the writing and photography of Neil Kramer

Tales of Health Insurance


For the last day, I have been reading a lot of the blog posts and tweets about Obama’s health plan, and I came away with a few thoughts:

1)  I am not learning much information from these blog posts and tweets.

2)  People who write exclusively about politics seem to get angry very easily.

3)  Political writers treat public policy as a team sport (my side shoots, scores!)

4)  Too many bloggers have one eye on the prize, and the other eye on “their prize,” whether it be a mention in The Huffington Post or Fox News, which is cool, but doesn’t really have much to do with health care.


But this is not a post about politics or health care.  It is a post about stories.


After the speech, I had one question on my mind, the same as many Americans — How is all this going to affect ME?!

Sophia and I are both freelancers, and we shell out $1000 a month for a mediocre HMO.  We have discussed changing our plan, but Sophia has a pre-existing condition.  We’re going to have to do something soon, because my plan is useless to me in New York City unless there is an emergency since all my doctors are in a “network” in Los Angeles.  We are lucky to have health insurance, but we pay for it in a huge way, and I would like to have more options.

With this question on my mind, I went on Twitter and asked, “Sophia and I pay $1000 dollars a month for health insurance — what do you pay?”

Some answered my tweet, all with different stories.  Some had great insurance plans from a spouse’s company, and were concerned about how changes would affect the quality.   One woman said she and her husband, being young and healthy, chose to use their money as a down payment for a house, rather than pay for health insurance.   Another woman said her sister went into debt because of a long illness.  One man was rejected by all but one insurance companies because his son was autistic, and is force to spend $2,000 a month for his family.  Most of those who answered are not in a dire financial situation (after all, we were all on Twitter with our expensive iPhones!), but we are as concerned about the state of our health care, both the quality and the cost, as anyone else, rich or poor.

Politicians love to use these types of personal stories to bolster their intimacy of their speeches.  Great orators since ancient Greece have trotted out a “true” tale of poor Hermes (or Jacques or Joe) who has no drachmas (or francs or dollars), but under their plan, if elected, will be provided with plentiful gyros (or croissants or Egg McMuffins) in every urn (or vase or pot).

Stories sell the political point.

The 140 character “stories” on Twitter were special to me because they were told for no political gain.  I had no idea of the political persuasion of anyone.  They were just life stories, and it is difficult to fight with a story.  You can disagree with a person’s choice, but it is their story to tell, and you can’t dismiss that.

I was most moralistic with the blogger who put a down payment on a house rather than buy health insurance.  As the son of an anxious father who took out extended warranties on RADIOS at electronics stores “just in case” it breaks, I do not have gambling in my blood.  How could they take such a risk, especially with their health?!  Then again, how “smart” have I been for paying $12,000 a year for the ability to go once a year to my doctor for a cholesterol test?  Who can judge another without being in their shoes, or first hearing their story?

The point is I learned more about our health care crisis by listening to your stories, than reading the angry rantings of political pundits.  All of us have stories about bad doctors, life-saving hospitals, uncaring nurses, brilliant physicians, Blue Cross customer service, the good and bad magazines in the waiting rooms, malpractice suits, and even the time your own family cheated Medicare!

Politics is important, but in this case, storytelling shoots, Wins!


  1. Otir

    I wasn’t on twitter when you collected those stories, otherwise I would have probably answered. Although I don’t have an expensive iPhone, maybe that’s why. As a matter of fact I don’t have insurance either.

  2. churchldy

    Thank you… my story seems to go unheard most times as I live in an area that doesn’t like to hear about anything remotely left. My husband and I have been self employed for 20 years and pay $1000. a month as well. We recently dropped our plan to a $10,000 deductible to get it to 500. a month. I can’t believe that I need to go work for Fed-X just to get an insurance plan. Good to hear something less about politics and more about people, thanks again.

  3. Heather

    I can tell you horror stories, Neil. Perhaps I’ll email you. Medical stuff confuses me, but now I’m working for a big health care co. and I’m starting to understand more about how the whole thing works.

    The stories are what breaks my heart though, they truly do.

    I liked your post– It brought an interesting perspective to me.

  4. Neil

    Otir, you don’t have insurance? How does that work? Are you having financial problems?

  5. Staceylt

    Whether we have health insurance or not, most of us are just one serious illness away from financial ruin. If you are having difficulty affording the premiums, how are all the copays and deductibles going to affect you? Insurance is a gamble too. I’ve heard too many stories about insured individuals unable to get approval for the care they need.

