When our second child, Zade, arrived in 2004, my wife and I thought we knew most of the hazards facing babies. Until the night in the fast food restaurant when Zade died.
At least that’s what it seemed like. I had taken him to the bathroom to change his diaper and he suddenly went limp, didn’t respond to me, and started turning blue. It was maybe 30 seconds, but it felt like an eternity. I can still feel the panic that engulfed me as I ran out of the bathroom screaming, with no idea what was wrong or what to do. An ambulance arrived and whisked my wife and son to the hospital. I followed with our daughter.
As we later learned, our son had experienced a febrile seizure.
These are fairly common: 2 to 5 percent of babies experience them. Most kids eventually stop having seizures and live totally normal lives. That’s exactly what happened to Zade.
The $16,000 ambulance ride, mostly covered by insurance, was followed by a few hours in the emergency department. Over the next few months of his toddlerhood, Zade had a few more seizures. Then they stopped. The terrible part of this story wouldn’t happen for another few years.
In 2009, I switched jobs and needed to buy health insurance for my family. This was before the Affordable Care Act had been passed, and I was required to provide dozens of pages of personal medical questions. Then followed humiliating discussions with a nurse from my new insurance company who asked about every single issue my family had ever experienced. He wanted to know when my birthmarks had started — I’m not kidding — and demanded letters, doctors notes, and intimate details about any time we had ever seen a doctor or taken a medication in our entire lives.
I told the nurse about Zade’s febrile seizures, my family history of high cholesterol, and even my struggles with depression. I knew that disclosing this information could potentially increase our premium, but if that’s what it took to get health insurance for my family, so be it.
Two weeks later, I received my insurance cards and a bill. I first noticed that I was now paying twice as much for our insurance as I had been. Then I noticed that the envelope held only three insurance cards; there wasn’t one for Zade. This insurance company, and five more after that, decided that my son might cost them too much money because of those seizures, which they called a pre-existing condition. So they simply rejected him from coverage.
For the next three years, Zade had no health insurance. I fought and pleaded with every major insurance company, to no avail. I tried to get him into a high-risk policy, but struck out there, too. Passage of the Affordable Care Act finally allowed me to provide my son with health insurance. He’s 13 now, and doesn’t remember this. But as his dad, I spent many sleepless nights terrified about what would happen if the seizures returned or he had an accident or any health issue.
Being unable to provide for and protect your children is one of the worst feelings a parent can endure. Zade’s being rejected for health insurance due to a pre-existing condition was one of the darkest days of my life. In many ways, it led me to start a company, GoodRx, as a way to take back control of my family’s health care decisions.
About 1 in 3 Americans, more than 130 million of us, have pre-existing conditions. It’s surprisingly easy to become part of that group. A friend of mine couldn’t get insurance because he was too tall; apparently tall people are more likely to have health problems. Others have been turned away because they work in high-risk professions, such as being a firefighter or police officer. Some are unable to get health insurance because of family history, regardless of their own current health. When companies can refuse to insure individuals because they have pre-existing conditions, at any moment you could find yourself without health coverage.
Recent moves by the Justice Department, the attorneys general of 11 states, and Congress seem to be paving the way for companies to once again use pre-existing conditions to exclude individuals from getting health insurance. As part of the dismantling of the Affordable Care Act, the individual mandate requiring all Americans to have insurance or face a tax penalty has basically been removed. Now another important part of the act, that health insurance companies can’t refuse to cover you or charge you more just because you have a pre-existing condition, is also on the chopping block.
Depending on how these moves play out, the recent ruling from Texas may include policies that individuals buy through the health insurance exchanges as well as employer-sponsored plans. In simple terms, it could mean that even if you have a full-time job and your employer provides insurance, you might not be able to get coverage.
The Affordable Care Act is far from perfect and, as a nation, we still need to come up with a way to rein in our out-of-control health care costs, which currently consume 26 percent of the U.S. budget and rising. But if our country chooses not to provide health care for all of its citizens, and lets private insurance companies decide who they’ll cover, we’re defying some basic tenets of what it means to be an American — fairness and social security for all.
