Cover America: The plight of the uninsured... doctor
Dr. Kesani advises his patients not only on their health, but their health insurance. Get your coverage lined up before you see me for a diagnosis, he tells them. Otherwise the insurance companies will likely leverage the pre-existing condition to charge you outrageous premiums—or reject you outright.
Dr. Kesani knows this better than anyone…he has diabetes, and he's uninsured.
Running his own practice is a near-literal description of Dr. Kesani, who hustles back and forth between several hospitals in the Chicago area where he maintains offices as a kidney specialist.
He wasn't always uninsured. Dr. Kesani had a group plan at a former practice in North Dakota, where he was shocked by the diagnosis of diabetes at the age of 33.
When an opportunity arose to start his own practice in Chicago, he decided to make the move and kept his group insurance through COBRA for a year and half. When it expired he was told that in order to maintain the same policy his premiums would jump to $1700 a month—five times what he'd been paying. Then he tried to apply for an individual policy. He was flatly rejected by his health insurance company of ten years, and several others.
Dr. Kesani doesn't need to consult a(nother) physician to know how to properly manage diabetes—he maintains a healthy lifestyle, takes his medication, and gets exercise by playing soccer a few times a week. Having the professional training to keep this health issue in check is one thing, but accidents and emergencies are another thing entirely. Those are things that no one, not even a doctor, is immune to. When asked what he'd do if he got injured playing soccer, Dr. Kesani said he's already had to tough out a few knee problems. And, of course, it helps having friends in the medical field.
He's looked into other health insurance options, but so far none have been the golden ticket to coverage. Although he qualifies for the Illinois Comprehensive Health Insurance Program, the state's high-risk pool, Dr. Kesani hesitates to sign on to a policy that would set him back $450 a month with limited coverage. He's holding out to see if an insurance plan soon to be offered to doctors by the Illinois State Medical Association will come through for him, unsure if the group plans to exclude applicants—even though they're doctors—based on pre-existing conditions.
When Dr. Kesani says "health insurance companies only want to insure the healthy," it's not merely out of sympathy for those struggling to get coverage. It's empathy shaped by his own fight to obtain reasonably priced health insurance in a system of care so broken that even a doctor can't afford to be a patient.
—Meagen Bohne, campaign organizer
Visit Cover America Tour to see more videos of the people we're talking to across America and to share your own health care story, and read more from our survey of Americans who can't depend on their health insurance.
Posted by: Tori | Mar 15, 2009 1:01:26 PM
Why don't you all quit complaining on here and do something about it. The problem with American Government is that too many Americans want to complain about it but not enough get involved. That's why all that's left politically is corrupt people who don't care. So get involved. Don't write on here. Write to your senator. Write to state reps. Damn do something other than sitting around pointlessly complaining about it.
Posted by: Linda | Jan 1, 2009 11:13:09 AM
Todd think you should rethink what you stated in your post. No Canadian would give up there medical insurance for any reason. The people that do cross over to the US will have there tests and surgeries paid for by there provincial insurance company under apporval prior to having it done. They will only approve payment if the medical services are not available in the city that they live in or there is not a closer facility in Canada to have it done.
I was injured on a holidday in the US and went to a hospital. I was billed for my visit before I left. I had to pay for it and then send a copy of my payment and the invoice to our medical. I never got the full payment back only part of the payment.
Also for general information no one in Canada (except those on welfare) get free medical. We all pay for it through our employment and income taxes. We have what we EHT (Employee Health Taxes) paid by every employer in Canada. The funds that they pay to the government is absorbed by us; because, if they didn't have to pay it our pays would be higher. With this each person pays yearly again for this tax through their income tax. The amount that they pay is prorated according to there salary each year.
I am getting tired of Americans that think that Canadian have medical coverage that is free. We pay for the right to see a doctor or to be admitted into a medical facility for medical attention. Also our insurance does not cover dental, medications, and some medical equipment. We pay for that ourselves. We do have private insurance company's. There policies are only available to those that are healthy or through certain employers.
The US government has discussed with the Canadian government in regards to how to set up a system like ours. I truely feel that you do not have a system like our more so because it would take jobs away from those that work for private insurance companies and put the onus on your government.
I do have a disease that is not considered a disablity in Canada. It will not kill me but it does make me sick most days. I have Crohn's and I pay for all of my medications and some that I have had to pay for up to $4,500 per dose.
Think back to when your HMO's were set up. Some how I feel the insurance companies have more to do with American's not getting proper medical coverage. Also, when they look at your income they also look to see what you have. Do you own a home or car? If you do then they feel that you have expendable funds. Though maybe there really aren't but if required then they are.
So please understand yes we are better off but not because it is handed to us. It is because we pay for it.
So I suggest to every American that you lobby your politition and stop complaining about what you feel you don't have.
Posted by: Nadine | Dec 15, 2008 11:05:11 AM
I am Canadian, I have lived in the US since I was 8yrs old. ONE of the main reasons I never became a citizen is because I didn't want to go with out health insurance. Now that I am older, I was fortunate enough to marry a military fellow with all benefits. How the US can't and won't take care of their people is beyond me. The thought of working hard all your life and then losing it all because you got sick or in a car accident and can't afford to get medical? Really sad Uncle Sam, really sad.
Posted by: Todd | Nov 8, 2008 10:23:19 PM
Paul - I live near Canada and work with some Canadians. Your statement couldn't be further from the truth. Fortunately, they've been able to cross the border into the US rather than waiting for months and months for needed care.
Posted by: chanin607 | Oct 15, 2008 7:14:49 AM
Good article
Posted by: womens health | Oct 7, 2008 2:06:40 AM
Getting (and keeping) health insurance is a daunting task these days ... and I don't even have a pre-existing condition like diabetes. A healthy family of 3 pays around $200/month with ungodly deductibles.
