Citizens' health care experiences:
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August 25, 2006
I have worked in the Health Care Industry since 1959, first as an RN and now as a PA. (Yes, I've been around awhile). I've seen the cost of a 30 day supply of oral contraceptives soar from $5.00 to $30.00 or more, while the need, especially among low income people remains acute.
After retiring from Government Service, I have worked intermittently
in the private sector where I have been appalled at the number of people
with serious, even life threatening conditions who had no health insurance,
and thus no access to regular, preventive care or treatment. Many of
these had insurance plans available, but had chosen not to enroll due
to costliness (over $100/month per person) which would make it difficult
to provide for their own and family members other needs. These are working
people earning $20,000 to $40,000 per year, which sounds like a lot,
but does not go far in today's world. (Submitted 8/2/06)
August 24, 2006
When I resigned from my job as a family physician in 2000, I sought out private health insurance. I thought I was pretty healthy. I exercised nearly daily, had total cholesterol of 164, and had no chronic health problems. As a physician, I also knew how to care of myself and did a pretty good job.
When I applied for insurance, I was astonished. The insurance company wanted all my medical records for several years. In them, it discovered that three or four years prior to my application, I had developed small esophageal erosion which was diagnosed by endoscopy. I had been treated for it and had recovered fully. I believe it had been caused by work-related stress. Not only was I no longer symptomatic, I had also dealt constructively with the problem by resigning and finding a different work environment.
Well the insurance company felt differently. As a result of that incident, it offered me insurance that excluded any coverage of almost any upper gastrointestinal problem. On top of that, the premium I had been offered doubled!! I don't understand why the premium doubled when they were already excluding coverage of the one lone problem I had had. Several months later, I received through the mail an application to buy insurance offered by the state of Colorado to patients who were high risk and could not buy insurance! So, there I was at 48 years old, with excellent physical health and good health habits such a exercise and diet, with good cholesterol and no chronic medical conditions, and also a physician myself, being considered "high risk!"
What do people do who really do have health problems? As a physician, I have been blamed by patients for diagnosing a chronic condition like hypertension or hypercholesterolemia that then prevents the patient from buying insurance--as if their illness is my fault! Obviously it is not my fault, and often not the patient's fault either.
Insurance should be just that--insurance where the risk pool is spread out, thus decreasing the cost/risk for each individual. The way insurance works now, the risk pools are divided and then divided again. The "high risk" patients are excluded so that the government has to pick them up because no private insurer will take them. This is NOT how insurance is supposed to work!
Since the government has the pick up the more expensive patients anyway, let it pick up everyone and get rid of the profit mongers in the insurance industry. Ultimately, that would be far cheaper for everyone while giving everyone the medical security each of us deserves. (Submitted 8/1/06)
August 23, 2006
I am a self employed small business owner with no health coverage.
I go to a local community clinic for my preventative care but have no
coverage for emergencies. Currently my husband needs follow up work
for an abnormal blood test but we cannot afford it. He doesn't even
want the follow up work done since if anything is wrong we cannot afford
the care he would need. A couple of years ago we did have health coverage
because my husband had taken a night job to supplement our income. During
that time we each had an emergency room visit. We had to take out a
loan to pay the out of pocket expenses. We each had about a $500 balance
that our insurance didn't cover. (Submitted 7/31/06)
August 18, 2006
I am extremely fortunate. I have a good union job and my employer
pays for all of my health care. However, just because I have generous
health benefits don’t mean the quality of healthcare is that great
in the U.S. About 4 weeks ago, I got a terrible ear infection. I went
to the urgent care as my doctor was not available. I was met by a somewhat
disinterested doctor who told me that I had swimmer's ear. She placed
an earwick in my left ear, drenched it with anti-biotics, gave me oral
antibiotics and codeine and told me to keep the wick in for 48 hours.
(I later found out that I was supposed to keep it in until it fell out.)
The next night I removed it and the next day was in more pain than ever.
