we're buying our own because the "employer-provided" coverage runs $15,500 a year, which would represent more than a third of my pay.
My spouse and I both work, often more than 40 hours a week, not at "dream jobs" necessarily, but at jobs that will get the bills paid. We have coverage, but once you pay for a (very basic) roof over your head and a week's worth of spaghetti, oatmeal, and peanut butter, sometimes that coverage takes every dime that's left and then some.
Beth at February 21, 2012 4:36 AM
I wouldn't know RPM. I don't have insurance on myself.
Robert at February 21, 2012 5:04 AM
@Beth How old are you that it's costing over $1300 a month for insurance?
If it's not age, then you're probably buying too much coverage.
I'm 42, and I pay $180 a month for major med with a $3,000 deductible and no co-insurance.
brian at February 21, 2012 5:09 AM
If you live in New York, you cannot buy the insurance Brian is describing. You will have coverage for your child's physical for college, "free" mammograms, and coverage for mental therapy, even if you won't ever need any of it. I pay about what Brian pays, but I only cover my wife and me since my children are on their own now. What's not included? The fact that my employer is paying probably 3-4 times as much as I do for my health care.
I see no reason to subsidize Kevin Zelnio's lifestyle. My high school classmate with the Marine Biology degree became a drug company rep - and this is probably before Kevin was born. There always were very few jobs in that field.
MarkD at February 21, 2012 5:30 AM
MarkD is right. Marine Biology degrees are a waste. Living in a marine environment, I know about a thousand people with one - almost all of them doing something else.
My ex just put our kids on his girlfriend's insurance. She works for the University of AZ, and has amazing coverage. Somehow, they cover my ex as a "domestic partner." The university didn't want to discriminate against gay couples, so they deemed that if you share a bank account and own a home together, you're "domestic partners". Then, they realized they couldn't discriminate against straight couples who did the same.
So, my ex and kids are covered under her insurance. The kids can now be covered until they're 26. I pay her their portion of the premium, which is $242 per month for a policy that covers 100% of hospital care with a $250 deductible - for two "kids" (18 and 22).
As happy as I am about that, I think it's crazy. I've never had such a good policy, as a self-employed person.
LS at February 21, 2012 5:56 AM
Brians's insurance has been touted for years as the responsible way to have health insurance. Why is it not available in NY? Look who is fighting the Medical 401k idea and decide who to vote for in the future. You put away $250/month per person to cover the deductible and if you don't use it in any year it transfers to your 401k for retirement. There should be many good years when you don't use it.
Ed at February 21, 2012 6:11 AM
Brian, I had a shock when I moved from CA to MA back in 2001. In CA I paid $130 a month for Kaiser, which included dental. In MA I paid $340 a month for less coverage, and a higher co-pay. Then it went up to $365 a month a year or so later. It was going to go up to $415 but then I got other insurance.
I can see how this guy originally thought he was making enough to cover insurance, but it kept going up and up and up every year. And if his jobs got worse and worse and worse, well...
NicoleK at February 21, 2012 7:18 AM
What I don't get is if he had insurance at the time of the visit, why didn't it cover the visit. The fact that he was uninsured at the time the bill arrived shouldn't be relevant, he was insured at the time of treatment.
NicoleK at February 21, 2012 7:19 AM
Brian, Beth has kids. I don't know how many she has, but I assume her numbers are including them.
NicoleK at February 21, 2012 7:21 AM
The cost of insurance is such that you're better off putting that money away and you can cover most of your medical costs out of that. Not true for all, but damn.
Robert at February 21, 2012 7:28 AM
"He wasn't eating and his fever was getting pretty high, up to 103. I drugged him the best I could with kid's OTC meds and on Monday my wife and I attended to his needs however we could.
We should have taken him to the Urgent Care right then and there. But we didn't."
No insurance? Just go to urgent care and put it on your credit card. When the bill comes, pay it off (or down) with all that money you've saved not buying insurance.
Lori at February 21, 2012 9:08 AM
Health insurance is essentially paying for a system you don't need - so it will be available when you do need it.
People who purchase insurance are laying the groundwork to establish hospitals, train doctors and medical staffs, and purchase equipment - so when those things are needed, they're available.
People who insist "I'm healthy" or gamble they won't need coverage are expecting the rest of us to foot the bill in setting up the system and then asking us to give it to them at a discount (or for free) when they need it.
