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Opinion: It’s More Unaffordable to Not Have Health Insurance

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As someone who has been self-employed as a rideshare driver and a freelance writer, I’ve received a crash course in making sense of the quirks and complications of the American healthcare system.

With full-time employment, in some cases, employers pay all the health care insurance costs. In other cases, they pay half. When your monthly premium is $400, that $200 subsidy could go a long way.

I’m single, but it’s even worse for families. My brother, who has a wife and two children, pays more than $1,000 for his monthly premium. Fortunately, he makes a good living and can afford it. But many families can’t.

“The total costs for a typical family of four insured by the most common health plan offered by employers will average $28,166 this year,” according to the annual Milliman Medical Index, an independent assessment of health costs provided by a private risk management firm.

I tried to do the responsible thing and buy health insurance, but it becomes prohibitive when you have to foot the bill yourself. Companies were quoting me premiums averaging about $400 per month – even with Obamacare, which is still too expensive and forces you to buy into the complicated healthcare system.  Even with additional Covered California subsidies the costs are still high for freelance workers.

But after I fell ill during the COVID-19 pandemic, I learned the high cost of not having health insurance, too.

I woke up in the middle of the night, experiencing the worst pain I’ve ever had in my life. I finally called an ambulance and was transported to the hospital. I stayed in the hospital for about six hours. They never performed any surgery on me, or gave me any medication. (I had a kidney stone) But when I got the bill, it was about $15,000. Now, I’m buried in paperwork as I try to get rid of this debt. It’s no wonder that healthcare costs are the No. 1 source of bankruptcy.

But people have to ask themselves, can you afford not to have health insurance? I chose to risk not having it and now I have nearly $15,000 in medical debt. The worse thing is this: even if I had medical insurance, I still would have had a large bill. However, I realize that owing $7,000 in medical bills is not worse than close to $15,000.

I finally bit the bullet and decided to buy an HMO program that costs me close to $350 per month. That’s not an easy bill to pay. When I complained about the cost to a friend, she told me I’d be better off saving the money. But I’ve already been down that road.

Therefore, I urge everyone in situations similar to mine to sign up for insurance through Covered California. It’s necessary. Open enrollment began November 1 and runs through Jan. 31, 2021.

And yet, I must point out that though Medical insurance is supposed to protect against medical debt, you still get hit with a pile of bills. As Massachusetts Sen. Elizabeth Warren said, medical insurance doesn’t work. It’s false advertising.

In 2005, Warren was one of the authors on a Health Affairs paper documenting a memorable statistic: More than 40 % of all bankruptcies in America were a result of medical problems. In 2009, they updated that research with an even more startling number: Medical bills were responsible for more than 62 % of all American bankruptcies.

I favor a single-payer system where everyone gets covered. It also lowers health insurance costs because it reduces the administrative and advertising costs for companies. And no matter what the for-profit healthcare talking points tell us, single-payer systems are more efficient.

The United Nations rated the French healthcare system the most efficient, and that’s a single-payer program. And you don’t see large numbers of Canadians crossing the border to go to American for-profit hospitals.

According to retired healthcare executive Randall Potter, the health insurance industry poured millions into a stealth propaganda campaign when director Michael Moore came out with his movie ‘Sicko.” The 2007 movie pointed out the flaws of the American for-profit system and showed how other countries had much more efficient health systems.

“The industry knows from years of focus group message testing that terms like ‘socialized medicine’ and ‘government-run health care’ scare many Americans and that many of us respond favorably to terms like ‘choice’ and ‘competition.’ Based on this knowledge, there were several big lies I helped craft — and that are still in circulation today,” said Potter in an NBC News article.

Whatever the answer is, we need to try something different, because this current system isn’t working. Just look at my story, and there are millions of people like me.

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Returning to Its Roots, the Oakland Black-Eyed Pea Festival Partners with the Freedom Farmers Market Sept. 12

POST NEWS GROUP — Freedom Farmers’ Market (FFM) vendors sell produce and promote wellness and nutrition through organic herbs, massage, and other gift items from July through October on the second and fourth Saturdays at a dozen canopies in the last block of Shattuck Avenue, where it merges with Telegraph Avenue.

