Jane Gets Her Insurance Card

Let’s start with my girlfriend’s situation.  We’ll call her “Jane” because Jane is not her name and this is the sort of story she’d rather I not be telling.  Jane makes $9.00 an hour doing work that is physically demanding, emotionally draining, and highly technical for a $9.00/hour job.  She can’t afford a car, so she either takes the bus to work or she rides her bike six miles each way.  She works ten hour shifts, which, when combined with her commute, means she is exhausted at the end of each work day.  In short, she is not what you would call a slacker.

Up until recently, she has been without health insurance.  Someone making $9.00 an hour does not have a lot of health care options.  Regular checkups were not something she could realistically afford and, when she got sick, prescriptions were too expensive to consider.  She had to try to guess what was ailing her and treat it as best she could with rest, over-the-counter medications, and whatever prescription drugs she could scrounge from friends.  Most of the time, she was able to muddle through with this method.  Sometimes, though, she’d get seriously ill and have to go to the emergency room.  Since single emergency room visits cost more than she makes in a year, the only realistic thing to do was to sneak out and ignore the notices from bill collectors when they inevitably came.

Jane has health insurance now.  She’s pays ten percent of her pre-tax gross income for her coverage and counts herself very lucky to have an employer who will provide insurance for someone who makes as little as she does.  She really felt as though she’d won the lottery when her health insurance card arrived in the mail.  

One Saturday not long after receiving her coverage, Jane was at work and started suffering severe abdominal pain and her urine was bright red.  When your pee has more blood than urine in it, you don’t mess around.  You go straight to the emergency room.

The good news is that, upon presenting her insurance card, Jane was treated much better than before.  No one asked if she was on drugs.  They treated her quickly, professionally, and, for the first time in her memory, respectfully.   A CAT scan revealed that she had a kidney stone which, given the symptoms, was the best she could have hoped for.  She was given several prescriptions and sent on her way.  Believe it or not, she was actually proud to pay her $100 co-pay at the desk.  She wanted so badly to do things “the right way” and not having to sneak out of the ER was a huge step in the right direction.

A month later, the paperwork arrived from the insurance company and from the hospital.  The total cost of her visit to the emergency room, prior to insurance, was about $20,000.  With her 80/20 co-insurance and her deductible, the amount she actually had to pay was “only” $3,900.  “Only” because that bill alone was more than twenty percent of her gross income.   Even though she now had health insurance, Jane owed over 20% of her pre-tax income in premiums, deductibles, and co-insurance.  And, making only $9.00/hour, Jane didn’t have a lot of disposable income to begin with.

Which is to say, Jane would have been far better off never to have purchased health insurance and just stuck the hospital, then the state, and ultimately, the taxpayers, with her emergency room bill.

Last night, I held Jane while she cried and cried.  She wanted so badly to get on the right side of the things, to pay her own bills, and she felt like she was being punished for trying to be responsible.  And you know what?  She was right.

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