So, it wasn't his fault his family had no coverage whatsoever?
Oh, I see. It's society's fault.
It's nothing he did or didn't do, it's the widespread cruelty of a society that has casually tossed aside almost 50 million of its inhabitants.
==============================
By the way, that "49 million Americans" figure gets tossed around a great deal.
49 million Americans are going hungry (USDA estimate).
49 million Americans don't have health insurance.
=========================
Reading the article, I got a bit annoyed with his whiny "it's not my fault" theme.
By doing a little research into the companies.
You were a frickin' PhD candidate. You should know how to do research.
It's not his fault he didn't get emergency coverage. It's those mendacious insurance companies.
The hospitals are evil, too?
No wonder this guy has no insurance or medical coverage whatsoever. Society is in concert against him.
=========================
For a PhD candidate, this guy writes like a pretentious college freshman, always opting for the extra syllables over concision and clarity.
"commonplace practice" instead of "common practice"
"North Carolinian university" instead of "North Carolina university"
"like myself" instead of "like me"
Conan the Grammarian at February 21, 2012 9:47 AM
Yep, kids are expensive.
But if you wait until you can afford to have kids, you might never have them!
:-P
Pirate Jo at February 21, 2012 9:52 AM
By the way, I got flamed to a toasty crisp on another website a few months ago, when the discussion focused on another one of these "tear-jerker" stories.
My suggestion was that if the family could not afford a basic term life policy (which would have solved all their problems) they couldn't afford to have kids in the first place and should have waited longer.
People generally do not respond well to the suggestion that they choose between having children and all the other stuff they want.
Pirate Jo at February 21, 2012 10:10 AM
Some of the critics are a bit harsh, but not as harsh as reality was on his family.
Of course, they could have asked me to comment on this. I mean, I'm never harsh.
I have nothing to add to what was already said, except that it seems to be a related mindset to the type of rude parenting Amy writes about. It's all related to this sense of entitlement that parents seem to have. Whether they claim the right to disrupt our dining experience or enjoyment of movies or public events because their kids act up, or whether it's gambling with your health insurance...it's this stubborn refusal to acknowledge that kids come with sacrifices to be made. Not ours. Yours.
Patrick at February 21, 2012 11:28 AM
Ugh. I had a little sympathy at the description---y'know, shit happens, birth control fails, people lose their jobs and can't afford the COBRA payments. None of those make me want to advocate for single-payer or anything, but I get it.
I also get why one would choose to do without insurance when you find that the kind you can get is practically worthless in your situation. I've had to make that choice and I ended up dropping the insurance and putting the money I had been spending on premiums directly into an account which I used to pay my kids' doctors directly. Doctors do still take cash, checks, credit cards---you don't need to have insurance to see a doctor, though it's usually the best idea to have it.
But this guy? I'm sorry, if you have $4,000 saved for a trip to effing Sweden, and you still wait til your kid is blue to seek medical attention for him because, oh, gosh, the ER will send you a bill, you are really, actually are a shitty person and parent.
Don't give me this bullshit about how if your son had been "able" to see a doctor the day before, the infection wouldn't have gotten so severe---the only thing keeping your son from seeing a doctor, at Urgent Care, the ER, or a private practice doc was your own wish to hold onto $4,000 for a trip to Sweden. Jackass. If you have kids and you have $4,000 that is what we call an Emergency Fund, not a trip to freaking Sweden fund! You know what you use emergency funds for? Taking sick children to the doctor before an ordinary little bug turns into something so severe.
Ugh. Again, I could muster up some sympathy and a donation for someone who just barely got off of Medicaid and is trying to get his/her family to be self-supporting when something major happens. This guy is just a tool.
Jenny Had A Chance at February 21, 2012 11:29 AM
Amy Alkon
http://www.advicegoddess.com/archives/2012/02/21/a_tragic_tale_-.html#comment-2992149">comment from Jenny Had A Chanceif you have $4,000 saved for a trip to effing Sweden, and you still wait til your kid is blue to seek medical attention for him because, oh, gosh, the ER will send you a bill, you are really, actually are a shitty person and parent.
Absofuckinglutely.
Amy Alkon
at February 21, 2012 11:58 AM
If I'm reading the article correctly, the $4,000 for the trip to Sweden was used to pay for his wife's ER visit years ago ... not for his son's visit to the urgent care facility.
He later joined a class action lawsuit against that hospital, but didn't recover much.
