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.