Sunday, April 4, 2004

Greater Cincinnatians share their stories

Sharon Braunstein, 54, and Ron Braunstein, 68, Deerfield Township.

The Braunsteins ran their own medical and scientific videography business for years. But their business slowed dramatically once Ron reached retirement age and even more after he was diagnosed last year with leukemia.

Now the couple lives a split life in terms of health care. Medicare and a supplemental plan have covered tens of thousands of dollars in bills for Ron, including a one-time medication that cost $7,500 and several doses of another shot that cost $900 per shot. Unlike many pills seniors take at home, these medications were covered because they were administered during hospital visits.

But Sharon isn't eligible yet for Medicare. For years, she bounced from insurer to insurer trying to find affordable coverage on an increasingly limited, semi-retired income.

"We were constantly shopping around. We even called some numbers people put on telephone poles," Ron says.

For several years, Sharon had coverage through Medical Mutual, but about three years ago that plan's premium leaped from $338 to $556 a month, she says. So she signed up with a discount service through the National Association for the Self-Employed. But doctor's offices were so unfamiliar with the plan that it was a huge hassle to get any benefits from the program, she says.

Today, Sharon has an Anthem plan that costs $238 a month. But it took at least four months to get that paperwork in order.

"In the meantime, the doctors and the hospital kept sending me bills and notices from collection agencies. I had a terrible time with all the rigamarole," she says. "The people on the phone were nice. But the problems never got fixed."

Carol Ruffin, 46, Kennedy Heights

Carol Ruffin has owned Blossoms Florist for about 25 years, starting out in her home, then opening a shop 14 years ago in Kennedy Heights.

She says her business wouldn't survive were it not for her husband's full-time job, which offers good benefits. The part-time people she hires are mostly students who have their own coverage through their families.

Ruffin doubts her business could absorb the costs of paying for health benefits for employees.

"It's very expensive. When you get ready to hire people, that's a piece most people need. But in this day and age, you have to count every penny," Ruffin says.

In her business, Ruffin deals with many other small business owners, from balloon shopkeepers to photographers to wedding planners.

"I've had friends who are single women in business for themselves, and I know they don't have insurance. I'm so thankful I haven't had to deal with that," she says. "I've seen some of them in their 40s who've had to quit and go back to other jobs because they need the benefits."

Thomas Dobbins, 59, Fairfield

Thomas Dobbins, a retiree from Fluor Corp., who moved to the area from Texas about four years ago to work on the clean-up project at the old Fernald uranium enrichment plant, was shocked by a recent jump in the costs of his company-provided medical benefits.

"My insurance went up 48 percent. This is ridiculous," he says. "I'm looking at real retirement (at age 65) in a few years. What's going to happen then if costs keep going up?"

Despite his own rising costs, Dobbins says he sympathizes with area doctors who have complained about low local reimbursement rates. One of his neighbors was a doctor, who moved out of town recently over frustration over weak compensation for physicians in Cincinnati.

Dobbins also recalls spending a lot of time making phone calls to hospitals, doctors and insurers to resolve a denied medical bill.

"You never talk to the same person twice," Dobbins says. "It finally got settled. But it's so complex, so convoluted, people don't know which way is up."

James Carson, 61, Amelia:

James Carson says he has been unable to work since a fall several years ago, and now his former employer is out of business. That leaves him stuck paying $547 a month to keep his old insurance via COBRA, a federal law that allows ex-employees to maintain coverage by paying the employer share themselves.

Carson also has diabetes and has survived two heart attacks.

The insurance bills and about $200 a month for uncovered medication expenses come out of his disability payments of $2,200 a month. He says he is frustrated by the hardship of paying for everyday living expenses plus health care bills on a limited income.

"It just doesn't leave you much money to live on. When somebody has worked hard all their life, what have they got to look forward to?" he says.

Carson says the government needs to do more to control the costs of health care before spending so much money on rebuilding Iraq or talking about sending astronauts to Mars.

"Let's take care of our own before we start worrying about everybody else," he says.

Sherry Howard, 56, Anderson Township

Sherry Howard says her biggest concern about the health care system is rising costs.

She works two jobs: a full-time job at a credit agency that offers benefits and a part-time job doing entry testing for a local junior college.

"Every year, our insurance goes up and up," she says. "It's not a crisis yet, but it's headed that way."

She grumbles about doctor office co-payments that have grown from $5 to $10 to $15 to $20 a visit. Even though paying $20 is better than paying the whole bill, the expenses start adding up fast for people with chronic illnesses who have to return for regular check-ups.

Howard was treated several years ago for a melanoma that appeared on her arm. Her insurance paid virtually everything for the surgery, but she felt strained by the co-payments she owed for lab tests and more than a dozen follow-up visits to various doctors the first year after surgery.

