money + health = f*ck

I've been wanting to post about this for awhile. I've not posted this topic, out of respect for my employer. Yet, tonight's Frontline: Sick Across America, prompted the following.

Let me start by saying this: I am not placing blame, anywhere. The healthcare system is broken. We are in an unfortunate situation. I simply add this to Gregory's story, because it is Gregory's story. Also, it is about awareness and action. Action needs to be taken. I don't have an answer as to what that action is or what the answers are. We desperately need healthcare reform.

I work for a small company. About 13 employees, with not all of them taking the group insurance that is offered. Which spreads the risk over very few employees. Due to the size of our employee base, we do not qualify for FMLA. Due to the size of our employee base, we do not qualify for COBRA.  In order for me to maintain my benefits, I need to work the qualifying minimum number of hours.  Which has been challenging.  I'm currently using sick/vacation time to make up the difference.  We do have a provision in our contract that allows me to continue coverage, for a three (3) month period, while not working.  As long as I pay my premium.  There is also an office policy (sorry, I'm gonna let the cat out of the bag.  I don't think my fellow employees know this part, yet!)  that allows fellow employees to donate vacation time, in order for me to maintain my minimum number of hours.  Which leads me to the point.  We are in the not-so-unique situation, where someone gets sick and the possibility of conitinuing coverage is slim.  I do know that we are able to obtain an individual plan.  Which means a hefty premium.  So this is good.  We will not be denied coverage, as long as Gregory maintains continuous coverage. 

I decided to take a peak at what claims have hit the system, so far.  Holy cow.  So far, and this is not all inclusive, this is only what has been billed to the insurance company, so far.  There are claims totally $89,000.  Which doesn't mean that is the allowed amount.  This is simply what has been billed.  We haven't even started treatment, yet.  We have a cap on the Bone Marrow Tranplant benefit, as well.  $250,000.  I don't know if that is a one time benefit, either.  What happens if we need to repeat the BMT?  Which is common.  This is a question I need to get answered.  We also have a 2 million dollar cap.  This is a lifetime cap.  For Gregory, this means his life.  We will do everything we need to.  We will move mountains to protect him.  Yet, this whole health insurance thing, is scary. 

Like I said, there is NO blame place here.  None.  I wish to document Gregory's story and provide awareness.  Those of you who are fighting for Universal Healthcare?  PLEASE, continue.  I can't help you in person, for now, but I am with you in spirit.  This needs to change.  We won't reap the benefits (ha, ha), but it needs to happen.  Now.