Conan the Grammarian at February 21, 2012 12:07 PM
NicoleK wrote: What I don't get is if he had insurance at the time of the visit, why didn't it cover the visit. The fact that he was uninsured at the time the bill arrived shouldn't be relevant, he was insured at the time of treatment.
My guess is that it was balance billing (someone who knows more about insurance might be able to correct me). In other words, he may have gone to an out-of-network provider. Basically, the provider will take your insurance card, send you on your way, and then contact your insurance company to see what it can get. The insurance company then pays whatever it covers for a specific procedure for a *contracted* provider (usually a discounted rate). And the provider then turns around and charges the patient the balance.
It's one of the more confusing/inefficient/messed up parts of health insurance. Sometimes, you'll go in for a checkup, the doctor will tell you to go downstairs and get some blood work -- the doc visit is covered, but the person who performs the blood work is "out of network." Nobody warns the patient because the doctor doesn't know who in the building is "in network." And the patient thinks, "Well, I made sure my doctor was in network, so I should be fine."
sofar at February 21, 2012 12:15 PM
I'll second that absofuckinglutely!
Charles at February 21, 2012 12:20 PM
"job satisfaction is for hippies"
Best. Quote. Ever.
Mike43 at February 21, 2012 2:43 PM
"a basic term life policy (which would have solved all their problems)"
What?? how does life insurance solve their medical insurance problem?
carol at February 21, 2012 3:07 PM
I started to read the article but got ill. Then I scanned the comments and actually puked. It's unbelievable that so many people in this world honestly believe they have a right to the services of others and/or the money of others to pay for those services. It's enough to make we want to start a wholesale welfare-fraud ring, to get enough people on to crash the system so we can start over.
momof4 at February 21, 2012 3:33 PM
"After I'm super rich, I'm going to start my own insurance company. My model would be simple:..."
With my model, you pay nothing until you need treatment.
And you earn interest on what you save in that account. And it doesn't matter what country you're from. And if the expense gets out of hand you get help. And nobody but a doctor gets paid for most work. And government doesn't ration anything for you. And you are not bound to an employer.
And since it's not what you've had drummed into your head on the infotainment channels by people who want to tell you what to do, you have no idea what this looks like. So go look. The link is not monetized.
Radwaste at February 21, 2012 4:10 PM
$1400 every six months for a family?! Where can I get such a good deal?
Gog_Magog_Carpet_Reclaimers at February 21, 2012 4:20 PM
I'm amazed at how many people in the comments apparently think "no payment" health care equals "free" healthcare.
Free? Really?
The doctors and medical supply companies are donating their products and services? The pharmaceutical researchers worked for no pay and donated the medicines they developed? The hospital was built by volunteers with donated materials?
"Paid for by someone else" does not equal "free."
========================================
The US healthcare and health insurance system needs an overhaul, but a single-payer system like Obamacare ain't it.
Nor is a Euro-style single-payer system. Like the British system, socialized single-payer systems eventually find themselves overwhelmed and begin reducing the quality of care provided, closing clinics, and reducing coverage in order to make ends meet.
The problems with a single payer system include a lack of vision ("why do it differently - it's the way we've always done it"), lack of cost controls beyond bureaucratic mandate ("we don't care what it actually costs, this is what we're paying for it"), and lack of incentive to develop or try new ways once the providers within the system have hit upon a money-making way of gaming the system for profit (doctors owning medical labs, etc.).
One problem with the US system is that it's tied to employment. Switch jobs and risk losing some coverage.
Another problem is that it's regulated differently by each state.
In California, buying an HMO-sponsored individual plan is doable. In Massachusetts, North Carolina, or New York, it's much less practical and affordable.
========================================
Early in his first term, GW Bush proposed to move the US toward a Health Savings Account (HSA) system in which people would have a set amount provided annually by the taxpayers along with individual and employer contributions. People would be free to contribute a pre-tax portion of their income into the account, reducing their tax burden and increasing their healthcare funds.
The amount would be carried over from year to year.
The money would belong to the account-holder and usable for any healthcare needs.
The account-holder would be free to determine what expenses will be borne (you want to do how many tests?) and which provider would be used.
Much like shopping for any service, the buyer would be in control.
The onus would have been on the service providers to provide modern, efficient, and effective services. Pharmaceutical companies would lose business if another provider could provide the same drugs at a lower cost to the consumer. Medical labs would find themselves in competition with other labs - instead of getting a steady feed of patients from affiliated medical offices.
