Fleeing the United States for affordable health care

FALLS CHURCH, Va. — My son’s forebears left Europe and came to the United States because they couldn’t get what they needed at home. I teach immigrants who came here from all over the world because they couldn’t get what they needed at home. Now I’m encouraging my beloved son to leave this country because he can’t get what he needs at home — affordable health insurance.

Reeve, born and raised in Minnesota, has lived in Miami for 10 years. He and his wife, Melanie, are visiting us this week in Virginia, and they surprised us with thrilling news — she’s pregnant with their first child. Melanie is a French video artist who has been working toward U.S. citizenship since they married. They would love to have the baby in Miami, and as the doting grandmother, I wish they could.

But for the baby’s and the parents’ sake, I am strongly encouraging them to have the baby in France, and quite possibly, to live there permanently. It will be better for my grandchild for Reeve to become a French citizen than for Melanie to become an American.

Despite both being college-educated and talented, hard workers, they have no health insurance. They work as serious artists, and occasionally sell their work to art collectors, but to survive, they also have jobs.

Reeve is an art handler for an art museum, but, as with so many jobs these days, it’s a contract job, so he works only when needed. When he works, he frequently works long hours seven days a week. He has no benefits, no health insurance. Due to the economy, the museum has cut back on Reeve’s work. Before the recession, Melanie was working in Miami for an innovative French company marketing video artworks to U.S. architectural firms, but the sour economy killed that job. She has looked for work, but is currently unemployed.
 
They have researched Miami options. For $3,600 they can contract with a birthing center, and if everything goes perfectly and they need neither a doctor nor a hospital, that might be a good deal. But, if things go at all awry, they would be saddled with debts — possibly tens of thousands of dollars — far beyond their ability to pay. This is a risk they cannot and should not take.

In contrast, if they go to France, they will enjoy virtually free health care and a stipend from the French government. Medical decisions will be made on the humane basis of what’s good for mother and child, not on the presence or absence of an insurance card.

A different situation
Their situation is in stark contrast to that of my husband’s daughter and son-in-law who introduced us to the world of grandparenthood in July. Nothing prepared us for our profound love for our grandson — surely grandparent love is the purest love possible — and we are so lucky that he and his parents live 30 minutes away. Every week I enjoy the delight of that sweet baby close against my cheek.

Our son-in-law is a mathematician working for a federal government agency on a special fellowship. Because of his fellowship, a foundation pays for his health insurance; he pays nothing. The roughly $15,000 in health costs from his wife’s first prenatal visit to the baby’s birth were paid entirely by insurance, except for about $20 worth of co-pays. By no means do I begrudge them their good fortune; they deserve it.

But no matter how hard I try I can’t get my head around the fact that one grandchild’s birth has been paid for entirely by health insurance and one grandchild’s birth has to occur 5,000 miles away in another country because health insurance is prohibitively expensive.

We all realize that the decision to move to France is no real hardship; it’s not as if the choice is between the United States and a war-torn or desperately poor country, and Melanie’s family will be delighted to have them there. If the choice were truly a choice, that would be one thing. But it feels more like the United States has turned its back on my son and his wife — and grandchild — and given them no ethical option but to leave.

There are people who still say we simply can’t afford to take care of our citizenry the way other more compassionate countries do; it’s simply too expensive. But not providing affordable insurance costs the country in ways beyond the emotional cost to one family.

If Reeve and Melanie could have their baby in Miami, they would continue to pay into the economy of that depressed area by paying for rent, groceries, art supplies — the same expenses they’ve had for years. But being parents, they would also inject new money into the local economy by buying a crib, clothes, diapers and all the other necessities for a baby.

In addition, my family and I would make multiple trips to Miami before and after the baby’s birth, as would Reeve’s father, family and friends in Minnesota. We’d all fly on U.S. airlines, spend money on American rental cars, hotels, restaurants. We’d all buy baby clothes, toys and books and the practical things a baby needs and not-so-practical items people love to give to new families. We’d buy those items — preferably U.S.-made – in American stores.

Economic cost to U.S.
I asked our son-in-law to estimate how much money went into the U.S. economy from pregnancy through the baby’s three-month birthday, including medical costs, airline tickets bought by family members in Minnesota, Colorado and Iowa to see the baby; baby gifts, gift cards, and the money spent on baby paraphernalia. He suggested that roughly $30,000 has been pumped into the economy since the baby’s existence became known less than one year ago.