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Elaine Smith, executive director of Farms to Grow, Inc., holds T-shirt for Ki’Ara LaFitte, winner of the Freedom Farmers’ Market Watermelon-Eating Contest at the season opening on July 11. Courtesy photo.

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The Oakland Black-Eyed Pea Festival (BEPF), a celebration of African American traditional music, food and art, will return to its roots through a partnership with Farms to Grow, Inc., the hosts of the Freedom Farmers’ Market on Sept. 12.

Now in its 11th year, the downsized festival sponsored by Omnira Institute will open with presentations by Wakan Wiya Two-Spirit Drum, a drum invocation for the ancestors by Awon Ohun Omnira, a performance by Andre Thierry of Accordion Soul, and most importantly, fresh black-eyed peas for sale.

Freedom Farmers’ Market (FFM) vendors sell produce and promote wellness and nutrition through organic herbs, massage, and other gift items from July through October on the second and fourth Saturdays at a dozen canopies in the last block of Shattuck Avenue, where it merges with Telegraph Avenue.

Over the years, FFM vendors have appeared at the Black-Eyed Pea Festival and vice versa, so this collaboration is like a family reunion.

Farms to Grow, Inc. Executive Director Elaine Smith said the collaboration with Omnira Institute was an opportunity she couldn’t refuse. “People talk about community and unity for Black people – I always want to be an example of what has to be done,” Smith said. “Anyway that we can partner with our people, we want to do that.”

Charlotte Jackson, a longtime vendor with FFM and the festival, had been known for her jellies, jams and chow-chow through Pots n’ Jars. For the last several years, she hasn’t been able to find a commercial kitchen she can afford, so she began selling vegan soap and skin care products that her son and his partner produce under the name Lather and More.

“It’s been a blessing,” said Jackson, who will tell her customers that although they can order the wares from the website, there’s no such thing as ‘smell-avision.” From her table, she encourages passers-by to take a sniff of the soaps, then directs them to the nearby booths.

Jackson functions as a sort of ‘town crier’ of ‘buying Black,’ never failing to encourage Black people to take their mule or Pontiac or Chevrolet and steer it toward Black businesses like Mandela Market.

Likewise, the Black-Eyed Pea Festival was established to encourage Black entrepreneurship by providing a space for Black creatives to sell their handmade or original designs and products without competing with commercially produced goods.

It also served as a way to both commemorate and invigorate memory of the once-thriving Black community of West/North Oakland before it was divided by highways, BART, and then ravaged by the crack cocaine epidemic.

“For one day, I wanted to invoke the success of that community through the sound of music, the taste of soul food and black-eyed peas and the beauty of our art,” Ravernell said.

Once deciding to follow through on the idea of holding a festival celebrating African American traditions, Ravernell settled on using the black-eyed pea as its symbol because of its pride of place in Black people’s consciousness on New Year’s Day and because the peas were originally cultivated in Africa.

Learning that Fresno farmer Wil Scott, former president of the California African American Farmers Association, grew black-eyed peas as well as other legacy crops that are the foundation of a soul food menu, Ravernell was intent on ensuring Scott’s presence at the first festival in 2014. Whenever he could, and whenever the weather yielded a bountiful crop, Scott would bring his black-eyed peas to the festival, shelled or on the pods.

Originally cultivated in Africa, the black-eyed pea is believed to have been brought to the U.S. hidden in the hair of African captives brought to the Western Hemisphere during the holocaust of the Atlantic Slave Trade.

Known to grow plentifully even in poor soil, the pea was associated with abundance in Africa and later, in the U.S., with good luck.

She also learned that black-eyed peas nourish poor soil, that they are a very good source of nutrition, and that they probably contributed to the longevity of the enslaved.

“I thought the black-eyed pea, its story and its significance for Black people made it a great symbol to represent Black culture,” she said. In spite of everything they endured, Black people emerged from slavery and Jim Crow as masters of making a lot from a little, creating a culture that would be emulated and imitated at home and abroad.

Feeling that many people know only the most recent iterations of Black music – Hip Hop and R&B – she created the festival to promote the music of earlier eras, which reflect the thoughts and feelings of Black people over time.

That’s why the festival highlights straight-ahead jazz, gospel, zydeco and the Second Line of the New Orleans jazz funeral.

