American Health Care System part 2

I spend a lot of my time dealing with health care. I have 3 dr’s appointments this week, and possibly a big ol’ test – if we can get insurance to approve it ASAP. So I think about health care a lot.

Today I was discussing live giving treatments and costs with a lady in a waiting room and it made me so angry I could barely see straight. Between that and a certain facebook post about a certain congressman who said “If you have cancer, and no insurance, sell your car.” Which made me vomit in my mouth.

I have a problem with our health care system.

Did you know that there are places in the civilized world where people think that internet access should be “an inalienable human right?” That’s right. In May of last year a United Nations Human Rights Council tried to decide whether or not “internet access” is a human right that should be defended and given to people in all areas of the world and, some would argue, for a minimal or no cost. That’s right. Internet access is considered by some very smart people of high influence to be a human right. Something we should not have to live without. Their arguments are sound – they list everything from sounding the alarm and getting info in a natural disaster to education in their arguments in favor.

I live in the United States of America. People are not even guaranteed basic health care by our country. In fact, we kind of have a “you can’t afford it? Well, too damn bad.” attitude in general to health care. We let children, mothers, elderly people, people just like you and I die every day because they can not afford health insurance.

I have to say it. I have to say it once – and I don’t care if you feel the same way or not.

HEALTH CARE SHOULD BE GIVEN TO EVERYONE. REGARDLESS OF WHAT THEY DO FOR A LIVING, HOW MUCH MONEY THEY MAKE, AND WHETHER OR NOT THEY CAN FIND OR AFFORD INSURANCE.

Guess what? Guess what I also think? I think health insurance companies are a racket – and I think they are killing people. They drive the costs up, they under pay doctors and hospitals so they have to charge more to cover costs, they choose what tests/treatments/help you get. THEY are the death panels.

(no offense dad – you know I buy life and auto and renters and health for my baby and husband. but come on! you know how much the health costs and how little it can provide for certain people IF they can afford it.)

I want to tell you a couple stories about some real life people. People either I personally know, or know through another person – one degree of separation or less here.

Story #1. My dear friend had an uncle. Her Uncle John died this summer of liver failure. He needed a transplant (now before you get all “well he did it to himself” on me, Uncle John had Hep C, not alcoholism – and anyone can be exposed to Hep C – and please get over this whole “he did it to himself thing” while you are at it) and he couldn’t get one. Uncle John’s story in her words: When he was first diagnosed with hep c his liver was healthy, if he had healthcare he would have had regular monitoring and outpatient treatments when his numbers started to change. But because he didn’t have healthcare, by the time he went to the ER with swollen legs 2 years later, he was in end stage liver failure. This man worked for the laborer’s union for 25 years, he at one point fell off his roof and shattered his pelvis, between that and multiple back problems from working in construction all those years, he couldn’t do it anymore. He had good healthcare through the union, but once he couldn’t do that type of work he lost it. But he continued to work. After several personal problems that were no fault of his own – he moved closer to family and started working temp jobs. With no insurance. When he started to get sick after 2 years, he was forced to go back to his old state where they at least have free clinics and low income housing. There he signed up for SSDI, and even though he was terminal, he couldn’t get on the transplant list without health insurance. SSDI took a long time to process, even though he hadn’t really been able to work for years and was terminal. He finally got SSDI (and medicare coverage)  9 months later and was put on the transplant list in May, the first call he got for a liver ended up being too fatty, the second call he was already in the hospital with cardiac arrest and not able to have the transplant, he died August 18th. He was 48 with 2 sons under 24. He left this world with nothing. He still hasn’t even had a memorial. I can’t believe people have to live and die like this in the greatest country on earth. I am so ashamed to live here.

Uncle John was a hard working man, living the American dream – work hard, do your share, provide for your family, get yourself a little money, a little happiness. And he died poor and abandoned by his country and it’s health care system.

American exceptionalism is the biggest lie I have ever heard. Or it has warped from “we are creative, we are ingenious, we come from many different backgrounds, and we use those differing viewpoints to our advantage” into “screw you, I will take care of myself and only myself.” One of the two.

2. My mother had insurance. She had good insurance, all her life, through her work. She even had veterans benefits if she needed them, because she had served in the army. She didn’t need them though, because she had good insurance. My mother was really sick the last 10 or so years of her life. They treated her for several different things that probably weren’t what was actually wrong with her. She had a couple major procedures done in that time, she had surgeries and babies and illnesses over her lifetime. She got a lot out of her insurance. But then, at the age of 56 or so, she was diagnosed with early onset alzheimer’s disease. She wasn’t able to work anymore. She took early retirement. When you take early retirement, sometimes you can’t get insurance through them anymore. She went on disability, but she couldn’t qualify for medicare until 2 years after her disability took effect. She had to start buying private insurance. It was expensive, though not as expensive as the option to pay per month for the insurance she had through her job. They soon found out that many many things weren’t covered. Or weren’t covered well. Treatments, hospitalizations, doctors in other states. All not covered or undercovered. Luckily her retirement was decent or they couldn’t have paid for all of her medical expenses and after she died my dad would have been drowning in debt.