If Reeve and Melanie’s child is born in France, however, no baby-related money will be spent here. I won’t buy anything for the baby in the United States, and I doubt other relatives and friends will either. I’ll send money in lieu of gifts to France, where my son can buy whatever they need without worrying about shipping. We’ll fly on Air France several times a year, rent French cars, eat French food, and spend our limited American dollars in France. We’ll no longer use vacation time to go to Minneapolis and put our money into its hotels, restaurants and Twins games. Reeve, Melanie, and her family will buy what they need in France, including art supplies and possibly a house. And if they “hit it big” in the art world, their tax dollars will go to France, not the U.S.

This is only part of the health insurance nightmare, of course. My husband, Jim, and I have relatives with serious mental health issues. One, who has always held a steady job, has never been able to afford health insurance; another lost his employer-based insurance along with his job. Neither is able to get the necessary treatment. And although Jim and I have insurance through his job, we’ve both been hit with medical issues in recent months, which fortunately have required neither surgery nor hospitalization. We pay about $5,000 a year in premiums for the employer-based insurance, and adding co-pays, prescription costs and other fees for uncovered charges, 2009 could be about a $10,000 health care year for us.

If Jim loses his job, we’re sunk. My job is another of those “contract” jobs — adjunct faculty. I get an hourly wage and no benefits other than the deep satisfaction of transforming students of nearly 90 nationalities into people who not only speak and write better English, but also know some U.S. history and culture. I believe that every day I teach I help my country. However, this week my students learned the words “exploitative,” which I explained, and “tirade,” which I demonstrated. They’re learning a lot.

The solution is obvious — affordable health insurance for all Americans regardless of occupation, health or age — that is, the public option so disparaged by both health and malpractice insurance executives, and their congressional minions.

With that option, my grandchild could be born in the United States. If Jim and I lose our health insurance while we’re still too young for Medicare but old enough to have numerous pre-existing conditions, we won’t need to panic and sell everything we own; and our two relatives can get treatment and live productive lives. In addition, our third adult child, a writer/musician/actor in New York who has minimal insurance, would benefit enormously from a public option. Like any good citizen, I’ve written emails and called those people with the power to enact such an option. I doubt I’ve had any effect.

We still have one child at home, Keir, who will be college-bound in three years. Melanie told me university costs in France are around $1,000 per year — and that if he were a student there, he’d have free health coverage. I know that’s because of socialized medicine — demonized by so many Americans as un-American — but at this point, why would I care? This form of American capitalism in which health insurance and care is doled out by people more motivated by greed than humanity hasn’t done a whole lot for my family lately. My husband and I are looking into what France can give us and Keir that we can’t get at home.

And for those so concerned about immigration and the type of people it attracts? When educated, contributing Americans such as our children and us leave this country, who do you think will replace us? Certainly not well-educated people from countries with decent health coverage. No, the people who will come will be like my forebears long ago — those from countries that already don’t give them what they need — the uneducated, the unhealthy, the traumatized, the poor, those with nothing to lose.

This evening we went to see a mural recently completed in Washington, D.C., that has garnered international attention. It was painted by Regina Holliday, whose husband and father of her two young children, died in June at age 39 of kidney cancer. Because he had no health insurance, his cancer went undiagnosed. By the time he was employed and insured, and finally diagnosed, it was too late. His widow lost her health insurance due to his death. In the mural, her dying husband holds a note with the words he told her before he died: Go after them, Regina.

When viewing the mural, my heartbreak competed with my rage. How can this happen? Certainly not in my country, not in my country.

So, maybe I live in the wrong country. My grandchild is due in April. I need to start learning the words to “La Marseillaise.”

Misti Snow, a former Star Tribune reporter and editor lives in Falls Church, Va. She teaches ESL writing and literature classes at Northern Virginia Community College.

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Comments (21)

  1. Submitted by dan buechler on 10/16/2009 - 08:43 am.

    Thanks for sharing. I too have felt the same way at times.

  2. Submitted by Joe Johnson on 10/16/2009 - 08:58 am.

    I think you sons skill set would be better served in Europe too, if we would like to continue art handling. Or just a thought your son or daughter-in-law could make the personal sacrifice of changing careers to find employment in a field with healthcare. Unfortunately family planning more necessary today then ever.

  3. Submitted by John Roach on 10/16/2009 - 11:28 am.

    A few years ago, a female relative of mine discovered that she was pregnant with her second child. Unfortunately, her husband had lost his job the previous week and they were without health insurance when the test came back positive.

