Sowing Poor Rural Health
Note: This is my latest post over at Change.org.
Still think the health reform debate has little to do with sustainable farming and food?
Think again.
I was struck by two stories on Morning Edition on NPR that drove home the point to me that health reform and healthy food and farming systems are deeply interwoven.
I've said before that if we want sustainable food and farms, farmers need affordable and guaranteed health care options. Unless the farmer has a husband or wife that has a job off the farm that provides health insurance, many farm families find themselves buying expensive health insurance as "individuals", instead of a group plan that shares the costs and risks among many families. As a result, farmers and their families are often stuck with high premiums and deductibles, translating into thousands of dollars of costs if everyone is healthy, and even more if a family member gets sick or injured.
Farmers deserve better than that, and these NPR stories remind me of how broken the system is for people trying to buy health care as individuals.
The first segment I heard featured two women who received cancer diagnoses and thought their respective health insurance plans would be covering the costs. The first woman, Susan Braig, had a "catastrophic policy" covered hospitalization, and Ms. Braig felt sure that it would cover her diagnosis.
When she learned she had cancer, she assumed her policy would cover all of her treatment. "A lot of it was my own inexperience, assuming every cancer treatment was a hospitalization or surgery," says Braig. "I didn't realize a lot of cancers are now being treated like chronic diseases."
Most of Braig's care was conducted out of the hospital. The MRIs, bone density scans, ultrasounds and chemotherapy were all done in her doctor's office. Her medical bills have now put her $40,000 in debt.
What kind of country do we live in that allows people to go into financial ruin for a $40,000 debt she or he did not choose and could not avoid?
The second segment was even more disturbing for me because it sounded eerily similar to something I experienced in my mid-twenties.
During the last economic bust, I [author Sarah Varney] got laid off and couldn't afford the monthly COBRA payments for my health insurance. I applied for an individual plan through Blue Cross.
I was 28 at the time and had no health problems...I got a letter from Blue Cross saying I was denied. They told me it was because my medical records showed I'd gone to the doctor complaining of stomach pain. The pain had long since gone away, but Blue Cross said if I wanted insurance, my doctor would need to fax a note guaranteeing I didn't have stomach cancer. He faxed the letter, and eventually I got a plan.
It makes you wonder, though, if Blue Cross didn't want to insure me — a healthy 20-something — how on earth do actuaries determine who's a good risk and who's not?
The piece went on to say that women pay more for health insurance because we go to the doctor for check-ups more often and because we can get pregnant. Last time I checked it takes two people to conceive a child, but women bearing the costs of reproduction is clearly a topic for another blog post.
I wanted to do some checking of my own, so I went to Blue Cross Blue Shield of Nebraska for a comparison. I pick an average plan and compared costs for men and women. Sure enough, the minimum monthly premium for a 30-year-old non-smoking woman was $150, while the same plan for the identical man was $100. If they'll even accept your application.
All this is to say that the health insurance deck is stacked against people, especially women and families, who want to start a farm and thus need to buy insurance on the individual market. It's not right, and we must fix it if we want sustainable farms and food in the future.
Read the rest of the post here, including actions you can take.