It is no secret that most states in the US face a financial crisis, and that state universities everywhere are being asked to tighten their belts. One of the recent belt-tightening news we received at my big state R1 was an impending increase in health insurance premiums. I love our health insurance plan (HMO): the network of doctors is large and excellent, and the premium payments were tiny. Even after the increase, the premiums are not very high, but looking at some of the announcements and delineated percentages of how much we pay versus how much the university pays, I realized that the annual cost of health insurance for my whole family (paid largely by my university) is over $20,000. Holy cow!
This reminded me of my first (and very sobering) encounter with how broken the health care system in the US actually is. I had my first child in grad school, when I was still new to the US (this was in 2000). I had the standard student health insurance plan at the time. I had a normal, uncomplicated vaginal delivery (there was epidural involved though), and was discharged after 2 days. Within a week of coming back home, I called my insurance and added the baby to my plan. Shortly thereafter, I stared receiving monstrous medical bills from the hospital, doctor, anesthesiologist, everyone separately, in the total amount exceeding $10,000. I was completely terrified and spent several months on the phone with doctors' offices, my student health liaison, and the insurance company, trying to straigthen it all out.
What happened was the following: when I called the insurance company to add the baby to the plan, the incompetent moron with whom I spoke did not know how to do it, so he terminated my plan the day prior to baby's birth and opened a new one for me plus baby starting on the day of the baby's birth. Since I started laboring a 8 am one day, was admitted at the hospital at 3 pm the same day, and delivered the next day around 5 am, my old plan was terminated by the idiot's mistake on the day of my labor and the new started on the day the baby was born, so I was treated as uncovered for the day of the labor. It took me months to sort it all out, and I was terrified the entire time: these letters requesting payment get progressively more threatening as time goes by, and my husband and I were really broke and had little idea of how the system worked.
What still baffles me to this day, is that, if you are uninsured, a simple delivery would cost over $10,000 (in 2000). How is that possible? It's not even an illness, it's the most basic of human functions -- shouldn't a woman, any woman, be able to deliver a child safely, in a hospital, without having to sell a kidney afterwards to pay for it all?
Now, when I see that my university and I combined pay over $20,000 per year for my family's health insurance, I still cannot wrap my head around the number. Yes, of course, I know how insurance is supposed to work -- everyone pays, whether they need health care or not, which spreads the risk around so that payments can be made on behalf of those who need care when they do. But still, the sheer amounts of money just astound me. For instance, just the the faculty in my 40-ish people department cost over $800,000 every year to insure! Doesn't that blow your mind?
After more than 10 years in the US, I still cannot understand some things, such as why were insurance companies ever allowed to be for-profits? I wonder how much less the costs would be if they were all non-profits. How much does it cost in places like Canada or most of Europe to pay for the equivalent of one worker's health insurance? Among the aspects I don't understand, or rather -- I understand but don't want to accept that the people can be so uneducated and misguided -- is this voluntary submission of people to the exploitation by companies and stubborn refusal to allow the government to do anything for fear of becoming a socialist country. There are plenty of developed countries in Europe and yes, our northern neighbor, Canada, where it has been shown that health and education, which should be everyone's unalienable rights, are best kept out of the hands of corporations. It is clear where the republicans are coming from (PlS nicely put it yesterday), but what I do not understand the resistance of a number of people to public healthcare -- I don't understand the blue collar workers who think that any corporation would ever look out for the workers' interest better than the federal government. Is it the education system that prevents an average worker from learning about the systems in other countries beyond the politically fueled fear-mongering? Is it the brainwashing via Fox and other red media? Is it the failure of the democrats to connect with the middle and lower class, deliver something tangible, and actually take credit for when they do?
This is such a great country, yet dysfunctional on such surprising levels... It's such a shame.