  6. Diana

    I’m sure if someone really wanted to they could make a pretty good case that my heart is, indeed, made of ice. But, you know, I’m tired of people’s stories. I don’t respond to appeals to the emotion, in fact I’m much more likely to immediately dismiss an argument rooted in someone’s sob story than listen any further. For that reason their overuse in politics has left me with a bad taste in my mouth for health care related stories whatsoever. Not that I was particularly interested in them to begin with…

  7. Neil

    Diana – I don’t like sob stories either. Not everyone’s story has to be a sob story. The guy who has good insurance and is worried about his taxes has a story, too. Acknowledging that everyone is human and has to make sacrifices and adjustments for others is a good way to create discourse, rather than dehumanizing the other side, which politics tends to do, so people scream across the hall “liar” and “racist.” That is not reasoned discussion. It is mostly for strengthening your troops and destroying the other. That is politics, which is necessary. But it isn’t the only reality. I have a feeling that most of us don’t even KNOW what we are talking about in this debate. We are just debating. Hearing personal stories reminds me what this is all about.

  8. Beth

    What story does for us in the health care debate is put real faces on what is, otherwise, a numbers discussion. If we only think about numbers and bottom lines, then we don’t have much to discuss.

    If we think about the ways that people are affected both by their health care and by their lack of health care, we can begin to see that there must be a change.

    There must still be debate about what those changes should be, but change will have to happen and, I suspect, it isn’t going to be comfortable for anyone on either side of the aisle.

  9. sweetsalty kate

    It’s only a sob story until it’s your own.

  10. sweetsalty kate

    …and also? $1000 a month? Absolutely flabbergasted.

    I realize that the cost of Canadian healthcare is simply more hidden, but from what I’m told, the taxes — once you destructure them all from all sources — are about the same.

    And it’s this, too, in terms of sob stories. After a crash c-section, we walked into the NICU with two-pound twins who needed two months of care in $60,000 intensive care beds, one of whom needed heart surgery and brain surgery.

    Not once did anyone ever mention money. Not the applying for it, not the justifying or administrating or worrying or qualifying. Never once. We had excellent care from excellent people. Money was simply not an issue. All that mattered was caregiving.

    No single system is perfect, but the spitting, hysterical divisiveness that’s seen from up here makes me think that Republicans, en masse, will be about as common as the urban platypus before too long. I’ve never seen a population shoot themselves so simultaneously in feet. It’s sad and bizarre to watch so many people argue in such an ugly manner from what our children will see quite clearly as a morally reprehensible position.

    At least, anyway, when it comes to sob stories.

  11. headbang8

    Bravo, Neil. What you’ve collected is great material for an article.

    Not everything is black and white. Stories show this.

    But even a preponderance of good stories does not outweigh our need to correct the injustice described in a single bad one.

    But there isn’t a preponderance of good stories. There is a preponderance of bad stories–like your own. People whose lives are diminished because the need for healthcare restricts their mobility, employment choice, and even their solvency.

    I might send you a story or two. Like Sweetsalty Kate, I have lived under the yoke of “socialised” healthcare most of my life, and find it a very easy yoke to bear. And the yoke is attached to a cart full of very good things.

    Not everything is black and white, as you point out. But in the US healthcare debate, one side seems to be a very, very dark grey.

  12. Rhea

    Thanks, Neil, for writing about this. The stories are what it’s all about. If you’ve seen “Sicko,” you know that. Here is a place to read tons more true health-care nightmares.

  13. Yelli

    I wrote about my experience (kind of vague) in my blog above. I am happy to share more info if you would like it for a story. My story is sad but I will give you a brief overview. A very close relative is sick with a manageable disease but lost her job and thus her insurance due to this manageable disease. We are now paying for everything ourselves (and a couple other family members) until things get sorted out. Again, please contact me if you want more specific info. Thanks for doing this.

  14. Di

    Then there are the ‘self-insured’ policies where the employer decides which claims they will and will not pay. I used to handle these types of medical claims and got so sick of it that I would rat out the employer. LOVED DOING THAT!!

  15. churlita

    The reason I work my boring job in cubicle world, is because I’m a single mom and I need the health insurance benefits…I suppose the paycheck comes in handy too, but I could make a lot more money waiting tables, I just wouldn’t have insurance then.

  16. Jurgen Nation

    I wasn’t on Twitter when you posted that, but I would have loved to read all the replies. Last year before I was laid off I worked in legal for a major pharmacy corporation. You would think we’d get great health insurance. Ha! I’ve always been afraid of HMOs, taking the indignant stance that I am not going to make an appointment to see a doctor just for the simple purpose of having that doctor approve me for another doctor, a “specialist.” HELL NO. That just sounded awful to me. So anytime I’ve had to choose health care I have chosen a PPO. I have never had such a horrible experience than I did last year. On one of many, many calls to the insurance company (Hey, Anthem Blue Cross, F&CK YOU!) I had to sincerely ask the customer service rep what benefits I was actually getting, because it seemed to me that even after a $1500 copay, I was still responsible for most of the costs. Last year was difficult for me because of mental and physical reasons, but I was absolutely astounded when I did my taxes this year and was preparing my Excel Spreadsheet so I could get some sort of tax credit for my medical expenses. In 2008, I spent over $8,000 (I know it was higher, but 8k is all I could prove because I’m absolutely shit at keeping records) in random, “regular” health care and prescriptions. I am fully aware that this amount may seem low to some folks, but it’s quite a lot considering that nothing serious was wrong with me. Chronic issues, but no surgeries, no emergency room visits.