After the ACA was enacted, my family was no longer interrogated about its health history and my son has been insured. Today, however, I’m worrying again that Zade might be uninsured, and about my friend who bravely survived liver cancer, and about the millions of Americans who battle mental health issues, high cholesterol, a family history of anything, or any condition that is deemed too expensive to cover.
I started GoodRx to help provide Americans with information they could use to find affordable health care. The recent decisions by the Justice Department and others seem to be moving in the opposite direction.
Most other developed nations have figured out how to provide basic levels of public or private health insurance, yet America is considering taking away that option. This can’t end well, and will likely result in increasing costs as more Americans use the emergency department as their doctor and are discouraged from getting preventive care.
Zade and millions of Americans like him deserve better.
Doug Hirsch is the co-founder and co-CEO of GoodRx.
Mr. Hirsch, thank you for GoodRx. My son’s wife needed a prescription recently that was going cost them almost $400 for a month’s supply. He called me in a panic. I sent him to GoodRx, and they secured the prescription for $37.
I am concerned that we open the door for ANYONE to be insured. There must be some way to exclude or seriously upcharge those who live unhealthy lifestyles, and just plain abuse their bodies. It is immoral for all of us to pay for them. Cases like your son are a no brainer. He should have been accepted and insured. But those who are morbidly obese for lack of personal discipline, those who abuse drugs, both legal and illegal, those who smoke or use tobacco in any form, those who abuse alcohol should not expect that you and me pay more because they cost more. Just my take.
Mr. Hirsch, Thank you so much for GoodRx.Your company has saved me a LOT of money!! Close to 10K since it’s inception. Even when having very good employer provided insurance, GoodRx was sometimes cheaper! These insurance companies doing what they did with your son & charging your family crazy premiums is insane and has to stop.
Over 50% of the US pop has a ‘previously existing condition’ of some kind, a family history, or have issues they just don’t know about because they’ve blown off getting checked out with or without insurance for so long.
The ACA was well intentioned, but a complete disaster. Healthy people being forced to pay much more because of the sick & elderly. Many could only afford the lowest tier & the deductibles were so high before any insurance kicked in that did these people got nothing, except cost them a lot of money for just the basics. During this time, insurance companies made a fortune, while people couldn’t afford any of the ‘plans’, wound up in big debt, or were forced to pay a ‘penalty’ for not signing up.
Social medicine like in parts of Europe & Canada is also a mess and costs lives. Documented if anyone looks. People have to wait for extemely long times for many tests,procedures,& surgeries. Sometimes the ‘insured’ are refused the above as they’re deemed ‘unnecessary’ for a lew of reasons.Many times it’s cost!! The end result of this gov controlled health care is people with so called ‘insurance’ end up dying unnecessarily, earlier then they should, or end up getting sicker because of the long wait times & refusal of services.
When the rich in parts of Europe & Canada need surgery or treatment ASAP, they come to the US for these medical services. They don’t sit around & wait to potentially die & know they can get the best health care here in the US. They’re are plenty examples of this for the ney sayers. The gov should not be playing God! Our gov is big enough & wasteful with our money.
What we need is to continue to have private companies providing health insurance, but not be allowed to exclude anyone because of a preexisting condition or family history. Caps enforced on these insane deductibles & offer very affordable ‘catastrophic insurance plans’. Younger people who think they don’t need insurance will be more inclined to purchase at least this type of plan. After being educated of the astromical costs if they get seriously injured/ill & the low cost of a simple catostrophic plan.
Everyone in America should have access to affordable healthcare/insurance. ‘Affordable’ being the operative word. Health insurance companies should also be able to make a profit & non profits should be able to at least break even. This all can be done if the far left socialists & over zealous profit driven health care companies can meet in the middle, be fair to all, and just use common sense!!
I love GoodRx, but wish it could save me money on my most expensive Rx, Lyrica. When there is no generic drug available, prices are exorbitant. The cost of this one Rx is approximately $450/month at the cheapest pharmacy.
Your letter of your experiences of what you have had to deal with as a family should be earth shattering to most common Americans but just as you have stated, it is clear with this Administration, Congress(such as it is) and Supreme Court,as we will soon know it, how do we fight this turn back in time movement. This is so unjust to us and I do believe that Trump voters have no knowledge or do not read at all to not see what is ahead! I am frightened for my grandchildren and children and myself as a senior. What can we do except to vote out all of these terrible individuals who have no worries about only themselves? This Congress should be ashamed !!!! Your Good RX is a Godsent to us -thank you and Godbless you and your family!
