Borderline insured
Sept. 1, 2011 was a monumental day in my life. It was the starting date of my health care as a high school Spanish teacher. That morning, I remember well. I stopped early in the school office, and pulled an envelope out of my mailbox. Inside, I found one thing: my insurance card. I walked into the staff bathroom, sat in a stall and wept, my hands shaking with joy as I held the card.
An insurance card, for the first time in a year, meant I didn’t have to go to financial counseling each time I went to the doctor’s office. I could actually go to the doctor’s office, in the first place. I had a prescription plan now, instead of a charity care plan from a major pharmaceutical company, which required I pay $65 for three months’ worth of medication. On my new plan, it dropped to $5, for medication that cost $330 for the same time frame. It was painful to go to a pharmacy, and as they rang up the full price (before I was on the charity plan), to listen to the person on the other side of the counter say, “You do know how much this costs, don’t you? You are prepared to pay this now?”
When I changed careers in 2008, I was able, through my doctor’s office, to get on a pharmaceutical program for medications I needed. The woman who worked seemingly round the clock at the medical center provided miracles for me and hundreds and hundreds of others. How she managed to stay on top of paperwork and tend to a growing number of charity care cases was beyond me.
In 2010, I lost my insurance when I could no longer continue working full-time and complete my field work and student teaching requirements. The COBRA health care offered to me at a reduced rate, was still too much for my budget. That was a long year. I remember having a student loan in my checking account, with enough money to pay for routine doctor visit. I was sick, and broke down and made an appointment. As I walked into the center where my doctor practices, the receptionist who greeted me was breezy and polite, smiling as she called me to her window. The demeanor changed instantly after I was asked, “Do you have insurance?” I replied “No,” and the tone of her voice and facial expressions changed. Coldly, she snapped, “Well, you’ll have to see financial counseling before you can proceed to your appointment with your doctor.”
“I have money on hand, to pay for the entire visit, right now,” I said, looking at her, almost pleading.
“I’m sorry. Everyone who is uninsured must consult with a financial counselor before any medical appointments. It’s our policy. If you have a seat in the lobby, someone will be with you shortly.”
Slumped in my seat, now feeling mentally and physically miserable, I waited until a counselor called my name. We reviewed my income, “Don’t you make any money? Anything at all? Do you receive any government assistance? Oh, I see you are a student. Do you have anything to pay with?” she asked. We reviewed my previous employment, and I had to explain the lack thereof. “I have money, in my wallet, to pay,” I said, again, as she handed me forms to fill out. While the counselor was polite enough, had I been able to treat the illness without a prescription or doctor’s visit, I would have left and toughed it out.
Toughing it out is a common theme among uninsured or underinsured Americans. Putting off tests, checkups, dental appointments, lab work, having that bad back looked at, refilling a blood pressure medication, living with the stress of working multiple low-paying jobs while raising a family, and wearing glasses that just don’t cut it anymore are all things I and others have experienced. Some folks have insurance, but the staggering deductibles that soar above $5,000 in many family cases, make preventive medicine a luxury in our country. And I don’t care what anyone says, the health savings plans are mere drops in the bucket and hard consolation when sitting (or laying down) in an ER, wondering how much each IV or X-ray is going to cost. Those who are fortunate to be treated on a sliding fee scale at a public or government health care center still often have to miss more work just to stand in line, in all types of weather, to get into the clinic to be treated.
A Gallup Poll conducted at the beginning of 2012 revealed that more than 17 percent of Americans don’t have health insurance. I have been fortunate. A friend of mine who has diabetes and is a breast cancer survivor can’t get insurance, and pays hundreds of dollars a month for insulin and other medications. Under the Patient Protection and Affordable Care Act, also known as Obamacare, her pre-existing conditions cannot prohibit insurance companies from offering her insurance.
I’ve listened to an acquaintance complain about how millions of Americans choose, instead of being forced, to live without insurance. Of course, this person has insurance. I think people make the choice to instead pay for vehicles, gas, clothes, food for the family, and other frivolous amenities. In fact, I would wager that most of the commentators, politicians, lobbyists, insurance industry executives and others who publicly rail against the June 28 Supreme Court ruling have some form of health care. Although, it does boggle my mind to hear those who are underinsured or uninsured decry it, saying, “It’s socialism! We are not Europe!” I keep thinking, quietly, that if we were indeed in Europe, they’d have insurance.
Trying to explain our American health care debate to someone outside of this country is almost comical. My British friend likes to tell the story of her father, at the time a teacher, who had a heart attack and 100 percent of his expenses were paid for, by national health care. Also an educator, my friend had minor surgery and chose the specialist to perform it. That meant she waited a few months, but she likes to point out, those in need are treated in a timely fashion. Not always the case here, is it? My sister-in-law watched in agony as her father, a veteran, waited months to see VA doctors, as his cancer continued to grow and spread beyond the point of treatment. Once he was able to be seen for health care, she drove him from Canton to Cleveland for care, but it was too late. So if we have some form of national health care, we’ve already failed.
Having good health insurance now makes me feel somewhat guilty, because I have so many friends and family members who don’t. “You know, now that you have insurance, don’t you think you should use it?” my mother snapped when I picked up my umpteenth cold as a first-year teacher (who are ridiculed as germ magnets). It seemed a novel idea. So did handing the card to a pharmacist, who said, “That’ll be $4.14” for a prescription after getting the cold checked out. Part of me almost felt I didn’t deserve it. Part of me shouted “You do!”
When I was completing my student-teaching training, I had to attend several sessions at the main campus of the university where I was enrolled. There were about 110 student teachers in the room. Ninety percent of them were between the ages of 21 and 24, I’ll wager. There were a handful of us old-timers. I listened in awe, as a retired educator explained contracts and benefits to the students, using a large-screen PowerPoint presentation.
“These are your typical medical benefits. How many of you know how to read an insurance policy?” he asked. Those of us over the age of 30 slowly raised our hands. The youngsters shook their heads, or appeared disinterested. I wanted to stand up and shout, “You idiots! Do you have any idea how good you’re going to have it, when you get hired over me, because I’m old, have a master’s degree, and cost more? Do you know what a benefit is, because you need to put down the phones, and pay attention to the most important part of your contracts, you morons!” Of course, I didn’t say that, and one school district did value me over someone like them and hired me. The problem for our young people is that we older folks have been raised in a society where health care coverage was the norm. Now, it’s a luxury. We don’t know how to get back what we once had. And we never will.
I spent some time looking at the pros and cons of the Obamacare plan. It’s not as rosy and helpful to some in need as supporters would think, nor is it as detrimental to small businesses as its detractors claim. The entire bulk of the bill is filled with the agendas of some, and its weaknesses will be exploited by those with differing plans. The sad reality is neither the voting public nor the executive, legislative and judicial branches have the power in this country: the massive, all-encompassing U.S. health industry does.
Published: July 10, 2012
