For 18 years Curt and Bertha Lou Tvedt walked a dangerous tightrope: working a farm with no health insurance coverage. “It’s scary,” Curt told me recently. “It kind of sits in the back of your mind knowing that one slip is going to cost you everything you worked for.” And then one morning that “one slip” occurred.
“Boom, I looked down and there are three fingers missing on my left hand,” the southeast Minnesota farmer recalls of that fateful day. He had been working on a total mix ration (TMR) machine when the horrific accident occurred. “When it happens, you get a pit in your stomach. Sixty cows to milk. What am I going to do now? What’s going to happen to the cows? What’s going to happen to me? How am I going to pay the bill?”
Tvedt’s experience is an extreme one, but throughout rural America similar choices and questions arise everyday as farmers and other small business owners struggle with access to affordable health care.
A recent health care insurance study conducted in Iowa, Minnesota, Missouri, Montana, Nebraska, North Dakota and South Dakota found that while 90 percent of the 2,000 farmers and ranchers surveyed said they had some sort of health coverage, nearly a quarter of them reported that the cost of health care was causing them financial problems.
The farmers and ranchers reporting financial difficulties spent on average 42 percent of their income on insurance premiums and out-of-pocket health care costs, according to the study, which was conducted by the Robert Wood Johnson Foundation.
The Land Stewardship Project and other organizations have come to realize that lack of access to affordable health care is a major impediment to sustainable agriculture.
The more time a farmer has to spend off the operation working a town job in order to afford insurance, the less time they have to do the kind of good management required to steward the land properly. This is particularly true when livestock are involved—animals require year-round daily attention.
And farmers and other self-employed people often have individual, rather than group, insurance plans. As farmers, the self-employed and other people have discovered, individual plans make it easier to be denied coverage for pre-existing conditions. People not in group plans are also more vulnerable to significant restrictions on what will be covered by insurance.
That’s why LSP has launched a health care reform initiative by joining forces with more than two-dozen other organizations participating in TakeAction Minnesota’s Affordable Health Care for All Campaign. One important element of this campaign is to tell the stories of average people who are affected by the lack of affordable health care. This is an important antidote to the health care industry’s message: “It’s your fault.”
“These are the kinds of arguments that the health care industry puts out: it’s individuals that are to blame,” Liz Doyle, Public Policy Director for TakeAction Minnesota, recently told a group of LSP members at a meeting in southeast Minnesota. “If you don’t have decent health care, it’s your fault. You must not be taking care of your family. This is your problem to solve as an individual.”
It’s time to take control of the conversation by making sure the people who are most affected by unaffordable health care are heard. Here’s a start. LSP recently produced a podcast (episode 63) featuring Curt Tvedt and a few other Minnesotans who know all too well that “pit in the stomach” feeling when life throws them a curve ball in the form of injury or illness:
• Tvedt, 66, ended up spending approximately $30,000 of his own money to have his mangled hand treated after a farm accident, and was able to eventually return to dairying. But he was recently reminded of how close he came to losing it all when a young dairy farmer he was mentoring had a piece of metal fly into his eye while working on a silo.
The eye became infected and complications set in, calling for some expensive treatment. If the young farmer’s wife wasn’t working in town at a job that provides health care coverage, his ability to follow his dream of milking cows would be in serious jeopardy, says Tvedt.
But both the husband and wife would like to be on the farm fulltime, so they could give the dairy their complete attention.
“I really feel for the young farmers that are starting out in a capital-intensive business, particularly the animal business,” says Tvedt.
• Inga Haugen, 27, recently left a job in the Twin Cities so she could return to southeast Minnesota and farm with her parents, Bonnie and Vance. Her parents welcomed her back on one condition: that she have health insurance.
The insurance company Haugen applied to said her weight made her too risky to insure, even though she is not obese. Now she has coverage, but it’s with a $3,000 deductible. In addition, if she gets pregnant, the plan will not cover medical expenses associated with childbirth. “And I pay more every month for my
insurance than I do for my rent,” says Haugen.• Katie Wera, 27, is a Winona State University nursing student. After graduating from Mankato State University she had a job that provided no insurance coverage. She applied twice to an insurance company and was denied both times because of a pre-existing condition of hypertension. She eventually qualified for a policy after working through an insurance agent and providing detailed medical records.
“But it’s under their conditions,” she says. “Anything in that first year would not be covered if I had a cardiac situation or a complication related to that.”
• Kaye Huelskamp’s husband John was employed by Randall Foods for 26 years when they read in the newspaper that the firm was closing in eight days. John not only lost his job but full health, dental and optical coverage for the couple, who live in rural Lewiston, Minn.
John eventually became self-employed, and they went out on the market to buy their own insurance. At one point the couple was paying $1,365 a month (with a $1,000 deductible) for insurance.
“If we had kept with that plan, we would have been at $16,387 a year for two people,” recalls Kaye.
In 2004 they switched insurers, which lowered their monthly premium to $308 a month and raised their deductible to $3,600.
That soon changed.
“We are now at $673 a month with a $4,600 deductible,” says Kaye. “It more than doubled in four years. Our fear is if we double our premium again in four years and the deductible keeps going up, we won’t be able to afford health insurance anymore. We are in our 50s and that’s a scary prospect for us. I don’t think I know anyone who’s not struggling with the health care system. It’s outrageous. It should be a right, not a privilege, to have coverage.”
These are the kinds of stories—unscripted, frightening, eye-opening—one can hear on a daily basis. These first-person accounts are powerful, and the health care industry knows it. They also know that in order for these stories to be heard, people must listen in a respectful manner. So perhaps it’s no surprise not much of that kind of listening is taking place at all of those loud town hall meetings.
I think Shakespeare described what takes place at such meetings long before co-pays and deductibles were ever invented: “…it is a tale told by an idiot, full of sound and fury, signifying nothing.”