A Story of SCHIP

Policy, numbers, technical terms don’t bring in many reader. To break it up, here is a story that was passed onto me. It comes from Sojourners through an organization that is new to me called PICO.

(I always like to know where things come from.  How else can you evaluate its merit?)

I am here as a mother to speak on behalf of my two children, Bernadette (age 14) and Joseph (age 10). I am also speaking for the tens of thousands of parents in the PICO network who lack coverage for their children.

Almost all uninsured children (83%) live in families where at least one parent works. I am a single mom who works. I am uninsured. … I was married at the age of 17 and I had two children. My husband was a very abusive man who walked out on us when my oldest was 5. I worked very hard so that I would not become a burden to my parents. Sometimes I worked two jobs. … I say all that to say this: As a single mother who has worked to be where I am now, it’s hard to know that my kids don’t have health care. Somehow we are punished for bettering our lives.

When my daughter was 4 she needed a lot of dental work. I was working two part-time jobs that paid $8-9 an hour and none of us had health coverage. I remember going to the welfare department and asking to enroll in Medicaid. I told them I did not need welfare or food stamps or anything else, just help with the dental work that my daughter needed. After I did the paperwork the caseworker told me I didn’t qualify unless I quit one of my jobs or had another baby.

When SCHIP became available, I was able to enroll my children in the Colorado Child Health Plus Plan and get my children health coverage. And like most kids, they needed it. While they were on SCHIP, both my children sprained their ankles, my son broke his arm, and my daughter had a bad burn. Both received good care that kept them from any permanent harm and allowed them to go back to school and allowed me to go back to work. I was not worried about how much these accidents were going to put us in debt. I just knew they were going to get the care they needed.

All that changed when we lost our coverage in September, because my new job paid slightly above the 200 percent [of the poverty level] cutoff to qualify for SCHIP in Colorado.

We talk about 9 million uninsured children. Behind these numbers are real children who go to school, have accidents and get sick. And real parents like me, who work hard to meet their families’ needs.

When insurance prices are outrageously high, as a parent I have to decide whether to put food on the table or buy health insurance. I cannot afford to pay the hundreds of dollars each month that it would cost me to buy health insurance for my children.

I worry that when my children, God forbid, have an accident or get sick I will not have the means to pay for the medical attention they need.

Both of my kids were home sick last week for a number of days. The first night I felt very sad that I couldn’t just take my son to the doctor because we don’t have health insurance any more. He was running a fever, and as I drove to the store to buy him some medicine, I began to cry. I felt like a failure. My kids needed something I couldn’t provide. As a parent you work to make sure they have what they need. I went into the store and picked up the generic brand of chest rub and some Motrin for the fever. As I got back into the car I felt the need to tell someone that of course I would take my children to the doctor if I felt it was an emergency. I wouldn’t care if I had to pay hundreds of dollars later.

I called my friend and told her. She just heard me cry for a while, and she said that it was important that I tell this in my story so that you would know that parents go through this helpless feeling every day. She was right, and I hope you do. … Thank you for the opportunity to tell you one parent’s story, on behalf of millions of parents throughout our country.

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4 responses to “A Story of SCHIP

  1. This mother’s sad story raises a number of issues. First among them would be health insurance affordability for this family. If she’s making more than double the poverty level and one makes the assumption that at 100% of poverty level wages, you should be able to buy food and shelter, she must be saying that health insurance costs more/year than 100% of the poverty level. Maybe that’s true…but I doubt it. Is this a mother who cries “Poor me, I can barely pay my cell phone bill, buy the premium channels on cable and pay for a new iPhone? Or is she REALLY so destitute that she can’t afford health insurance for her kids? My sympathy for her greatly depends on answers to questions such as these.

    And I really gag on whiners who express an entitlement mentality about their needs while failing to acknowledge their own responsibility in their plight. True, she was legally a minor when she made her first big mistakes (parenthood and marriage to an abuser). And she claims that she’s doing everything possible to care for her children (although no longer working two jobs…maybe there’s a good reason, maybe not). But when someone expects to get a handout, they really should be prepared to answer enough questions to determine whether they are, in fact, a victim or merely someone who wants some other citizen who’s worked hard, made sacrifices and been responsible to assume the burden for her ineptitude.

    Last decade, we dismantled a welfare program that had trapped millions of Americans in poverty. It was a program that made all taxpayers “enablers”, co-dependent with those burdened by their financial insufficiencies. We have the potential for doing the same thing with health care in this country and the strongest ammunition in the arsenal of universal health care proponents will be sob stories such as this. If you can’t make a rational case for UHC, then tug on those old heartstrings! Can’t we just stick to a discussion of the facts?

  2. To give more insight into the affordability issue here are some numbers. 200% of the poverty level puits this family making $33,200 with two kids. The average family premium in the U.S. according to the Kaiser Family Foundation stands at $1,008 per month and the Coloroado Spring Gazette quoted a family premium at $1062 per month. That is not including expenses for deductibles, co-payments, etc. Further, this woman will be buying in the individual market (just know that prices in the individual market are much higher than the large group market) so her costs might be even higher. But let’s assume these quotes are accurate and she has no deductible and minimal co-pays. Her premium come to over $12,000 a year leaving her with just about $20,000 to live on (this is a best case scenario). There are no I-pods in that budget. She is barely making it. Yes, people spend their money foolishly, but that is a weak argument based on little to no accurate information. These premium costs are going up rapidly and getting out of the reach by more and more. The group with the fastest growing number of uninsured is the middle class. This is no longer just a poverty issue. It is more complicated and major reform is needed.

  3. lpauls, your analysis obscures the real problem. By specifying an income cut-off number for benefits, the SCHIP program creates some silly circumstances, to wit:

    CASE A: Someone making $33,200 with two kids gets insurance (under SCHIP) and has his/her entire income for living expenses (might even be able to afford an iPod or two).

    CASE B: Someone making $33,201 (i.e., one dollar more) with two kids must purchase insurance, leaving only about $20K ($12K less) for living expenses.

    The person in Case B is better served forfeiting a dollar of income to preserve his/her SCHIP eligibility but that’s often difficult to arrange. The SCHIP program should feather out their income eligibility threshold (and also make the starting point escalate to reflect wage inflation). But it’s not likely that’ll happen, even under a Democratic administration. Government programs seldom make a great deal of sense, either administratively, economically or fiscally. They tend to look like the proverbial horse designed by a committee (a camel). In any case, I’d be the first to say that reforms are needed.

    And finally, in reference to the woman whose case is detailed above, I hope she’ll show the same commitment to working “…very hard so that I would not become a burden…” to taxpayers as she has for the benefit of her parents.

  4. In any program where there is a cut-off point, the areas around that point are going to messy. It is too costly and time consuming to look at every detail of every person to see if they rightfully belong. So yes, some get services that should not. This messiness and complexity is exactly why these programs are inefficient and costly. They are not inefficient and messy because they are public, but because they create a fragmented system.

    There are two government-run health programs running today that are extremely efficient, popular, and effective. These are Medicare and the V.A. The common quality they share is that they are universal for the population that they cover. Government programs have their issues, but so do private companies. Private insurance companies are not great examples of efficiency. Their overhead and marketing costs are exorbitant (and lets not talk about other private corporate scandals, bubbles, and the over charging of our government and costing you the tax payer billions of dollars). I will go into the V.A. and Medicare at some point, but know that they are considered to be well run and effective programs (the biggest fault is that Medicare does not cover enough leaving holes and that the Medicare Part D program, a private/public partnership, is a mess).

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