Doctors are worth good money but this much? really?
Posted by: Paul | Oct 6, 2008 4:29:35 AM
If you ever watch Michael Moore's Sicko, you'll understand that other countries with economies not half as great as ours, are able to afford health care for all. Ask any Canadian. NONE would want to give up their health care. Ask any Frenchman, Englishwoman, Norwegian, etc. Don't believe the lies of the Republicans and the health care industry lobbyists.
Posted by: Gary Brandon | Oct 6, 2008 1:19:13 AM
We have 46 million people without health care in the U.S.I did not see that bail out in the 700 billion we gave those deep pockets on wallstreet.If they were smart they would be investing in our health care.Have they forgot who build this country of ours. Sick or dead people don't spend money on wallstreet. We are left with paying for this bailout without even having a say in what we need. This a sad day in our world for those that can't afford insurance do without. We are all facing the same outcome if we don't take control of our own health.we have been programed to think you should go to the doctors when you don't feel well. We have not been in charge of our health.Our health has been in charge of us.If we were to put as much effort in preventing illness instead of treating after the fact.Our health and the cost of health care would not be what it is today.We do have a choice in what we put in our bodies. Thats why I did my own research and found the Acai berry from the amazon. This berry and 18 others have restored my health. Our bodies were designed to heal themselfs with the understanding that you feed yourself the right amount of nutrients in your diet. We can no longer depend on our fruits and vegtables. I hope this was some help to the people reading this. God Bless
Posted by: Logan | Oct 6, 2008 1:12:39 AM
move to canada.... we dont have the best health care system, not everything is covered, but when someone is in trouble, you can be damned sure theres no need to worry about paying 10x your annual salary cuz u need an appendectomy
Posted by: Paul | Oct 6, 2008 1:10:08 AM
Almost all European countries have universal health care coverage. And yet their economies are not worse off. In fact, their workers enjoy an average 5 weeks of paid vacation per year - and they still enjoy an excellent standard of living.
Taiwan has universal health coverage. Is it any less competitive on the world market?
Don't believe in the lies of the rich in America, who have bought lobbyists and Congressmen and John McCain.
Posted by: Laura W. | Oct 6, 2008 12:36:37 AM
I can't afford health insurance, its 8000 a year for a self employed person I wish I had moved to a country like england when I was younger. It's horrible living as a older person in America, knowing that when your teeth fall out and the cancer gets worse..you're going to die like some person in a 3rd world country. America doesn't care at all about their own people.
Posted by: Stephen | Oct 5, 2008 11:35:08 PM
I thought I had major medical insurance through my employer. I found out differently when I had a heart attack, and was sent to the county hospital's emergency room by the urgent-care facility associated with my primary physician. When all was said and done, I found my insurance only covered 46 percent of my medical bills. Why? Because the urgent-care facility didn't send me to a hospital on my insurance coverage's "approved" list. They didn't cover any of the ambulance/parametic charges.
The consolation that my insurance company left the state, unable to write coverage, is a small one when you consider that I'll be at least seven years paying off the medical bill.
I don't want socialized medicine. I want the tax deduction for my medical insurance coverage, so that I can select the coverage and not be beholden to what my employer thinks they can afford for me.
Posted by: Daniel | Oct 5, 2008 11:19:08 PM
You need to move to Massachusetts. Here the insurers cannot exclude you based on pre-existing conditions, and have to cover them after a short period. There are no health restrictions on getting insurance. Also, since it is mandated, you can actually get insurance as an individual, unlike most states.
The rest of the country should follow our lead...
Posted by: Burbur | Oct 5, 2008 11:14:30 PM
Please stop using the term 3rd world country, it's not about being PC but avoiding using really archaic terms that are highly derogatory and slanderous. 3rd world infers that there is a 1st world which is superior.
Anyways I feel that social reform is needed, and medical care like they have in places like Canada and Britain will never come about because the medicine industry is not out to help, but rather profit. We all know this, in other countries the health industry is a mix of profit and helping - but our system has enabled it to be a solely profit driven venture. Which means you can't expect good care unless you can offer doctors and the industry compensation (financially) otherwise it's not in their interest to help you. They strive to treat, not cure.
Posted by: Sean Rasmussen | Oct 5, 2008 11:02:29 PM
It's sad to see the insurance companies sabotage the very people that look after our citizens. So who's side are the insurance companies really on? It's obvious, that it is the same as the banks. And that aint ours...
BTW. The banks own the insurance companies.
Posted by: Ryan | Oct 5, 2008 11:26:27 AM
I'm diabetic too; I have had to live in Japane for the past 7 years to get health coverage.
Posted by: karen | Oct 3, 2008 9:07:55 PM
we really have become a third world country.I feel such pride
to be an american every time I cough up blood.How can you
line up insurance with the will of insurance company's against
you (I have allergy's).nooooo insurance for me.it is so sureal.
how many more people have to die because of this unregulated
uncontrolled and out of control health care system.it's not
working can we go back to the old system?was it really that
bad?I don't recall seeing so many sick people unable to do
anything about it.
Posted by: D. Murray | Oct 3, 2008 5:39:37 PM
I have had medical coverage through my husbands work for over 35
years. I have been treated recently for high blood pressure and all those things that go along with aging. In July my husband passed away. After being a loyal Teamster employee for all those years I find myself in the Dr.'s situation. I am now on their Cobra plan at $788 per month ,it is 1/2 of my income, and I feel I am suppose to be grateful for this.......It is my worst nightmare. Please,someone out there hear this country's plea and do something about our Medical Insurance Industry.