Thoughts on healthcare

There's a debate raging in this country about national health care and an overhaul the current government has been promising. As time goes on, it seems that more and more people are against a plan that would offer coverage to all American, possibly by adding a government run health plan option for all Americans. And as the debate rages, I have to wonder why my fellow citizens oppose everyone having health care.

For you to understand my perspective, let me explain a little about myself. I am fairly young, in my early 30's. I'm pretty healthy as things go, I have some normal things like allergies and my cholesterol is a little high due to genetic factors. There is nothing particularly alarming or critical about my health, but I cannot get private health insurance, I have to be on a work-sponsored group plan or else I am without. Why you ask? Because of a genetic condition that is rarely even a factor in my care but that in the right circumstances could be fatal. Because of that, no one will insure me unless I'm in a group situation where they aren't allowed to review my medical history. Furthermore, if my coverage should lapse, that very condition would be uncovered as a previously existing condition. I did nothing to deserve this; no lifestyle choices contribute, it is merely something I was born with that I almost never think about. And yet, it drastically affects my life. Furthermore, my husband works for a very small employer that is not bound by law to provide us health coverage at all, and certainly is not obligated in anyway to cover me and our children in addition to him, and is, in fact, reviewing that level of family coverage right now. So in many ways, we live with a reality that we could find me uninsured and uninsurable, without a COBRA option since COBRA also isn't required of his employer.

The last time my husband changed jobs, we were both working, but my employer didn't offer family coverage. His employment was a fixed-term appointment that was ending. To get insurance through my employer would have cost us $1,500 a month. You read that correctly, that is more than our housing payment. So as he looked for, and found a job, he accepted it and moved a few hundred miles in a very short 2-week window. Meanwhile, my children and I stayed a month longer so that I could provide my employer with the appropriate notice that I was leaving. We did this all for health care, and it was miserable.

Over my working life, I have seen tremendous changes in my insurance. It was really just 10 years ago that I entered this world of employer sponsored benefits, and when I started, I paid less than $100 a month for the premium health plan and a $10 co-pay on office visits. Prescriptions ranged from $5 to $25 depending, and I could get them filled anywhere. Most everything else was covered fully. So much has changed. Now we are nickle and dimed by our insurance. Lab tests have co-pays, visits are denied because they didn't have acceptable diagnosis codes, we have to prove we don't have secondary insurance, we pay extra if we don't use mail order for prescriptions, the list goes on.

Now it so happens that a few years ago I got sick while in Europe. I called my health insurance provider and they instructed me to go to the ER, and they would reimburse me for my costs. After consulting with some locals, I decided instead to go to a local doctor and swallow the cost of an office visit, which is something I could afford to do, whereas I had no way to pay potentially a $1,000 or more for an ER visit (which was my low-end estimate based on costs in this country) even if I was going to be reimbursed for it. I went to the doctor, he checked me out and gave me prescription medication. I didn't wait at all, everything happened in one place, and as I left and tried to pay, they laughed. No money exchanged hands for this half hour visit and prescription medication. Let me mention that in this same country, they have wonderful, clean public transit everywhere, and the standard of living is very high. People are very healthy and homelessness and poverty are, compared with our country, quite rare. Their government is not bankrupt, their doctors are not poor, and most of all, people are not bankrupted by illness. I don't understand why people in this country do not want similar coverage.

A few years back, I fell and broke my leg. I visited 2 emergency rooms in the process, stayed 4 days in the hospital, discharged before I was ready to go home under coercion from the hospital staff as I tried to explain through tears I was in tremendous pain and unable to care for myself. I had surgery, 2 ambulance rides and physical therapy. The whole thing cost thousands of dollars. I exceeded deductibles and out of pocket maximums and was stretched to the very limit of my finances to pay for it all. My husband, however, broke is ankle in a northern European country, also requiring a hospital stay, surgery and physical therapy, and the grand total of his care cost him $50 for the taxi he took to the hospital. In that country, the government is well endowed and its people enjoy the very highest quality of life in the world. How can one compare those 2 and say we have the best system? The answer simply is that we do not have the best system.

Conservatives are fighting hard to derail any change to our current system. Seniors identify in great numbers as conservative voters, and oppose health care reform at rates of greater than 3:1. But does no one see the irony in this? These opponents of "socialized medicine" are the very people who receive their health care through the federal Medicare system. Were they to be thrown into the situation the rest of us have, they would never be able to retire and being jobless would bankrupt them because, like me, seniors would never qualify for private insurance. Veterans, another overwhelmingly conservative group of individuals, are also often entitled to health care provided by the government through the VA, and many of them also would not qualify for private insurance because of injuries suffered in battle. Don't get me wrong, I do not begrudge these individuals their health care, I am glad we, as a country, take care of our seniors and our soldiers. What I'd like is for all of us to have such care open to us, so that if my husband loses his health plan, we do not suffer without insurance. Why am I less deserving because I am not old enough and was not eligible for military service? Why is anyone less deserving than another human being?

I know people are afraid of losing control, of losing choice, but if you'd only pay attention, you have been losing choice in the current system for years. Lack of competition unfairly driving private companies out of business is a concern, and yet I tell you the current system has been driving companies out of business. For example, my employer 4 years ago was the major employer in our small town. While I was there, they switched to a mail order prescription plan. No longer could you get maintenance medication through the local pharmacy. At this privately owned local pharmacy, people knew you. The pharmacist would remember conditions and ask you how things were working. They remembered when I switched vitamins and checked to make sure the new one was going okay. This switch at this one employer drove that pharmacy out of business. We now had to go to the next town to the large, national pharmacy chain for one-time prescriptions as well as any other pharmacy type need. That gave one store a monopoly on such business for several miles around. Where then was the choice? You no longer have the choice to see any doctor you like anyway. Sure, it's not a problem when all goes well, but what happens when you get really sick and the best specialist, the one experienced with exactly your situation, isn't on your plan? Or what if, as happened to a friend of mine, your baby is born prematurely and the only NICU in your area isn't covered under your insurance? Even though her insurance agreed to pay, because they didn't have a contract with that hospital, the hospital is still billing for far more than insurance would have to pay with a contract. You have no choice today, and if you exercise choice, you pay dearly for it. In truth, people on medicare, the government health plan, have more choice than you or I do in our private plans. Does your policy have a lifetime maximum? A few years ago none did, now one single bout with cancer is enough to expire that limit on most policies leaving you to die or lose everything you have to pay for the care you need.

Don't get me wrong, I don't think you should have to give up your health plan if you don't want to. I just think everyone should be able to have coverage. I hear more and more about pregnant women who are losing insurance because employers are cutting back in this bad economy, women who want to self-pay for coverage, can even afford to, but can't get it because they are pregnant. And while they could afford private coverage, they cannot afford the tens of thousands of dollars a standard hospital birth costs in this country. Please tell me what is good about such a system. And I'm sure some of you are reading this and thinking about the welfare rolls and people who some deem "too lazy to work", but I assure you, these are not the people going without insurance. Indeed, anyone that poor qualifies for medicaid, no it is the people who work very hard at low paying jobs for employers who do not offer insurance, or at least do not offer affordable insurance who are suffering the most. People who are living just above the poverty line because they do work and work hard.

There are so many myths out there, but the reality is that our current system works for some but not all. For people who never get sick, who make six-figure salaries, or who have made it to the golden age of retirement. For the rest of us, we have a precarious existence, and a single incident would throw any one of us off a cliff. Open your eyes, America, in this case we are clearly not the best.