I went to my own doctor who told me that because the ear canal was still
open I didn't need another wick, just keep taking the antibiotics and
using the drops. I kept taking the antibiotics and nothing helped. The
next day, in tears, I went to a very competent and empathetic ENT. He
put a wick back in my ear, again drenched it with antibiotics, ordered
me to keep it in until it fell out, made sure I had enough pain killers
and oral antibiotics and told me to go home and rest. In 2 days I was
better. The point of this story is: it cost my insurance company 1 urgent
care visit ($85.00), 1 doctor visit ($75.00) and 1 specialist visit
plus follow-up ($285). The last two could have been avoided if the urgent
care doc knew what she was doing. (Submitted 7/27/06)
August 17, 2006
I am a 44 year old mother of 4, grandmother to 3 who has been married for 23 years. My husband is 48 years old. He has been injured on the job more than once; he is supposed to have lifetime medical, but has yet to receive it, even when we both had excellent health insurance coverage through my employer, I was told it was against the law to use our private insurance and the doctor would not even book him an appointment to see him. Anyway, treatment for my husband is something we have learned to live without because we have never had the money for an attorney. My husband has lost a lot of weight, mostly muscle, from his injuries, and suffers constant pain.
My whole life changed about 5 years ago, when I began menopause. My father passed away, my marriage was suffering, and I lost my job. I have not been able to find another decent job since then. I have had odd jobs, but nothing like I used to. We even lost our home. We were paying for a double wide and were purchasing the property, but could not afford it anymore when my husband’s boss retired and he was without a job. I used to be the primary bread winner and brought in 70% of our household income for 15 years of marriage. We have not had insurance since 2001. We are basically a healthy family with the exception of I am hypothyroid, and my husband has compression fractures in his back and dental problems.
Anyway, what it boils down to is this, of the 40+ million uninsured
people in the world, we are two of them. I am unemployed, while my husband
is employed. As we get older, I worry how I am going to raise my children
all by myself if something were to happen to him. And what really blows
my mind is after looking at the 2000 Census figures and seeing that
just hospitals alone (not the entire health care industry) brings in
a whopping 500 trillion dollars, nothing is going to be done about the
rising costs of health care. Instead, everyone wants to make it a law
that you have to have insurance or go to jail. Everyone, wants this
because they believe it will bring down the high costs of health care.
(Submitted 7/26/06)
August 16, 2006
I am a 57 year old woman recently divorced. I have no health insurance.
I am unemployed because of a work injury. Therefore, I cannot get health
insurance through an employer. I think it is horrible that women in
my predicament cannot get affordable health insurance. I am afraid to
get ill. I pray every day that I stay healthy. I am on a limited income
and have taken over the home. It's a shame that we have to choose between
having a place to live or having health insurance. Is this really America?
I don't feel like I am living the American Dream. (Submitted 7/25/06)
August 15, 2006
My husband and I have received both excellent and disgraceful medical care. Now we receive none, as we have no insurance and a $10.75 hourly income is too high to qualify for horrible care at the County Medical Clinic. We can go to the emergency room, but my husband never has after seeing how I was treated there. In our 10 years together, I have visited the ER approximately 3 times in a two month period. A nurse made it clear to me that I should not go there for my "chronic" conditions, and that I must go to a doctor. I made it clear that we have no access to medical care outside of ER. We are both afraid to go back.
Examples of this terrible system: When my husband was making $8.75 hourly, we had to pay to use the County Medical Clinic. He was very ill and needed antibiotics in order to be able to continue working. He was prescribed erytabs, a drug (form) that is well known to cause side effects. A respected patient would get Zithromax, Biaxin or even Keflex, but we paid the clinic both for the visit and for those horrible drugs. The drugs made my husband vomit blood. He discontinued the drugs and we could not return to the clinic because we could not pay yet again. Thankfully for us, he managed to continue to work in food service so that we could continue to have a place to live, and he eventually got well. He caught the sickness at work, of course, from others in the same predicament. The effects of depriving the citizenry are contagious and even those whose needs are met are subject to the consequences.
After my ER visit, I called the county clinic to ask if it was okay to take ibuprofen with an aspirin a day. The male nurse, upon hearing my symptoms, said I should come in for an office visit. I told him I could not pay. He told me to "make it available". I did not go.
I went to the county clinic for a "free" mammogram. It was done at a separate, legitimate facility. But I was billed nearly $900 for it. I'm not going to pay it, but apparently free mammograms are not necessarily paid for by programs that claim to pay for them. And I also wonder what good it does to give free mammograms to women who have no medical coverage for the treatment of breast cancer.
I have had proper medical care and coverage in the past. My husband
had some good care once through the county, but outside of that has
not had medical or dental care. Both of us need medical and dental care.
