As you start your historic — and no doubt childish and hysteria filled — discussions about healthcare reform in conference committee, I’d like to share a story about my insurance company with you.
As you read this please keep in mind that I have great insurance. I get better care, more care, with fewer hurdles than most people — than I’ve ever had before — courtesy of my husband’s employment with a certain large software company based in Redmond, WA.
I have had rheumatoid arthritis for seven years. My care is coordinated by a world-renowned rheumatologist. I am a hard case, and have gone from drug to drug trying to find one that lets me get out of bed for more than four hours a day. Most of these drugs have been new and therefore expensive. But the same expensive — about $22,000 per year regardless of which biologic I’m on. My doc has me on a new one now. Because it’s new, the pharmaceutical company is footing the bill for it for six months. Still, I got a letter from them a couple weeks ago telling me that they were approving my use of this drug, but only for three months. After that I’ll have to get approved all over again.
The moral of this story is that it doesn’t matter whether healthcare is run by a company or the government: there is always going to be someone between me and my physician, between me and the care he or she thinks I need. The only way that won’t happen is if I win the lottery and self-insure. Then I can ask myself if I really need something, make my doctor provide me with proof that I’m really sick (faxed, please — we don’t do electronic medical records yet), and try to talk my doc and drug companies into accepting less money than what they bill for my care.
Good luck and try to be civil. There are children watching.
Lisa
It is so frustrating to have a huge insurance company that is profit driven actually managing your medication allotments. It’s truly infuriating. When we had TWO (TWO!) kinds of insurance we still paid out of pocket for malaria medications that neither company would approve. Had we gotten malaria, we would have been treated. But they would NOT pay for prevention. We paid over $9,000 that year even though our entire family was HEALTHY and NO ONE went to the doctor. Now we have no insurance at all. I know that’s risky but, god, I am so glad not to have to spend half my day fighting with these jerks. Congress, wake up!
My husband just went on Medicare and, so far, it has been wonderful, and cheap! No co-pays, no ER payment. He just had a procedure with one-night in the hospital and we did not pay a cent. It saddens me that people were misled into thinking anything-government would be bad, causing the public option to be dropped from the Senate bill. I had hoped President Obama would deal with the insurance lobbies, but they proved too powerful. I can’t wait to be able to go on Medicare myself!
It drives me nuts that our insurance has gone up in price by 20% each year for the past few years while our benefits are decreasing. I was in the hospital in preterm labor and kept getting letter after letter telling me I had to prove it. And we have a PPO!!! I honestly think this healthcare bill is just going to make things harder and more expensive. I wish congress and the administration would create a plan that’s better than ‘better than nothing.’ That’s a lousy reason to pass a bill for anything much less something that affects us all so deeply.
Alexandra, my mother just went into medicare and loves it! Combined with her supplement, she gets everything she needs. I think we all need medicare plus a supplement – It’s what the French do and they have the best healthcare in the world!!
So true. My insurer raised my rates by $100/month, just in time for Christmas. I can’t believe I’m now paying $400/month just to cover myself–and this coverage sucks. I mean, it REALLY sucks. I would take a government plan anyday over this crap. ANYDAY. Let the people decide whether or not a public option is viable. I WOULD PAY FOR IT.
My two sons have just graduated from college and are experiencing, first hand, what it’s like to deal with insurance companies. They are, naturally, shocked and disheartened. Partly out of his experience, my older son is planning on going to law school and concentrating on healthcare policy.
On another note, it’s maddening to think that our health is being decided upon by people who know less than our own healthcare providers and treat us as statistics and risk groups.
This American Life recently did a two-part series on the health care decisions that are going on right now. Definitely worth a listen:
http://thislife.org/Radio_Episode.aspx?sched=1320
http://thislife.org/Radio_Episode.aspx?sched=1321