Yes, I am Selfish

I have a health insurance story too. Don’t we all? Mine isn’t as dramatic as some who have been denied needed supplies, such as testing strips for diabetes, or important tests, such as those for a suspected heart problem, but it’s my story and that makes it important—at least to me.

My regular readers know that I suffer from Fibromyalgia Syndrome and they also know that TheMan was recently laid off from his job. My condition is chronic and regardless of what some people have said, it has been progressing (though not necessarily causing permanent harm) and I need to be able to access my doctor. When TheMan got laid off we lost his insurance and my access to my doctor. People will say “What about COBRA?”1, which we were offered. However, COBRA coverage would have cost us $900 a month. For the people who are screaming that we don’t need anymore government mandates or that we don’t need government involved in medical care, this probably doesn’t seem like a lot of money. But when one person in your household is on unemployment2 and the other is working two part-time jobs that don’t pay a lot or offer employer-provided health insurance, there isn’t $900 lying around to pay for the COBRA. We have to pay a mortgage3 and the electricity and the other bills—including, but not limited to food and household supplies. I wanted COBRA, of course, but it really wasn’t a realistic option.

Of course, the first thing I worried about was my “pre-existing condition”. Not how am I going to continue care or let me find a cheap doctor, but how I would manage to get insurance to cover my chronic condition were TheMan able to get back to work. Once you’ve lost the insurance and it’s been lapsed for so long, well, the new insurance won’t pay for what the old insurance paid for. The Certificate of Coverage would mean squat after about 60 days from the point the insurance lapsed. Luckily for me I was eligible for a personal “gap coverage” type of insurance that will, I hope, allow me to get treatment when we’re able to get our insurance back. The premium is only $120 a month. I can’t actually seek treatment for my condition(s) though, because my insurance specifically states that “This policy will not cover treatment for chronic conditions. We recommend another policy for those needs.”4 This gap insurance only pays $1500 a year, 2 days in the hospital and no more than $50 a month for prescriptions—after the $700 deductible for medical treatment and $20 copay for all prescription whether they be generic or not. I can find a new doctor to treat my symptoms, though, but only the ones on their list and only if they’re taking new patients. On this type of policy, there really aren’t that many doctors. I’d like to find one where the office visits cost less than $100, but that’s not likely to happen so I’ve got to figure out a way to get the money for my initial visit (remember the deductible?).

I’m scared, though, because I’ve developed two new symptoms, which actually might not be directly related to my FMS, but which scare the fuck out of me. I mean, sent me into a panic attack and nearly had me to the emergency room. The issue of money has prevented me from going to the doctor for any reason but I especially fear the cost of tests. Did you know that a lot of doctor’s will refuse to see you for a second time if you refuse to follow their treatment guidelines5? Interesting, huh? “Sorry, Doc, I can’t afford that procedure. Can we do something else?” leads to “You obviously don’t want to follow my advice, so you’ll have to find a new doctor. Thanks for coming.” This almost happened to me when I had insurance, actually. I had more confidence to tell my doctor where to stick it at that time—but that’s a whole other story. Anyway, I digress. My symptoms are pretty damned scary and are a big reason I stayed mostly offline for two months. Who needs the stress of seeing other people’s problems when yours are taking over your life? Not me. I didn’t care about what other people were going through because I was so goddamned scared.

I’m going to have to bite the bullet and go see someone and to hell with the costs. Really I am. I know that. I’m a mother and have a responsibility to my children to be alive when they need me. I also know that finding out what’s wrong with me and then getting treatment will send us over the edge. I will have to have an MRI and blood work up. There is no doubt about that. Do you know how much that costs? I know what it costs with insurance and they paid 80% of my last one. This one will be out-of-pocket. And doctors tend to charge more when there is no insurance contract to hold them back. That’s not fair, but it’s a fact. Another fact is that I will no doubt be denied some kind of test or treatment based on my ability to pay. If I was a rich woman I would get gold standard treatment, as it is they will do only what is necessary to cover their own asses.

I keep reading about the UK and Canadian health care systems and how they get pissed at them, but they don’t have to worry about the cost. They don’t have to worry about losing their homes and possibly their lives because of the cost of health care. I see these fucking nutters screaming “we don’t need government health care! Buy your own!” and blah blah blah. They’ve got it, no doubt, and many of them are on government programs. They say we don’t need anything like what the British, Canadians and French enjoy, but we do. When people work their asses off and still can’t afford to go the fucking doctor, something is fucking wrong. I don’t give a damned if someone thinks government is too big—and then enjoys such things as driving on safe roads, knowing 9-1-1 will bring the firemen when the house is burning and knowing they can go to the store and someone has made sure the food there is safe (relatively speaking). I don’t care about the hypocrites. I have no use for them with their spouting off about the evils of government coming between them and their doctor and rations and other such bullshit.

