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Finding a compromise between health and money
A health care reform package that meets everyone’s needs is elusive
By Holly Cook
Alicia Marsicovetere waited 90 days to receive health insurance coverage after she was hired as a telemarketer.
She paid $80 for one month and then her rate doubled.
Betting on her 26 years of good health, Marsicovetere decided to cancel her plan and joined the group of 10 million uninsured young adults across the country.
“It was too expensive, and they didn’t have a good plan for someone who’s healthy,” she said from her house in Englewood. “I would have rather had that money for something else.”
Like gasoline.
The new South Metro resident was living in Genesse Park and commuting to Highlands Ranch each day.
When she quit her telemarketing job, she remained uninsured, taking a lesson from her 34-year-old boyfriend, who hasn’t had coverage since he left home.
The couple is an example of what some health insurance experts are calling the “young invincibles” — young people who assume they won’t need health insurance or who would rather spend their money on other things.
Young adults are uninsured for a variety of reasons. According to a 2008 study by the Urban Institute, young adults are less likely to work for employers who offer coverage; they may not qualify for public programs such as Medicaid; and even the leanest private insurance plans may be too expensive when combined with student loan payments and credit card debt.
Health care reform legislation before Congress could change all of that. For many young adults, reform could mean relatively inexpensive individual policies.
Yet, the trade-off would be that every person would be required to buy at least minimal coverage.
And there could be a fine imposed, if someone opts out.
The Senate Finance Committee in an early draft of a proposal has recommended setting the penalty at $750 or $950 per year for a single person, depending on income.
But for someone like Marsicovetere, it would be cheaper to pay the fine than to buy insurance.
“A $60 fine is a little easier to swallow when you’re unemployed,” said 33-year-old Lindsey Kesel, who was laid-off from her marketing job over a year ago.
As a senior writer for a customer relationship marketing company, she was paying $24 a month for what she describes as “pretty decent coverage.”
Her plan provided a $ 20 co-pay on all doctor visits. Generic prescription drugs cost $15. The list goes on.
Now she pays over $100 a month for a bare-bones catastrophic policy, “just in case something happens.”
According to U.S. Senators quoted in the Washington Post, young adults are crucial to paying for any health care reform package.
“As low-cost additions to insurance pools, young adults would help dilute the expense of covering older, sicker people,” they said.
“Depending on how Congress requires insurers to price their policies, this group could even wind up paying disproportionately hefty premiums — effectively subsidizing coverage for their parents.”
Take 61-year-old Donovan O’Dell for example. With an advanced form of esophageal cancer, Type 2 Diabetes and arthritis of his eyes, the Littleton resident needs health insurance coverage.
The problem is that he doesn’t have it anymore.
Like so many hit by the economy, O’Dell was forced to lay off five of 10 employees at his wheelchair lift manufacturing company. And he had to stop providing health insurance coverage for them and himself, which is a death sentence for small business in his eyes.
“As an employer I need healthy employees. Having sick employees does not work toward my advantage or the advantage of the nation.”
Nor does being a sick boss.
Every two years, O’Dell is required to undergo a biopsy for his cancer, which costs him more than $3,000 out of pocket. It used to cost him $800 under his plan through Blue Cross Blue Shield.
“Now I’ve got to take out a loan to pay for my medical bills,” he said half joking, half serious.
Frustrated with the system, O’Dell spends his time at Town Hall meetings gaining an education on health care reform.
He’s a self-proclaimed supporter of a single-payer option, who ultimately wants a bi-partisan solution.
“It’s frustrating on a human level because we’re not engaged in dialogue to solve the problem,” he said. “We’re playing to much politics on issues that are in the vital interests of citizens. The Declaration of Independence was written to provide for citizens life and liberty. Nothing is more closely tied to life than health care.”
Marsicovetre, who claims to know very little about reform legislation, has a different opinion.
