Frustrated by a health care system tied to jobs

There's a lot of talk about freedom in the debate over health care. This is what I think: I'd like to be free of worrying about paying for my family's health care.

We're healthy, which is a good thing. For that we can thank good genes, the YMCA and an obsession with eating well. But nothing protects us, or anyone else, from a devastating disease or accident.

We have to have health insurance to protect against that possibility. A serious illness without the safety net of some kind of insurance could rob us of the financial security carefully constructed over decades.

The fallout of a health disaster would mean more than scaling back travel in retirement. It would likely cheat my daughter out of the chance to go to the kind of college she's worked hard to prepare for.

It would mean that I'd work more and longer and have less time to volunteer, less money to contribute to causes to help the community. It would mean vacations, like the one planned for this summer, where my far-flung family gets together, would be less frequent.

So, we have health insurance. But, let me tell you about the world of health insurance for people like me. I worked for the Herald-Leader, and loved it, for 19 years before I was laid off in October, 2009. Through COBRA, we were able to maintain health insurance from that job (my husband is self-employed, so no options there) for 15 months.

Luckily, I found full-time work this winter with health insurance benefits; unluckily, it was a temporary job that ends this month. However, that should restart the COBRA clock, at least for a while. With that in mind, we opted for the health insurance with relatively low premiums but high co-pays and deductibles.

The upshot of all this is that my out-of-pocket ezpenses for an annual checkup, including blood work and a regular colonoscopy, has now reached over $1,500. Good thing I'm not sick. I'm lucky. I can actually pay that $1,500, my family is healthy and we do have insurance.

The other day I was talking to a friend who also lost her job in 2009. She and her husband haven't had health insurance for a year. They pay $80 a month to insure their three-year-old. My friend had to have a tooth pulled recently and that was $1,000 out of her pocket. This is the kind of thing we talk about when we get together.

We also trade stories about our daughters, our search for work, our new life strategies, our mutual friends, but the conversation inevitably comes back to the looming issue of health care.

We talked about how you think twice before you go to the doctor, sometimes much more than twice; how you put off getting tests done; how while a doctor is talking you're calculating what the next bill will be; how losing weight becomes important not just so you feel better but to avoid the cost of blood-pressure medication. It goes on and on.

There's a lot of adjustment when you lose your job. You adjust to not having a deposit appear in your bank account every two weeks. You adjust to being alone a lot more and you adjust to losing some important part of your identity. I was not at all bitter when I lost my job. I knew that my layoff wasn't about me; it was about a balance sheet. There was no one to blame.

What I found hardest to adjust to, though, was what I think of as a broken societal promise, albeit an implied one.

I worked hard, got a college degree in night school, eventually got a master's from an Ivy League university, put a huge amount of mental, physical and emotional energy into doing my work well, saved money, stayed healthy, was not a drag on the system.

And what do I get when the economy zaps my employer? I get to worry about whether I can afford health care.

Worrying about medical bills and insurance premiums is not productive economic activity. We all know people who stay in jobs they don't like, where they may not be fully productive, so they can be in an insurance group.

That seems like a drag on the economy, too, a misdirection of time and talent. I wonder how small businesses and start-ups that can't offer health benefits compete to hire the best and the brightest.

The economic downsides of health insurance tied to employment seem endless and very constricting. This is hardly a recipe for a thriving open market in employment.

I won't say we're enslaved by health care issues. But I will say that anyone who thinks it's liberating to operate in this world of health-care insecurity is detached from reality.

I really have no idea what politicians are complaining about when they suggest that health care reform, or Obamacare, is a threat level just a notch below al-Qaida. I can never decide whether they're venal or just stupid. Perhaps both.

One thing I know for sure, they've never sat at lunch with a friend talking about the challenge of finding and paying for health insurance.