Health Insurance Coverage essential

By JENI LEWIS

For the Daily Tribune



The increasing cost of health insurance - up an average of 13.9 percent last year - has some people opting out. Nationally, about 41 million people don't have such insurance.But going without health coverage is a mistake, warns John Skaden, chief financial officer for Saint Joseph's Hospital in Marshfield. "There are some people who are willing to take the risk in not having insurance, believing when the devastation hits, they can find some means or some way to pay for it, or somebody else will pay for it," he said. At Saint Joseph's Hospital, 90,000 people are treated each year. Of those, 3,000 or 3.5 percent, don't have any insurance. This count is low, compared with national numbers, Skaden said.Health insurance costs vary widely and depend on the health history of the insured and whether insurance is purchased through an employer or as an individual. If employer-provided, the size of the group covered also determines cost. For instance, each employee in a business with five employees will pay much more for health insurance than those at a company where hundreds work.In 2003, the average cost of health-care insurance obtained through employers in the Midwest ranged from $3,436 for preferred provider plans for single workers to $9,359 for conventional plans for families, according to the Kaiser Family Foundation. The Lacke family of Edgar is an example why health insurance is important. For a year and a half their son, Matt, 18, suffered from hepatocellular carcinoma, or liver cancer. On Oct. 30, Matt received a liver transplant at Children's Hospital of Pittsburgh. "You never know when your son or daughter is going to need that liver transplant, and there is just no way a person can afford that," Skaden said.An organ transplant at Children's Hospital could range from $150,000 to several hundred thousands of dollars, said Marc Lukasiak, director of public and government affairs for the hospital. A program called Free Care Fund is available to families who live within 150 miles of the hospital. If the family of a child receiving a transplant doesn't have health insurance, or the health insurance they have doesn't cover the operation, assistance comes from the fund, Lukasiak said.Since the Lacke family lives beyond the 150 mile radius, health insurance has been a necessity. Matt's father, Edgar School Superintendent Mark Lacke, said the family will not hold any fund-raisers because he and his wife, Barb, both have good-paying jobs with Edgar School District, and have health insurance. Financial aid the community has given the family was used to help Matt's older sisters, Heather Weyda and Jamie Lacke of Cudahy, buy plane tickets to visit him in Pittsburgh.Not every family will need a transplant, but other conditions can be costly, Skaden said.The bill for a healthy newborn with a normal delivery at Saint Joseph's Hospital generally would be $1,700.But if the baby is born early or has complications and needs 24 hour care in the neonatal unit, costs can soar to anywhere from $11,000 to $350,000. The average cost is $91,000 when a baby in stays in the hospital for 30 days, Skaden said."It's unfortunate when we find these surprises," he said. "Every one of us as human beings, probably back to the age of 5, we have choices we have to face all the time, and we have decisions we need to make. I'd take insurance."