The View From Your Sickbed

by Patrick Appel

A reader writes:

My employer offers health insurance coverage, but I have declined coverage because I am HIV+.  I have opted, instead, to purchase very costly insurance through the State of Illinois for persons who have the financial means, but are uninsurable.   My monthly premiums are $730.00. Many people don’t understand why I would voluntarily pay $8,760.00 in health insurance premiums a year when better coverage is offered free by my employer. The fact is, if I were covered under my employer’s group plan, I would astronomically raise his rates because we are a very small office. From my personal experience and the experience of my HIV+ friends, insurance companies all but reveal to employers the identity of the employees that have a big affect on premiums.   While the insurance carrier may not name names, in a small office such as mine it is easy for the boss to identify the “45 year-old male Caucasian non-smoking employee” referenced by the insurance agent. The implied message is, “get rid of that employee, your rates will become more affordable and we won’t have to insure someone so costly.”

Even though I consider myself very healthy and have never suffered an opportunistic infection, my annual prescription costs exceed $26,000.00 a year and my quarterly doctor visits run about $1,200.00 per visit because of the costly lab tests that must be performed.  Without ever being hospitalized or missing a single day of work due to my condition, my annual medical expenses still exceed $30,000.00 a year, and I pay approximately 20% of that out of pocket.

If I were to go on my employer’s health coverage, the unfortunate reality is that I will become too costly to employ.  With small businesses looking for ways to cut costs, it would only be a matter of time before they would find a reason to let me go.  I know it is illegal, I am an attorney, but people who do not believe such things happen in America are delusional.  Good employees are routinely let go for bogus reasons simply because they jack up the employer’s monthly health insurance premium due to a chronic illness.

The truth is, I’d rather spend $15,000.00 a year and keep my job, rather than go on my employer’s group plan and be looking for work in 3 months.