September 27, 2007U.S. health system has pair bound for ItalyLarry and Anna Shield stand like precarious dominoes in America's health care system. At 62, Larry is on disability retirement because he has a neurological disease. A former software engineer and educator, Larry doesn't yet qualify for Medicare because he retired on disability less than two years ago. So he's on Anna's health insurance. Anna, 55, is an administrative assistant and grant-writer at the Art Museum of Western Virginia. But she has kidney disease. Her health is stable though not robust. If Anna becomes seriously ill and has to stop working, the dominoes start tumbling: She loses her health coverage. And Larry loses his. The Burnt Chimney couple, who've been married for 30 years and are childless, don't want that scenario to become reality. So later this fall, they're moving. To Rome. Italy. "It's an escape plan," deadpanned Larry, who, despite his illness, retains his dry wit. Added Anna, "It's just a much more progressive plan over there. I'm not saying it's perfect, but at least you're halfway there. They do respect you as a person." America's health care system is broken. We often lament the circumstances of the millions of uninsured in this country. But the system can be a frustrating journey for those with coverage. The Shields' decision sounds like a case study from filmmaker Michael Moore's latest movie, "Sicko," in which he compares the U.S. health system with national systems of other countries. (They haven't seen the movie.) They emphasized their decision is not for everyone. And their choice is not random. Anna was born in Italy. She moved to Chicago when she was 8 and has dual Italian and American citizenship. She regularly visits her native country. She and Larry plan to move there before the end of the year for its public health system. Because Larry is a foreigner, he might have to pay a one-time $800 fee in Italy to get medical services. To many people, the Shields' move may seem a drastic remedy. They see it as assurance they won't be stuck in health care limbo. "My health is dependent on her being healthy, and she's not healthy," Larry said. "She's working for health care." With the move, they say they will be able to avoid some of the red tape they've faced in the health system here. Larry was diagnosed with Charcot-Marie-Tooth in 2001. The genetic disease causes weakness in his extremities. It affects his arms below the elbows, and legs below the knees. Larry has problems with balance. The disease also causes difficulty with breathing. It has robbed him of strength and muscle tone, and he tires easily. "It's not life-threatening," said the former avid sportsman. "It's life-disgusting, but it's not life-threatening." Anna has polycystic kidney disease, which is genetic. The benign cysts on her kidneys diminish her kidney function. Eventually, most patients need dialysis or kidney transplant. Thankfully, she's not at that point. If Anna lost her job, she eventually would be covered by Medicare because of the nature of her disease. But Larry, who has been on disability since July 2006, will not qualify for Medicare coverage until July 2008. For the Shields, navigating the system can be as difficult as living with disease. Anna shared the frustration of waiting on preapprovals for prescription refills. Insurance companies, she said, are stingy when the drug is costly or when a generic brand doesn't exist. For the past several years, Larry and Anna have paid about $7,000 annually in out-of-pocket medical expenses for such things as a leg brace, medication and co-pays. I pointed out that she and Larry are fortunate to have the resources to pay medical expenses. Many Americans can't afford that. "We are fortunate," Anna said, clearly aware of the point. Still, they worry. One afternoon a few years ago, they were sitting in their house tucked in the woods on a gravel road when the idea of moving to Italy came up, rather flippantly. Anna was watching Formula One racing on television. Larry came in the room, fretting about their health care. His worries distracted her. "Shut up, I'm watching the race," Anna said, laughingly recalling the conversation. "We'll move to Italy or something." From there, the idea stuck. It made sense on a number of fronts. Anna has an elderly aunt in Rome. The couple have purchased a great apartment on a tree-lined street, next to the Vatican. But most important, they said, their health care worries would be gone. The $7,000 they pay annually here in expenses would be greatly reduced. They would not pay for health coverage, and the majority of medication is free, Anna said. Oddly, in three decades of marriage, Larry has never accompanied his wife to Italy. No need, he said. He doesn't like to travel and her relatives were always welcome here. Recently, Anna met another woman who is considering moving to Italy for the health care system. "I'm not a progressive Democrat," Anna said, "but I see a need for health care reform in this country." |
About this blog In her signature plainspoken style, Michigan native Shanna Flowers peels away the layers and gets to the heart of the issues. No pretense. Just straightforward perspective. Shanna writes about local people whose circumstances reflect decisions made as near as City Hall or as far away as the halls of Congress. Other times, she weighs in on a topic because it is incredibly ridiculous. Or heartening. Or fascinating. Read Shanna's column three days a week, Sundays, Tuesdays and Thursdays, at roanoke.com
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Comments
[September 28, 2007 4:24 PM]
Bobby Buck : →http://www.infobuck.comHealthcare in the wealthiest and presumably the most intelligent nation on the face of the earth? I say presumably, because other nations that may have been considered third world are advancing technologically at a much more rapid rate. In other words, technical knowledge in computerization, infrastructure, communication, and transportation determine the ability to advance in medicine, science, research, and cures to diseases. What's also needed is an individual's responsibility to make wise choices in maintaining as much of a healthy profile as possible through proper living habits. Last, interpersonal patient cooperation is needed among caregivers covering hospitals (clinics), primary care physician cooperatives,pharmaceutical manufacturers, pharmacists, and insurance providers as opposed to competing to squeeze as much "buck for the bang" from an otherwise insecure and understandably disadvantaged sick person, who's subjected to the system as simply another numbered cog drowning in the sea of healthcare confusion.
