Guaranteed Healthcare

I am 55 years old and my husband is 56 years old. We exercise, eat healthy, balanced meals, and do not have many of the ailments that often plague others of our age group, such as heart disease, obesity, diabetes, high blood pressure, and high cholesteral.

Our main maladies are my hormonal migraines and his asthma, which he has had since he was a child. We have not gone to the emergency room or hospital for either of these problems. My migraines are controlled by Imitrex (I don't even take a full dose) and my husband's asthma is controlled by Advair on an as needed basis. Most of our medical visits are yearly preventative check-ups and screenings.

Neither of us has ever had a hospital stay for anything. For almost 20 years I have had Motion Picture Health and Welfare, a great employer insured plan which had no deductable, offered free office visits at plan facilities and 100% payment of negotiated fee rate to plan providers, and included prescription, dental, chiropractic, and vision coverage.

In the last few years, while attempting to advance my editing career (as opposed to assistant editing on bigger union features), I have accepted non-union work on lower budget independent films. Consequently I have not worked the necessary number of hours to qualify for insurance. When my insurance eligibility lapsed I moved into a COBRA plan, shelling out $700 a month for pared-down coverage -- no dental or vision -- for myself and my husband.

Last August, my 18 months of mandatory COBRA insurance coverage ended. I applied for individual insurance with Blue Cross that allowed us to continue using Motion Picture Health Plan facilities. The new plan (BCL&H RightPlan PPO 40 w/Generic Rx) offered a lot less for a lot more money. Our new plan added a co-pay of $40 per office visit, required us to pay 40% of the negotiated fee rate at participating providers and hospitals, added $400 a day hospital co-pay for the first 4 days, did not include maternity benefits, and covered only generic prescriptions.

Choosing the plan from the miriad of plans was also confusing (I was an honor student, so it should not have been that hard). There might be a better plan for us, but we had no idea who could to advise us on the best plan for our situation. The advertising of the plan was also a bait and switch, as far as I am concerned. The published price was $330 per person, theoretically $660 per month for the two of us; but when it came down to paying, my insurance was 50% higher and my husband's was 75% higher: $495 for me and $577 for my husband, a total of $1072, or 35% higher than our COBRA payment, plus all the additional costs any time we need to use any medical service.

For healthy people, this is an outrageous amount to pay and it is putting major stress on our budget. I pity anyone with more pressing medical issues. We're the same people, with the same minimal health concerns but our insurance has gone higher and higher for less and less coverage. It is time for one-payer, negotiated group coverage in this country comparable to that received by Congress and the other politicians that would bring this country up to or above the standards of medical coverage enjoyed by the rest of the industrial world.