22 Year old Dies Uninsured

Avatar for ddnlj
iVillage Member
Registered: 03-26-2003
22 Year old Dies Uninsured
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Tue, 09-29-2009 - 9:05am
Doctors say now that she died, not from swine flu, but from viral pneumonia, but the cause is less relevant than the fact that she died at all.
Like a large number of young people in this country, this young woman was uninsured. Most young people can't afford private insurance because the jobs they hold don't offer it or don't pay enough. These are kids who haven't yet gotten their first "good" job with benefits. Some are still in college. Some are working p/t while going to school. Some may not, for various reasons, be retained on their parents' health insurance. In any case, most of them rarely earn enough to pay for health insurance so they do without.

Shouldn't there be something in place to protect these young people?


Uninsured 22-Year-Old Boehner Constituent Dies From Swine Flu

hjnyoungkimberly09-_568332bA 22-year-old woman from Oxford, Ohio, died from swine flu on Wednesday. Kimberly Young graduated from Miami University in December and continued to live in Oxford, Ohio, within Minority Leader John Boehner’s congressional distrct. Reports now indicate that after initially getting sick, Young put off treatment because she was uninsured:



Young became ill about two weeks ago, but didn’t seek care initially because she didn’t have health insurance and was worried about the cost, according to Brent Mowery, her friend and former roommate.


On Tuesday, Sept. 22, Young’s condition suddenly worsened and her roommate drove her to McCullough Hyde Memorial Hospital in Oxford, where she was flown in critical condition to University Hospital in Cincinnati.


“That’s the most tragic part about it. If she had insurance, she would have gone to the doctor,” Mowery said.


According to the Kaiser Family Foundation, 30 percent of 19-24 year olds are uninsured, more than any other group. Despite the conservative argument that young people are voluntarily refusing health coverage in favor of extra spending money, the reality is that high costs on the individual market put coverage out of reach. As Suzy Khimm notes at Campus Progress, young people “are far more likely to be working part-time or lower-paying jobs for employers who don’t offer coverage”:



In its 2008 study, the Commonwealth Fund found that 66 percent of young adults aged 19 to 29 who experienced a time without coverage in the past year said they had gone without it because of the cost.


Young people might have a better chance of accessing comprehensive coverage if there were a public plan, which could lower the cost of insurance, particularly for those without good employer benefits. Young people may also have a better chance at coverage if there were generous subsidies for lower-income individuals, as many take lower-paying jobs when they first enter the workforce.


Even though Boehner represents a large university, he has been an outspoken opponent of a public option that would make insurance cheaper and more accessible to recent graduates like Young. On Meet the Press last week, the Minority Leader continued to stick to the obstructionist Frank Luntz-endorsed talking points, dismissing the public option as “big government” while defending a watered-down plan.

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iVillage Member
Registered: 09-18-2009
Wed, 09-30-2009 - 10:34pm

>He said that people in Canada usually have home remedies for such things and that the only time they ever visit a doctor is for emergencies only. Wow! If that's true, Canadians must be a lot of homeopathics or something.<

From my own experience...

I live in a small (about 12,000 residents) rural town in the Southern Ontario, Canada. We have a small but excellent hospital with a total of 8 family doctors serving the community and one surgeon.
Our own family doctor is in a brand new medical complex along with 2 other doctors. It is connected to the hospital, so any tests that are ordered, are done on the premises. His office has instituted a new appointment booking procedure. The morning of the day we need an appointment, we call the office and we will be scheduled in that same day. They have also begun to focus more on preventative care, so prior to seeing the doctor a nurse will come in and do a preliminary exam taking BP etc.

If there is an emergency which can not be handled at the hospital's ER, the patient can be air lifted via helicopter to a city about 35 miles away. That city has 5 hospitals.

iVillage Member
Registered: 08-30-2002
Wed, 09-30-2009 - 10:58pm
Only 8 weeks? I have ovarian cysts and I


iVillage Member
Registered: 08-30-2002
Wed, 09-30-2009 - 11:06pm
Is the air lifting covered as well? A man at my church was hit by a pickup truck while riding his bike on a rural road. He had to be life flighted to a University med center, due to a head injury. The helicoptor ride cost $18,000. It is not covered by his insurance. The community is staging a benefit concert to raise funds to cover some of the costs.


iVillage Member
Registered: 09-18-2009
Wed, 09-30-2009 - 11:48pm

Is the air lifting covered as well?<

I am not sure, but I will find out and let you know for sure. :)

iVillage Member
Registered: 02-06-2003
Thu, 10-01-2009 - 1:41am

I think that you are right that it is all about money, and no group, not insurance companies, pharmaceutical companies, doctors, hospitals OR patients are without a share of the blame. And yet every one of those groups wants to see the responsibility of all the others while ignoring their own contribution to the problem.

