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I'm the Reason Your Health Insurance Premiums Are So High

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I love drugs (but not the illicit kind). Until side effects got control of my life, I firmly believed: the more, the better. Now that my medicine is being lowered, I feel better but I will always be on expensive prescription psychopharmaceuticals.

I have schizoaffective disorder and am a part-time attorney. I work hard to be functional. That involves taking my medicine religiously, seeing my psychiatrist once a month, and going to therapy. I have been in the psychiatric ward six times and have, over my life, spent over a year and a half in full day hospital programs. I have no interest in being ashamed of my mental illness.

Although I am a Jewish atheist, I grew up in a family with a Protestant work ethic. I have worked at the largest law firm in New Jersey as a property tax attorney, the largest legal nonprofit in the state representing the indigent, Social Security Administration, a Social Security disability think tank, and at other positions. Along the way, I have always been disabled but mostly blessed with good insurance and a sturdy flexible spending account.

I have not worked full-time since 2014 and I rely on government insurance because I have a disability. I do not anticipate being on Social Security Disability Insurance (SSDI) for more than a few years, but who knows. Since I get SSDI, I get Medicare. The premiums and copays, not to mention the thousands of dollars I would have to spend because of the “donut hole” where Medicare will not cover my pills for a time, would normally be catastrophic. However, I have Medicaid through NJ Workability, a program for disabled individuals who work. It covers most of what Medicare does not pay.

Without my medication, I would be psychotic and likely suicidal in an institution, if I hadn’t already killed myself.  I would not be paying taxes and using my expensive Smith College and Rutgers School of Law education to increase the GDP.

While I was working full-time, I was the reason my coworker’s premiums were high. As I am on government insurance now, I am the reason your taxes are higher.

My possible death smacks of eugenics when it could have been prevented by some medication. It does raise the question, does society or my co-workers owe me affordable pills? I did not bring schizoaffective disorder on myself. It is genetic and perhaps environmental. My successful brother, who works in finance, is not mentally ill. I do not think he gets mental health treatment. Due to bad luck, I got the gene.

However, it could have been him. It could have been you. Does society owe you treatment when you cannot fend for yourself? I think it does if you legitimately value life, especially if you believe that birth begins at conception. Life does not end with your first breath. Society has an obligation to make sure you are safe, if for no other reason than it is in your own best interest. Disease can happen to anyone.

With health reform possibly coming back, I am scared for me and my brethren. I am not at the point yet where I can work full-time and get insurance. Even if I could, I am not even guaranteed that my insurance would cover prescriptions in any meaningful way. I may end up back in inpatient. I may end up in an institution. Of course, I could just be dead.

This does not seem to be a just outcome for me for a chromosomal fluke. When I was born 40 years ago, the link between family history and mental illness was not very clear. How could my parents know that my brother or I would have a chance of illness? If they did, should they have not had me because of a risk? Is that good planning? I do not know. I will not have a child because I do not want one. I have cats.

For those against spreading the risk by insuring everyone so nobody is without their medicine, there is a moral argument that you should only get what you pay for. Otherwise, you are “cheating the system.” My death and the deaths of those with cancer and other serious conditions would be cheaper, but life is not just for the rich. If fetuses allegedly have the right to take a breath, why don’t I? If you pay for Medicaid and Medicare you pay for survival, and for a life worth living.

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Getty image by Sarinya Pinggam.

Originally published: February 12, 2018
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