This is our family's health care story. It's for anyone who thinks the public option in health care is for lazy people who just want to live off other people's taxes—you know, "those people.”
When B. and I got married in 1998, he put all of his income into his new construction business and I supported us for a short time with my income. Our health insurance came through my employer. A little over a year later, when our first child was born, our insurance company refused to pay for my emergency Caesarean birth for over 7 months, even though my employer had always paid my premiums on time.
The bill was over $16,000 and the obstetrician’s office was increasingly angry with us. B and I were getting desperate. Finally, I called the insurance commissioner and filed a complaint. Long story short: The insurance company paid the claim. But the commissioner's staff then told me that the refusal to pay claims is routine practice for insurance companies, and that they count on the fact that some people--whether it’s because they are too sick or just don’t know their rights--won't speak up.
We have three children. I became a stay-at-home mom when our first was born, and since that time, our insurance coverage has been a disaster. First, we started paying COBRA at full price. Then we tried going in for a co-op insurance, but the group discount was miniscule, and the premiums were raised every year at an alarming rate. We tried switching to another, lower premium insurance, but that had so many hidden costs, we could never predict what our health care costs for one month would be—even to the nearest hundred! Finally, we switched back to the higher premium plan because it was a predictable amount. The last premium that we paid was $1,126 for one month. That generous plan included $25 copays for office visits, $50 copays for ER visits, and ZERO prescription coverage.
That was a long time ago. When the insurance company jacked up our monthly plan to $1200, we had to give it up. It was like having two mortgages.
For those of you who are under the impression that socialized systems have no place in this country, please consider the whole notion of public school. Sure, it has room for improvement, but what's the alternative? Pay private tuition rates for all children, 2 to 22, if you're lucky enough to have the money? Lead an uneducated life?
I'm really upset by being referred to as "those people” by people who think we’re trying to sponge off the system. B. and I pay our taxes. He owns a construction business and I’m a teacher. I volunteer on a regular basis. Have the people who insist that we’re “those people” done the same?
What I want from my health care is actually pretty simple: I want to go into a doctor's office when I am sick, to have that doctor be familiar with my file and to have my insurance company to pay legitimate claims.
More than anything, I want everyone understand that right now, insurance companies in the country are punishing people like me to make record profits, and if we’re going to stop them, we have to change our system from the bottom up.
User post: In the current health care system, we are "those" people
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Posted by Thu Oct 15, 2009 9:24am PDT
Report AbuseThe sad reality is that your story is too common. If the insurance companies can't deliver better care at a better value, why should they even have a seat at the table? Imagine if policing, instead of being "socialized," were carried out by for profit militias who only protected those who could pay? Besides administrative overhead, what would be lost by eliminating the for profit insurance sector entirely?
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Posted by Thu Oct 15, 2009 9:35am PDT
Report AbuseWell said! I have employer provided health insurance that is fully paid by my employer at no cost to me but in order to cover my children I would have to pay $400 a month for each of them and then of course my spouse would also be charged that amount. We both work hard and pay taxes and yet there is no way for us to afford medical coverage. Luckily President Obama raised the income guidelines a little bit this year so my children qualified for the childrens health program in my state for free. The past couple of years I paid $40 a month for this same coverage and that was a godsend. My hubby of course still has to pay, his employer used to cover half until about 6 months ago and then he informed us he could no longer afford to do so, now we pay $80 per week. We will have to cancel it soon and hope he doesn't get sick. So Sad. I have a feeling that a good amount of the people that oppose the plan can more than afford health insurance and have never had to live in discomfort or pain because they can't afford to go to a doctor or dentist.
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Posted by Thu Oct 15, 2009 10:39am PDT
Report AbuseI truly think that insurance companies have no place in healthcare. Why should they be making ridiculous profits out of people's misery. Granted some people's health problems are attributable to lifestyle, but many, many more just happen to suffer from health problems through no fault of their own.
