Why So Expensive?

Why is health insurance so expensive? There’s probably a 1,000 answers to that question. Here are some excerpts from articles I found on the Internet with some of the answers. The first is from the National Coalition on Health Care web site. The article is titled Health Insurance Cost.

“Experts agree that our health care system is riddled with inefficiencies, excessive administrative expenses, inflated prices, poor management, and inappropriate care, waste and fraud. These problems significantly increase the cost of medical care and health insurance for employers and workers and affect the security of families.”

The second titled How Wrong Laws Make Health Insurance Expensive was written by Conrad F. Meier and published in It's Your Health. The publication date is January 1, 2004

“Health Care News, a publication of The Heartland Institute in Chicago, featured a series of monthly case studies documenting how government regulations like community rating and guaranteed issue have destroyed the individual health insurance markets in eight states, creating a large uninsured population.

The evidence shows these laws are poorly crafted and fundamentally unworkable. Such poor public policy-making explains why, for example, health insurance premiums in New York State are three times higher than in California.”

The first article blames the health care system and the second article blames the lawmakers. I’ve never even heard about these government regulations. Could it be the lawyers themselves, especially those that sue doctors for malpractice for 10’s of millions of dollars? Maybe it’s the fault of judges who award plaintiffs such large sums. How about…we could keep this up forever. All of the reasons mentioned are legitimate.

One big reason for the high cost of health insurance not mentioned is the number of people who aren’t insured. That’s 16% of our population. If everyone had insurance, it would spread the cost across a larger group. There’s another reason that hasn’t been mentioned. The number of people who use the health care system, don’t have insurance, and don’t pay the bill. This raises the cost of health care for everyone which raises the cost of insurance.

Well what do you think? Does that about cover it? No it doesn’t. As I said, there’s a 1,000 reasons. Two reasons mentioned above are community rating and guaranteed issue. What are community rating and guaranteed issue? Next time we’ll take a look at these.

How Much Does it Cost?

On September 14th US News and World Report had an article on their web site written by Michelle Andrews titled Health Insurance Costs Rise Again. Here’s an excerpt.

“Health insurance premiums rose more slowly in 2007 than at any other time since 1999, but the 6.1 percent increase still outstripped the rises in workers' wages (3.7 percent) and inflation (2.6 percent), according to a study released this week. There's no relief in sight for workers, who paid almost $3,300 on average for family coverage this year. Forty-five percent of employers polled say they're likely to increase employee premiums next year, with a significant number reporting they plan to increase employee deductibles, copayments, and drug contributions as well.”

Did you notice the good news, “Health insurance premiums rose more slowly in 2007 than at any other time since 1999.”

As I said in my last post, Cheryl and I are experts on the cost of health insurance. We started buying our own in 1997. Our total cost for health insurance in 1998 was $4,176.00. That year my employer reimbursed us 50%. By 2003 it was up to $10,668.00 and my employer was reimbursing us 33%. Not bad.

In 2006, we paid $19,164.00 and my employer contributed nothing. Do you think that’s why we drive a Kia van rather than a Honda?

Why is it so expensive? That’s for tomorrow.

Why Universal Health Insurance?

Why do I think we need universal health insurance? Simple, insurance has been an escalating problem for Cheryl and me for the past 10 years and we consider ourselves lucky; we have insurance. I remember the days when my Dad had health insurance with BlueCross BlueShield and it was 100% paid by his employer. Most of the companies he worked for were small. They were auto parts stores where there were eight to 10 employees. In the olden days, the 50’s through the 70’s, it seems like everyone who had a job had health insurance and the employer paid.

The latest census data shows that the percentage of people in the United States without insurance has increased from 13% in 1987 to 16% in 2006. That doesn’t sound like much of an increase but it’s a number that’s been growing for a long time and my sense is that if something doesn’t change the number will grow every year. By the way, that’s 47 million people without insurance. A Congressional Budget Office (CBO) report titled How Many People Lack Health Insurance and For How Long? published in 2003 stated that “75 percent of the uninsured in working families do not have access to insurance through their employer” and “the other 25 percent have access to employment based insurance but do not accept it.”