People would be free to switch providers at will.
Employers would have provided contributions to employees' HSAs, rather than administer an expensive benefits plan.
The HSA would be transferrable across states and usable anywhere.
And it wouldn't be tied to your employer - it would be yours to take with you through life. If you were judicious in your youth with your HSA spending, you would have a large account built up for your old age.
Of course, not only did Congress refuse to even consider such a proposal, they killed the few provisions for HSAs that existed (no carry over, limited applicability, etc.).
Pelosi, Reid, Clinton, et al had already decided their vision of single-payer system was coming and they got rid of all the competing proposals.
They did the same thing with Bush's proposal to give people some control over their Social Security funds.
Congress is not your friend.
I'm not saying Bush's proposal would have been the perfect system, but it was worth considering - and deserved at least as much public debate as was ignored by the Obamacare proponents.
Conan the Grammarian at February 21, 2012 4:55 PM
"job satisfaction is for hippies"
Bill Gates is a hippy? DINKs are hippies? Yuppies are hippies? Sigmund Freud was a hippy? These people are carefree ne'er-do-wells?
dumbest..statement..ever.
Gog_Magog_Carpet_Reclaimers at February 21, 2012 5:29 PM
Both my prior and current employer offer MSA's. But I never can predict what medicines or other medical stuff I'll need in a given year.
Now if there were a pre-tax HSA that was a lifetime account tied to me, I'd do it in a heartbeat.
Jim P. at February 21, 2012 6:45 PM
He should have been an illegal alien. Then the ER would have to treat him...
There is nothing that government can't make worse.
MarkD at February 22, 2012 4:51 AM
Carol, I was referring to a different story. In that case, one parent died and the other became unemployed. So the remaining parent and two kids were living in their car. In their situation, a life insurance policy on the spouse who died would have provided for that family during the subsequent job loss.
Pirate Jo at February 22, 2012 5:34 AM
I got sucked into the comments there. For your info, I am a cruel heartless (apparently rich) bitch with a crystal ball, according to them. Because I stated I thought the man should ahve bought insurance before planning european trips. And that he should ahvbe taken his soick kid to the Dr earlier. heartless bitch, that's me. My bumper sticker should be here soon.
momof4 at February 22, 2012 11:35 AM
Amy Alkon
http://www.advicegoddess.com/archives/2012/02/21/a_tragic_tale_-.html#comment-2993988">comment from momof4I'll take one of those if you've got a duplicate, momof4. Right there with you on this!
Amy Alkon
at February 22, 2012 12:53 PM
Conan the Grammarian:
Per HSA's:
The money would belong to the account-holder and usable for any healthcare needs.
The account-holder would be free to determine what expenses will be borne (you want to do how many tests?) and which provider would be used.
Much like shopping for any service, the buyer would be in control.
Somewhat. We've got the HD/HSA plan - not quite what you're describing, and we're still not "in control".
Our insurance is still the bigger arbiter, but we do have _more_ skin in the game, and more importantly, it's _our money directly being spent_.
Not just we threw some into a big pile, and then are trying to get as much as we can back out - that's our money in the HSA.
It's convertible to a IRA if it makes it that long and we retire.
But when I hand over my HSA card, that's my bank balance that's being affected, and it's amazing the transformation that occurs in thinking there.
Which, of course, his why it's dangerous to the whole concept of "single payer" (ie, you're the single payer.)
Unix-Jedi at February 22, 2012 3:09 PM
Unix-Jedi,
Unfortunately, I was not describing any plan that exists now.
I was describing the outline of a plan being bandied about by GW Bush.
It was shot down by Democrats (and some Republicans) in Congress before Bush even got to flesh it out and present it for a debate.
Despite a slim Republican majority in Congress, Nancy Pelosi, Harry Reid, Dick Gephardt, Hillary Clinton, and company let him know his proposal would be dead on arrival if he tried to present it.
The Democrats in Congress were holding out for a government-controlled single-payer system very much like the one we now call Obamacare.
The insurance companies were also a bit nervous about the HSA proposal since they could potentially lose the premiums and the control they now have over the healthcare system.
But the insurance companies were equally nervous about being shut out of any future single-payer system - probably still are despite the proposed Exchange on which people will be able to purchase "competitive" insurance packages.
Conan the Grammarian at February 22, 2012 5:49 PM
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