Thank you!!! My son takes three medications, and has no insurance (long story…). He wasn’t able to afford his meds before GoodRX. Without GoodRX, 800.00 per month. With GoodRX, 42.00per month!! There aren’t enough words to thank you!!!
This administration wants those death camps. Period.
Do not forget to register and VOTE! Health care should be a basic right for all Americans (Life, liberty, and the pursuit of happiness).
” .. Do not forget to register and VOTE! Health care should be a basic right for all ..”
Mao and Ho used the same tactics, all talk and NO action. Won’t be fooled.
Mr. Hirsch, a few facts — many states used to have special funds for those with cancer, diabetes, etc. And OweBama (D) made a mess of them, and, as predicted by many, PPACA has proven to be a financial wreck. That is what happens when the inexperienced jam-down, top-down “solutions.”
You claim other countries have universal care. Yeah — and it is lousy .. see this —
https://www.ft.com/content/dfd41b72-785b-11e8-bc55-50daf11b720d
The USA has been subsidizing global medicine for decades, according to U. of Rochester research. That day is over — time for Asia, UK, and Europe to pay their fair share.
As for funding mental health — it is nothing like treating cancer, or cardiac. Like comparing apples to oranges.
You cite a bunch of grand-sounding memes. Do you have any plans/budgets to implement them? Bernie Sanders makes a lot of speeches, gets paid $$$$$ for them — never provides any details.
No one sane will financially support mere talking points. Bet the farm on that.
Mr. Ding Ow, a few facts – state run high risk pools were a mess. I know, I was in one. High premium, $10,000 individual deductible, $20,000 out of pocket maximum. Both now illegal, thanks to ACA. ACA is a law – laws don’t have finances. Other countries love their universal health care despite your and other’s fear mongering. I notice you haven’t provided any details to support any of your arguments either. So much for relying on your comment.
” .. I notice you haven’t provided any details to support any of your arguments either ..”
You didn’t read this, did you? OK — 2nd time, only grade available is 2.0/4.0 , don’t make me post it, a 3rd time —
https://www.ft.com/content/dfd41b72-785b-11e8-bc55-50daf11b720d
And this – https://www.ifs.org.uk/publications/13111
Key findings
Overall, our analysis shows that the NHS performs neither as well as its supporters sometimes claim nor as badly as its critics often allege.
Compared with health systems in similar countries, it has some significant strengths but also some notable weaknesses.
Its main weakness is health care outcomes. The UK appears to perform less well than similar countries on the overall rate at which people die when successful medical care could have saved their lives.
Although the gap has closed over the last decade for stroke and several forms of cancer, the mortality rate in the UK among people treated for some of the biggest causes of death, including cancer, heart attacks and stroke, is higher than average among comparable countries. The UK also has high rates of child mortality around birth.
Among its strengths, the NHS does better than health systems in comparable countries at protecting people from heavy financial costs when they are ill. People in the UK are also less likely than in other countries to be put off from seeking medical help due to costs.
Waiting times for treatment in the UK appear to be roughly in line with those of similar countries and patient experience generally compares well.
While data is limited, the NHS seems to be relatively efficient, with low administrative costs and high use of cheaper generic medicines.
The NHS appears to perform well in managing certain long-term illnesses, including diabetes.
Health care spending in the UK is slightly lower than the average in comparable countries, both in terms of the proportion of national income spent on health care and in terms of spending per person.
The UK has markedly fewer doctors and nurses than similar countries, relative to the size of its population, and fewer CT scanners and MRI machines.
Bernie Sanders knows nothing, he’s a Socialist gas-bag who used to write “sex columns” and now makes $1,000,000/year, tearing down others. He’s got nothing.
Bang people don’t like facts. My insurance went to 12000.00 deductable,I have 1 perscription,$300.00 a month,I need surgery,can’t because I can’t afford to take of work for recovery time. Then I can’t pay premium! My last 2 GPS quit because they were not getting paid! I can’t have my doctors because they pulled out of plans. I live in pain hoping to make it to 65. In the meantime I need the script I mentioned. I can go on and on but until it hit people personally they will never get it.
