Why My Family Prays for Obamacare

I had already seen from a distance that dealing with American health insurance wasn’t much fun. My friends had to write an average of three letters for every medical procedure: first, an application in which they had to explain why the procedure they sought was necessary, then an explanation that the costs for the procedure were within acceptable limits and finally a letter of complaint when their claim was still refused.

But when our son was born seven months ago in New York, I had no other choice. The private German health insurance I carried since the early Stone Age was willing to insure only me — not my wife and not our baby — because they had never resided in Germany, which was understandable.

So I gave them notice and started looking at alternatives. That’s where I learned my first lesson: In America, children aren’t automatically covered on their parents’ health insurance policies. Policies for kids have to be purchased separately.

$4,000 per Month

Second lesson: Most Americans have health insurance through their employers, and I’ve never been employed in the United States. So I called Blue Cross Blue Shield and asked how much it cost to insure a family of three. The answer is “$4,000 a month and have a nice day.” For heaven’s sake! I’m not Stephen King, and I’m not King Croesus either.

On the other hand, neither am I poor enough to qualify for Medicaid, the health insurance for the indigent. And I’m a long way from being old enough to get Medicare, the insurance that’s driving America to the edge of bankruptcy. Then in a subway, I happened to see an ad from the Freelancer’s Union, a sort of labor union for the self-employed that read, “Ask not what you can do for capitalism, ask what capitalism can do you!” It was right up my alley.

Through the Freelancer’s Union, I managed to get coverage for myself, my wife and our son. The price tag is $1,650 a month, conveniently and automatically debited from my bank account every month. Can I afford that? Of course not.

Heart-Rending and Inefficient

Visit the emergency room of any hospital you choose; there, you will always see people in the waiting room who are obviously not emergency cases. These are the uninsured who are also too poor to pay for medical treatment. There you can hear heart-rending stories of mothers who put off seeking help for their children until it was too late.

But even without the heart-rending tales, this system is downright grotesquely inefficient. These are the patients who are treated by bleary-eyed doctors who just finished working their umpteenth hour of overtime on multiple shifts, something also far too expensive for the hospital to afford. And what happens to those costs? The hospital writes them off as “bad debts” they will never collect. And who eventually picks up the tab for those bad debts? The answer is “all the patients who have health insurance.”

The whole thing is so idiotic that one would think it had been thought up by a panel of experts or a government commission. But that wasn’t the case; it came about almost spontaneously.

Meanwhile, the fact that I was now $1,600 per month poorer still didn’t mean we had comprehensive insurance by a long shot. I have to pay $50 for every other visit the baby makes to our (outstanding, by the way) pediatrician. While there is no additional charge for inoculations, every “well baby” visit (where it’s all about reassuring neurotic parents that the baby’s not missing something) must be paid for.

We Had No Choice

Recently, I had a minor accident: A piece of chicken got stuck in my esophagus. I choked and spat; after 20 minutes my wife called for an ambulance. I eventually had to have the chicken surgically removed under general anesthesia, for which the hospital billed me several thousand dollars. The insurance company refused my claim because the procedure — according to them — had not been preapproved. Fortunately, my wife is an attorney who can get really energetic on the telephone. She was able to clear the matter up over the course of a single morning.

But there was one matter left: The ambulance ride to the hospital. They charged us several hundred dollars more than my insurance company was willing to pay; we had to pony up the rest. We had no choice.

An Act of Higher Management Artistry

A lot of criticism has been leveled at Obamacare from many sides. The law is terribly complicated: It’s said that the printed version is as thick as a telephone directory and anyone unschooled in Talmudic dialectics — i.e., legalese — shouldn’t even try to understand it. Those who refuse to get insurance will reportedly pay a penalty in the future, but experts say the fine is far too low to be an effective deterrent.

Nevertheless, the creators of the Affordable Care Act appear to have recognized a basic problem with it: American companies have degenerated into entities whose main function now is to provide health insurance to their employees. Now and then a finished product — a car, for example — rolls off the assembly line. With such a business model, no firm can hope to be competitive on the world market.

My little family is praying for Obamacare so that we might at least have more and better insurance choices. Since Oct. 1, many states — among them, New York, where we live — have opened exchanges on the Internet where the uninsured can purchase insurance coverage and where they can get advice on how to get financial assistance to buy insurance if they need it. Those who are already insured can look for better deals. And in the future, children can be kept on their parent’s policy until age 26 years.

Who knows? Maybe Obamacare will be able to deliver us from the nightmare of $1,650 per month for insurance payments. But so far, I have not been able to get to one of those Internet exchanges. The demand is so great that their websites are overloaded.