    The pregnancy was now a “preexisting condition” and was not covered under the policy that they ended up with. She ended up needing a C section.

    Their baby was healthy and is now a fine young man. They are still paying off the debt from his delivery. This is our health care system.

  4. Submitted by Geoff Laskowski on 10/16/2009 - 11:54 am.

    Mr. Johnson,

    “I think you sons skill set would be better served in Europe too, if we would like to continue art handling”

    I assume you are aware that there are numerous museums, galleries, and corporations with art collections in the United States that would require the services of someone with Ms. Snow’s son’s skillset.

    “Or just a thought your son or daughter-in-law could make the personal sacrifice of changing careers to find employment in a field with healthcare.”

    As Ms. Snow stated, her son’s work is contract work. The fact that he is an art handler is immaterial, for many contract workers or consultants in other fields are not provided healthcare either. And to which “fields with healthcare” are you referring? Are you referring to employees of major corporations in “fields with healthcare” that get dropped from, or cannot receive coverage because they have a pre-existing condition? Or are you referring to someone in a “field with healthcare” who loses their job and can’t afford to extend it with COBRA? Or are you referring to a “field with healthcare” in which a small business owner can’t afford to provide coverage to either himself, his family, or his employees because the cost of said coverage is too high, and would put him out of business if he did provide it?

    A public option could provide low-cost, portable insurance to anyone, regardless of their chosen field. Wouldn’t you rather have people utilizing their best, most productive skills in preferred careers, or even as entrepreneurs rather than merely working at a job because it provides health insurance?

  5. Anonymous Submitted by Anonymous on 10/16/2009 - 12:33 pm.

    “Unfortunately family planning more necessary today than ever.”

    Mr. Johnson, by that statement alone, I infer that you are a Republican. By implying that if you can’t afford children, you shouldn’t have any is one answer to our heath care problems is typical right-wing heartlessness. No wonder this country is a mess in so many ways after you and yours ran this country for eight years. Did Misti Snow’s article not show you that children are an economic boon to our country, and far more important–a joy to their families?

    Ah, but there is no joy in “Mudville,” the community created by selfishness.

  6. Submitted by dan buechler on 10/16/2009 - 12:48 pm.

    One of the major determinents of a young man agreeing to join the volunteer military is a female pregnant with their child. Were it not for that plus college costs we would have to resort to conscription. I am not defending the status quo I am merely stating some uncomfortable truths.

  7. Submitted by Richard Parker on 10/16/2009 - 01:09 pm.

    My niece, Nora Longley, died in May at age 27 after nearly four years of fighting cancer that was diagnosed too late. After college graduation (art history) she had no, or inadequate, health insurance because she wasn’t established in a career job yet. Minnesota Women’s Press had an article about her a while back (hope this link works): http://www.womenspress.com/main.asp?SectionID=1&SubSectionID=1&ArticleID=3394

    My youngest daughter, Amy, turns 28 on Oct. 17. She was born two weeks after Nora and they were close cousin friends. Amy spoke at a rally outside Sen. Al Franken’s office Wednesday urging a public option, and she appeared briefly on the evening news on the local CBS and NBC stations. (My wife pointed out that her pitch for a public option got a very short sound bite, much briefer than the coverage given to tea-baggers ranting about death panels at town hall meetings.) Amy, a waitress and graduate student whose credit load doesn’t qualify her for health coverage through school, recently was denied coverage by Medica. She later did get coverage through work by agreeing to more waitressing hours.

  8. Submitted by Peter Soulen on 10/16/2009 - 01:13 pm.

    Ms. Snow, thanks for sharing your story. I’m glad you wrote here. You would not have had to publish very far from the safty of MINNPOST to have had your sweet story torn to shreds by the bootstrap crowd.

    Good luck to you and to your family and to all our grandchildren – for whom we hope that better days are ahead.

  9. Submitted by Kassie Church on 10/16/2009 - 02:52 pm.

    Unfortunately Florida has one of the worse public assistance programs in the US. In Minnesota, the mother and child would likely be covered by Medical Assitstance. The income limit for them would be 250% of the Federal Poverty Guideline for a family of 3. All assets are excluded. Instead of moving to France, moving to Minnesota or one of the other forward thinking states may be an option.

