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Self-insured Sitkans hail Supreme Court decision

The Supreme Court’s decision was hailed by some residents. Many fishing families in Sitka are self-employed and therefore self-insured. It’s expensive, with annual premiums into the thousands. Wendy Alderson’s family is a good illustration.

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“We’re a family of three: my husband, myself and my 9-year-old daughter,” she said.

They also own a 47-foot boat named the Katie J. It’s a troller/longliner, and they shrimp in the fall. Alderson fished for a while, but now she’s a stay-at-home mom.

The family carries a lot of insurance: Boat insurance, liability insurance for the crew, home insurance, car insurance.

And they pay $12,000 a year for health insurance. The premium comes with a $2,500 deductible – the amount you pay out of pocket before the policy kicks in. And all of that only covers catastrophic events.

“It’s hospitalization, surgery – you know, I’ve read my policy many times, and I’ve asked my insurer many times, and I’m still completely not sure of what it covers,” she said.

She wasn’t sure about six years ago either, when their daughter, then age 3, fell suddenly and seriously ill.

“We were traveling and we were, luckily, in Seattle. We went to Children’s Hospital and they hospitalized her immediately not knowing what was wrong with her,” Alderson said. “At that scary, scary moment, thinking she had some life-threatening illness, I called my insurance agent. The response was, well, I’m not sure that’s going to be covered. Has there been a surgery yet? So that was not very reassuring to me.”

And if someone in her household needs preventative care?

“That’s the worst. OK, that is the worst,” she said.

They pay out of pocket for basic medical expenses — for example, the glasses Alderson wears. And then there was $3,500 of dental work two years ago. But it’s more than that.

“It’s wondering whether you should go to the doctor or not. It’s knowing that it’s $200 to walk into a doctor’s office, and you may or may not have a prescription that’s going to be $45 to $50,” she said. “It’s kind of scary having a sick kid, and thinking ‘Are you sick enough to go to the doctor? Is your earache going to be gone in the morning?’ We always err on the safe side, but it’s still frustrating.”

So news on Thursday that the Supreme Court upheld President Obama’s health care legislation was, she said, a step in the right direction. Still, she’s like many people we talked to, who offered the caveat that they didn’t know much about the specifics about what the law will do.

“I know what I would hope that it would do for us,” she said. “I hope that it would basically just bring down the cost of our health insurance.”

Proponents of the law hope so, too. The law will include restrictions on how insurance companies can spend your premium. It also requires them to justify any increases of 10 percent or more. Insurance will be available through co-ops, which proponents hope will cut down on costs, and consumers should be able to shop around in different states.

Now that the Supreme Court has upheld the law, Alderson says it’s time to dive into the details, and more importantly, to go deeper than the rhetoric surrounding the law. After all, in principle, she’s for the measure, and she believes it’s a step in the right direction for her family. But she says as she looks into it more, she’ll probably find parts she likes and some she doesn’t.

“You have industry you don’t trust, and you don’t particularly think you like. And you think well, if industry’s against it, then I must be for it. There’s that knee-jerk reaction of them against us. That’s not an educated opinion. You can have an educated opinion, but it shouldn’t be just a knee jerk reaction.”



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