When I was in second grade, I got health insurance for the first time. I remember my parents—with looks on their faces somewhere between proud and relieved—telling me that it was now totally okay to fall out of a tree and break my arm. Frankly, that didn't sound like much fun, so I never took my parents up on the offer.
It's only years later, as an adult, that I really understand the significance of that event. I honestly have no idea how my parents paid for the regular preventative check-up appointments I remember going to. I have no idea how they paid for the time I smashed my finger between the hinges of a door and ended up in the hospital. The fact that those things happened, at a time when we had very, very little money and no insurance, gives me a little bit of a retroactive sense of budget vertigo. Did my parents lose sleep over this stuff? In all likelihood, yes. It's a wonder I was allowed to climb trees at all.
Since I was a kid, the costs of healthcare—and the cost of insurance—have increased dramatically. And that's widened the gap that people fall into, when they make too much for Medicaid, but can't afford insurance. When I was uninsured, my mother was a home daycare provider and my father was a bartender. Today, it's perfectly possible to have a Ph.D., have a decently paying professional job, and still have to make some terrifying budgetary decisions that leave you and your children without health insurance.
Kevin Zelnio is one of those people. He's a marine biologist who left academia after a string of contract teaching jobs—positions that come with no security, no hope of tenure, and usually no insurance benefits. Today, he's a science journalist, blogger, and science communications consultant. But that means he's self-employed. And since his wife doesn't have insurance, either, that means his family has no medical safety net.
This is not a good position to be in. (And I'd be in the exact same position if it weren't for my husband's job.) The only health insurance Zelnio's family could afford is high deductible—leaving them to pay thousands to an insurance company every year, in exchange for only the promise that, if the Zelnios spend more than $5000 or $10000 in a year, the insurance company will cover some percentage of anything above that. And, of course, that comes with a lot of caveats, because we all know that paying for large expenses is not something insurance companies like to do.
That's a situation that feels pretty hopeless. And it leads to people taking risks with their health that they shouldn't have to take. Kevin Zelnio has a post up on Scientific American that puts a sharp spotlight on this devil's arithmetic that every uninsured or underinsured family has to do. It starts with this question, based on Zelnio's real-life experience: If you didn't have insurance, how long would you wait to take your child to the hospital if they were extremely sick?
How do you balance your family's future financial well-being against the immediate health needs of a 5-year-old? That's a decision that nobody should ever have to make. If you don't remember a time when you didn't have health insurance, if you've gotten complacent in the security your current insurance provides, or if you just want further proof that our healthcare system is based around the wrong incentives and the wrong priorities ... you MUST read Zelnio's story.