“It’s not enough to remember,” Ravernell said. “We need to actively nourish the roots of our culture.”

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Business

NPRC Scores First Advocacy Victory: David Shaw Finally Gets His Wish to ‘Go Home’

POST NEWS GROUP — The National Probate Reform Coalition (NPRC), formed by the Post Newspaper Group in January following years of reporting on alleged abuses within the probate court system, helped Beverly secure the return of her husband, along with the couple’s property and assets.

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Beverly and David Shaw were separated by a hospital after Beverly took David there to treat his dehydration. The hospital determined Beverly was not caring for David property and placed him under their guardianship. Courtesy photo.

For nearly four years, Beverly Shaw fought to bring her husband home.

She watched as David Shaw moved through three nursing homes, became increasingly sedated and repeatedly expressed his desire to return to his wife. Last week, that finally happened.

The National Probate Reform Coalition (NPRC), formed by the Post Newspaper Group in January following years of reporting on alleged abuses within the probate court system, helped Beverly secure the return of her husband, along with the couple’s property and assets.

For NPRC, the Shaw case represents its first major advocacy victory. For David, it means something much simpler: He finally got to go home.

In a letter to the court, Beverly raised serious concerns about her husband’s care at Riverview at the Park Nursing Home.

She alleged that David was frequently heavily sedated and questioned whether his medications were properly documented. She said an aide told her medications were sometimes administered without proper charting, although she acknowledged she had not independently verified that information.

Shaw also said she was unable to obtain David’s medical records and questioned medications he was receiving despite previous medical instructions following his 2023 stroke.

“I believe David has been subjected to abuse, neglect, and unnecessary chemical restraint,” Shaw wrote.

The allegations are Shaw’s account and have not been independently established. But they raise questions central to NPRC’s mission: Who is watching when a vulnerable person becomes subject to guardianship? Who is accountable when family members say they are ignored? And who makes sure the person under guardianship, not the professionals surrounding them, remains the priority?

“Please let me go home”

Perhaps the most compelling part of Shaw’s case was David’s own voice. Shaw told the court she possesses recordings in which David repeatedly expressed his desire to return home.

After 45 years of marriage and four years apart, Beverly argued that David deserved the opportunity to spend his remaining years at home with his wife, receiving individualized care.

NPRC responded with a “Request for Compassion” letter-writing campaign to Judge Thomas Inman, Associate Circuit judge for Ste. Genevieve County, Missouri. The coalition also helped Shaw pursue appropriate legal filings and engaged with her attorney to press for action.

The court ultimately returned David to Beverly’s custody and restored the couple’s property and assets.

“What we have here is the power of coalition,” said Alee Carrino, an NPRC planning committee member. “We applied pressure from all sides, and it worked.”

The victory comes during NPRC’s eighth month of organizing for probate reform. The coalition advocates for greater judicial and governmental oversight, court ombudsmen, mandatory mediation, transparency in probate billing and stronger protections for elders and disabled people.

The Shaw case sends a powerful message: Guardianship is supposed to protect vulnerable people, not permanently separate them from those who love and care for them.

David Shaw asked to go home. His wife fought to bring him home. NPRC supported her every step of the way, and this time, the system listened.

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Commentary

ESSAY: California Can Close Its Colorectal Cancer Gap

POST NEWS GROUP — The numbers are stark. From 2014 through 2018, the age-adjusted colorectal cancer incidence rate was 40.2 cases per 100,000 Black Californians, compared with 35.8 among non-Hispanic White Californians. The mortality rate was 25.3 deaths per 100,000 among Black Californians and 17.7 among White Californians—a 43% difference.

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Dr. Gracie Ann Dinkins, left, and Sydney Y.K. Brown, MA

Every breakthrough in cancer care carries a promise: earlier detection, better treatment and longer life. California has helped deliver that promise through world-class cancer centers, a statewide cancer registry and major public-health investments. Yet colorectal cancer still exposes a painful divide: Black Californians are more likely to develop the disease and far more likely to die from it than their White neighbors.

The numbers are stark. From 2014 through 2018, the age-adjusted colorectal cancer incidence rate was 40.2 cases per 100,000 Black Californians, compared with 35.8 among non-Hispanic White Californians. The mortality rate was 25.3 deaths per 100,000 among Black Californians and 17.7 among White Californians—a 43% difference. 

