On Universal Healthcare

We keep hearing it, over and over. The crisis in healthcare is that millions are uninsured. Provide insurance to the masses, and the healthcare crisis will be solved. We're told that making insurance available and affordable is the main priority. To someone like me, who is "lucky" enough to be covered by affordable health insurance (courtesy of my husband's union job!), this simply doesn't make sense. I'll admit that, for short-term major medical issues such as a hernia or appendicitis, having insurance can save thousands of dollars. But when it comes to actual healthcare, particularly "alternative" medicine or preventative care, the insurance is sometimes actually an obstacle. Before I got married, I had insurance through my employer. It cost me $152 per bi-weekly pay, and that's with half of the premium paid by my employer. So roughly $300 per month, about 1/4 of my earnings, went to cover just me. Besides monthly chiropractic/massage therapy and a yearly gynecologist visit, I rarely used my health insurance. Both of these were fully covered by my policy, and my cost was a copay of $15 per visit. After getting married, I was eligible for coverage on my husband's insurance policy. Although it was much less costly (he pays less than half per month for coverage for both of us than I did a week for just me), there were restrictions. Only 10 chiropractic treatments per year, massage therapy no longer covered at all, and a deductible to be met. The insurance paid $0.02 (yes, that's 2 cents!) for each visit, and the rest of the bill was my responsibility. Because I am employed, the insurance company even denied a claim, demanding proof that I had no other insurance! It took 3 months to straighten it out. The entire health insurance industry is a nightmare. Convoluted policies that require a legal team to decipher, copays and deductibles, restrictions and lifetime limits, and qualifying conditions all make for a maze that can quickly confuse anyone. A typo or misdiagnosis on a claim can result in denial of payment which can take months to sort out, resulting in damaged credit scores. HMOs denying care that doctors deem necessary, skyrocketing monthly premiums, and employers changing insurance providers on a yearly basis are enough to challenge even Ghandi's peaceful demeanor. Pre-existing conditions are a big problem and sometimes impossible to avoid. I had major dental issues for several years, at a time when I had absolutely no dental insurance. Knowing that I would be married soon and have coverage, I put off having major work done until after the wedding. In fact, I had an abscessed tooth on my wedding day! As soon as my dental coverage went into effect, I immediately got started with the needed work. The dentist agreed that pulling all of my bottom teeth and getting dentures was the best option, so we went forward. Because there was a yearly limit of $1000, and the cutoff date was January 1, we had to wait to complete the dentures until after the new year. Unfortunately, my husband's employer switched insurance companies without warning at the end of the year, so the new insurance company determined that I now had a pre-existing condition (no teeth) and denied payment. After the waiting and suffering, I ended up paying out of pocket! Then there's the "preferred" provider restrictions. When I first began to realize that I probably had multiple chemical sensitivities, I had to search far and wide to find a doctor that even knew about this condition. I luckily found a top specialist in the field only an hour's drive from home, but of course he was not in my insurance company's "circle" of providers. So I paid the $400 consultation fee out of my own pocket and then all of the fees for testing. Had I not been able to save for several months, I could not have afforded it. Since he is one of only two specialists in this field in the entire state, neither of which were covered by my insurance at that time, a "preferred" provider was nonexistent. Without my own money, I would have been out of luck and undiagnosed. Most insurance policies make no provision for preventative medicine; they simply won't pay for it. I have a prescription card, but it won't pay for dietary supplements or herbal remedies. Try getting a so-called health insurance provider to pay for acupuncture, Reiki, chiropractic, or holistic treatment. Yes, there are some who do, but they are increasingly hard to find, and most of us don't have the option to choose the insurance provided by our employer. Even better, try getting a cash discount from a healthcare provider that accepts insurance. When I found out that my insurance paid only 2 cents (less than the cost of the stamp to bill them) to my chiropractor, I thought it would be less hassle for everyone if I simply paid cash and avoided the insurance altogether. However, it seems that the insurance companies get a huge discount instead, so my bill would have been increased by the amount the chiropractor "writes off", another $45 or so per visit. THIS is where the crisis originates. The price is different if you have insurance. Why? Another major problem that I see is people who can't afford to miss work if they are sick. Having insurance is not going to help the working single mother with the flu feed her children or pay her bills. With the threat of pandemic flu looming increasingly, the health of millions could be compromised quickly unless a solution is found. Education must be part of that solution, but the economic factors should also play a large part. This national debate about universal healthcare is really about insurance, not healthcare. No one is talking about a plan for health. There's a big difference between healthy people and a healthy bottom line for insurance companies.