01/16/2009 05:12 am ET | Updated Nov 17, 2011

What's Wrong with Our Health Care System: #538 of Infinity

Here is my choice: In order to keep my family from going under financially, I can continue to go broke taking paying the ridiculously expensive COBRA plan we're on now or I can take all of us (including the baby) off the grid so that none of us have health insurance for 45 to 90 days.

Is there any universe where that makes sense from a public health perspective?

First, a little background: I'm 46, a promotional copywriter for magazines and newspapers with just over 20 years in that field. In February 2008, my wife and I welcomed our first child, Owen, into our family. A month before that, I'd been job-eliminated after two years at a media giant where I'd already spent 7 years during the 1990s. This was hard news, coming as it did a few weeks before Owen was born and a few months after my wife, a waitress, had broken her foot.

Of course, because she worked as a server at a three-star restaurant in Manhattan, my wife was not entitled to unemployment, maternity leave, or worker's compensation (think about that the next time your coq au vin is a touch late getting to the table, please). At the time, I saw this as a blessing in disguise, given the nature of the work, the hours she would be traveling to and from work and her categorization as a geriatric (over 35) pregnancy.

Even after I was laid off, I figured things would be okay. I tend to be an optimistic person to begin with, and I'd never had too much trouble finding jobs. I began to see the lay off as a chance to spend time with our new baby and help my wife out as she recovered from both childbirth and her broken foot.

In April, I was offered a freelance copywriting gig with a national newspaper that was promising and had a nice day rate. Until the end of May, I was still on company-subsidized health insurance, and so I was able to save the money that we're living on now.

Unfortunately, the freelance gig did not convert to a long-term (they had to hire from "my" position from inside the company). Meanwhile, in June, I started paying COBRA. At $1,552.87 cents per month for our family of three, it's a lot of cash, about the same as our rent. For a while, I took solace in the fact that that money is tax deductible (which is exactly why John McCain, with his threats to remove that deductibility, scared me even more than the usual Republicans).

Suffice to say that, when I saw the flyer for Family Health Plus, I had hope that at least a part of my worries could be reduced. A New York State Medicaid-style program, Health Plus promises all the features our family needs--wellness visits, inoculations, emergency care, etc.--and is based on needs. I reasoned that, even with stringent standards, our family, which is living on our savings plus $405 per week, would qualify. We might not get off with free health insurance, but we could at least save some.

So I called the number on the flyer. After a few days, I was finally able to connect with Yariy Colon, the Health Plus representative for Brooklyn. She listened patiently as I explained my situation, but stopped me abruptly when I mentioned COBRA.

That's when I found out that, in order to qualify for this safety-net health insurance coverage, I had to go without any kind of health insurance for anywhere between 45 and 90 days. Not just me, but my wife and baby as well. I could, she assured me, get emergency Medicaid for the baby if he were injured or got sick enough to take to the emergency room.

As for my wife and me, we would be on our own while New York State (the political entity that administers my Unemployment Compensation, it bears pointing out) investigated whether my (lack of) means justified my being placed on the roles of its health insurance backstop program.

To me, Ms. Colon's suggestions seemed to constitute the very definition of insanity, and the choice she presented me with seemed the ultimate catch 22: take your middle-aged self and your wife and child off health insurance completely for as many as three months or go broke continuing to pay for health insurance you cannot afford.

In high school, our crusty old business teacher explained life insurance in the driest possible terms: you're betting, he explained, that you're going to die; the insurance company is betting that you're not. Conversely, stopping the odious COBRA payments and taking me and my family off health insurance would be betting that we're not going to get sick or injured.

Clearly, it's not a bet I'm willing to take, so that leaves only the choice of continuing to go broke paying for health insurance while hoping for either enough regular freelance to pay COBRA payments (while they're still offered--that ends, too) or hoping that my efforts to land a new job with benefits finally pays off.

Doug Hatt is a freelance writer and bluegrass musician living in Brooklyn.

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