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Penny Ericson (an alias), Los Angeles, California
Penny Ericson, a self-employed transcriber who lives in the vastnesses of Los Angeles, feels like a yo-yo, so furiously has her health provider, Blue Cross, jumped her premiums up and down over the past decade. In the past two years, the movement has been all upward, and she is now paying roughly $1,700 more a quarter than she did when she joined Blue Cross and double what she was paying in 2001.

The numbers tell part of the story. When Penny joined Blue Cross in 1988 she was paying a little more than $200 every quarter. Over the ensuing years the premium price has jolted around like a downed power line on a dark, rainy street.

In 1993 Penny was paying almost $800 a quarter. In 1996 it was a bit higher than $800. In 1998 it jumped to more than $1,200 and by 2000 the per quarter premium was some $1,600. Then, inexplicably, in 2001 the quarterly premium dropped to just under $1,000, and remained there for six months. Later that year, it went back up to $1,200. In January the following year it climbed to $1,500 and then to $1,600 later that year. On the most recent bill, the quarterly premium was more than $1,900. Penny is paying more than $7,800 a year, and that does not include either dental or vision.

As the numbers rocket upward, the coverage declines. Penny says her plan has gone from 75-25 coverage to 70-30. A prescription for a medication she uses on a regular basis that she filled last month for $30 now would cost her $165. Her Blue Cross plan offers generic prescriptions for $10, but in Penny's case the generic drug does not work. Penny indicated that she is allowed to appeal this cost.

The numbers tell only part of the story. They don't reveal the tremendous emotional fallout on Penny and other health care consumers caused by the uncertainty. In fact, Penny, feeling victimized many times over by health care providers, is so distraught that she is not using her real name in this interview; she is afraid of repercussions.

"It's made me crazy," she says. "When I get a letter from Blue Cross I'm in tears even before I open it, When I call them to ask for an explanation, I cringe."

Penny's anxiety results mainly from fear of her future brought about by rising health costs and uncertainty about what is coming next. "I never know from day to day what they're going to do," she says.

Penny's disquiet is exacerbated by the fact that she feels trapped. She has pre-existing conditions, which has left her deathly afraid to leave her health plan. She worries that in today's world of health insurance another plan either won't pick her up or will charge far more than she can afford.

Penny has several medical conditions for which she is receiving treatment. Because of 'all this history" she feels she has no choice but to suffer through whatever Blue Cross hands her.

In fact, she worries that given her past medical problems, Blue Cross might be actively looking for reasons to cut her loose. "My insurance agent told me to never miss a payment. I'm in one of those groups where they'd love me to screw up."

So Penny, 55 and self-employed, goes about her business and wonders what is coming next from the people who are supposed to give her some solace about her health. Her only comfort is that her husband is covered through his work. As to her, "I'm petrified."

Penny is angry that this is allowed to happen. She wants to see the state have control over insurance companies. She wants costs controlled without a decrease in benefits. She would like to see regular audits of the books by an independent body not connected with the health care industry.

Most of all, Penny says, "I want to see some fairness."