A later state analysis showed that the incidence gap remained in 2021, at 39.0 versus 35.0 cases per 100,000.

These differences should not be treated as an inevitable consequence of biology. The more revealing explanation lies in what happens—or fails to happen—across the cancer-care continuum: prevention, screening, diagnostic follow-up, treatment and surveillance after treatment.

Colorectal cancer is one of the few cancers that screening can sometimes prevent. Colonoscopy can find and remove precancerous polyps, while stool-based tests can identify people who need further evaluation. The U.S. Preventive Services Task Force recommends screening for average-risk adults from ages 45 through 75, with several acceptable options. But a screening test saves no one if it is never offered, never completed or not followed by a timely colonoscopy after an abnormal result.

California’s cancer-burden report shows both the urgency of the problem and a troubling data gap. Nearly six in 10 colorectal cancers were diagnosed at a regional or distant stage among both Black and White patients from 2009 through 2018. The racial difference in stage was not statistically significant. Yet, the registry report did not include screening information, so it could not show who was offered a test, who completed it or who received the necessary colonoscopy afterward. It also did not assess whether survivors completed recommended follow-up. California can count cancers and deaths, but it cannot yet see every missed opportunity that produced them.

The disparities become clearer after diagnosis. A California Cancer Registry study of nearly 27,000 people with stage I through III colorectal cancer found that Black patients had 39% higher odds of receiving less than guideline-recommended treatment and 78% higher odds of waiting more than 60 days for treatment than White patients. Neighborhood socioeconomic disadvantage explained part of the substandard treatment, but racial differences persisted even after researchers accounted for where patients lived.

Survival reflects the accumulation of these missed opportunities. Among Californians diagnosed from 2009 through 2013, five-year relative survival was 58.8% for Black patients and 65.1% for White patients. After researchers adjusted for age, insurance, neighborhood income, stage, chronic illness and other factors, the survival difference was no longer statistically significant. That does not make the gap less serious. It identifies much of it as potentially preventable: when access, timing and health conditions are unequal, survival will be unequal too.

California already has proof that a better system can work. Kaiser Permanente Northern California built an organized program that identified eligible patients, mailed annual home stool tests to those overdue, offered colonoscopy as an alternative, and tracked abnormal results through follow-up. Screening among Black members rose from about 40% in 2009 to 80% in 2019. Over the same period, their colorectal cancer death rate fell from 54.2 to 20.9 per 100,000, essentially eliminating the Black-White mortality gap within that health system.

The lesson is not that every Californian must join one health plan. It is that equity requires organized care rather than reliance on chance encounters. Mailed screening outreach, patient navigation and guaranteed follow-up colonoscopy should become standard across Medi-Cal, county health systems and community clinics. Health systems should publicly report screening completion; time from a positive stool test to colonoscopy; time from diagnosis to treatment; receipt of guideline-concordant therapy; and completion of post-treatment surveillance—each stratified by race, insurance, and neighborhood.

Transportation, paid time off, bowel-preparation costs, childcare and distrust are not side issues; they determine whether patients can complete care. Community organizations, churches, clinicians and public hospitals should help design outreach from the beginning, not merely deliver messages created elsewhere. Survivors should leave treatment with a clear surveillance plan, navigation support and reminders that do not disappear when active therapy ends.

Closing California’s colorectal cancer gap is achievable. The state has the tests, specialists, data systems and proof of concept. What it needs is the will to connect them. Success should be measured not only by how many cancers we treat, but by how many we prevent, how quickly we act and whether every Californian has an equal opportunity to survive.

About the Authors 

Gracie Ann E. Dinkins, MD, FACS, is a Clinical Assistant Professor of Surgery and Surgery Clerkship Director at the Charles R. Drew University College of Medicine, Department of Surgery. Her mission is to help realize the CDU vision: Excellent health and wellness for all in a world without health disparities.

Sydney Y. K. Brown, MA, is a medical student at the Charles R. Drew University College of Medicine whose work focuses on clinical research, community engagement, and health equity. She is committed to advancing equitable access to high-quality care and improving health outcomes in underserved communities.

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