  10. Submitted by Joe Johnson on 10/16/2009 - 03:33 pm.

    I love all the responses, but I wonder the anger would change if the story was about a shop worker in Blaine as opposed to a art handler in Miami? Some how I think it would be dumb republican redneck type posts. Two highly educated people who didn’t think insurance is important before deciding to have a child, yes it is a decision, so they can now they pay up for their lack of planning. I hope them the best but it’s their own fault.

  11. Submitted by dan buechler on 10/16/2009 - 04:16 pm.

    JJ one of my coworkers is from Blaine. I work with my hands and have 8 calluses to prove it and I bet I even have a bigger woodpile than you. We will have expanded healthcare in this country and maybe when you are in your fifties you will appreciate it. JJ you are a bit rough around the edges perhaps you need some bondo an excellent 3M product used by rednecks like me with 8 year old cars. If you got some rust or a dent we will mix it and fix it. I’ll even let you smell the paint fumes.

  12. Submitted by David Brauer on 10/16/2009 - 04:16 pm.

    Joe – speculating about what people *might* say if circumstances were changed is pretty weak tea. The shop worker in Blaine is screwed by our health care system, too. That’s part of the problem. He/she wouldn’t get any less sympathy. In fact, empathy seems to be lacking on your side.

  13. Submitted by Karen Sandness on 10/16/2009 - 04:58 pm.

    When I was younger, I had opportunities to move overseas, and I didn’t take them, for what seemed to be valid reasons at the time.

    Now I could kick myself across two oceans for not taking those opportunities, because in any of the three countries I could have moved to in the 1980s (Norway, Japan, Australia), I would not have had to worry about health insurance as a self-employed person. Now I’m too old to be considered a desirable immigrant.

    I personally know Americans who live overseas because they developed a medical condition while over there on short-term jobs or educational programs and are now considered uninsurable in this country.

    If a young person were to ask my advice about emigrating, I’d tell him or her to go for it. This country seems to be in decline in so many respects, not just health care.

  14. Submitted by Joe Johnson on 10/16/2009 - 05:36 pm.

    David as always thank you for being the thought police, talk about weak tea I wonder what the comments on Minnpost said about Bristol Palin, abortion/adoption/trash? The reason I have no empathy is that this couple is likely older than myself and my wife and have no understanding of how to manage their lives. How did their planning go, I have no insurance but still employed and I’m unemployed with no insurance, I hope we don’t get pregnant because we can’t afford it, but we can save money if stop using contraception. It must be more of my rightwing heartlessness, but stupid is as stupid does, if it’s money that’s the issue save the two thousand on the flight to France and call Planned Parenthood. I fully endorse the right to choose.

  15. Submitted by Richard Schulze on 10/16/2009 - 06:51 pm.

    Joe, I have to wonder how many of us were the result of perfectly timed “family planning”? But I digress…..

    Harry Truman wanted to provide universal health care in 1947. The American Medical Association, the doctors, hired a PR firm, who invented the term socialized medicine. Nobody knew what it meant, but I think the idea was if you wanted to provide health care to your sick neighbor, you were a commie, and you know, during the Cold War, that was a powerful argument.

    The amazing thing is it’s still a powerful argument. I don’t know that anybody can define socialized medicine, but nobody seems to like it, except, when Americans get government-run medicine, they really like it. The VA, the Native American Health Service and Medicare are the three most popular health care systems in America, all run by government.

    Let’s look at the French model because this seems particularly relevant to the topic du jour. The French system, I think was rated the number one health care system by the World Health Organization study that ranked countries around the world. I can see why. It’s a very good health care system.

    France is a country who doesn’t let insurance companies make a profit on “basic health insurance”, and they have pretty strict rules. I mean, this is nice insurance. There are many insurance companies. It’s not single-payer. I want to make that point, but numbers of insurance companies. If you don’t like your insurance, guess what: You can drop it, shift to the next guy, and the new guy can’t raise your premium. Now, that’s more choice than anybody in America has. These companies have to cover everybody. They have to pay every claim. They don’t have all those people going through, saying sorry, we don’t cover that.Generally, they have to pay in a short period of time. In France, the doctor has to be paid within three days.

    What’s missing in all doctors’ offices in France is all the files of patient records, and there’s no billing office. Here’s what happens: The patient comes in. Out of her pocket, she pulls this green credit card. It’s called the Carte Vitale. The doctor puts that in a reader on his desk, and her entire medical record shows up on the screen. And he chats with her about her problem. He’s typing down what she’s got wrong, and he says to her, well, I think I’m going to prescribe a course of antibiotic…. and then he’s finished with her. Then the doctor hits one key on his computer, and the entire bill has gone to her insurance company. He’s going to be paid in three days, and she’s going to get her co-pay back from the insurance company within two weeks, done. No paper. And the next time she goes to a different doctor, he can put her card in the reader and see what this doctor had prescribed and what this doctor thought.

