Friday, September 02, 2005

Health Care's Potholes

Health care's potholes
By David Lazarus, San Francisco Chronicle, Friday, September 2, 2005

Just about everyone has a tale of woe that illustrates why the U.S. health care system is in such miserable shape. Duane Vickrey's story is particularly illuminating.

It also gets to the heart of a problem many other people face: soaring insurance costs for the most mundane of medical conditions.

"Unless you can show you have a pristine state of health -- found more in theory than in nature -- they'll find a way to jack up your premiums," said Kevin Grumbach, who heads the Department of Family and Community Medicine at UCSF Medical School.

Vickrey, 41, graduated from UC Berkeley in May with a master's degree in social welfare. While attending classes, he was covered by a Blue Cross insurance plan available to students. He didn't step right into full-time work once he left school, so Vickrey decided to maintain his Blue Cross coverage under an individual policy.

He's not alone. According to the U.S. Census Bureau, more than 16 million Americans are covered by individual health insurance policies, as opposed to company-sponsored plans.Vickrey decided on a plan that cost a manageable $86 a month in premiums but that also came with a deductible of $3,500.

In other words, he's responsible for the first $3,500 in annual health care costs, making the plan primarily a hedge against catastrophic medical troubles. Luckily, Vickrey has no serious health issues. Or so he thought.

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