The complaints against the insurance companies have been talked about ad nauseum, many of which I agree with and some I disagree with. For one thing, I am not completely against insurance companies having the right to deny coverage or charge higher premiums for pre-existing conditions. Primarily because insurance is supposed to be protection against unforeseen loses, not basically a discount for known expenses. For example, my ds is on psychiatric medications that run approximately $1100 a month. Why should an insurance company be forced to sell him a policy for, I don't know, say $700 a month knowing that he is going to need at minimum $1100 per month in services? They know that he is going to be a liability every single month. So if forced to insure him at the same price as everyone else, their only option is to raise the cost for the rest of their customers. Now while some people's chronic conditions could be compensated for by their paying slightly higher premiums, obviously there are those who have major ongoing expenses, and their has to be an option for them. And that is where I see the benefit of a government plan. Something along the lines of the Federal Flood Insurance program, or here on the Gulf coast, windstorm insurance. Shoot, even bad drivers have their own high risk insurance options. Of course theirs in only marginally subsidized causing their premiums to be dramatically higher. But then they're in that pool due to their own actions and they should pay for them.

Medications are certainly expensive, especially the newer ones. But you also have to consider the length of time that it takes to actually bring a drug to market. It could be as much as 20 years or more. And even then, they could spend years developing a drug only to have the clinical trials show that it doesn't do what they thought that it would or that the risk out weigh the benefits. And while a company may post huge profits one year, all it would take is one drug that after approval started showing unforeseen side effects to wipe those profits out.

Doctors have huge student loans to pay off, as well as expecting a nice living from all the years of hard work to get there. And of course they have to carry malpractice insurance, just in case. Because no matter how hard they work, or how careful they are, there is always the risk that something won't go as expected. Of course there are honest errors, and even some careless neglect, but there is also the times that the doctor has to make a judgement call. And since not all people will respond in the same way to the same treatment, they may not get the same result. But you can be sure that if the patient or their family wants to find one, they will find a lawyer willing to file a claim against the doctor.

Itemized hospital bills are enough to drive anyone insane with their outrageous charges. But then again, we also know that they have to make up for non-payments and they do that just like any other business, by raising the cost to the rest of their consumers.

And then there are the patients, and honestly, I believe that that where you have to start to get costs under control. A big problem, as I see it, is that over the years we have become more and more distant from the cost of our healthcare. Not that long ago, most people didn't buy comprehensive health insurance, they bought major medical. Routine expenses they paid out of pocket, but having the security that if something major came up they were covered. Slowly we have expected our insurance companies to foot more and more of the bills for those routine services. We have come to expect our insurance to pay for most if not all routine screening exams, the bulk of illness related office visits. All with the justification that if they didn't, people wouldn't have them done and it would just end up costing the insurance company more in the long run. And there is some validity to that argument, after all, if mom doesn't take the little one in to the doctor for an earache, they may very well end up in the ER with a ruptured ear drum. And no one would suggest that the child should then be denied coverage because mom was neglectful. Same with a woman finding out that she has advanced cervical or breast cancer. Still, as the insurance has picked up more and more of these costs, the costs of those procedures has gone up and so has the cost of the insurance. The more distance you put between a consumer and the cost of the service, the less the consumer is going to care about the cost, as long as someone else is paying. And like it or not, the one paying the bill is going to have some say on what services can be obtained. For example, I have 2 grandsons, 1 was very prone to ear infections, the other was not. The 1 who had many ear infections was originally treated with amoxicillin and it worked well for the first 3-4 infections. They then had to start with some of the stronger and more expensive drugs, like augmentin and omniceph. The other, on the first of only 2 ear infections he ever had, the doctor immediately went to the augmentin. And btw, they are not brothers and have never gone to the same pediatrician so he wasn't using family history to decide on the augmentin. At the pharmacy they only put the amount of the co-pay on the receipt, which was $27. I asked what the full cost was and was told it would have been $87. Full price for the amoxicillian would have been $12. On his next infection, I took him in and again the doctor wanted to prescribe augmentin. I asked why not the amoxicillian and he said that it was so over used that it just didn't work anymore, better to just go with the augmentin to begin with. I pushed and he agreed to try the amoxicillian, it worked. My dd didn't even question what drug he prescribed and would never have thought to ask the price difference, or even what the actual cost was. Other than her co-pay, it didn't concern her. Now honestly, how many people do you know who can tell you what their doctor charges for an office visit? Not how much their co-pay is, but what the insurance company is charged? I'm going to guess that most people don't know and don't care. The doctors know that and they know what the max the insurance companies will pay for their area, and you can bet that most will be charging the max.

