NPR Story on CF

NPR did a news story on families struggling to manage their CF-related medical costs. We continue to hope and pray that there will be a soon be breakthroughs in (a) treatment for CF and (b) provision of health insurance.

Insurance, Part 2

We sucked it up and finally made a decision about our company insurance this morning. We decided to continue, basically, with what we have and just shoulder the cost increase for 1 more year. This gives people time to explore options for switching doctors, and make arrangements for their ongoing care, before we go to a single-provider this time next year. (Right now we offer employees a choice between Regence/Blue Cross and Group Health plans; next year we'll choose one or the other, or a different provider, and we'll all be covered under the same plan.) The good news is that Will can keep all his doctors and that the substance of the insurance isn't changing much; our amount of coverage is decreasing (again) from 90% covered to 80% covered, and the deductibles and the out-of-pocket maximums are all going up too, but the basic system remains the same. (Between the higher stop loss and the higher deductible, I think it will be about a $2000 annual increase in exposure for us, if I'm doing the math right.)

Either of the single-provider plans we were considering would have put us in a bigger pool, would have been significantly less expensive, both out of pocket and for the company, and would have provided more coverage; but we have people who are facing serious health situations (besides Will) who were committed to seeing things through with their current doctors in one plan or another. So, we buy another year and face this again next summer. Either way, I'm glad to have this decision made and behind us, since the stress and anxiety over it was starting to really get to me. The answer that was clearly right for my family was just as clearly wrong for other families who also are in complicated situations -- it felt like an impossible choice. Even though it will mean the company will have to cut spending in other ways next year, I'm glad we were able to see our way clear to stick with two plans and keep all the employees with the doctors and insurance company they trust, for now.

Please, please -- as we move into election season, think about health care when you vote. We pay so much for so little in this country compared to others, it's remarkable. I'm far from an expert on this, but according to the Congressional Research Service, which looked at information from the Organization for Economic Cooperation and Development (OECD), we spend more money per capita on health care than any other OECD country, generally, more than double what other countries spend. For this huge investment, we consume less actual care, we have fewer average hospitalizations and many fewer than average doctors visits. And, we don't have any significantly better health outcomes, in fact, our life expectancy is slightly lower than the average of OECD countries and we have the third highest rate of deaths from medical errors. Get the actual numbers here. (The OECD is a collection of 30 democracies generally the wealthiest countries, so the US, Japan, most of the European countries, etc.)

Insurance

We rely on our health insurance for everything. Before I met Will and became his means to access insurance -- he is insured through my work -- I never paid much attention to it. Now, if there's any trouble with insurance, it is consuming. Currently we have a great situation -- all of Will's doctors and hospitals are in our network and the pharmacy covers many (most, really) of his medications to some extent. (And Will's parents generously help with deductibles and costs for what isn't covered.) In the past few weeks we found out that our company's health insurance costs are expected to increase by over 30% next year. Over 30%. We're a 35 person company and, basically, can't afford this -- especially as it comes on top of double-digit insurance cost increases each year for at least the past 3 years. So, we really are going to have to look seriously at reducing benefits and/or changing or reducing choice in insurance plans. I understand that these difficult choices are necessary from a company perspective but, for my family it is, in a word, terrifying. Really -- like, I start to get tunnel vision and have to close my eyes and breath deeply whenever I start to think about it. Let alone the guilt I feel because certainly Will's claims and needs are -- in part at least, and maybe in large part -- driving some of this increase. We heard from our current insurance pool coordinator that our increases are due in part to "heavy use." (Of course, we've also had at least 5 pregnancies across the staff in 2 years (including my pregnancy with Liam) and at least 2 people with cancers (including Will), so I guess that all counts too.)

I wish I knew what to ask people to do to "fix" the insurance problem in this country. I have been listening to some NPR stories comparing US insurance approaches with those in other countries and I recommend them as enlightening and thoughtful, but I don't really know what action every-day people can take to cause change to happen. All the normal stuff -- write your elected officials, consider this issue when you vote, get involved locally. Mostly, stay healthy if you can.