    My heart absolutely bleeds for those who don’t have health insurance because these people who run this industry just do not care. They will do anything for a buck and to me there is something fundamentally wrong with such a hugely profit-driven industry overseeing our health care.

    Incidentally, I went with an HMO when I was choosing for my current job and couldn’t be happier with the service, care and costs. (Kaiser, I’m looking at you, sweetheart.)

  17. Jurgen Nation

    Oops. $1500 deductible, not co-pay.

  18. Otir

    Neil, yes, I don’t have insurance (I love when I use a positive to agree to a negative sentence, does that make you crazy too? 🙂

    And yes, it’s because I can’t afford paying for an insurance premium with my income. Does that make me a gambler? I bet.

  19. gorillabuns

    well, with my bills for my son who subsequently died after two days, the total came out to $64,000.00. and we payed over $950.00 in insurance premiums.

    luckily, so many strangers and friends alike helped us to pay off our part of his medical bills. yet, he’s still not buried as we can’t seem to afford $3000 + in this area.

  20. Nat

    Just to compare. I’m Canadian. We pay roughly $40 a month to get extended health care/life insurance at work for the family. (It was a $25 deductible on first prescription and includes dental, drugs and things like physio, and massage therapy — things considered allied health care. It also includes Long Term Disability — if we’re off for more than 13 weeks. LTD is mandatory, there are levels of coverage.)

    In terms of taxes… because this is how I pay for health care. In the high income bracket,I pay roughly $800 a month in tax. (This includes the cost of Employment insurance and Canada Pension Plan.) But there is no deductible, and I’d pay less if I earned less, I’d pay nothing if I wasn’t employed. Health care does not include prescription drugs, which are generally cheaper than down south. This is my entire federal/provincial tax bill and includes all other government services as well.

  21. Anne Arkham

    My health care is covered almost 100% by my employers. This is a huge part of the reason why I am so pro-union.

  22. Diana

    You do have a point, Neil. I like your outlook. Everyone DOES have a story. But let’s face it, those that aren’t “sob” in nature don’t get the airtime and never will. Why? Because they don’t help elicit irrational and emotional knee-jerk reactions to win votes.

    I have no doubt you find both types of stories valuable, you’re an incredibly genuine person. But when it comes to the politics of the situation, you’re just not going to hear them without going to the people.

    And even then, I think a lot of people are scared to tell that story. When they do, after all, they’re called “morally reprehensible”… or worse. It’s assumed they have never struggled with health care costs, etc.

    Funny, I’ve never seen “reprehensible” listed in a thesaurus as an alternative to “different”. We’d better run and tell the Buddhists that they’re reprehensible. And the Muslims. And the Taoists. And the Hindus. And… well, I think you get my point. 😉

  23. Neil

    I actually do find all sides of the stories interesting, even those who oppose health care reform for whatever irrational reason. Despite what some Canadians tout as their wonderful medical system, I also hear stories of patients waiting months to see a doctor. I can understand the fear that some have, especially those who worked hard to get where they are, about “socializing” medicine and how it would affect their health care. I think America DOES have the most sophisticated health care and equipment in the world, but only those who are well-covered get to use it. I think if everyone understood where the other was coming from, it would be better.

  24. Ren

    In your last comment you alluded to something I’ve heard referenced before which is that America has the best health care for wealthy or well-covered people. I’ve been wondering recently how much the rest of the world, particularly the countries with government-provided health care, benefit from the high end advancements allowed by the private (and expensive) system in the US.

    I think it is a reasonable concern that moving to government run health care system has a large risk of greatly reducing the amount of innovation that occurs in the health care field. The evidence of how well it has worked for other countries doesn’t mean much if they are simply benefiting from innovation that occurs in other countries.

    I honestly have no idea if this is truly a valid concern or not.

  25. Stephen Juarez

    In my opinion, because Iive in a third-world country health care and insurance is also exaggeratedly overpriced. You can see people rallying because of the main reason that is lowering their income tax from 32%. I don’t believe the hype because one way or another these politician’s concern isn’t really service, it’s their egos and they have the NERVE, to tell the people that they love serving them. Well, to rip them off mainly.

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