Tuesday, August 26, 2008

I got a headache, and my insurance company caused it

I have thought very hard about the following post for a few reasons, chief among them that because Guåhan is small, the concept of burning bridges is not merely a cute anecdote but one that, in my opinion from my first two months here, can have very serious ramifications career-wise and personally. The fact that Guåhan is small exacerbates the niceties and drawbacks of close relationships, which themselves entail intimacy, gossip, nepotism, reciprocity, and lots of other facets too numerous to name here.

But the current debacle That Boyfriend and I are facing is one not unique to us nor lots of other people in Sanlågu, so I feel it’s worth sharing and trying to create some space for people to offer advice/receive information. This was written as a very long post and I’m going to split it up into sections for easier web reading. But this information is essential for any civilian who intends to relocate to Guåhan—or indeed, anyone who already lives here.

Essentially, I want to start posts that relate to health care on Guåhan. It’s certainly an ongoing challenge here, where Pacific Islanders’ health outcomes are some of the worst in the U.S.: high rates of diabetes, cancer (some of which are certainly related to environmental abuse perpetuated by the U.S. government), obesity, and heart disease. Additionally, from what I’ve observed so far, a high birth rate, meth epidemic, and culture of alcohol consumption stresses the health care system here in a unique way.

Our situation so far: we are part-time workers, currently on school group rate health insurance based in Sanlågu. We are looking for employment and think that our employment options are very good; we will get jobs (we’re very lucky in that way) but most likely our employment situation will most closely resemble that of a consultant or independent contractor. My coverage runs out this week, and so I’m currently shopping around for individual plans—which I expect to be more expensive than insurance through employers. I’m a very healthy young person under 30 years of age.

There are essentially four insurance companies on Guåhan, only two of them offering individual health care plans. One company would not give me a range of possible estimates for monthly payments for an 80/20 payment plan without me first paying $50. The $50 is a reasonable fee to research my medical history, but the fact that this company wouldn’t even give me an estimate for coverage prior to paying out this $50 strikes me as fishy. I essentially did, however, manage to beg out an estimate from an employee, who quoted me around $390 a month.

The second insurance company has an upfront estimate of individual monthly payments for a plan that offers similar benefits to the first company. The monthly estimate? $485 a month.

These benefits are generous, and probably too much so for the kind of coverage I need. For someone in my health and age, for example, I would probably want to pursue catastrophic health insurance, which has a high deductible (like $5,000) but low monthly rates (when I was in California I paid about $100-120 a month a few years ago). Yeah, I couldn't get basic doctors' visits covered, but if I got into a car accident (one of the leading causes of death for young people), at least my hospital stay would (maybe?) be covered. And I could pay up to $5,000--it's a lot, but manageable on a credit card if it came down to it.

The next post will delineate a little bit as to why these rates are so high. Some of the reasons are similar to those in Sanlågu (poor community health outcomes) and others are those specific to small markets. Any comments are very much appreciated, unless you’re just going to accuse me of being a communist because right now my gut reaction is to loudly proclaim love for single payer health insurance.

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