I can’t imagine being without health insurance. It has happened to Cheryl and me only twice in our lives together and both times Cheryl was pregnant and within weeks of delivering when we found ourselves uninsured. Fortunately there were no complications with the deliveries and the cost wasn’t prohibitive. How things have changed. I wouldn’t want to be without insurance today and have my wife in her ninth month. Based on the number of people without insurance, you can safely assume that many families are facing that dilemma. For many citizens of the United States of America, that is their reality while most of rest of the western world has provided a system to avoid those circumstances.

According to the CBO report referenced above, “The high cost of insurance and lack of access to employment based coverage are the two most commonly reported reasons for being uninsured.” From my experience, both of those reasons for being uninsured are for the same reason, the high cost of insurance. Except for the period of September 2006 to August 2007, Cheryl and I have been self insured since 1997. We’re experts on the cost. Tomorrow I’ll describe the “high cost of insurance.”

A Decision Made

I’ve made a decision whether to write about more than one subject on this blog. My decision is to do it. While we’re waiting for an answer from the agents, let’s go off on a tangent. I have a passion for many social issues and they relate to the plight of those less fortunate. I don’t necessarily mean people who are financially disadvantaged. Being less fortunate may mean not having access to an educational system that recognizes your special needs and provides programs to address them. This could happen to a person with learning difficulties or a genius who’s bored to tears. Not addressing the educational needs of a child is an awful waste of our natural resources. I taught high school for 10 years and I have a lot of experience with this issue.

As I already mentioned, I believe our lack of universal health care is an abomination. There are a number of states attempting to provide universal health care for their citizens and there are many plans being offered by the presidential candidates. This issue will be a big one in the next election and I’m going to add my two cents. I’ll address this issue first. Universal health care is what will get me on the road. I have to check with the law enforcement agencies to determine what road blocks (pun intended) may be in my way and I have to determine if Tallahassee might be too far. A person can’t walk for so long that people lose interest. That’s assuming me walking for a cause generates any interest. First, I need to state my case for universal health insurance on this blog then, God willing, I’m on my way.

Speaking about walking a long distance; I need a new brace. I couldn’t possibly walk a long distance in this worm out brace I’m wearing; can’t go to the dance in this old dress. Next Thursday I have an appointment with an orthopedic specialist to get a prescription. Many of the times that I’ve seen an orthopedic specialist they’re so fascinated with an old polio patient that the doctor calls all their partners in the room to see this dinosaur. To get a new brace, the doctor has to write a prescription for an orthotic, a device which supports or corrects human function, in my case a leg brace. That’s really a little humorous. I usually help the doctor write the prescription. And I have to pay them!

Sending the Query Letters

Today I made my final selection of the first five agents to receive my query letter. With the selection finished, my work had just started. Sometimes I think it would be easier if we owned a typewriter. The process of getting the letters out is a long one. First, I had to write the letter in Word. That wasn’t too hard. Second, I had to check each agent on the Internet to make sure they were still in business and their address hadn’t changed. I’m using the 2004 edition of the Guide to Book Publisher, Editors, & Literary Agents. The book’s three years old so I didn’t want to take any chances. I just read about a guy that sent his query letter to an agent and he got a call from another agent in the office. The guy asked the agent how she got his query letter and she said that the agent he sent the letter to had passed away. In the end, she got him a million dollar advance on the book and a movie contract. Wait, maybe that’s what I should do, only send my query letter to agents that have… No that wouldn’t work, with my luck I wouldn’t hear from an agent until I got to…well you know where.

Third, after verifying all the addresses, I opened Excel and put the name of the agents in one column and their addresses in another. Fourth, I went back to the query letter in Word and attempted to do a mail merge. A mail merge takes the data from the Excel file and places it in the Word document. It’s not as easy as it sounds. I found out after my first attempt that the first and last name had to be in separate columns in Excel and the address had to be split into separate columns for street, city, state, and zip code. I got that done and after a few more changes I got it to work. Hurray, one letter turns into five with the correct name, address, and salutation on each letter. That only took about three hours. Now where was I, oh yeah, fifth, I had to perform the same mail merge in Word to produce the envelopes. That took a few tries. Now I’m done but I discover that I have some business paper but no envelopes. By that time, it was nearing dinner time so I stopped, ate dinner, and went to the store for envelopes. I now have paper and envelopes that match.

