Jim in Bedford, Pennsylvania

Jim in Bedford, Pennsylvania
Originally uploaded by walk4healthcare

“I would call myself a fiscal conservative,” Jim told me as we sat together discussing healthcare in his living room. “I believe that health savings accounts, HSAs, and patient involvement in the decisions will be important to bring costs under control.” He added that in his experience, once health benefits are provided, it’s “very difficult to backtrack.”

He’s worked in government for 32 years and is currently retired. “Personally, I think the government plan, if made available to all, would work well. I think that would be easy to implement. It allows choice, there’s already a mechanism to collect premiums. and there could be some income tiering.”

Jo in Bedford, Pennsylvania

Jo in Bedford, Pennsylvania
Originally uploaded by walk4healthcare

“I think that it’s possible to have a very basic plan as a public good.” Jo told me she’s seen examples of that and she “believes it’s a good use of taxpayer money.” But she also realizes how it could get out-of-hand. “It all depends on how and what ‘basic’ is defined as,” she said. “Sometimes that’s too abstract.”

Eric in Bedford, Pennsylvania

Eric in Bedford, Pennsylvania
Originally uploaded by walk4healthcare

I met with Eric in Jim’s living room (at the home where I stayed that night). Jim had invited several neighbors to stop by for a discussion of healthcare reform and Eric was gracious enough to share his story with me.

First, he does not have health insurance. He looked into it, reviewed the policies from three companies and saw that there was essentially no difference among them. “It was 80/20 coverage and no doctors were covered,” he told me. The premiums started off at $300 a month and went up to $900 a month within a year. “Worse than the cable company!” And so he dropped the coverage.

As it turns out, Eric did have a serious health issue last year—a pituitary adenoma (a form of benign, but still very dangerous, brain tumor). One morning he woke up nearly blind—all he could see was a tiny pin-prick of light (an extreme form of a condition called ‘tunnel vision’). He had himself taken to the emergency room.

To make a long story short, he was treated at UPMC. He told me “Hershey refused to talk because he had no insurance.” Being without insurance, he now, after all was said and done, owed $160,000. He was able to make deals with the doctors but the hospital, he told me, “was never cooperative—a monster to deal with. And there was no negotiation.” He told me about his ongoing struggles with the hospital.

“And the billing was so strange," he added. As someone who checks things out carefully, he told me how an MRI at UPMC cost $7,000 but the same scan, on the same machine, cost $2,000 in the nearby town of Altoona. “And a single Tylenol pill cost $10! It’s a crazy system.”

Kay in Bedford, Pennsylvania

Kay in Bedford, Pennsylvania
Originally uploaded by walk4healthcare

Kay’s a part-owner of a small business—all of three people. Because of the high cost of health insurance, the deductibles, and ‘all that,’ “they’ve got no discretionary income,” she told me. They’re with Highmark and the premium went up $100 a month within the past few months alone. Her husband has had two heart surgeries (done at the Cleveland Clinic). The cost was $4,000 a day but they ended up paying $700. “That was a relief,” she said. “But we're lucky. We can afford healthcare insurance—barely—but that leaves us with no extra money.” Clearly up-to-date on various healthreform proposals, she added, “It would be nice if I could deduct it as a tax credit.”

“But here’s the real problem,” Kay continued. “If my husband—or I—couldn’t work then we wouldn’t be able to maintain the income to pay for any insurance. How will we be able to pay for health insurance when we actually need it most? That’s what doesn’t make sense.”

I was readying to leave when Kay interrupted. “One more thing. I think much of these premium monies are being wasted.”

“How so?” I asked.

“I went to a Pirates game and they were giving out free bobblehead dolls.” Guess who sponsored all that?”

“Who?”

“Highmark. That’s where health insurance premiums go—to advertising.”

And so my experience came full circle as I recalled the giant Highmark billboards scattered among Pittsburgh’s downtown when I had been there four days earlier.