    You think of France as a model of management efficiency? The French insurance industry spends four percent on administration. Germany, five percent, Japan about five percent. So we are just pouring tons of money into stuff that doesn’t buy anybody health care largely because we have this hugely complicated overlapping set of systems and that’s one of the reasons all the other countries went to a single system.

    In those countries, the insurance companies are basically charities.They’re community organizations, and they have one goal in life, and that is to keep people healthy. That’s what they’re for, and the reason for that is those countries have all decided that there’s a basic conflict between making a profit for investors and covering people’s health.

  16. Submitted by dan buechler on 10/17/2009 - 06:57 am.

    Richard, excellent points and very well written by the way. As many of you middle aged commentators know our system is messy. I hope I am finally back on a good plan.
    Being laid off at fifty I used cobra for 9 months as my new smaller employer temporary job had no insurance. I was denied cheaper riskier insurance because 2-3 minor preexisting conditions. Went to blue cross and got a plan where you hope to not get sick. I had to switch dentists, eye doctor, health clinics. Now am back on a plan where I can use my established care providers. A fair number of extra paperwork was done just because of a one year change in employment.

  17. Submitted by Bernice Vetsch on 10/17/2009 - 08:44 am.

    Norway and Switzerland have systems similar to that in France. Insurance companies must be nonprofit organizations. The government determines the price of premiums and forbids all the crimes against the sick that American insurers have, until now, gotten away with.

    In all other advanced countries, citizens may have other worries, but never have to worry that needing medical care will bankrupt them (often in spite of their having insurance) or limit them to emergency room care if they are unable to insure themselves. Needless to say, the people in these other countries are happier with their governments and more content with their lives.

    And to those who say we can’t afford to provide care to all? We would save $400 billion per year on administrative costs alone. Our premiums buy all that marketing, lobbying, gigantic executive salaries and bonuses, and denial-specialists and other personnel as well as coverage.

  18. Submitted by Thomas Swift on 10/17/2009 - 03:27 pm.

    Free health care, a stipend *and* I hear the government cheese is much better in France to boot!

    I can see why Misti (is that short for something?) would be encouraging her serious artists to shuffle off to Burgundy, but I’m wondering why she isn’t booking passage for herself as well.

    The fact is, I’m thinking that everyone that can make heads or tails of Misti’s thinking processes would probably be much more comfortable in France.

    No, really,

    France has been sporting an 8% unemployment rate for over 25 years, this economic disaster stuff is old hat for them, the government is predicting that next year the public deficit will hit 8.5% of the French GDP this year.

    The whole thing just screams “scary smart” and “reality based”, doesn’t it?

  19. Submitted by Richard Schulze on 10/17/2009 - 04:50 pm.

    Typical Swiftee. He uses anecdotes as his platform instead of facts and figures and it reflects in the errors of his conclusions.

    Demagoguery, name calling, making personal comments about the author and her name. The lack of facts, the use of fuzzy stats, and frankly not a very well reasoned comment. It goes to show how your failure as an erstwhile candidate is made more clear, by seeing how you attempt to communicate your ideas.

  20. Submitted by Peter Soulen on 10/19/2009 - 07:36 am.

    Yeah Richard, Swiftee is one of the bootstrap crowd that I have run across in other forums – as it would appear you have too. A bit anti-social he is, but he reigns it in here at MP.

    He is representative of the frighteningly large number of our fellow citizens who do not seem to care about much outside of their own narrow set of interests. They don’t just want to water board the government, they have the whole bathtub filled and ready.

    If it weren’t for those pesky liberal voters who believe in the power of government to do good, he’d be pushing its shrunken head under the water right now…

  21. Submitted by Thomas Swift on 10/19/2009 - 09:35 am.

    Huh.

    I could swear that I received an e-mail message from the MinnPost censor last week, informing me that engaging other commentators in any way, was against the rules.

    So I removed the name of the fellow whose points I was addressing (I wasn’t directly addressing the fellow, mind you) and my comment received a travel pass.

    I appreciated the censor contacting me to let me know what the problem was, but now I’m more confused than ever.

    I guess I’ll just never understand the rules of conduct that the scary smart, reality based community lives under….unless of course I apply Occam’s Razor.

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