Tuesday, June 23, 2009

The Consequences of our Decisions

In today's New York Times, columnist David Brooks says health benefits should be taxed because otherwise, patients get a free ride and don't appreciate the "consequences of [our] decisions." This is so outrageous I could scream!

We have health insurance through a small plan that is appended to the state employee plan, an innovation designed by our wonderful state Comptroller, Nancy Wyman. It costs $996 per month. Yes, it has the lowest deductibles and copays that are offered. We choose that because higher deductibles and copays would actually cost more than the difference in the health insurance premium between our plan and the less generous option.

But don't think for a second that I don't appreciate the consequences. I can't hire another employee because I can't afford to offer them this expensive health insurance. When I go out of network, I pay a ridiculous amount out of pocket because my insurer thinks what's usual and customary is about half of what my doctor charges. Even my monthly drug copays and the cost of things that are not covered, like probiotics, remind me of the consequences of my decisions.

I choose to get the best health care I can find. That keeps me working and productive. Would David Brooks prefer it if I went on disability, lost my health insurance, spent my savings down in a couple of years, and then filed for bankruptcy when my bills mount up? Does he think that would be a better outcome? Jennifer


  1. Jennifer, I'm the parent of a teenager with coexisting chronic illnesses, including IBD, and you were quite helpful to me when he was first diagnosed -- I'm following your blog religiously now and telling others about it. Brooks' comment is indeed outrageous and is just one more symptom of a trend that worries me greatly: the tendency to speak of each and every chronic illness as completely preventable. I do believe preventive care and patient education is terribly important. I've had asthma since childhood and definitely recognize that regular exercise does me as much good as does my inhaler. I also know enough not to smoke. But there's no exercise my son can do to keep his IBD at bay, and how do we "make decisions" about preventing diseases for which we don't understand the cause in the first place?

  2. I keep saying this, and people keep shouting me down because it sounds like I'm against prevention, which of course I'm not. But most of the autoimmune diseases -- IBD, lupus, MS, type I diabetes, to name a few -- are not preventable, and we need to focus on treatment, including good care coordination.