Posted by
Wil on Sunday, August 23, 2009 5:21:49 PM
It is so easy to oppose federally controlled health care, so easy to say the words. But what happens when you become one of the uninsured? Let me share with you our story, as an uninsured family.
I had never really thought much about health insurance or its lack as a young man. By policy rules, I remained covered under my parents policy until I was 23, but I was young, healthy and rarely needed it. Between 23 and 25, I was an uninsured person. My last year of college and my first year solely in the working world, I had no health care. Had something catastrophic happened, I would have felt its lack, but I had no idea that it would ever matter. My first job after completing college, I was a part time teacher, and I chose not to pay for the optional health care, that would have been out of pocket since I was not full time. Then after a year, I joined the Navy. Tricare meant everything was "free", and while I still didn't use much medical care, I sure noticed it when I got married and had a couple of kids. We didn't pay any copays, any deductibles, and it was considered one of our benefitssince military pay was not all that high. What I noticed with Tricare was that military hospitals had very long waits, many less than competent doctors, and huge inconvenience. But of course, there was no cost. Because of this, we were there all the time. Every time a kid got a sniffle, we were there seeing if she had an ear infection. Turn an ankle? Sit in the ER waiting room 4 hours for an x ray. Long waits, inconvenience, and mistakes were part of the price we paid. I laughed when I left the military and people said one of the things we'd miss was the "free health care".
Five months after I left the Navy, I began teaching in Sacramento. The school district gave us three choices, one that was completely covered, and two where we paid part of the premiums. The premiums were very expensive. And for each visit, you had a copay. For each prescription, you had a copay. For x rays and tests, you paid a percentage until you reached a per person deductible. After not thinking about what medical care cost my whole life, there was quite a bit of sticker shock. For six years after that, I taught at a private school. Being a small non profit business, they found health care premiums to be a huge burden for their 30-40 employees. Their policy was crazy, large out of pocket premiums to cover the family, 40 dollar copays on visits, 25 dollar prescriptions, and patient pays a percentage of everything beyone routine. My daughter broke her wrist. Our portion was over $1000. My wife went back to school and then was hire in a hospital. Much better health care, but still, 20 dollar copays, still $150 a month to add the kids and $1000 deductible per family member. Still, another broken arm (elbow this time and a different daughter), $500, a miscarriage, over $800. Our third daughter born? Again about $1500 (not sure how it ended up over the deductible, but it did). She needs minor surgery? Our portion was close to $2000. All of these were just incidents of daily life, nothing extravagant, nothing our fault, and yet over the last six years, we incured nearly $7000 dollars for a family that makes about 50,000 a year and that is with insurance. Without insurance our bills would have added up to nearly triple that. Hillarycare may not be so bad.
This summer I decided to switch careers. Lots of reasons, not going to discuss them here, but one of the challenges was that even with higher pay, the company I work for has just 6 employees, so they do not provide insurance. We have applied with several companies as a family. We have been turned down. I am fat. So even though I have normal blood pressure and cholesterol, and have never had any diagnosed problems except sleep apnea, I am a risk and they are unwilling to insure me. My wife is also uninsurable because she has recurring migraines and has been on depression medicine. So our kids are now insured, for the fairly reasonable price of $200 a month, but my wife and I are uninsured. We could enter a "medical pool" for around 30% of my current income. We could pay much much higher rates for catastrophic only coverage we've been told. We could milk the system we've been told. If we walk into an ER we have to be treated they say, and we could make arrangements afterwards to pay it back. So how exacly is Obamacare a bad thing?
Well, it goes beyond Obamacare to insurance as a whole. Insurance gives you the freedom to not be responsible. When we had "free care" we took excessive advantage of it. So did many families, thats why waits were so long. Even when we had employer provided insurance, we never looked closely at bills, just what our portion was. Before we got the kids insurance this summer, we had to take our oldest daughter to the doctor. A simple visit, 15 minutes to diagnose a problem we already knew and prescribe a medicine which we couldn't do without a doctors visit was going to cost $180 with the first doctor. My wife called 4 doctors, and found one that only charged $105. For a visit that used to "cost" 20 dollars with insurance and nothing with Tricare. And thats a big part of why insurance is a problem. You want a car, you shop around. You want car insurance, and you see dozens of ads on TV trying to get you to switch, they incentivize good clients because the costs of a good client are less than the expenses. Car insurance is just for emergencies though, for accidents. You have repairs, you pay out of pocket. Medical insurance should be the same. If doctors weren't forced to keep huge amounts of insurance against lawsuits, if they didn't give "free" visits to medicare, medicaid and other government programs, they could afford making daily visits more reasonable. If you the consumer had to make decisions about which Doctor to go to not based on who your insurance accepts, but who was reasonable cost and did a good job like a mechanic, our system would be much better because the doctors would care about customer service like competing mechanics do. If we had portability, if employers had nothing to do with health care, but we could take the care with us when we switched jobs, we could maintain policies for long term, and the company would make their money off us early in our 20's and 30's when we are healthier. If we only had a social safety net to cover people who will need life long catastrophic care like those with birth defects or long term diseases like muscular dystrophy or cerebral palsy, then the system wouldn't be facing bankruptcy.
While it may feel like it to the uninsured, the answer is not Obamacare, its not Hillarycare, its not a government behemoth that covers every contingency and deals with every issue. Its people being accountable for their own care, saving money like we are doing now to cover office visits and small maintenance, and getting insurance only for the big ticket health needs. Its doctors competing for patients, not the other way around. Its tearing down the walls, whether insurance built or government built between people and their health care decisions. Europe and Canada have shown that a one size fits all solution is a contributor to a bigger problem, not a solution to our current problem. There are some major changes in health care that need to occur, but they are painful and people don't want to hear them. And they come from the ground up, from people being accountable and holding their service providers accountable, not from some mandate on high.