Policymakers have failed the estimated one million direct-care workers in this country who don’t have any health insurance, and the thousands of others who have coverage they can’t use because it is too expensive. These direct-care workers provide care and support to elders and people with disabilities, helping countless families every day.
The desire to make health insurance more affordable for these workers, and millions of other uninsured Americans, is one of the reasons so many of us voted for change last November. We continue to want change. We want our national legislators to fix our health care system now.
Karen G.
Direct-care workers such as Karen G. in Washington, PA, are all too familiar with living without health care coverage. Karen has a painful bladder syndrome known as interstitial cystitis (IC) — a condition that results in recurring discomfort or pain in the bladder and the surrounding pelvic region. After Karen’s urologist ordered a series of expensive diagnostic tests, she stopped going there altogether. Now she tries to endure the chronic discomfort she feels every day.
As a personal care attendant, Karen does a lot of heavy lifting. Direct-care workers have one of the highest injury rates in the country, surpassing construction workers, truck drivers, firefighters, and police officers.
Consequently, Karen has developed a hernia above her abdomen. There is a simple hernia-repair surgery, but without health insurance Karen simply cannot afford it. (She has already accumulated over $4,000 in medical debt.) Leaving a hernia untreated is risky, potentially resulting in infection, gangrene, intestinal perforation, shock, or even death.
If Karen is too sick to work, her client cannot get out of bed, take a bath, or eat a meal. This problem affects us all.
Paula H.
Even direct-care workers whose employers do offer insurance find that they cannot enroll, because the plans are prohibitively expensive. For years, Paula H., a home care worker from McKeesport, PA, relied on her husband’s employer-sponsored insurance to cover her family’s health care needs. But when he changed jobs, the family found itself temporarily uninsured.
During that time, Paula tried to enroll in her employer’s insurance plan. But the cost to cover her family was nearly $600 per month, far more than she could afford. (The average wage for direct-care workers is $10 per hour.) In addition, Paula had a heart condition; indeed, that condition was the primary reason she needed solid health insurance. But because the condition was pre-existing, the insurance plan denied coverage for any heart-related medical procedure.
Paula also faced a $10,000 annual cap on her coverage, a figure that could be easily reached after just one serious medical event. Paula’s employer saw excellent employees become diagnosed with cancer and have their coverage run out before undergoing a single treatment.
Change Needed Now
Situations such as Paula’s and Karen’s are simply unjust. Insurers have too much control. They decide the size of our premiums, deductibles, and co-pays, as well as the size of their own contributions — and they make these decisions based on their bottom line, not our well-being.
Even during these hard economic times, insurance companies are reaping record profits while hardworking Americans are being squeezed by higher costs. It’s no coincidence that while we’ve experienced an enormous increase in our premiums and out-of-pocket expenses, we’ve also seen more of our claims for prescribed procedures denied. Ever wonder how, even in our suffering economy, the insurance industry’s profits have doubled, and insurance company CEOs make more in a day than most hardworking Americans earn in a year?
Our current health care system is unsustainable and irresponsible — too costly and too risky. But it doesn’t have to stay this way. We can build on what currently works, and fix what doesn’t. We need reform that will improve our quality of health care while making that care affordable for all. We want to know that our insurance will always be there for us when we need it.
It’s time to deliver for Karen, Paula, and the millions of Americans who can’t wait for health reform any longer.
Tracy Lawless
PA State Campaign Coordinator
tlawless@phinational.org
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