It’s now 8:10 PM and I have to wait for Cheryl to finish working before I can print the letters and envelopes. I haven’t set up our computers in a network; another very long process that neither of us has time for. Because we aren’t networked, I can’t access the laser printer Cheryl’s connected to. I want to print the letters and envelopes on the laser printer because the ink from ink jet printers can smudge. Just what I need, send out the letters and the envelopes get a little damp and the addresses smudge (not possible in this humidity). I think it’s time to stop and print in the morning. I would ask for a vote on this but I’m too tired. Tomorrow the letters go out; then the long wait. Reading the web sites of some of the agents I see that it takes them four to 10 weeks to send an answer. Maybe I should take a walk while I'm waiting.

The Query Letter Completed

Okay, the query letter is finished. I am so ready to get this letter out. This week I will print five letters and send them to five literary agents. That’s the easy part. The hard part is waiting for a response. With each letter, I will include a self addressed stamped envelop (SASE). From what I’ve been reading on the Internet, the SASE will be used by those agents who will be sending me a form letter thanking me for my submission but no thanks. If an agent is interested, I could get a phone call or an email asking me for a chapter for their review.

I can only imagine what Cheryl and I will feel when we get that phone call or email. What an experience that will be. I have been so fortunate to have had so many challenges in life and succeeded that I am excited to have the opportunity to show others that no matter what challenge they’re facing you can not only survive it, you can come out the other side healthy, happy, and on top of the world. I don’t mean to lessen the hardship that people can endure but there is life on the other side of the struggle. My friend Bob, who has been my friend since before I had polio, has faced challenges that I hope to never face.

Bob’s wife died of cancer and not too many years later his youngest daughter died of cancer. I couldn’t imagine facing those challenges. Bob is an inspiration to me. I’ve completed almost four chapters in the first book of the series of three books that I plan on writing and Bob is in the first three chapters that I’ve completed. I sent them to him to read and he said he told a friend of his, who is a screen writer, about the books I’m writing and she said she’s interested. The idea of getting the books published is exciting. The story becoming a play or movie is just beyond my imagination. Stay tuned this could become very exciting.

Strength-of-Character

Today I rented the movie Quiz Show. The movie is about the quiz show scandal in the 1950’s. One of the most popular shows was Twenty-One. A contestant on Twenty-One by the name of Herb Stempel told a grand jury in New York that he was asked to give a wrong answer to a question so that Charles Van Doren, an instructor at Columbia University, would win. Richard Goodwin, an investigator for the House of Representatives Subcommittee on Legislative Oversight, read that the grand jury had sealed its findings. The subcommittee is the oversight committee that has jurisdiction over the television industry. Richard knew that sealing the findings was irregular and wanted to investigate the operation of the quiz shows.

Richard was given permission and he found that not only were contestants on Twenty-One asked to lose but they were given the answers to the questions. Charles Van Doren was subpoenaed by the subcommittee to answer questions regarding his experience. In the movie, Charles went to his father to tell him that he, like the others, got the answers prior to the show. Before he could tell his father the truth, Professor Van Doren, hearing Charles had been subpoenaed, made a disparaging remark to Charles about our elected members of Congress. He said, “You’ll run circles around them, it’s not exactly Jefferson and Lincoln down there anymore.”

I rented the movie because I saw the movie on television this week and when I heard the remark it resonated with me. I had to rent the movie and watch it again to get the exact quote. For some time, I’ve wondered about the people we elect to our national offices. Professor Van Doren’s remark was about their intelligence and many times I question that but my wonderings have more to do with their strength of character. The 56 men who signed the Declaration of Independence knew they were committing treason by their actions and most suffered greatly but none recanted. They were a special group. Now I wonder about our members of Congress. How many would stand up to that test. How many would take on the special interest groups. How many would be willing to step forward to fix what is broken regardless of the consequences.

I contend that our health insurance industry is broken and no one has the strength of character to fix it. I know this sounds like I have significantly strayed from posting about the process of getting my book published but in the process of making a tongue-in-cheek remark about gaining notoriety I realized that I had undermined a cause that I feel so strongly about. I realized how disgusted I am with the state of our country and I had to treat this seriously. Yes I’m serious about walking to Tallahassee and speaking out about the health insurance industry but that’s just the beginning.

I may have to start another blog about my walk and the state of our health insurance industry. I’d much rather keep this blog light hearted and the subject of this post is anything but. Tomorrow it’s back to the query letter. I’ll let you know if I start a second blog.

