Health Care, Insurance and the Middle Class

The current health care debate seems to center around those that do not have health insurance.  Some of those people don’t have it because they are poor, some don’t have it because they are young and choose to spend their money or benefits elsewhere and some don’t have it because they, for one reason or another, are considered uninsurable.  In all of the chatter about health care the Middle Class always seems to get left out of the equation and continues to see their standards of living eroded. 

In this email I’d like to talk about one of the major problems looming on the horizon for these Middle Class Americans that do have health care and what I would propose we do about it to ensure that it remains affordable and that coverage doesn’t disappear because they’ve had a run of bad luck health wise.

 This past weekend I was involved in holding a benefit, pancake breakfast to help raise money for a woman who needed surgery for her brain cancer.  It was a great event and lots of people came together to show their love and support for the woman and her family.  It was the type of event that renews your faith in your fellow human beings and makes you glad to belong to the groups you belong to.  That’s the great part of this email; the bad part is that the event should have been totally unnecessary.

The reason for this fundraiser was because this family’s insurance has an annual expense limit and, because of previous cancer treatments, they had reached their benefit limit for the year. 

A couple of weeks ago we learned that a friend’s wife was going to have to go in for her third brain cancer surgery as soon as possible.  They are hoping to be able to get it all this time and solve the problem.  Everything was set and everyone was ready and then the real problem hit.  It appears that the family had used up its health insurance benefits for the year and the insurance company would not pay for any of the operation and related costs unless they waited until January to have the procedure done.  With brain cancer it is rarely a good option to wait.

These are not people who have shirked their responsibilities.  The husband has his own plumbing business and they have purchased their own insurance for the family.  However, no one ever expects that they will actually run out of insurance coverage, but this is what happened and as I’ve researched the subject it appears that this happens more and more these days.

As an example, On Thursday, November 29th, the Wall Street Journal had a page 1 article entitled, “As Medical Costs Soar, The Insured Face a Huge Tab”.  This article told the story of how a person, who has worked all his life and who carries good medical insurance suddenly found himself facing a huge medical bill and potential financial ruin when his lifetime benefits of $1,500,000 were maxed out due to some severe medical conditions (and what I consider fraudulent hospital billing schemes, but I will deal with that in a later email).  In fact, the article goes on to state that the majority of people facing financial problems because of medical bills actually do have health insurance. 

This appears to be a problem that should be fairly simple to solve, but since it doesn’t involve great sound bites and the ability to be a champion of the poor or illegal, our politicians have no interest in dealing with it.

Shouldn’t our political leaders be paying attention to make sure that the 260,000,000 of us who have health insurance and are trying our best to take care of ourselves and our families in a responsible way are given the safety net that appears to be needed in the face of rapidly rising health insurance costs and the potential of catastrophic illness or accident?  I say that this is a very important part of the discussion and it is getting lost in the sound bites surrounding the uninsured.

Most of you know that I am not a big proponent of giving the Federal Government more control and involvement in our daily lives, but this may be a case of where Federal Government involvement is necessary.

I believe there should be a Federal safety net for people with insurance who, through no fault of their own, use up their health insurance and are left without coverage when they need it most because of a catastrophic illness or injury.  People who try to do the right thing (buy or have a job with insurance coverage) should always have the backing of the government for circumstances far beyond their control.

I believe there should be a Federal health insurance pool for people who cannot buy health insurance from traditional sources similar to the Flood Insurance Program currently in place and the Disaster Insurance Program that I have proposed in an earlier email concerning the government’s response to disasters.

The true purpose of a Federal health insurance program should be to prevent people from suffering financial ruin when a major medical event happens in their lives, not to pay for every little thing and every time they want to see the doctor.  When a governmental program starts to pay for every little thing, it gets abused, our money is wasted and costs spiral even more out of control.

Let’s do what is right by all Americans and develop a safety net so that everyone has the ability to be covered against the major medical events and can buy major medical insurance while maintaining some individual responsibility for the day-to-day health care items whether it is through their one’s own private insurance policy, an employer insurance policy or by paying for it out one’s own pocket.

The health care system in the United States is a huge part of our economy and will only grow larger as our population continues to age.  I will have further emails on this subject as we continue towards the election to discuss other parts of the equation that also appear to be in need of adjustment.


“Anything is Possible in America”

Frank McEnulty

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2 Comments on “Health Care, Insurance and the Middle Class”

  1. insurance Says:

    Michael Moorer’s “Sicko” touched on a lot of this.

  2. Dean Calvert Says:

    Good info. and reading. I would definitely bookmark you to check for new updates.

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