Ideally, the doctor and the patient would make decisions about care based solely on the needs of the patient. But that is never going to happen. The doctor will always have to consider his own needs both from a defensive and business position. And whoever is paying the bills, be it the patient directly, the insurance company or the government, is going to have to consider financial position. If the patient is in control of both the final decision medically and is in control of the purse strings, they will be better consumers. And better consumers will lead to lower prices.

Now I know that many will say that to many people just can't afford to pay for the routine care themselves. And the way we have things set up now, probably so. But going back to major medical instead of comprehensive medical, combined with Health Savings Accounts (not the use-it-or-lose-it flex spending accounts) funded by pre-tax dollars would go along way to addressing that, and you have to start somewhere. My oldest dd's company just started offering this type of plan, so as an example, I'll use her numbers as she decided to go with this option. Previously, she paid $360 per month for insurance and added $50 a month to go into a flex spending account which was use or lose. She had co-pays of $30 per office visit and 20% of things such as x-rays, MRIs, hospitalizations. Her new plan has a $5000 annual deductible after which they pay everything at 100%. Her premiums are now only $100 a month and she is still contributing $50 a month but now it is into a HSA which will be hers for medical expenses until she spends it, no matter if that is this year, next or 10 years from now. Also, her company is saving so much on what they pay toward the insurance that they are making annual contributions of $2000 to the HSA of each employee taking this option. So she is saving $260 a month in her insurance premium for an annual savings of $3120, her employer is contributing $2000 to her HSA plus she is still contributing a pre-tax $600. Since her annual out of pocket expenses is capped at $5000, between her premium savings and her HSA, even in a year that she maxed out her expenses, she would still save $720. And any year that she didn't use all of the $2600 in her HSA, that amount would roll over to the next year. Even if she leaves the employment of this company, that account remains hers. If her next job didn't offer such a plan, she could still use the money in the account but wouldn't be able to make further contributions to it.

Sheri

Avatar for ddnlj
iVillage Member
Registered: 03-26-2003
Thu, 10-01-2009 - 8:28am

What an EXCELLENT and informative post. I agree that there needs to be something in place for everyone. The major medical is a good idea; however I think it might hamper preventive healthcare and/or cause some people to put off seeing a doctor until an injury or illness is more costly to take care of.


You're also right about people getting more involved in their own healthcare. Before the age of HMO's and PPO's, average people didn't run to the doctor as often for every little ache or pain. When I was little I had chicken pox,

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iVillage Member
Registered: 02-19-2008
Thu, 10-01-2009 - 9:22am

"$400/month may well put the cost out of reach for some young adults, especially those working part time while in school."

OK, say they can not afford the $400 per month. How will they pay their premiums under BO's public option plan? How will they pay tax increases?

iVillage Member
Registered: 02-19-2008
Thu, 10-01-2009 - 9:24am

" But then they're in that pool due to their own actions and they should pay for them."

Not always, courtesy of no-fault insurance laws.

iVillage Member
Registered: 02-19-2008
Thu, 10-01-2009 - 9:30am

" And that is where I see the benefit of a government plan. Something along the lines of the Federal Flood Insurance program, or here on the Gulf coast, windstorm insurance. "

Some reports I read stated that over one-half of homeowners living in New Orleans did not have flood insurance when Katrina hit. Now as NO was 30 or so feet below sea level you'd think it would be pretty obvious you needed it. Yet people still did not purchase this insurance. This is one of my quarrels with this public option .... if people either can't afford premiums or simply don't think the purchase of health insurance is that important what makes someone think a new government program will solve this problem?

iVillage Member
Registered: 03-18-2000
Thu, 10-01-2009 - 10:13am

"The soonest mine can get me in is January 5th."


That's terrible. Yet 'some' continue to scare people with Canadian or British type healthcare. In England I was able to see my GP without an appointment on any weekday morning. It was on a

 


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