Crazy Man

This idea of walking to Tallahassee to make a statement about the poor state of affairs of health insurance in the USA is sounding better and better. My wife, Cheryl, and I are on our way out to visit a friend. Our friend has a moped that’s not running so I’m taking a shot at fixing it. I’ve had it running once before but being an old moped with a lot of miles it might cost more to fix than it’s worth.

I want to tell you why I’m more excited than ever to hit the road but I’ve run out of time this morning so I’ll try to get back to writing later today. Boy am I excited. How does 100 days on the road walking to Tallahassee on crutches sound to you. I can’t wait to get started. Stay tuned for more.

Gaining Notoriety

Is there a way to ensure that my book gets published? Sure, become famous. I’ve had some experience with fame. I was in the papers when I had polio. Maybe that was too long ago. Okay, I’ve got another idea. We’ve all seen people like David Blaine gaining notoriety through some stunt. He made his name as a performer of street and close-up magic. In November 2000 he performed a stunt called "Frozen in Time," which was covered on a TV special. Blaine stood in a closet of ice located in Times Square. He survived and has had many specials since. Now I’ve given some serious thought to what I could do to gain notoriety.

I have no talent or artistic skills so I too would have to do something that might be regarded as challenging. For several years I have been completely disgusted with the state of health insurance in this country. I can’t get private insurance in Florida because they don’t sell insurance to diabetics in Florida. Seems there’s too many of us here. Now how can I gain notoriety and make a statement about the state of health insurance? My first thought was to call the local TV stations and tell them I’m walking from Florida to Washington, DC speaking about the sad state of affairs of health insurance in the USA.

I mentioned this plan to a friend, Anthony. Now Anthony is a very bright young man. He smiled, raised his eye brows, and said he thought the idea had merit. The expression on his face didn’t match his words. I decided to continue relating my plan to see if he was humoring me or if he was serious. We talked about how long it would take for me to walk to Washington. It’s 1,000 miles and at one mile an hour (I don’t walk as fast as I did in my youth) it would take me a 1,000 hours. Assuming I walked eight hours a day. Well, you get the picture. I would arrive in DC in January. What Floridian would walk north in the winter. I want notoriety not suicide. Anthony agreed.

After much thought and discussion we came to the conclusion that walking to Tallahassee might be more reasonable. Anthony suggested he would be willing to follow in a car when he wasn’t working. By the end of the conversation I still wasn’t convinced I had Anthony’s support. I still sensed that he was humoring me. Actually I could sense a lack of respect for my plan from a man 20 years my junior. It was subtle but I’m certain that’s what it was. I need to know what you think. The cause is definitely one we can all rally around. With all these presidential candidates making speeches, it’s a great time to get the issue out in the open. Okay, who wants to follow me in the car?

Weigh In

I had an appointment this morning with my cardiologist. The first thing the nurse did is ask me to step on the scale. That was my official start diet weigh in. For me, that was the most important part of the visit. Remember, I just started a diet. In six months I will be visiting the doctor again. That will be my official weight loss weigh in. Of course I’m assuming I will lose weight. My official start diet weight is 157 pounds. I plan on losing at least 17 pounds. I’ve never lost that much weight without being sick. When I became diabetic and didn’t know it yet I lost 40 pounds before I realized I wasn’t losing weight because of the diet I was on. When I had bypass surgery I lost 30 pounds between the surgery and recovery. Now I have to try to just lose weight. No help. No tears please, I’ll survive.

The query letter is almost done. My next step is to make a list of all the agents I will contact. I’m using a book titled Guide To Book Publishers, Editors, & Literary Agents by Jeff Herman. This is the book recommended by all the Internet sites I visited looking for information about literary agents. My wife has already made a list of the agents that we should consider. She found about 50 agents. Tomorrow I will review the list and pick the top 20 or so. A part of me can’t wait to get the letters out. You know, “Damn the torpedoes, full speed ahead!” Another part of me could spend the next six months being sure the query letter is perfect. I’m trying to reach a reasonable compromise. Of course, I have a rudder and a throttle on this boat. Someone is making sure this is completed as soon as possible with few excursions. Thank God for my wife.

Oh yes, the doctor said everything looks fine. I may get this project completed after all.

