Healthcare
Beginning in 1799, fishermen aboard U.S. registered fishing vessels were provided health care coverage, but that ended in 1981. Since that time, fishermen (in a highly seasonal and dangerous occupation) have found it difficult, expensive, and sometimes impossible to get coverage. Currently, the rate of uninsured fishermen is three to four times the national average. Most fishermen are small business persons who operate their own boats or are crew members. By nature, they’re independent-minded, self-sufficient, hard-working and skeptical. On top of that, fishing crew members move frequently from boat to boat and employer to employer. They can be hard to reach, and hard to convince.
Under the new health care reform bill, outreach to fishing families will be provided for. This outreach will be essential to providing access to care for hard-to-insure groups like fishermen. The health reform bill approved by Congress also provides funding to fishing organizations to assist fishing families to navigate the health system beginning in 2014.
How National Health Reform is Good for Fishing Families
by J.J. Bartlett and David Bergeron
It took more than a year for the U.S. Congress to enact a bill reforming the nation’s health care system. And what an excruciating process it turned out to be! Be that as it may, the new law represents a giant leap forward for fishing families everywhere in the U.S.
On several occasions over the past year, Fishing Partnership Health Plan (FPHP) administrators and board members briefed White House and Congressional staffers on the plan’s success in bringing high-quality, affordable health coverage to Massachusetts fishermen. Those discussions often centered on how the plan worked with fishing industry outreach workers living in the state’s fishing ports to seek out uncovered fishermen and help them obtain health care coverage. Without that kind of outreach, the FPHP would not have been able to successfully reduce the number of uninsured Massachusetts fishing families.
Fishermen have always faced unusual obstacles when trying to obtain quality health coverage. Health insurance in this country is designed to work through employers. The larger the employer group, the better. As we know, fishermen do not work in big offices with human resource departments. Even if they did, who would want to offer coverage to the most dangerous industry in America? As it turns out, few companies do. Fishing families are 3 to 4 times more likely to be uninsured.
Sadly, people without health care coverage are sicker and die younger than people who have insurance. A Harvard study published in the American Journal of Public Health found that 45,000 people die each year because they do not have health care coverage. Furthermore, hundreds of billions of dollars are lost because uninsured, sick workers are less productive or out of work.
The health reform law will change this by ensuring that fishing families will have access to health care coverage by 2014. The law calls for the formation of insurance pools that group together individuals and small businesses. This will provide fishermen with the opportunity to purchase private insurance at a market competitive rate. The monthly insurance bill will be further reduced for those who cannot afford the full rate. This is what we set up for fishermen in Massachusetts in 1997 and it is the model Massachusetts established for all residents in 2006. Now, 97% of the people in Massachusetts have health care coverage.
2014 is a long way away, but there is a lot of work to be done between now and then. Billions of dollars will be spent to train doctors who will work in rural areas, and to build community health centers in places that do not currently have access to health care. This will be very important to fishing communities in places like Alaska. The law changes insurance rules so that insurance companies will no longer be able to deny people coverage because they have a preexisting condition, or kick people off their plan when they get sick. There will be minimum standards so that insurance companies will not be able to take your money and offer you a “junk” policy in return. Moreover, there will be no lifetime limits on the amount of health care you can receive.
None of this will be easy – nothing in health care, or fishing, ever is. The system may remain complicated, but soon grant funding will be available for fishing organizations to educate their members on the health care options that are available to them, and to assist their members in signing up for the appropriate programs. I am proud that the Fishing Partnership Health Plan was able to work with organizations like the Commercial Fishermen of America and the National Family Farm Coalition, to make sure that this outreach funding will be available to fishing, farming, and ranching organizations. Massachusetts’ Senators John Kerry and the late Edward Kennedy, as well as Congressman Barney Frank deserve credit and thanks. When Senator Kennedy was chairman of the Health, Education, Labor, and Pension Committee, he guaranteed that this key outreach language was in the original bill. Senator Kerry was responsible for amending the final reform bill to include this legislation, and Congressman Frank used every minute of the time allotted for him to speak on the House floor to promote health outreach funding for fishing, farming and ranching organizations. Thanks to their efforts, fishermen and fishermen’s wives will be trained to provide health care outreach to fishing families.
We work closely with fishing families, but we are not fishermen. So, we will end with the words of a fisherman’s wife, who wrote to us about what it meant for her to get health care coverage for the first time:
As a fisherman’s wife, I worry. I worry about my husband’s safety. I worry about the weather and the catch. I worry about the boat and the gear. I worry about the many unforeseen expenses that come with this life. I worry about the price of the catch. I worry about rivalry at sea. I worry about the kids, the car, the bills and the cat. But one thing we never have to worry about is health coverage and access to high-quality health care. We know that, if we ever need immediate medical attention, we can get it, no questions asked. That’s a wonderful feeling.
All fishing families and all Americans deserve this security. And now, it’s the law of the land.
J.J. Bartlett is the founding president of the Fishing Partnership Health Plan, which has provided access to high quality, affordable health care coverage to Massachusetts fishing families since 1997.
David Bergeron is the Fishing Partnership Health Plan Vice President.