[September 30, 2007 12:31 PM]
Kashawn McIntireShana,
How much does an apartment on a tree lined street near the Vatican in Rome cost? Has this couple already purchased this apartment? Are you shure they are moving because of healthcare cost of $7,000 a year, or the fact that Rome is a nice place to retire and this is their "excuse" for you, the liberal media in America. They should have purchased healthcare when they were healthy. It is cheaper than waiting until they are unhealthy and can not afford it.
[September 30, 2007 1:49 PM]
ShannaWithout revealing the Shields' personal business, they were able to move because the apartment was very affordable, probably less than your house and I know for a fact less than mine...and I live in a modest split foyer.
They've always had health insurance. Their genetic diseases manifested themselves as they got older, hence their increased health care costs.
As for "liberal" media, health care is a nonpartisan issue. Whatever their political bent, Americans of all stripes are becoming increasingly frustrated by health care in this country.
Whether one supports universal health care or not, reasonable adults would agree that American health care today is broken.
Independent thinkers, regardless of party, will agree that health care was much better in this country when doctors---and not profit-driven insurance and pharmaceutical companies---were making the decisions about our health.
I don't care how it's fixed, just fix it.
s
[October 1, 2007 9:32 AM]
Kashawn McIntireShana,
I am not being argumentative, however, "not to reveal their personal business" would be filtering their healthcare problems. Maybe $100,000 sounds like a good figure for the cost of their Italian Villa. That would pay for about 10 years of healthcare coverage at todays spending rate. Oh yeah, Medicare will kick in for both folks within 10 years. Again, pick an excuse other than blaming the US Healthcare issue. Most folks say the issue is that people do not have access to healthcare. I thought the issue with healthcare is that folks can not afford it, however, this couple has coverage, and are just worried about the future and potentially losing a job. Wow, what happended to looking on the bright side, his family has coverage, and they are moving to an amazing retirement place and able to downgrade the US on the way out the door. Shana, can you be more specific about the issue with healthcare in this country? We have great doctors in this country, some of the best technology in the world, copious amounts of prescription options, and the ability for someone else to pay for a majority of the cost. Even my plan pays 80%. I will take US healthcare over any other country any day. What is broken about this? Oh yeah, the reason the insurance companies make decisions is because they are paying the 80%, so if we paid for it out of pocket, they have no issue and no worries on your part.
[October 2, 2007 6:01 AM]
marie battenThe bottom line is that no American should lose their home in order to have health care. Baby boomers would have been better off had there been a compromise in the 90's with Hillary's proposed plan rather than the uproar supported by the doctors and insurance providers to have it defeated. Very little medical progress has been made under this republican banner - only big bucks for the industry's bottom line...just look at the stock market charts during the last 6 years.
[October 2, 2007 11:31 AM]
ShannaPlease feel free to argue, or as I like to say, engage in civil debate. That's what the blog is here for.
The point I guess I'm not clearly conveying is that if Anna loses her job, neither she or Larry qualify for Medicare immediately. So they're left without health coverage...and they both have two serious health issues. If they lost their insurance, I suspect it would cost much more than $100,000 over 10 years. She likely eventually is going to have to have a kidney transplant.
I'm not denying that America doesn't have good physicians. Problem is, we don't let them make the decisions. The decisions are being made by some numbercruncher in an insurance office somewhere who couldn't tell a corn from a bunion.
The concern with health care is not only those who don't have insurance, but increasingly those who do.
I don't believe we'll have universal health care in this country for a number of reasons. However, that doesn't mean the one we have now can't be improved.
Yes, insurance is paying the bulk of the bill. But it has always paid the bulk of the bill. I say this sincerely cuz I just can't remember, but I really don't remember my parents having to jump through all the hoops with our insurance then as I/we do now.
I've got to think that has something to do with health-care being more profit- rather than medical-driven.
s