Holding On To Health Insurance That Works For some Americans, insurance is what it's supposed to be: coverage when you need it. Dave Koenig, 49, has a job with good benefits. Still, he thinks some aspects of the insurance industry should be changed to protect patients from losing coverage.
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Holding On To Health Insurance That Works

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Holding On To Health Insurance That Works

Holding On To Health Insurance That Works

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From NPR News, this ALL THINGS CONSIDERED. I'm Melissa Block.

President Obama's plans to overhaul the health-care system depend on one key group: the people who already have insurance, generally through their employer, and who like what they have. According to the latest census report, more than 175 million Americans currently have employment-based insurance.

From Capital Public Radio, Kelley Weiss reports now on one insured American who is nervous about all this talk of reform.

KELLY WEISS: Dave Koenig is a tall guy with a buzz cut. He's 49 years old and a manager for a tech company, Hitachi Data Systems. He lives in a pristine suburb of Sacramento with his wife and 8-year-old son.

Mr. DAVE KOENIG (Manager, Hitachi Data Systems): Hot out, very hot.

WEISS: On a 100-degree day, he's looking out over his pool.

Mr. KOENIG: A bunch of fruit trees in the backyard: peaches, pears, oranges, apricots, cherries, plums.

WEISS: There is a foosball table on the patio and a hammock in the shade.

Mr. KOENIG: It's kind of a quiet, pretty expensive neighborhood. Guess we'd probably be considered middle to upper class.

WEISS: And his high-paying job doesn't just mean a nice house. He also gets pretty decent health benefits. It's private insurance through Blue Cross. He pays a monthly premium of about $300 for his family's coverage.

Mr. KOENIG: And my current insurance through my company is wonderful. I pay co-pays for doctors' visits. I pay a co-pay for prescriptions. Through the six or seven surgeries I've had in the last five years, I've never paid a dime to a hospital, an anesthesiologist, blood work. I haven't paid anything. It's been fully covered. So I'm, of course, very happy with my insurance.

WEISS: A sports injury one and a half years ago caused some of those many surgeries.

Mr. KOENIG: I was playing racquetball, started to feel a pain in my upper leg, lower back. The pain got worse over a day or two or three, so I went in to see my doctor. It was very cut and dry: We're having this test done. The MRI showed I had two ruptured discs in the lower part of my back. They referred me. I had the surgery done. I went through rehab, and now I have no problems.

WEISS: Things weren't always that easy. In the early '90s, he was laid off and went without insurance for several months. He says it was an uncertain time, and he sympathizes with the millions of Americans who don't have coverage or at anytime could be dropped.

Mr. KOENIG: I mean, you hear horror stories about people who have insurance, and then all of a sudden get denied coverage somewhere down the line because they may have had a pre-existing condition.

WEISS: And that's why Koenig is on board with parts of the big push to change the health-care system. But he says the focus should be on regulating the insurance industry and not what he believes President Obama is pushing for: a government takeover.

Mr. KOENIG: I find that scary for me personally because right now, I've got what I feel is great coverage from my company. Tomorrow, it could all change. You know, I don't know. I don't want to see massive overhaul. I can see reform taking place in areas. But do I want the system mass - you know, overhauled? No. And I don't think the majority of the people in the country want it overhauled.

WEISS: Koenig keeps going back to the fact that in his experience, health insurance has been great. He points out a smiling woman in a family photo in front of Niagara Falls.

Mr. KOENIG: That's my younger sister there, her three kids, her husband, my mom and dad, and then all of our kids. Well, the two oldest aren't in here.

WEISS: Five years ago, his sister, Jane, collapsed while out for a jog.

Mr. KOENIG: Had the heart attack running into a court. And it's just -she got lucky that some neighborhood women were out for a walk, and they walked by and saw her lying on the ground, gasping for air.

WEISS: Like him, his sister has good, employer-based health insurance. She gets it through her husband, who is a vice president of a credit union.

Mr. KOENIG: She's 46 now. She was 41 when she had her heart attack, 41 when she had her transplant, so they ended up finding a genetic heart defect. She had full coverage so, you know, I guess we just didn't even think about it at the time, but thankful for it now.

WEISS: And this is what Koenig is worried about: that the insurance he and his sister are happy with will change under a complete overhaul, whatever President Obama says.

For NPR News, I'm Kelley Weiss in Sacramento.

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