Howard says she doesn't have any big answers for fixing the health care system, but she can think of a few things that would help.

"People can't be suing people for everything," she says. "And people need to pay attention to what their doctors are telling them to do. Don't wait until the last minute (to make healthy changes)."

David Lathrop, 43, College Hill

As a union electrician, David Lathrop gets his health benefits through his union, and he's been very pleased with the coverage.

Even so, Lathrop says he is concerned about the rising costs of medications and feels a sense of sympathy with doctors who have complained about soaring medical malpractice costs.

"Some jury awards are just crazy. And you know that all figures in to health care costs," Lathrop says.

Lawrence Meeks, 67, Springdale

Meeks is one of many seniors in Greater Cincinnati who have started buying drugs from Canada to save money.

He spends as much as $750 for three-month supplies of five medications for his wife and himself, which he estimates is at least 30 percent less than he would pay in the United States for the same drugs.

He checked out Ohio's Golden Buckeye Card. The savings didn't come close to matching the savings he gets from a mail-order company that imports through Canada.

And he has become deeply skeptical of the blitz of media announcements from government agencies and special interest groups that have recently claimed that importing drugs from Canada is dangerous.

"It think it's all lobbying on the part of the drug companies," Meeks says.

Patricia Haverland, 78, Western Hills

So far, the Haverlands have been able to take care of themselves. A combination of Medicare and supplemental insurance pays for all but the medicines Patricia Haverland needs to take. And her husband still works.

"We don't have drug coverage, but we've been able to handle it," she says.

Haverland hasn't paid much attention to the Medicare prescription drug plan and would prefer that reformers not get involved.

"I don't like the idea of people depending on the government for everything. I really don't," Haverland says.

Harold Penn, 64, Loveland

Harold Penn says senior citizens are complaining too much about health costs, because plenty of people, including seniors, seem to have money to burn.

"As long as you see Argosy Casino and Belterra Casino turning record profits, people must not be hurting real bad yet," Penn says.

Penn says there's still too much fat in the system, from high-paid insurance executives to drug companies spending massively on television ads.

"There needs to be a meeting of the minds. But nobody is going to take on the drug company lobby," Penn says.

State governments haven't done a good job on the health front, either, he says. Instead of using billions of dollars from a settlement with the tobacco industry to offset rising Medicaid costs, most states have spent their tobacco settlement funds on everything but health care, Penn says.

Penn also says he has no problem with charging higher insurance rates for smokers, obese people and others.

"Why do I need to subsidize an unhealthy lifestyle?" Penn says.

Anne Paquette, 71, Cherry Grove

Anne Paquette says the rising costs of health care prove that it's time for a single-payer health care system in America.

"I've seen the medical field go from when everybody could afford a doctor to where you almost have to be rich to afford one," Paquette says. "Hospitals and doctors are pricing themselves out of business, and Congress sits on their duffs and doesn't do anything about it because they don't have to worry about health care."

"I think if we had a single payer health care system like they do in other countries we'd be better off. That way we could do away with the insurance companies. We certainly can't be any worse off."

It boggles Paquette's mind that Congress passed a bill that prevents Medicare from using its clout to negotiate lower rates for medications. The recently passed Medicare reform bill just convinced her even more that special interests have all the power in Washington.

"And why can't I buy my prescriptions from Canada if I want to? I can buy a car from Japan," she says.

Stephen Bailey, business owner

As the owner of a local job placement agency, Stephen Bailey sees exactly how the rising costs of health care and health benefits have affected job seekers.

"I know people who are taking jobs just because of the benefits package a company may have," Bailey says. "And I know others who won't change jobs because of their benefits."

This fear of losing benefits exists even though federal laws require new employers to continue coverage for job-changers.

And good health benefits are getting harder to find, especially for people who were on welfare and face losing Medicaid benefits when they take a new job, Bailey says.

"Most of the people in the system who are coming out, we try to match with companies that offer great benefits," Bailey says. "Some companies only cover the actual employee, and don't offer family plans."

Bailey says many families would be able to make it on their own if there were better transitional coverage for people leaving welfare-Medicaid coverage for the working world. Not just family health benefits, but support for affordable day care.

"People who aren't making more than a certain amount of money should still be able to get some of the benefits they had," Bailey says. "We want people to be able to make a permanent economic change. But if you put a single parent into a job that only pays $5.50 a hour, you're asking them to spend money just to not be at home."


Paying the bills
The rising costs of health care have spiraled into a crisis.
Full survey results
Return to special report front

Healthy lives, lower premiums
Most favor penalties for smokers, fat people and those who don't take care of themselves.
Employers offer incentives
Editorial: Don't blame others

A common fear
These families share a worry about the cost of health care.
Small business owner
Young professional
Living with chronic illness
Union worker
Concerned senior
Retired executive
More stories

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