Health Care Reform: A Disappointment at Best

Last Updated Mar 22, 2010 9:32 PM EDT

President Barack Obama finally succeeded in getting health care reform passed. I wish I could say I'm relieved. While I'm thrilled there are millions of Americans who will now finally get the coverage they need, I feel like the bill didn't go far enough for the rest of us who already have insurance. We're still going to see our out-of-pocket costs rise beyond what many families feel they can afford.

In 2009, the average household spent $2,500 on out-of-pocket medical expenses, according to the U.S. government. (This sum excludes premiums and deductibles.) If you're healthy, you probably got away with digging into your pocketbook far less than that. But if you needed any serious medical attention, like I did, you likely rang up much higher bills.

As I wrote last week, I recently had a baby. It turns out I delivered a very expensive little girl. Excluding my premiums, I ended up spending over $4,000 out of my own pocket despite having what's considered high quality, employer-sponsored health insurance.

Part of the reason my delivery cost so much is because I have a steep $2,000 deductible. I didn't choose it, my husband's employer did. Like so many other small businesses, the only way the company could afford to provide its workers with reasonable monthly premiums was to offer a plan that shifts more costs onto its employees. Health care reform won't change this and families should expect to see more cost shifting in the future.

The other $2,000 wasn't covered because my insurer said my out-of-network doctor charged too much for her services. The official jargon is that the delivery bill exceeded what is considered "reasonable and customary" for my area. While my OB wasn't exactly cheap, her fees were in line with what plenty of other New York City obstetricians charge. Can I fight the insurance company on this point? I don't think so. The insurance community doesn't tend to consider "reasonable and customary" figures negotiable.

Perhaps you're thinking my bills were my own fault because I chose to go out-of-network. That may be partly true. But even if you stay in-network, you could get hit with budget breaking bills if you get sick. More than 60 percent of Americans who file for bankruptcy each year do so because of medical expenses, according to a report that was published in The American Journal of Medicine. And three-quarters of those people have insurance.

So forgive me if I'm not jumping for joy over health care reform. I fear it will end up feeling a bit like credit card legislation. It will make for a lot of headlines, but little consumer protection for the majority of families.

More on Money Watch:
Health Care Reform: Who Wins and Who Loses
Broader Health Care Comes First, The Pain Later
Stethoscope image by a.drian, CC 2.0.
  • Stacey Bradford

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