The Query Letter

Last night our company arrived and I gave them a copy of the rough draft of my query letter. They were here to pick up some furniture and they had two other stops to make so we didn’t get a chance to talk about the letter. I’ll see them Thursday night and get their comments. I’ve been thinking of posting the letter here and finally came to the conclusion that if this post is about my journey to getting my book published then I needed to include the query letter in the post. So here goes.

I contracted infantile paralysis, or more commonly referred to as polio, at the age of 20 months. When I was released from the hospital after three weeks in isolation I couldn’t move my legs, sit up, or move my head. My parents elected to take me to therapy three days a week and do my exercises at home the other four days rather than house me in a facility where I would receive therapy and schooling. After twelve years of physical therapy I walked with crutches, had a full leg brace on my right leg, and my left leg was just barely strong enough to no longer need the brace. I have never understood the words “I can’t.” It’s not in my vocabulary. If I had to tell you my philosophy of life, I would say that you live life by doing “Whatever it Takes.”

I attended public schools, I was a Cub Scout and Boy Scout, I graduated from college, and I have a wonderful wife and two grown daughters who share my philosophy. I have been an automotive machinist, a draftsman, a teacher in four public high schools, an instructor in a high tech computer company, a technical writer and trainer for a high tech oilfield down hole services company, the manager of a documentation department, and a national sales manager. My wife and I have lived in four states and I’ve traveled throughout the United States and in Europe training computer service engineers and customers. I’ve had an exciting life and if I wasn’t being challenged I changed it.

If that wasn’t enough, in the midst of the 56 years since polio I have become a Type 1 diabetic, I have arthritis, I’ve had two heart attacks, bypass surgery, and a heart stent. Does life get any easier? No, if it did I’d be dead. I'm going to write three books that chronicle my life from polio to diabetes, diabetes and arthritis to bypass surgery, and bypass surgery to the present. Each stage of my life has given me new and escalating challenges physically and emotionally.

There’s more to add to this letter but that’s the body of it. The question is, if you were a literary agent, would the letter cause you to pick up the phone and offer to represent me. If it would, then you think the book will sell and you will get paid for your efforts. If you have any comments about changes that would improve the query letter, let me know. I can use all the help I can get. One last thought. I forgot to mention that I started on a diet yesterday; a new blog and a diet all in one day. I was 130 pounds nine months after my bypass surgery and now I’m nearly 160 pounds. I looked like death warmed over at 130 pounds so I’m looking to get down to 140 lbs. At 130 pounds I was the same size I was in college; 29 inch waist and a size 40 jacket. It’s funny that I didn’t look like death warmed over then. I wonder what changed.

Hello World

This is my first post. My reasons for blogging are many but I have decided to focus on the process of getting my book published. I am writing an inspirational autobiography. I have been fortunate to have had a very full life even though I walk with crutches and have Type 1 diabetes, arthritis, and heart disease. I was brought up to never view my handicap as a disability so I’ve never imagined that I couldn’t accomplish any goal. That’s not to say that I haven’t experienced difficult challenges. Every day is filled with challenges and as I get older it doesn’t get any easier. I make it look easy and I’m not one to complain so most people have no idea what it’s like to get through life with crutches under my arms, an insulin pump clipped to my belt, arthritis in my limbs, and the reality of heart disease.

This blog will be a chronicle of my efforts to get my book published but I will also write about what I’m dealing with on a daily basis. I must admit that I’m a little nervous because I’ve looked at other blogs where the blogger posted day after day without any comments and then there would be a few days missed followed by a few days of posts again without comment. Finally, weeks and months would pass without a post. I have a lot to learn about blogging, the first of which will be about finding an audience. Well, enough about what I’m going to do. It’s time to start doing it.

The process of getting a nonfiction book published when you’re as obscure as I am is to find a literary agent who is willing to sell your idea to a publisher. In the case of nonfiction, as I understand it, it’s not important to have written the book. What’s important is to have a very clear idea of what the book will be about and sell your idea to a literary agent. The agent gets a cut of my part of the book profits. That’s how they generate an income. The vehicle used to sell my idea is a query letter. The query letter is for the most part a one to one and a half page description of the book. It’s also a good idea to include who would be interested in reading the book. If a literary agent thinks I’m right, they will contact me and we’re off and running looking for a publisher who agrees with me and the agent. Today I will finish my first draft of the query letter. We have company coming tonight and I want to show them the query letter to get their opinion; more about the query letter later.