LETTERS From CAMP Rehoboth |
CAMP Fitness:Health Insurance - Here We Go Again |
by Rick Moore |
You will have to excuse me, but I am still a littleno a lotupset over a surprise I received in my mailbox the other day. It was my renewal rate letter from the health insurance company. In bold type across the envelope was printed: "Your new rates are inside." That couldn't be good! My agent had warned me. He's been warning me since we acquired health insurance over 5 years ago. Every year it has gone up. This year? Our new rates are up a full 50%. In fact, they've been up by huge amounts every year. This may sound familiar to all of you. Just last year, I let everyone know my rates were way up. That column hit home with many people, in fact, I got a lot of feedback. And I even sent a copy of that column to Delaware Governor Ruth Ann Minner. As a small business owner, it's the highest expense I pay every month. It's more than a mortgage payment. It really has me quite perplexed because I had only one office visit last year, and I paid for that out-of-pocket. I am a pretty healthy guy. I even won the bench press contest last year for my age group. I took second place the year before. Many of you know I don't smoke, nor do I drink alcohol. And I've been told I really don't look my age. So what gives? The state of Delaware has no law putting a ceiling on the rate increases for health insurance companies. The companies have been getting away with announcing publicly that a rate increase will be coming, but they can't do anything about it. You see, costs keep rising. Yes, I understand that things do go up, but 50% each year? Last year, to keep our costs down, Dave and I made concessions, raising deductibles and dropping some coverage. But it still costs more. Lately, I've found out that the health insurance companies are getting away with not paying for key parts of treatment. Here's one for you, ladies. Some plans limit the amount they pay for a procedure, or even deny payment altogether. For example, you may have coverage for a single mastectomy, but later, if it is found that your second breast has a tumor, you may be on your own. It's considered an out-of-pocket expense. And here are some other critical aspects of care that may not be covered: pacemakers, hepatitis drugs, pre-transplant heart pumps, even the search for a suitable transplant donor is not covered. You could be covered for a bone marrow transplant, but the donor search is disallowed. This out-of-pocket expense could cost you $10,000 or more. Why, even drugs to treat hemophilia and Chron's disease are not covered. And you'd better hope you don't have a stroke, because if it affects your speech, you may not be covered for speech therapy. That will truly leave you speechless. While I am ranting about a lack of coverage for drugs by the insurance companies, let's get after the drug companies. It seems that the Food and Drug Administration has recently hardened its position against anybody who leaves this country to buy their prescription drugs. We all know that prescription drugs from Canada are cheaper, mainly because of government price controls. In Mexico they are cheaper because they are generics. But with pressure from the drug companies, our government is thinking of prosecuting you should you go to Canada to buy the cheaper alternatives. Yes, you'd become a criminal because you tried to save money. Our drug companies are asking Uncle Sam to crack down on this kind of discount shopping. They want you to pay the full, inflated U.S. price. Other countries strictly control drug prices to keep costs down. So drug companies see the unregulated U.S. market as the perfect place to cash in. Not only are U.S. residents paying for their own drugs, we are actually subsidizing health care in other countries. Many cities along the border with Canada and Mexico have daily jaunts by seniors, who travel by the busload to save money. For some, it's either that, or do without heat, air conditioning, food, or other essentials. So much for that kinder, gentler conservative mumbo-jumbo I've been force-fed the year of the last elections. Many of the border towns stock the hot meds, so needed by the U.S. population. Items like asthma inhalers, Celebrex, Zocor, and Lipitor, and even Vasotec are big-demand items in Canada and Mexico. But the good old U.S. and the drug companies don't want you to save money. They want you to pay. And now let's get to the meat and potatoes of this column. Remember, as a small business owner, our governor told me that we are the backbone of the state of Delaware. I thought that my letter sent to her last year made a difference. Soon after, our lieutenant governor, John Carney, formed a commission to help small business and their plights with health insurance. TV and newspapers announced that an investigation into covering all small businesses under the state was more or less on its way. All Right! So now we would pay a fair rate and not be gouged by the insurance companies. Since then, one of my clients told me he was dropped by his health insurance company. He was paying $800 per month, and they cancelled his coverage when he went to renew. He's a borderline diabetic who is training with me to help keep it under control. Doesn't that count? Apparently not. He is considered uninsurable. That is, unless he sells everything and becomes a ward of the state. That way, the state will be responsible for his care under Medicaid. Or, his other choice would be to close his business, fire 5 employees, and go to work for a large company like GM or DuPont so that he'd be covered under their group plan. Does this make sense? Well, it surely doesn't. But this is what really baffles me. The state's investigation into coverage for small businesses has been shelved. As of January, no more action is being taken. What happened? If small business is the backbone, I hear it breaking. Rick Moore is a personal trainer certified by the American Fitness Professionals & Associates. Visit him at www.ricksfitness.net, or call 302-684-0316. |
LETTERS From CAMP Rehoboth, Vol. 13, No.5, May 16, 2003. |