Universal Healthcare in America?

It’s a big thing for anyone with a chronic illness—health insurance. Ask anyone who sees specialists, who has expensive medications, or who has not-so-great insurance what they would do to make things easier, and you will almost always hear "universal health care."

I am one of the lucky ones—my husband is in a union. We have amazing insurance. I think it is roughly $90 a month for the four of us, and includes dental and some vision. The best part of our insurance are the spending caps. It goes like this—we have a $500 deductible. After that is met, we have a $1500 out-of-pocket spending cap per person, and it is a total of $3000 for the family before we do not have co-pays any longer. That means that I no longer have co-pays each year starting somewhere between May and late June. I take at least 5 different medications each day, the cost of each prescription ranges from $12 for generics to $24 for name-brand drugs. Everything that I take regularly is a generic. So what does this mean for our family? My drugs alone cost $96 a month. Add to that monthly doctor's visits, and any extras, we are averaging about $150 per month on my expenses alone. Add to that my husband, who has occasional migraines and takes a name brand drug for them at $24 for a one-month supply, and anything that might happen to our children, we budget about $300 a month for medical expenses.

To put this into perspective a bit more, I am a stay at home mom and the only income I have is from occasional knitting classes and my writing. My husband is a college graduate working in a skilled technical position, making about the top of what he can in our area. His insurance is through a union, so costs of that are low. We still spend close to 15% of our monthly income on medical costs. Granted, we do have a son with autism, and my medical condition is far from normal, and in a given month I can and have had several visits to various specialists.

The county I live in has a 5.4% uninsured rate according to the Minnesota Department of Health's 2001 Health Insurance Coverage for Minnesota Counties. That is considerably lower than the national average, cited in the CDC's Health Insurance Coverage Estimate, which puts the national rate at 14.5% for 2004, the most recent year available. While in general these numbers have dropped significantly in the past 10 years, it is a bit more dire when you get to the working poor. A whopping 60% of those working at minimum wage jobs are without insurance, and up to 69% of poor children are without health insurance. Those figures are staggering. Sure, there has been almost an 8% drop since 1996, but the figures for those making below $30,000 a year are not so encouraging. If a family of four, making a total of $30,000 a year had our expenses, they would be overdrawn each month. Healthcare costs are rising each year, in some areas at a greater rate than the cost of living. What can we do about this?

Well, there a many answers: provide more accessible insurance for low-income families, require all employers to provide health insurance for employees who work a minimum of 20 hours a week, or universal health care. Personally I am a fan of a universal healthcare system, one in which every legal resident of the United States would qualify for coverage, with the option of private insurance for those who have employers that chose to provide it. I also feel I need to explain a bit more about why I feel this way—my husband is English. His parents still live in the UK and are covered by the national insurance there. They know that they have coverage, no matter what. My mother-in-law fell a few years ago on Mother's Day, fracturing her elbow and requiring emergency surgery. Here, a surgery like that, even with good insurance, would have cost hundreds, if not thousands of dollars. On a limited income where healthcare costs already take 15% of the monthly income, this could send a family into bankruptcy, or at the very least, severe debt. Her surgery was covered, no worries. If that had happened to me, for instance, I would have been responsible for about 15% of the total cost of the surgery and resulting hospitalization. This works out to about $2,000, or a bit under half of my husband's monthly salary.