Friday, May 15, 2009

Health Care

We're at a crossroads in this country, sez I, and I'm sincerely hoping we take the right path. Specifically I'm hoping we take it in the area of health care, by passing the President's plan to cover everyone in America. Personally, I'd like to see the sort of universal health care that the UK and Canada enjoy, but I can live with the Obama administration's plan.

"Live with" being the important term. I can give you the big picture, maybe better than some folks because I lived in England for six years. Yes, sometimes you have to wait a bit to be seen for non-critical items. Like you don't have to do that here now? In spite of what a Big Bucks gentleman's commercials would have you believe, I don't know a single Brit or Canuck who wants what we have, and I know several.

I could also point out to you that we already have universal health care, and I lived under that too, when I was an Air Force wife. Yes, I couldn't always count on seeing the same doctor. But I got great care, and I didn't pay a cent. We made less than we would have on the economy as a trade off, but only having to pay for my meals when I had my two C-sections? So worth it.

So please understand, I do have a fair idea of what I speak. For that matter, I usually do or I don't open my mouth. :-) But today I'm going to ask you to support this health care plan for all our sakes, and specifically, share why I need you to do so.

As you know, the DH and I are self-employed. Yes, we struggle some in this economy. But we struggle far more than we should to provide health insurance for ourselves. In 2001, when we had to purchase said insurance, we found it excruciatingly difficult. We finally got Mega Life and Health through the National Association for the Self-Employed. Would seem to be an excellent thing, yes? A group plan for those of us whom we're always told are the backbone of America. Maybe we are, but I think we're losing spinal fluid at an alarming rate. In the 8 years we've had the policy, our premium has more than doubled. We had to raise our deductible to $7,500 EACH just to keep it as "only" doubled...and needless to say, we don't have anything like that if we were seriously ill. To be fair, during that time I was diagnosed with Type II Diabetes, but I'm very compliant and on the most minimal and generic medication there is.

And this policy covers almost nothing. One doctor visit a quarter is covered - with a co-pay; do you know any doctor that sees you for anything substantial then doesn't want to see you back in a week or two? I have to pay that out-of-pocket. I did physical therapy to avoid having to undergo anesthesia and a manipulation to unfreeze my shoulder, thereby saving them money, right? Sure did, because they refused to pay for the PT unless it was after surgery. All that, out of pocket. The prescription plan has a deductible, a co-pay, AND a cap of $1,000. With what the drug companies make in America, that gets eaten up FAST. I actually get my generic diabetes med cheaper at WalMart than I do in the plan I PAY FOR!

So we're now trying to get policy through Blue Cross Blue Shield. A very reputable company, which we now know Mega is not...they are dissed by everyone who is stuck with them. We went to an insurance broker, told him everything about us, and he got a quote for us. The underwriters quoted us at Tier 4. Middle-of-the-road, 1 being best, 7 being you're next to terminal. Based on the deductible we could live with, we'd be paying a little more monthly, but it would be real coverage, and we were delighted. We went in and did the official paperwork, hoping to have it in place by the beginning of the month.

A few days later, our agent called. They came back with us on Tier 7! Nothing changed, no new conditions, and he was as shocked as we were. I flat told him, absolving him, of course, that I felt this was fraudulent, a classic bait-and-switch. We asked what we could do to appeal. He didn't know, having never had this happen to him! We asked our physician to write a letter for us, and bless him, he did, stating that through my own efforts my blood sugar is well within normal, and I could probably even go off the med for it. He added that there was no reason I shouldn't be at a lower tier. The agent faxed that to his contact, and they came back at Tier 6. However, he also had us write a letter directly to BCBS Underwriting, giving us word for word what it should say, also including the doctor's letter. We've not heard back anything from that, and it's been about two weeks. Prayers are welcome.

A doctor recently told me that we were playing Russian Roulette, having the insurance (so-called) that we do, and he's absolutely correct. And folks, that shouldn't be. We work hard. We don't make much, and we're paying on health insurance about half what our house payment is. In this country, where we have so much, people working their butts off shouldn't have to be afraid of losing everything just because the insurance industry is greedy.

Do you know the majority of bankruptcies are due to health care costs? Trust me. I am afraid. One of us gets seriously ill, and we have to chose between treatment and losing everything. And we are very much not alone. So please, for the sake of all of us, let's get real coverage for all Americans.

I'd sure sleep better.


beadntat said...

Amen!!! You know how much health coverage I have at the present time with my issues....yup. I'm right there with you.

Anonymous said...

I absolutely 100% agree with everything you said. Amen.

ellen said...

This situation makes me really angry. I have not had health insurance for over a dozen years. When I get sick, I just wait till it gets better, cause I can't afford doctors. I don't understand what is WRONG with this country, that universal care isn't in place. I just don't get it.