When illness strikes
Little Joseph Oliver had a happy infancy. He was developing as he should, and his parents were pleased. When the violent seizures began a few weeks before his first birthday, they were terrified ... and baffled.
Kevin and Michelle Oliver, both Naperville Central graduates, knew they would do whatever it took to find out what was wrong with their baby and fix it. There was no other choice.
(Jonathan Miano/Staff Photographer)
PHOTO GALLERY
• Health care examined
• About this series
• Factbox: By the numbers
• Do-it-yourself medicine
• Photos: Health care examined
• Poll: Would you help someone?
As the health care debate rages in Washington, we asked for your thoughts about this controversial issue. The response was overwhelming. Hundreds of you wrote, e-mailed or went online to share your feelings. This series addresses the issues you’re most passionate about.
• Sunday: When illness strikes
Even those with insurance aren’t protected from financial and emotional disaster.
• Monday: Don’t take my money
Many taxpayers don’t trust the government to fix the problem; nor do they want to bear the burden of those uninsured.
• Tuesday: Speaking of uninsured
Those who can’t afford health insurance want more options than disability or welfare.
• Wednesday: Fire the lawyers
Some are convinced tort reform could go far in fixing our health care woes.
• Thursday: Your suggestions
So how do you really feel? We look at more of your concerns.
62.1 percent: Proportion of U.S. bankruptcy filings in 2007 that were tied to medical expenses.
78 percent: Segment of those filing bankruptcy during the period who had health insurance coverage when they incurred the expenses (six out of 10 had private coverage, not Medicare or Medicaid).
Source: Harvard University
It took nearly two more years, and many more seizures, for the epilepsy diagnosis to come. The expenses had quickly piled up.
"I have medical bills from every radiologist, neurologist and hospital in the area," said Michelle, 27, a pediatric nurse.
Although insurance is provided by her husband Kevin's employer, DHL International, it isn't enough for the family to pay all their medical bills and still cover their living expenses.
"We can do one or the other, but not both," Michelle said. "We're just overwhelmed."
And it doesn't help that the couple fears Kevin's job could lie in the path of the layoff ax expected to fall in the coming month.
Meanwhile, Joseph's baby sister Shelby, 14 months, slumbers in her crib each night, so far apparently healthy. Joseph, who is now 3, spends each night nestled between his parents, who are afraid they might miss a truly catastrophic seizure.
"We don't know what else to do," Michelle said.
Underinsured
Because Joseph's health issues have forced them to take time off from work as their expenses continue to swell, the young couple is drowning in debt.
They moved out of their south Plainfield house in March and put it up for sale. Offers have come in, but all have expired while the couple waits for the bank to process the paperwork, Michelle said.
The couple missed two car payments, and Kevin's car was repossessed. The lender, looking to collect the remaining due, along with fees and penalties that more than doubled the balance, froze their checking account.
"We are trying to make ends meet, like a lot of Americans today, but are really struggling," Michelle said.
The couple is far from alone. An estimated 25 million adults were underinsured in 2007, according to a study by the New York-based Commonwealth Fund. The number jumped 60 percent from 16 million in 2003.
The group defines people as underinsured if they spent 10 percent or more of their income (or 5 percent if they were low-income) on out-of-pocket medical expenses, or if they had deductibles that equaled 5 percent or more of their income. Michelle estimates that she and her husband have about $20,000 in bills yet to pay, "and there's more to come."
Some of the comments from Naperville readers who responded to The Sun's recent call for input on health care reform reflected the inadequacy of insurance coverage for many Americans. One told of paying $13,200 in annual premiums and still having an additional $5,000 deductible to cover.
On the question of whether her family presently has adequate coverage, respondent Sandie Loechle split her answer: yes for her spouse, no for herself.
"My husband has Medicare — government option," Loechle said. "I have private insurance."
Going without
Lacking sufficient coverage, the underinsured often wind up going without needed care, they don't see a doctor when they're sick, and they forgo filling prescriptions, according to the Commonwealth Fund study's authors.
It's one of the problems health care reform advocates want to see tackled by proposed health care bills in Congress. Michelle isn't sure it would fix what has happened to her family, but she does know unanticipated medical bills can rapidly spiral and put a household in dire circumstances.
"Things got out of hand," she said.
Commonwealth Fund Vice President Sara Collins testified earlier this month before a House subcommittee, reporting that increasing numbers of middle-class wage earners are becoming underinsured. The most rapid growth occurred among adults in households earning between $40,000 and $60,000 annually, she said in a copy of her testimony provided by the Commonwealth Fund (www.commonwealthfund.org).
Also, older adults ages 50-64 are the most likely to be underinsured. From 2003 to 2007, the number of underinsured in this group rose from 11 percent to 18 percent, a 60 percent jump.
Collins urged Congress to act on health care reform. She spoke in favor of HR 3200, a health care reform bill that includes a public option. That bill would go a long way toward reforming the individual and small-group insurance markets that feature high premiums and high administrative costs, she said, ensuring coverage for people regardless of age, health or pre-existing conditions.
Root causes
Scott McKibbin thinks it's a good idea to provide coverage for already-identified health challenges. The Naperville health care consultant said adequate insurance — the sort that allows pre-existing conditions and puts a limit on the portion patients must pay out of their own pockets — would have benefits for everybody.
"The people who have insurance are paying anything from $800 to $1,300, $1,400 a year (in increased premiums) to cover people who don't have the coverage they need," said McKibbin, who worked on health policy in Washington, D.C., during the Clinton administration. "Hopefully all the proposals they're talking about in Congress can make some progress toward mitigating some of these problems."
Deductibles and co-pays are putting strain on a lot of household budgets, McKibbin said, even when the people in the house are healthy.
"The trend for out-of-pocket expenses for people that have coverage has been doing nothing but go up for the last several years," he said, adding that coverage can be spotty, often excluding experimental treatments.
The father of four, a former Naperville Park District commissioner, knows firsthand about how quickly medical bills can accumulate. He has a genetic form cancer tied to the rare Birt-Hogg-Dube syndrome, and while he currently has no active tumors, the condition will never go away. He must have annual scans that bring substantial co-pays. The McKibbins currently have Cobra coverage, at more than $1,600 monthly, but he has been told that when his eligibility for the plan ends at the end of 2010, he can expect to pay 67 percent more than the general population for coverage through a private insurer, because of his pre-existing condition.
McKibbin isn't surprised that many families, faced with unexpected illness, are grappling with expenses far greater than they can manage.
"Unfortunately, it's not uncommon. Sometimes you can be one illness away from something like what you're talking about here," he said.
Michelle Oliver knows that all too well. It's still hard to fathom that her family has arrived at such a desperate place.
"It's just ridiculous," she said, particularly exasperated over being denied access to the money in her bank account. "We're not felons."
