What's your most pressing health care need?

by Andrew Haeg, Minnesota Public Radio

St. Paul, Minn. — Minnesota Public Radio's Public Insight Network team partnered with nonprofit investigative reporting outlet ProPublica to find out how the health care system is affecting the people who rely on it.

We sent a query to people across the country asking them to tell us about their most pressing health care need. More than 500 Americans responded. Their stories, many of which are mapped below, provide a compelling picture of how people are coping with the failures of this country's patchwork health care system.
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Rising costs, tough trade-offs and the high stakes debate over health insurance reform
It's hard to say when exactly it happened. Maybe it was in the late 1990's when the annual growth in health insurance premiums took off, rapidly outpacing wage growth. Or maybe it was back in July, when President Obama started talking about "health insurance reform" instead of "health care reform."

Whatever the case, health insurance—not health care—has become the focus of the health reform conversation in this country. That much was clear from the more than 500 people who responded to the health care query distributed by American Public Media and ProPublica.

When prompted to share their stories about how the health care system has failed them, respondents from across the country rarely talked about long waits in the doctor's office, misdiagnoses, incompetent care providers, or any of a range of other predictable complaints.

Instead many shared stories of struggling to get and hold onto health insurance—or like Jenn Posterick of St. Francis, Minnesota, losing it altogether. She is self-employed, has a pre-existing condition and was refused an individual policy. One insurance company offered her coverage so long as everything related to the condition was excluded. "Applying for health care has been demoralizing," she says, "Sadly, I am considering letting my personal business take the back burner so that I can get some job that will give me health care."

Posterick was one of 500 people who responded to a health needs survey distributed by American Public Media and ProPublica. The survey was self-selecting. Here's a snapshot of who we heard from: The average age, 57, was relatively high, and the median income was about $50,000 per year. Two-thirds of the people who wrote us had private insurance, and of those people, about half received that insurance through their employer. Another 20 percent were on Medicare. A fact that surprised us: Only 11 percent of respondents were uninsured, a lower rate than the national average.

But nearly all people, regardless of income, age or insurance status, spoke of making choices — life altering choices — in order to affford health care.

Wrenching choices
For Jeannette d'Armand of Seattle, Washington, the choice is between doing work she loves and taking a mindless job for the benefits. D'Armand wants to be a singer and a voice coach, but is doing data entry instead because she needs the benefits to pay her $500-plus health care expenses to take care of her Type I Diabetes. "I just feel that if I live in one of the wealthiest countries in the world," says d'Armand, "I shouldn't have to choose between health care and career."

These are high-stakes decisions. But for June of Titusville, Florida, the choice could conceivably be between life and death. She's 62 and self-employed as a math and reading tutor. She can't get health insurance because of two pre-existing conditions, and can only wait for Medicare to kick in three years from now. "If I were to get cancer," she says, "I would have to contemplate suicide rather than bankrupt myself and my family."

It's working fine for some
We asked for stories of health care concerns, and we got them. But we also heard from people who had no problem with their health care or health insurance. Bruce Jugan of Los Angeles, California had both hips replaced -- a procedure he scheduled only weeks in advance. His insurance paid up, and all is well. "We pay a lot for health care and insurance," he says, "but we also get a lot."

Health care questions
Everyone seems to have a story to share about the health care system—and a question too. Many wondered why talk of a single-payer system had seemingly been taken off the table, when it seems to be working reasonably well in other countries (Canada and France to name two). Many asked how much power big pharmaceuticals and insurance companies were wielding, and how much they're influencing the debate over the future of health care in America.

Many others wondered why the focus wasn't more on smoking, overeating and other lifestyle choices that are driving up health care costs for the rest of us. Paul Zurawski of Washington, D.C. was overweight but is no longer, and has family members who have quit smoking. Given that experience, he says smoking and overeating are choices, and, "These choices, reaffirmed daily by individuals, are driving up costs for everyone," he says.

Over the coming months, we will be following up with respondents for further help guiding health care reporting across American Public Media's programs and services, including Marketplace and Minnesota Public Radio News. ProPublica will also drill down into some of the themes that have emerged from the responses. You can follow the coverage on ProPublica's web site.

Share your experience with the health care system.