“There are so many different groups that aren’t getting the proper care — different age groups, people who are already sick, people who are healthy,” she said. “We’re never going to find a solution that works for everyone.”
She paid $80 for one month and then her rate doubled.
Betting on her 26 years of good health, Marsicovetere decided to cancel her plan and joined the group of 10 million uninsured young adults across the country.
“It was too expensive, and they didn’t have a good plan for someone who’s healthy,” she said from her house in Englewood. “I would have rather had that money for something else.”
Like gasoline.
The new South Metro resident was living in Genesse Park and commuting to Highlands Ranch each day.
When she quit her telemarketing job, she remained uninsured, taking a lesson from her 34-year-old boyfriend, who hasn’t had coverage since he left home.
The couple is an example of what some health insurance experts are calling the “young invincibles” — young people who assume they won’t need health insurance or who would rather spend their money on other things.
Young adults are uninsured for a variety of reasons. According to a 2008 study by the Urban Institute, young adults are less likely to work for employers who offer coverage; they may not qualify for public programs such as Medicaid; and even the leanest private insurance plans may be too expensive when combined with student loan payments and credit card debt.
Health care reform legislation before Congress could change all of that. For many young adults, reform could mean relatively inexpensive individual policies.
Yet, the trade-off would be that every person would be required to buy at least minimal coverage.
And there could be a fine imposed, if someone opts out.
The Senate Finance Committee in an early draft of a proposal has recommended setting the penalty at $750 or $950 per year for a single person, depending on income.
But for someone like Marsicovetere, it would be cheaper to pay the fine than to buy insurance.
“A $60 fine is a little easier to swallow when you’re unemployed,” said 33-year-old Lindsey Kesel, who was laid-off from her marketing job over a year ago.
As a senior writer for a customer relationship marketing company, she was paying $24 a month for what she describes as “pretty decent coverage.”
Her plan provided a $ 20 co-pay on all doctor visits. Generic prescription drugs cost $15. The list goes on.
Now she pays over $100 a month for a bare-bones catastrophic policy, “just in case something happens.”
According to U.S. Senators quoted in the Washington Post, young adults are crucial to paying for any health care reform package.
“As low-cost additions to insurance pools, young adults would help dilute the expense of covering older, sicker people,” they said.
“Depending on how Congress requires insurers to price their policies, this group could even wind up paying disproportionately hefty premiums — effectively subsidizing coverage for their parents.”
Take 61-year-old Donovan O’Dell for example. With an advanced form of esophageal cancer, Type 2 Diabetes and arthritis of his eyes, the Littleton resident needs health insurance coverage.
The problem is that he doesn’t have it anymore.
Like so many hit by the economy, O’Dell was forced to lay off five of 10 employees at his wheelchair lift manufacturing company. And he had to stop providing health insurance coverage for them and himself, which is a death sentence for small business in his eyes.
“As an employer I need healthy employees. Having sick employees does not work toward my advantage or the advantage of the nation.”
Nor does being a sick boss.
Every two years, O’Dell is required to undergo a biopsy for his cancer, which costs him more than $3,000 out of pocket. It used to cost him $800 under his plan through Blue Cross Blue Shield.
“Now I’ve got to take out a loan to pay for my medical bills,” he said half joking, half serious.
Frustrated with the system, O’Dell spends his time at Town Hall meetings gaining an education on health care reform.
He’s a self-proclaimed supporter of a single-payer option, who ultimately wants a bi-partisan solution.
“It’s frustrating on a human level because we’re not engaged in dialogue to solve the problem,” he said. “We’re playing to much politics on issues that are in the vital interests of citizens. The Declaration of Independence was written to provide for citizens life and liberty. Nothing is more closely tied to life than health care.”
Marsicovetre, who claims to know very little about reform legislation, has a different opinion.
“There are so many different groups that aren’t getting the proper care — different age groups, people who are already sick, people who are healthy,” she said. “We’re never going to find a solution that works for everyone.”
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