Got, about your pharms, something to consider —
Most pharm firms have discount plans for working people. Write the CEO, use U.S. Mail. You should get an answer back. There’s an old saying — “you don’t ask, you don’t get.” Ask. Now. Today.
I had a DME vendor (unit of local hospital), kept claiming non-payment. I kept sending the payment documents, kept getting bills. Finally, I wrote their CEO and noted that fraud could be a criminal offense. The incorrect bills stopped. I asked. I got.
Thanks Bang, I’ll check that out. I can use any help I can get, since Obama got in my whole plan in life has been altered my retirement destroyed until I can figure it out! I’m on my own with no family to help, I wish people could really understand how this is destroyed everything I work for! And angers me so, and no I don’t want socialized medicine
Thanks Bang, I’ll check that out. I can use any help I can get, since Obama got in my whole plan in life has been altered my retirement destroyed until I can figure it out! I’m on my own with no family to help, I wish people could really understand how this is destroyed everything I work for! And angers me so, how people are believing this. And then technically I’m being called lazy!! The ignorance if this is crazy! Thanks again for the help!
” .. I notice you haven’t provided any details to support any of your arguments either ..”
You didn’t read my response, did you? Here is the data again — don’t make me post it, a 3rd time — https://www.ifs.org.uk/publications/13111
“Overall, our analysis shows that the NHS performs neither as well as its supporters sometimes claim nor as badly as its critics often allege. Compared with health systems in similar countries, it has some significant strengths but also some notable weaknesses.
“Its main weakness is health care outcomes. The UK appears to perform less well than similar countries on the overall rate at which people die when successful medical care could have saved their lives ..
Single-payer, “Medicare for all” — make everyone suffer. Just like OweBamaDontCare.
Thanks to the pathological liar…. TRUMP and his royal minions.
Until something is done, God help us all.
MJ, you left out the biggest lie — “You can keep your doctor” .. WashPost “Lie of the Year” 2013. You’re welcome.
Ignore Bang Ding Ow. Anyone who didn’t keep their doctor did so out of their own laziness in not making sure their doctor was in network before buying a plan. Which is the same thing they would have needed to do when changing insurance companies before ACA.
Ignore WashPost fact-finding? Why? Because it doesn’t fit your politics?
Not good enough, J. No sale, pal.
I understand the distress of not having insurance for pre-existing conditions! But then why not just get insurance for everything after your sick? Or don’t buy car insurance until after the accident, or house insurance until after the fire? Where would the funds come from if that were all possible?
Difference is that if you have a high premium on your house due to living in a flood zone, you have other options. You can move. If you can figure out some way for me to move out of my broken-ass body, I’m all ears.
So where would the money come from? Should the doctor who spent a half of million dollars,and studied to get the degree not get paid, hospital and staff all volunteer,all meds made free? Just asking,where would it come from?
” .. I notice you haven’t provided any details to support any of your arguments either ..”
Here is the data again — don’t make me post it, a 3rd time — https://www.ifs.org.uk/publications/13111
“Overall, our analysis shows that the NHS performs neither as well as its supporters sometimes claim nor as badly as its critics often allege. Compared with health systems in similar countries, it has some significant strengths but also some notable weaknesses.
“Its main weakness is health care outcomes. The UK appears to perform less well than similar countries on the overall rate at which people die when successful medical care could have saved their lives ..
Single-payer, “Medicare for all” — make everyone suffer. Just like OweBamaDontCare.
Gottahavehope. This is why we had the individual mandate. In this way it WAS no different from car insurance – we ensure that people don’t get insurance after the accident by requiring them to have insurance in order to be on the road. If we reinstated the mandate there would be no “paying for it” issue. It should never have been turned over in the first place.
” .. This is why we had the individual mandate ..”
That is just insane, when the choices are crappy. Look how NHS is going bankrupt —
https://www.ft.com/content/dfd41b72-785b-11e8-bc55-50daf11b720d
OweBama (D) had zero experience, and created a giant mess that has to be cleaned up. Repeating stupid rookie mistakes is ridiculous, absurd, and useless.