I am British, having lived here in the States and still cannot get used to the role that money plays in healthcare. I grew up knowing that being sick meant going to see a doctor if warranted and all that was involved in that visit was making an appointment, being treated and if necessary prescribed a medication that was not maybe going to cost an arm and a leg. None of this producing an insurance card, paying a copay and waiting for the EOB to arrive and checking it and maybe spending a lot of valuable time on the phone trying to get the insurance company to process the claim involved.
I am the mother of a 26 year old with a chronic disease who suffered a debilitating infection due to medical neglect, whilst a student. Her recovery was greatly affected by the fact that she had to remain a student and take courses, in order to keep her health insurance. Her health deteriorated and as of this time, she is considered disabled. However, if her condition improves from being "disabled", she will be without insurance as she will have timed out. I laud President Obama's efforts at healthcare reform, but would wish that a public option were offered. Penalising those who can't afford insurance will not help those who don't qualify as being disabled and who can't hold down a job because of their health.
Let me end this by saying that my family has very good health insurance coverage, but we are lucky and my heart goes out to the sick who can't get health insurance. Healthcare should be the right of all Americans.
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Posted by Thu Oct 15, 2009 10:53am PDT
Report AbuseGreat article and thanks for providing your perspective. I am currently covered by my employer, but my boyfriend lost his job in July, and of course his insurance. COBRA is a joke. It would have cost us half of his monthly unemployment benefits, and those are barely enough to cover the bills. And even if we were married, my insurance only covers me with no option to cover a spouse. He has started working again, but still can't get health insurance since he is considered an independent contractor and we cannot afford it ourselves. We are crossing our fingers that he doesn't get sick until we get married and I can find a job that will provide health insurance for both of us.
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Posted by Thu Oct 15, 2009 11:22am PDT
Report AbuseThe insurance companies say a public option would be unfair competition. I say: a public option would be FAIR and necessary competition.
If the insurance companies are threatened by a public healthcare insurance option - perhaps it is because they fear honest competition - competition that presents a fair and honest alternative to their highly profitable dis-honest, unfair practices, which have built-in loopholes in their policies, which allow them to cut people off when they most need healthcare benefits.
We need a public healthcare insurance option under which people will not face lifetime limits to insurance coverage (after which bankruptcy or death become the only choices for people stricken with catastrophic illnesses).
I firmly believe that it IS possible to offer a cost-effective non-profit option to the public. [ for example: Medicare appears to be quite successful. and it is non-profit. and it is run by the government.]
However, hand-in-hand with a public healthcare insurance option, we must also insist that everyone must buy health insurance [For that we'll need a system which pro-rates required premiums in line with ability-to-pay]. And then, if someone still refuses to purchase any form of health insurance, then they must accept that they – and NOT the public coffers – will bear the financial burden of any and all of their future medical costs. Without such a requirement, public healthcare insurance will fail, if/when the voluntarily-uninsured - who chose to contribute nothing into the system, show up expecting “free” care when they do become sick. ]
And, if the insurance companies can't compete with public healthcare insurance and still make a profit ?? Well - that's how capitalism works, isn't it?? No-one, no company, no group of investors or shareholders, is ENTITLED to make a profit when they run a business. If the insurance companies can't compete - then perhaps they SHOULD fail.
Let's have a real, viable, rational, affordable, public healthcare insurance option for the general public
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Posted by Thu Oct 15, 2009 11:29am PDT
Report Abusethe great thing about the "socialized medicine" agenda is that it does NOT have to like every other countries we can tweek it to help our country......im right there with ya watp
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Posted by Thu Oct 15, 2009 11:52am PDT
Report AbuseI agree very much with all of you above! Good points! But there are a couple of points missing. Currently in many locations of the country there is a shortage of health care professionals. How are we going to get good care with a shortage of health care professionals? There is a shortage of health care workers, yet to get into a nursing, physical therapist or medical career takes years of education, expense and interning. There are so many apsects to this issue that haven't yet been turned over. I think we need to address them and keep all this in mind as we evaluate and change the system.
