Friday, September 14, 2007

Legalized Gambling

Small business owners Gordon and Babette Brennan used to pay as much as $800 a month for health insurance. But the Jupiter, Fla. couple felt like they received little in return: Claims for ordinary pediatrician visits for their son Ryan were denied. Procedures like blood tests weren't covered. Co-pays were $40 a pop.

Received little in return.

Who buys an insurance policy hoping for a return? Where does this kind of mentality originate?

But making a combined salary of $90,000 from their dog-training school, "we were in this pocket where we made too much to get assistance but couldn't afford a good plan," says Babette, 39.

$90,000 disqualifies them for public (taxpayer funded) assistance.

Wow. Who woulda thunk?

So in 2002 the couple decided to drop their policy and go off the health insurance grid.

Going naked.

Wonder what kind of return they will get on money they did not spend on premiums?

It seemed like a reasonable gamble at the time: Pay out of pocket and maybe spend less than premiums and co-pays combined. For a while it worked too.

When Babette became pregnant with their second child in 2004, she negotiated with her doctor for delivery costs - and spent $2,000 less than insurance would have charged in premiums alone.

So far it looks like they gambled and won.

But everyone knows the customer rarely wins.

The only way to "win" (get back more than you pay in) with an insurance policy is to suffer a major loss. What kind of logic is that?

Then baby Sarah was diagnosed with Leber's amaurosis, a congenital eye disease that leaves her legally blind. Over the next few years, the doctors say, she'll require about $1,500 a year in ongoing care, a test that will cost $20,000 and possibly surgery costing $5,000 or more.

With Sarah's pre-existing condition, the Brennans feel like they won't get an affordable insurance policy at this point. Yet with little savings, they face the prospect of borrowing money from family to pay for Sarah's care or getting a corporate job just for the benefits.

Sounds like they gambled and lost.

I bet they wish they had done things differently.

Any takers?
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