(Submitted 7/25/06)
August 14, 2006
I'm pregnant with our fifth -- it's very frustrating to be subjected
to expensive, needless tests, and forced to use an obstetrician because
homebirth and non-nurse midwives (the most appropriate form of care
per the WHO) are not permitted in our state nor do physicians sponsor
them. Non-nurse midwives and homebirth are statistically associated
with excellent outcomes. I’d like to see consumers given more
latitude, our judgment trusted if we want to use non-MD-directed health
care (midwifery, chiropractic, alternative cancer treatment etc). The
way things are now, I doubt that will happen. Cost-efficient, alternative
health care is antithetical to physicians' lobbies and the power wielded
by the pharmaceutical and hospital industries. (Submitted 7/24/06)
August 4, 2006
My family was finally in a position to apply for medical insurance.
We are in an income bracket that excludes us from Healthy Families but
doesn't leave a lot of extra money at the end of the month. I initially
applied with an independent insurance agent and applied to HealthNet,
the application was taking weeks to process and finally my husband and
children were approved. I was sent a letter telling me that I needed
to contact my physician for the reason of my denial. My doctor was very
supportive and attempted to determine the reason for the denial. Based
on my medical file he did not understand why I had been denied. Please
note that I have only been in the hospital for childbirth. My only other
visits were annual checkups which were always normal. It took several
weeks of correspondence with the insurance company which claimed that
they had never received my records. Medical records claiming they had
sent them twice and the doctor saying the file was sealed. It became
a run around that felt like a stalling tactic. I had personally sought
counseling for depression and after six months of my therapist recommending
anti-depressants I hit a low and gave it a try with the plan to get
off the meds in six months. In the interim our family moved to another
state and I sought help at the local community center to get off the
medication. This ultimately would be the reason for the denial and an
additional waiting period of six months before reapplication. What became
glaringly obvious to me was the double standard that an uninsured person
seeking preventative care could then establish a medical record that
would bar them from coverage in the future. I reapplied with Blue Cross
and we were approved at $255/mo premium with $5000 deductible for first
two family members. I consider myself a fairly intelligent person, someone
who reads the fine print, asks questions and understands a good deal
of the information and choosing a program requires an advocate that
can explain the coverages, deductibles, and limitations. We were able
to maintain coverage for about five months and then my husband who is
in the loan business hit the slow winter months. At first we fell behind,
then a cancellation was issued with a grace period in which the past
due premiums could be paid; the total was $765 to reinstate benefits.
When income is limited and you are stretching every dollar to buy a
meal for dinner, a few gallons of gas(which at this time is also climbing)to
continue to get to work, falling behind on utilities there is no lump
sum available to pay up premiums. We are uninsured again and I hesitate
seeking any medical help for the reason stated previously; will I be
denied in the future? (Submitted 7/10/06)
August 3, 2006
My husband retired 13 years ago and I lost my health insurance coverage
as a result. So, I looked for private individual health insurance. The
first company I used went out of the health insurance business and passed
me along to someone else. That one then went out of the health care
business and I got passed along again. This final company also went
out of the health insurance business, tried to pass me along, but failed.
I was unable to obtain any private health insurance because of several
pre-existing conditions. THANK YOU, ILLINOIS FOR HAVING AN "ICHIPS"
PROGRAM AND THANK YOU THAT I ACTUALLY WAS ACCEPTED. Fortunately, my
family can afford high premiums but $8,000 a year is one big bill for
those less fortunate than ourselves. There needs to be a better way!!
(Submitted 7/11/06)
August 2, 2006
My son 4 yrs old has an individual PPO plan from BlueCross to save money from the high cost of insurance that my company offered for HMO and POS plans. In to order to get PPO I had no choice but to get an individual plan for me, my wife and my son. Recently my son had a left forearm fracture and the doctor said that we have two choices to set the bone and we can do it either in his office or at the hospital. I was told that if it’s done in the office then the child might have to go thru bone setting procedure more then once while he is conscious. Having heard we preferred to get it done in hospital which they called a minor surgery with general anesthesia. The so called procedure was done in about 45minutes and my son was discharged back on the same night with a total stay of about 4 hours in hospital. After insurance having paid their share of 60%, my co-insurance is about 3500 dollars which includes the hospital bill, emergency treatment bill, anesthesia bill and doctors charges for the procedure. I believe the total bill would be more than 10,000 dollars including the insurance payments, insurance write-offs or adjustments and my co-insurance. The question here is: are these charges legitimate for a simple procedure like this. Who governs the charges for the services provided by these health care facilities? Can we question them? I tried my best talking to hospital to get the charges subsidized but ended up with payment over months option. (Submitted 7/13/06)
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July 2006
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