Cough Cough….Sniffle Sniffle

My side of the story

I have had 3 (what I would call major) medical procedures during my lifetime…..and the only one that any type of employer related insurance paid for was having my wisdom teeth removed in 1995. It was the summer before I entered college and I was still a dependent on my mother’s insurance.

I’m a unique situation. I was born on Carswell Air Force base. All of my medical treatment for the first 10 years of my life was there. I am now the wife of a veteran….again…..military medical treatment is available. In between those years I was often a cash patient with the exception of my college years when my mother began taking advantage of the health benefits of working at a hospital and my father rejoined the government as an employee. I had “good insurance” then. I could choose between BCBS or Kaiser depending on where I was.

Let me stop right here and tell you that “good insurance” is an oxymoron. Seriously. Before I got married I declined all employer paid insurance and resumed being a cash patient. When I got married we re-evaluted that decision with the concern about pregnancy and childcare.

Let me give you a little background on my decisions and beliefs that our current health insurance system is extremely flawed and mostly benefits the physicians, insurance companies, pharmaceutical companies, and politicians in bed with them.

In 1997 I lost my eyesite and was told that my spinal cord was producing excess fluid which was building in my head and putting extra pressure on my optical nerves. My opthamolegist referred us to a neurologist who had experience with such a thing. He was the best in the city…..and not in our NETWORK. So we went into the first appointment as a cash patient (we being my mother and I). What happened is what happens to (what I believe) is all cash patients. We gave him a deposit to get the process started, worked out a payment plan, AND MADE PAYMENTS. Imagine how my mother felt to work at a hospital and have her insurance tell her that her only child’s neurological issue would not be covered by the insurance that she made payments on every month. At the end of the day we paid the doctor a total of $5,000. Yes…low income families will not be able to pay $5,000…but they will be able to make payments and they will be healthy. Which is more important!

Now to add to that….consider this scenario. A patient WITH INSURANCE goes to the doctor and is diagnosed as diabetic (which is a common occurence in the black community). When I was working my insurance payments were $110 weekly. So imagine I am that patient…I have already spent $440 for the month on insurance (assuming we’re only in January….like I actually go to the doctor enough to use that much benefits). The doctor’s co-pay is $25. To diagnose me, the doctor orders additional tests…glucose levels and such. Then they write me a prescription which I prompty take to my local pharmacy. Remember…we’re at the beginning of the year, so there is a deductible to be met and until it has been done, there is no discount. So let’s say that the medicine cost s $60 (generic of course). Two weeks later I get a bill from the hospital for those additional tests….$200. Two weeks later I get a notice from the insurance company saying that diabetes is a PRE-EXISTING CONDITION and is not covered… my claim has been denied. That means I’ll get another bill from the doctor for the services ($250) and the monthly medication will be full price. So for the month of January I have spent $950 to be told that I have diabetes and need to pump myself full of medication on a monthly basis. And by now it’s February so I’m paying another $440 for this INSURANCE.

The good thing about our show is that the three of us are truly in different stages in life.  TJ is a parent….so her health insurance concerns include the best option for her children.  Melette is a single professional relying on employer sponsored benefits…she deserves options other than those of people getting kickbacks over cigars and golf.  I am a veteran’s dependent and have been all my life…..but I also recognize the luxury of not depending on a PPO or HMO and being forced to wait 8 months for a doctor’s visit because they aren’t taking any new patients.

I reached a point where I got tired of paying co-pays and deductibles and decided that I wanted to control how my money was spent in terms of my health care. So I became a cash patient. When I got sick I didn’t worry about finding out who was covered and at what percentage…I just called and made an appointment and went. Some people will say that they can’t afford that option. No…what you CAN’T afford is to get laid off in this piss poor economy and have no income AND get dropped from your insurance company! That is why this health care reform is so important!

The current administration is proposing comprehensive healthcare and believe it should:

  • Reduce long-term growth of health care costs for businesses and government
  • Protect families from bankruptcy or debt because of health care costs
  • Guarantee choice of doctors and health plans
  • Invest in prevention and wellness
  • Improve patient safety and quality of care
  • Assure affordable, quality health coverage for all Americans
  • Maintain coverage when you change or lose your job
  • End barriers to coverage for people with pre-existing medical conditions

On this past weeks’ show we addressed all of the above issues as well as pregnancy as a pre-exising condition (it is one), end of life counseling, and myths that are currently floating around.  I strongly encourage everyone out there to read the links we’ve posted, visit the REALITY CHECK section of the White House’s health care reform page, and gather information about the issue.  Do not rely on your favorite radio or television personality to keep you informed…get the facts for yourself.

FACT: There are no plans for a death panel.  That is a fear tactic.

FACT: You will not be FORCED to discontinue the insurance you have now (if you have any).  You will have the OPTION to choose.

FACT: Obama’s plan for health care reform “ends exorbitant out-of-pocket expenses, deductibles or co-pays.”

MYTH: The Democrat-backed health care reform plan “will require (Americans) to subsidize abortion with their hard-earned tax dollars.”

MYTH: Illegal immigrants will be given insurance under the Democrat backed health care reform plan.


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