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Posted by Thu Oct 15, 2009 12:08pm PDT
Report AbuseI'm 33 years old, single and I have mild spastic cerebral palsy and epilepsy. I also have adhd, low testosterone and I'm infertile. I work, part time at minimum wage. I have no college degree and the highest I ever earned was as a supervisor for $27k per year for a three year period (left the job on a bad note). I have no insurance through work, and the only insurance I could get was a medical savings plan (discounts only) and I have a 2 year waiting period for pre-existing coverages to start. I'm cancelling it though because of tight finances. My 49cc scooter I've been using since march (is always broken down) so I'm switching back to cycling to work, and my dog is hurting really bad right now too and needs vet care but the folks refuse to help. So insurance has to go and the medical help I need will have to wait for another day.
On a side note, I've also been robbed 3 times at gunpoint, had a vehicle stolen from my works parking garage and totaled by an accident caused by the thief. I also had another vehicle repo'd due to the bankruptcy.
Meanwhile, my body is getting worse, I'm in more pain, all my joints are shot. I have to ride a 34 year old 18 speed bicycle again, 3 miles to work, and I filed chapter 7 bankruptcy earlier this year. My teeth are horrendous (probably need dentures), need new eye glasses for sure, need hearing aids (don't currently have but got tested last year). I've been living with my parents for the past 3 years, I'd be homeless if not for them. And I have a very bad cigarette habit right now (stress, wonder why?). Oh, forgot about my knee surgery (workers comp) about 10 years ago, which has been making my knee act up a lot lately and my good knee is starting to go.
Is there where I should say, "Life is great, sign me up for more."? LOL
Anyhow, I am not disabled enough for SSI or SSDI or whatever, to young to retire, but I'm disabled enough to where it has ruined my life, as have the other things that have occured in my life.
Socialized health care sounds good to me. It's not much at this point, but I'll take anything I can get. It's got my vote.
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Posted by Thu Oct 15, 2009 12:26pm PDT
Report AbuseI am a nurse, I am uninsured. I can't afford the health insurance. It is too costly. or it covers next to nothing. I don't understand how the insurance co thinks we are foolish enough to put hard earned money up front to them while they refuse to cover care. I see hospitals across this country going into building plans to take care of the rise in ill people they expect to see. While at the same time fighting to give staff fair reasonable manageable assignment and giving staff propaganda about the need to cut expenses. So, there is no raise. And, the best is the laying off of ancillary help while expecting us to be responsible for more. How many of you out there know the rumor that Hillary Clinton said no nurse should earn more than $12/hr. I for one will walk the 1 mile from my home & get a job at the McD or another fast food place for the $10/hr they pay. I won't have to be exposed to unknown communicable diseases or violence from confuse patients or from angry visitors. I won't be cussed out by Doctors who are mad because I have called them about a crashing patient in the middle of the night or because I can't answer all of their questions about a patient I just assumed care of that they have seen for days in hospital. I won't have to spend large sums of money for continuing education or uniforms or stethoscopes that disappear. Don't get me wrong. I love nursing. It is a very rewarding career, but when a community forgets who the caregivers are or devalues your worth (that community being the organization you work for, the Doctors whose patients you take care of, and the politicians who are in office making the laws concerning our roles) it makes me wonder why I continue to do it. It is for the patient. But realistically, I must be able to pay my bills, too! I don't want to go on food stamps to eat. I don't want to work paycheck to paycheck. Nurses are routinely called off or asked to stay over or to work extra. We are human beings also. Please try to remember that. Personally I believe that insurance should be nonprofit. I'm sure they would find a loophole just like nonprofit hospitals do. Hospital assns, Doctor assns, & Insurance all have big $ lobbyists in place to speak for them. Who speaks for the average american citizen who does work & can't afford or is too wise to throw their $ away on coverage that isn't really coverage at all?
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