Response to questions about Scott's insurance coverage

Reader comment on: Nicholas Kristof's Roommate With Cancer

Submitted by Matt Blumenfeld (United States), Oct 20, 2012 23:55

I attended the memorial service for Scott Androes earlier this week. He was a personal friend of mine. He was also an incredibly good-hearted person. Although it hasn't been brought up, as far as I can tell, Scott believed that the strong should help the weak. As evidence of that, he served on the board of REACH, a Portland, OR based organization that creates and maintains housing for low income people.

Although he isn't here to validate my answers, I can try to respond to your questions:

1. Why couldn't he have continued his health insurance from work for 18 months under the provisions of the Consolidated Omnibus Budget Reconciliation Act of 1985, or Cobra? As someone else pointed out, COBRA coverage is expensive. While it may be "affordable" in some sense, it's costly enough to be regarded as a luxury if you aren't already aware that you need to pay for an existing condition. In Scott's case, he wasn't already sick and given his income (about $13,000 last year) he probably wouldn't have had money for rent or other necessities if he'd purchased overage under COBRA. Even if he HAD paid for it, that coverage would have lapsed long before he became ill.

2. Question: did he have a regular physician and get annual physicals back when he did have insurance? When he had insurance, he wasn't having health problems, at least as far I know. I can't speak for Scott, but I know that when I was younger and unmarried I wasn't particularly diligent about getting annual physicals. I'm 55 now, married, with health insurance, and my wife makes me go to the doctor. (Because my insurance covers colonoscopy, I had several polyps removed not too long ago. I am pretty sure that I wouldn't have gone for that procedure without my wife making me do it.) There isn't much reason for me to think that my behavior is all that unusual.

3. See the above. Although there may be other reasons that being a bachelor was lucky (like not having a wife nag you about things like going to the doctor), I don't think that having "cheaper" insurance matters much if the insurance is too costly to begin with. Given his income, I am not aware of his having had much "disposable" income.

4. Without a mandate, I doubt that Scott would have purchased insurance. Going back to the amount of money he was earning, he would have needed for it to be much less expensive, which would likely be the case if everyone was forced to have insurance. This assumes, of course, that the insurance companies aren't smart enough to offer useless policies that meet the legal requirement without actually offering much real coverage.

5. I had a conversation about this with Scott, when he was in the hospital earlier this year. He told me that he'd actually gone to two doctors (presumably the strip mall doctor and the urologist you mention) and both of them misdiagnosed the condition as a prostrate INFECTION and treated him accordingly. I can't say it with certainty, but I would guess that his lack of insurance may have been a factor in the doctors deciding that he didn't need lab work which would have detected the elevated PSA levels. It wasn't until a friend took him to the emergency room in April that his PSA level was taken and a correct diagnosis made. I don't know that the name of the doctor is particularly relevant, to tell the truth, other than allowing someone to be "held accountable" so that everyone can feel better about making someone pay for making a mistake. At this point, that mistake has already been paid for with about the highest cost imaginable.

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Other reader comments on this item

Title By Date
⇒ Response to questions about Scott's insurance coverage [627 words]Matt BlumenfeldOct 20, 2012 23:55
Why did he quit job without money to buy insurance???? [44 words]MarcOct 16, 2012 00:11
Government intervention is responsible for his plight [44 words]Harry BinswangerOct 15, 2012 21:18
Brilliant column by Ira Stoll [171 words]Eliot AmesOct 15, 2012 18:08
Why MUST we bear his burden? [85 words]Tibor R. MachanOct 15, 2012 17:36
More Krug "Journalism"
[w/response] [110 words]
Dan CalabriaOct 15, 2012 17:23
[w/response] [9 words]
Dan CalabriaOct 15, 2012 19:10
If only people were forced to share their toys under a Kristoffian dictatorship [136 words]Dan RandOct 15, 2012 02:25
To answer point #4
[w/response] [83 words]
LyleOct 15, 2012 01:00
Is that a one time thing?
[w/response] [61 words]
LyleOct 15, 2012 12:04
answers from my world [715 words]ChadOct 15, 2012 00:54
Government is not your Daddy [72 words]Harry BinswangerOct 15, 2012 22:46
Your response to Kristof's article [594 words]Matthew ChamberlinOct 15, 2012 00:06
No Dr. Bills [18 words]BillOct 15, 2012 18:39

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