Why Are People with Health Insurance Going Bankrupt?

[Ms. Toad]

78. Costs get covered for those who are insured.

Large employers have pools which include everyone - so their premiums reflect the average cost of the care they pay for (a few with large expenses like my families - at $60,000 a year, but by and large most of their employees will cost a few $100 a year. That makes the premiums reasonable.

Small employers like mine have premiums based on what is actually paid out - so because my family costs so much, we pay the top premium. The last time I knew, specifically, the premium for my family was $22,000 a year. Most small employers cannot or will not provide coverage at that price tag.

Individuals just can't get coverage unless they have pristine health. Everyone in my family has been rejected for health insurance. No insurance company will issue a plan for anyone in my family now, because they don't have to - and no one wants to take the risk of being the insurer the year my daughter needs a half million dollar liver transplant, or $100,000/year of anti-rejection drugs a year for the rest of her life.

So no. Costs do not get covered, except for those with large employers, or who have a small employer like mine who bites the bullet and pays premium rates, or the very healthy.

If insurance companies are forced to issue plans to anyone who wants them, without assessing health, they have to spread the cost of families like mine out over everyone covered. As premiums rise to cover those costs - which they do not currently have - those who have few health needs (and who know that once they do have health needs they can jump right in that plan) drop out. Whem the lower cost people are gone the price rises more, and more and more lower cost people drop out, driving the price up further, and it is a vicious cycle.

It is simple math, once you force insurance companies to issue non-discriminatory policies regardless of health. Premiums skyrocket driving out those who are healthy and making it unaffordable for those who are not.

I would much prefer single payer - but we were never going to get there. Since the reform is insurance based, the pool has to include everyone in order to make the economics work - that means a mandate, with subsidies both for premiums and out of pocket expenses for those who can't afford the premiums. I hope this is a start toward single payer - but at least this way no one can be denied insurance, as happens to millions now.