Tuesday, March 23, 2010

My Own Two Cents

I understand the fears about Universal Health Care.
I am by no means an expert, but I do have quite a few of my own experiences, as well as having family in other countries that have national health care systems in place.
My insurance company was threatening last year not to provide any coverage for the hospital that saved my husbands life. We went through months of anxiety, wondering if we were going to lose everything, because we would end up paying out of pocket for his medical expenses. Fortunately, this didn't happen. Although we have quite a bit we do have to pay for, we were greatly relieved.
The same insurance company also refused initially to pay for the nutritional feeds my husband needed via NG & Gastric tube. The expense of the liquid nutrition, plus equipment is staggering, and that doesn't include the extra protein concoctions I had to purchase, because the feeds barely sustained him nutritionally. And the worst of it was the medical company we dealt with; we were referred to them, and had the initial consult in the hospital, in fact, being ignorant of the process, they were the only one's we were referred to.

This medical company, of course assuming that most people who have health insurance are going to be covered, don't tell you the cost of everything. When I discovered that we were probably not going to be covered for the expense, I was hot on the phone to find out exactly what the costs were, as I would be now be doing some comparison shopping.

It took me over TWO MONTHS to find out the costs. They called us every week without fail, to find out what we needed, but when I started asking what it cost, suddenly, whoever you were speaking to on the phone had to have someone else get back to you, because they didn't have that information. I finally threatened to take our business elsewhere, and to seek legal counsel for unethical consumer practices.

Eventually, the insurance company agreed to pay for the feeds & equipment.

I know many people who have chronic diseases, such as Diabetes. One friend of mine, a former coworker, has to contribute a dear amount to her health premium costs, plus has substantial copays. She cannot afford the out of pocket costs for her test strips, syringes, and even the meds. She is the working poor. And as a result of this, she develops many of the associated medical problems associated with her disease. She misses work, loses wages...it's a vicious cycle.

Many people have misconceptions about national health care programs in other countries, one concern cited is the long wait to see specialists. I have news for you, even with excellent insurance coverage, I've been told that I'd have to wait upwards of 6 months for an appointment with some specialists.

There have been many months in the past, when I could not afford the medications I needed, because we have to pay out of pocket, then get reimbursed at the insurance company's leisure, I might add. It would be fine if they reimbursed in time for me to get my refills, but that's often not the case.

I've been through the experience of being denied coverage for pre existing conditions; in my case pregnancy. I went without prenatal care for a certain period of time, while I scrambled to try to find temporary assistance. I developed complications, partially because when I did finally get approval at a hospital clinic, the care was subpar. It put the life of my unborn child in jeopardy. Both during my prenatal care, and during the delivery. This country has one of the highest infant mortality rates in the world; are you kidding me?

These are just my own experiences; I strongly believe that this country needs health care reform; I believe that the concept in itself threatens us to our Capitalist core that we could achieve this. I do think you have to go through your own life experiences in order to form an opinion; and based on what I've seen & experienced here, and in other countries, that we can do better.


3 comments:

Missie said...

We have Aetna and have had it for years. We do pay a fortune for it, but we've never had a problem getting to pay for anything. I think it all depends on your health insurance company and what plan you have.

We don't have money to pay for social security or medicare now, how will this country afford this health plan? Plain and simple. We'll all be paying for it.

I'm paying enough for our health care, I don't feel as If I should pay for someone else.

Hope you're having a good day. It's been cloudy and damp here today:(

HeathD_Pa65465 said...

Efforts to fight fuel!........................................................

Cathy said...

You've been through so much, my Maire, I can only wish for the answers to give you but I've none. Sustain yourself!