We Need Health Care Reform

This is not a political issue. This is not a party issue. This is a human issue. Every one of us, insured or uninsured is one major illness away from a catastrophe. No matter how well insured you think you are or how well off you think you are, one major illness could wipe you out. No person should have to go bankrupt in order to preserve his or her life.

I’ve stayed quiet on this for as long as I think is rational, but I can’t stay quiet any longer. Consider this. My insurance company covered the birth of our daughter. They didn’t balk at the extra expenses of more exams because the pregnancy was high risk, but they did refuse to cover the high risk specialist, though they did cover the ultrasounds that he did every month (go figure that one out; we’ll pay for the test, but not for the guy who reads it). They covered the immediate birth of my daughter, no sweat. They attempted to argue every single charge related to my near-fatal complications.

They refused to pay for the second anesthesia on the 17th because it wasn’t “medically necessary” for the purposes of giving birth. It was medically necessary, however, to save my life. That, apparently, was secondary. They argued about the number of units of blood. They argued about the amount of fluid I was given. They argued with the tests run to make sure my kidneys were functioning (a common complication after the surgery I had), and on, and on, and on.

This same insurance company feels I should stop taking the asthma drug that controls my asthma except during extreme situations, and take something that is “similar” — it’s not the same pair of drugs and it doesn’t work the same, and my doctor doesn’t believe we’ll have the same results, but my insurance company argues (and sends me letters monthly) suggesting that it is in my best interests to switch. They believe that I should have no more than 4 migraines in a month and so limit my medication on that front to four pills.

I get that people don’t want the government controlling their health care, but, honestly, your doctor isn’t controlling it now. Your insurance company is and they don’t care about you, your health, or what’s best for you. They care about what’s best for their bottom lines. And that’s no way to care for patients.

I have incredibly weird reactions to drugs. For example, I am severely allergic to Naproxen. Like, throat swelling, can’t breathe, nearly died, allergic. My insurance company doesn’t care about that and frequently tries to insist that the medication that I can take for migraines should be substituted with one that contained Naproxen. So, I pay more in order to stay alive because the only drug I can take is not on their preferred list.

Or, if you want another example, take my daughter. While her life is not threatened by her condition, her eyesight and normal development is. Because of all the screwing around on the part of the insurance company, we are now assured this surgery won’t take place before October 1. Because it won’t, we are now going to be out $4000 plus 20% rather than $3000 plus 20%. It’s going to be hard to absorb that hit, but we can. And the worst of it is that they reset the policy on October 1, but the calculations of our out of pocket expenses gets reset on January 1. It works to their benefit, not ours. This is the result of letting private industry regulate our health care.

Or, you want to argue quality of care? Okay, I can do that, too. My daughter had an outstanding surgeon. One we felt extremely comfortable with and were really happy with having do the surgery. But, because our insurance company won’t cover her, we can’t afford to use her. And remember, even though I needed I high risk specialist for both of my pregnancies, neither insurance company covered that cost, so we had to. We’re fortunate that we could afford to do that. What if we couldn’t afford it? Then what would have happened?

Add to that what I’m seeing with my mother- and father-in-law, both of whom have been hospitalized for nearly a month. A conservative estimate of my mother-in-law’s care? $300,000 to $1 million. My father-in-law’s care will likely be somewhere in the neighborhood of $200,000. They have no insurance and no money. We certainly can’t afford to pay for that (nor are we legally responsible to pay it). So, who pays it? I don’t know. I do know that they will end up bankrupt. I know that my father-in-law, who is a World War II veteran was told at the VA that there’s no help for him there at all.

Finally, P and I lived uninsured for the first five years of our marriage. It was extremely scary and not something I would ever want to do again. But insurance doesn’t fix the fear or save us because insurance isn’t actually there to benefit us. They bet on us. If we’re well, we’re a good risk, but if you get ill or develop a chronic illness, health insurance works against you in every way that it can.

We need a system that protects the people of this country and puts the health and welfare of the people above the cost. We need our doctors to be doctors and not be dictated to by people who read spreadsheets, but who have never set foot in a medical school class. We need a system that is not broken and that allows everyone to receive care pre-existing condition or not without fear of losing their homes, hopes, and dreams.

We need health care reform and we need it now.

4 thoughts on “We Need Health Care Reform

  1. I so totally agree! I have a friend, who has had medical issues on and off, and her husband is diabetic. Because he was laid off some time ago and being 60ish can’t easily find another job, they pay for their own insurance. $2500 a month, but its all they can do, they have to have insurance, they would be bankrupt in no time at all, and even with that princely sum the insurance companies nickle and dime them to pieces.

    Right now I worry about health insurance constantly. We had a nice policy with the state but silly husband wanted a job that paid more than 11 bucks an hour, and took a real job in his field, as a contractor. We are now on COBRA for 1200 bucks a month, its great insurance, but in another 11 months we will be back to no insurance, and I’ll probably have to quit my job as a professor as I am not full time, and go work at Wal-Mart or Home Depot so we can have insurance. Its crazy, crazy, crazy….

    People should not have to go bankrupt because they get sick, people who have money put aside to retire should not have to eagerly wait to turn 65 so they can get Medicare now that they’ve spent all their retirement on insurance.

    This is a problem of the last 30 years. In 1978, I had pneumonia, I had no insurance, I spent 7 days in the hospital and the bill was 2500 bucks, a huge sum back then. The hospital wrote it it down to 1900 bucks, the amount insurance would have paid them, and I paid it off at 30 bucks a month, I was a broke grad student.

    In 2008, I had pneumonia, I went to the ER, it cost 5700 bucks and I was there for 2 hours!!! I was glad I have insurance, but 2 hours for 5700 bucks, that is just nuts.

    • I completely get it and I think it’s a shame that we’re in this situation and that people can’t recognize and understand that whether we do a public option for health care or not, they’re still paying for the folks without insurance. It would almost have to be cheaper to pay for insurance than to pay for the uninsured.

      Health care costs have skyrocketed and I’m still not sure why that’s the case. We need to figure that out and then maybe we can get to the root of how to fix the problem.

  2. I love this post. This is so true.

    When we were younger, we had to choose between buying a house and having health insurance. My husband’s company did not provide coverage and it was that expensive. We chose to buy the house and we went for over a decade with no insurance. We had 3 children, and I had two surgeries, all paid out of pocket and we still came out ahead.

    Someone on Twitter suggested to me yesterday that choosing not to buy the health insurance for all those years was irresponsible. I didn’t know how to respond to that. Insured or not, if one of us gets seriously ill, we will be financially ruined.

    We have insurance now only because my husband is on active duty in Afghanistan. Army National Guard and Reserve members do not have health coverage when they are not on active duty.

    • I know what you mean. Like I said, P and I went without insurance for the first five years of our marriage. What I didn’t say is he continued without it for several more years. He didn’t want to get on my policy and he didn’t want to pay for the policy at his place of work because we were dealing with paying the expenses for two households (he lived in Virginia while I lived in Alabama).

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