Have you tried to get “experimental treatment” for a condition through your insurance? Have you read the exclusions of your medical insurance? Have you read how much they’ll pay during your lifetime? THE LIMITS OF PAYMENT? Did you know that some schmuck who’s never even met you looks over your files and then determines what treatment they will pay for based on the file? Unlike the “death panels” bullshit or the “government intrusion” bullshit, these are not talking points. These are truths. When you have insurance, there is ALREADY someone coming between you and your doctor. There is already someone looking at the numbers and deciding whether a certain treatment is beneficial to their bottom line. This is how things are now. Except millions of people can’t even get those few benefits offered by the insurance companies because they can’t afford them. Insurance companies run this fucking country and it needs to stop. There should be no reason why someone has to go to the emergency room for basic treatment—except that’s the only doctor they have because no one else will see them without medical insurance. Why cut off health care for millions of people instead of getting these damned companies in line? You know, it was nice being able to go to my doctor and get those tests run and find stuff out—though it took 2 goddamned years. Through no fault of our own, though, that was taken away from us and our health care is rationed.

Gods, but I’ve pissed myself off now. I feel so helpless because of this fucked up condition I have and the fact that these motherfuckers are going to torpedo health care reform so that the insurance companies can continue to suck the life out of Americans. And I don’t really expect anyone to give a rat’s ass about what’s happening to other people. My situation doesn’t hurt anyone but my family and me. The situation of millions of other people doesn’t hurt anyone but their families and them. People with insurance and good jobs and pseudo-options6 can easily look the other way while other people suffer. They don’t realize that they’re one layoff or job loss or heart attack away from losing that security and that ability to say “FUCK YOU, people with no insurance”. And in my evil mind, with the way I feel right now, I wish that the loudest motherfuckers telling me to suck it up would fall flat on their faces. I wish this suffering on Glenn Beck and Rush Limbaugh and those spineless motherfucking Blue Dogs (I’m looking at you, Zack Space)— on every single person that works so hard to deny me the security of affordable health care. I wish they’d lose their insurance and then come down with a chronic, life-threatening condition. And I don’t feel the least bit guilty about it. I’m sure that whenever someone in their community has a fundraiser to pay for an organ transplant or cancer treatment they are right there offering up their hard earned dollars. Right? Don’t hold your breath. Why should any American have to hold a fundraiser for a fucking organ transplant?

By the way, Medicaid pays for those. Did you know that? So, there ya go. As long as you qualify for Medicaid you don’t have to worry about actually paying for that liver or having your insurance company deny payment for it (please take a moment to look at your insurance’s policy on organ transplants).

The rest of the family, though, is covered. Lil’lady is getting Healthy Start, which offers the Medicaid card, and TheMan is covered through the Veteran’s Administration—both government programs. Lil’lady’s regular pediatrician agreed to take the Medicaid for her7 and TheMan has no problem getting an appointment at the VA clinic. At least those two are well cared for (except for Lil’lady’s dentist, but that’s a whole other story). TheMan went back to work, but because he was laid off for so long he’s not eligible for the insurance until November’s open enrollment. Who knows if it’ll still be available to him then?

The fact is there is no reason something can’t be done about this right now. There is no reason our country can’t take care of our people—just like France, Britain, Canada, Germany, et al. These countries aren’t flushing themselves down the toilet of despair by taking the burden of health care off the shoulders of their citizens. These countries aren’t stifling new business/ small business by offering health care to their citizens. These countries aren’t falling back into the dark ages because government pays for the health care of their citizens. I don’t give two fucks what some rightwing noise machine claims. Look for yourself, talk to the people living with real options. Then talk to people here who don’t have the same sort of options—or even any options. Compare notes. You know, one guy might have to wait 2 weeks to get that corn removed from his foot, but he doesn’t have to pay for it. Yes, there are wait times in those countries. Guess what? There are those here too. Sometimes longer. But we have to pay a hefty price for it. They spend less on their health care—even through taxes– than we do on ours. Make sense? Not to me. Not to this person who is dreading getting treatment because she doesn’t want to lose her house. To the townhall mobs and Glenn Beck wannabes, I give a not-so-healthy fuck off. I want what those other countries have and I too am willing to fight for it. I’ve got a better reason to fight against the anti-reformers than they have to fight the reform, though. My life may depend on it.

P.S.

I’m looking for neither sympathy nor money and that’s why I haven’t included in this particular diatribe my new symptoms. I’m fully aware that other people have bigger problems than mine and I’m fully aware that some fuckhead will think I’m trying to get money. I’m not. The point of this post is to point out that I do, in fact, have an excellent reason to support healthcare reform and that there is a good reason why I can’t even engage in a “civilized” debate with the other side.  

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  1. Which, by the way, was mandated by the government. []
  2. Another government program, by the way. []
  3. On a house we bought with A-1 credit and a $10K down payment, I might add. No foreclosure for us. []
  4. At an outrageous cost, of course. No way could I afford that. []
  5. Things they “suggest” you do for your particular visit. []
  6. You’re really not in charge of your health care, but you’re allowed to think that while you’re paying the premiums and deductibles. []
  7. Contrary to popular belief, doctors in Ohio aren’t required to accept it and, in fact, most don’t. []

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