3. I had insurance with my parents until I was out of college and age 23. I was lucky that I was still on my mom’s insurance when I had to have an emergency gall bladder surgery and had to stay in the hospital for 28 days due to a staph infection in my belly. Then for years I wasn’t covered. The jobs I had either didn’t offer benefits (nannying, maid service) or if they did, they kept people at just below the minimum hours to get benefits – like at a retail store. I started working for our local school district and was able to have good benefits for a relatively low cost. When I changed jobs I found one with benefits as well. For the first time in my adult life I had insurance coverage for 4 years in a row!!!! Then I got pregnant, and I was very ill. I was on bedrest during my pregnancy and had to stop working. I paid for the COBRA plan I was entitled to, but it was expensive – over $400 a month for just me. My husband was self employed and had no insurance to cover me under. I am glad I stayed on it, because not only did I have the baby, but I had cancer as well. I ended up fighting over 3 years against that cancer, and I just recently had my first good test results. 6 years after my diagnosis. During that time I paid for COBRA coverage as long as I was allowed by law (18 months) and my son either qualified for CHP+ – low cost health insurance for kids through the state which was very inexpensive – less than $100 a month, or was on my husband’s work insurance when he left his self employment job for one with benefits – that paid less. The benefits he has are expensive – it has always been over $300 for the both of them. At one point we were paying over $700 for the three of us to have health insurance (we couldn’t just buy my son insurance through hubby’s work – it doesn’t work that way – you have to pay for both). When my COBRA ran out I had to apply for the state’s “high risk” insurance pool – for people with pre-existing conditions that don’t qualify through their employers, for people who have exhausted their COBRA, or for people who lost coverage at some point and can’t get it back because of the gap in time where they weren’t covered. That was also expensive – $365 a month. FINALLY I applied for disability at my parent’s insistence  I had hoped I would be able to get back to a normal life – back to work – back to my old self. But it hasn’t happened. Through disability I receive medicare. It is sometimes difficult to find a new provider if I need a new specialist. If I ever want to go back to work even part time I will loose that benefit. But otherwise I have been pretty happy with the coverage I get. I have to pay for a secondary insurance, or pay 20% of all of my costs. Plus co-pays. My secondary insurance is just over $200 a month. Plus I end up paying for over half of my yearly prescription costs. Cash value – out of pocket. There is this thing called the coverage gap or the donut hole – whomever made that up should be brought back to life and tortured and killed. I don’t know how elderly people on medicare afford their prescriptions. No wonder people joke about them eating cat food. It isn’t a joke.

Here you have 3 examples of people who worked hard, had medical coverage. Who tried their best all their lives – or most of their life in my case – and still, the system failed us. It failed us when we needed it the most.

Newsflash, people – MOST people who need medical coverage look EXACTLY like you. Perhaps they had a set back – lost a job, were laid off. Perhaps they do work that doesn’t generally give out benefits. Perhaps they got sick, lost coverage, retired, got old. Perhaps they were born to parents who are struggling and don’t have benefits. MOST people who need medical coverage look just like you. And most who die from not having medical coverage ALSO look just like you.

Beyond all this – beyond the actual buying and selling of health care “benefits” – there is a lot of behind the scenes “approving” and “disapproving” going on out there by companies who don’t care a lick about you and look at you as a number. One of the diagnostic tests I had done that saved my life – that told us I had more cancer BEFORE we did the treatment that makes it almost impossible to take out the tumors after the fact without leaving a lot of cells in there because it makes it brittle – that test was not generally covered under insurance claims. In fact, the radiology department suggested it and when my doctor called to get it pre-approved he had to talk to them for hours to get it approved. Most docs simply can’t do that. They don’t have time. You can’t do it for yourself. The insurance doesn’t allow it. The radiology guy told me most people just DON’T EVER KNOW they could and should be getting it because docs know it isn’t approved most of the time.

How would you like to know that your son or daughter died because a test or treatment that usually isn’t approved was simply overlooked or not applied for, because it is too costly and time consuming to do. And that you were never even offered it- to pay for yourself or to find a way to make it happen – because most people can’t afford it? It happens all the time. And by all the time, I mean daily.

We have to be our own advocates. Do you know how hard it is to find the energy to make this happen when you are sick? Do you know how much energy it takes to research, make calls, contact doctors and hospital departments and stay on hold with insurance for hours at a time? I do. I could barely take care of my son and my physical needs, much less do all of that, and yet I had to.

In a health care system that is for profit, we all loose. We all loose out on quality care, time with our providers, treatments that could help but either aren’t FDA approved or aren’t insurance approved, we loose out on good medicines because the drug reps get into the doctor’s heads. We loose out on time with our families when we are at our sickest and we loose out on being able to concentrate on healing and fighting for our lives because we are focused on bills, insurance, doctors fees, hospital break downs, etc.

The people I know in countries with socialized health care get GREAT health care. The best – as good as mine ever was and better in some cases. I have talked to them about their cancer care, their birthing care, their pediatric care – they are all happy with it. In some places – like Canada – you can even choose to buy different coverage if you want, but you also have a universal system if you can’t afford that.

I know a lot of people are afraid of universal health care “taking away their choices and taking away their rights.” Honestly I think the biggest problem is that many people don’t “want to pay for other people’s health care.” I have heard this a lot. To them I say first: What is wrong with you? Have you no human decency? YOU would rather have children and elderly people dying painful deaths than to pay into a universal healthcare system? Second: who do you think pays for the under or uninsured right now? We all do – in higher premiums, higher hospital and doctor’s fees, and emergency medicine costs. We pay for it already.

Why not build a system that works better and helps more people for the same costs?

If you don’t like “the Affordable Health Care Act”, that’s fine – I respect logical discussion about this issue. But don’t just shut down the entire discussion because you are afraid. If you have better ideas FOR THE LOVE OF GOD, bring them up, pass them around, take them to your representatives, go to congress. DO IT. Because this system is broken, and so many people have been brought into hysterics from the lies about “death panels” and “not being able to make your own health care choices” that we can’t get into this new system to even see if it will work.

I don’t like to be hysterical, but you know what? Right now our health care system warrants hysterics.

It’s broken.

People are dying.

Figure out how to fix it.

Cause this shit is broken.

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