For many Americans, 2018 was the year that health care reached a breaking point.
Insurance was still too expensive to buy. It didn’t cover nearly enough. And as the country’s politics festered, the government once again failed to solve the insurance conundrum, even as a large majority of Americans who flocked to voting booths said health care was their top concern.
My colleagues and I spent much of this year talking to people who had weighed the health benefits against the financial burden of purchasing insurance. Most decided to risk it, betting that going without made more sense than paying for coverage.
We started off following a dozen families: people who were trying to work, raise children and pay for a house or college. When we invited others to share their stories about going uninsured, an overwhelming number did — more than 5,000. Many sent us messages that could break your heart or raise your blood pressure.
In Virginia, the Jordan family shared their tale of sinking into bankruptcy because of unexpected medical expenses, even though they had insurance.
The Maldonados, in Texas, were forced to choose which members of their family to keep on insurance policies as costs ratcheted ever higher.
Others tried to find creative solutions, like the patchwork of alternatives to traditional coverage that the Bergevin family in Boise, Idaho, assembled. A nurse in South Carolina told us that she buys insurance every other year, getting screenings and care in even years and rolling the dice in odd years.
One theme that came up over and over again was that this is a problem reaching far higher into the economic spectrum than we first thought. Many of the more than 100 people we interviewed over the year had incomes of $100,000 or more. These were comfortable families, from outside. Yet, when they opened up their books to us, it became clear how much they needed to stretch to afford health care.
That often meant self-imposed health-care rationing. They didn’t make these decisions lightly. These weren’t uninsured-by-choice “young invincibles.” They weren’t reckless or ignorant — quite the opposite. Many were educated professionals, entrepreneurs and business owners. They had bad options and were forced to make a choice about which family “need” had to be downgraded to a “want.”
“We don’t have enough money to go out to eat, or take my grandchildren to the movies, much less pay for health insurance.”