probably a billion blogs and counting on the issue but i’m blogging from the personal experience side (probably a million personal blogs on that too)….
two things keep coming up on the healthcare reform issue that strike me. one is the preexisting condition issue and the other is the having no coverage with financial issues. i’ll speak personally to both.
when i was child i had medical issues. 1) asthma 2) migraines 3) bronchitis/pneumonia. these issues came up over and over again. i had to see dr.’s repeatedly for these health issues. it was draining on my parents finances. my father owned his own business and healthcare was expensive so they paid out of pocket when they could. when they couldn’t, i would borrow my dad’s asthma inhaler or by an over the counter inhaler. i was miss 3 days of school at a time to deal with migraines because we thought it wasn’t threatening enough to justify the expense of doctors and e.r. visits though my mom did try now and then. because i have asthma and allergies…during cold seasons i would be hit hard.
i was hospitalized on christmas 1988 for pneumonia. (a neat aside to that later.) that was out of pocket for my parents….why? because when my mom tried to get health coverage for me…(just for me…couldn’t afford everyone) the insurance company agreed to cover me.
yeah!
not so fast…they would cover me for everything but asthma, migraines and bronchitis/pneumonia as they were each preexisting conditions.
what??
yep, preexisting so therefore, not covered. what the hell did we need insurance for if not for those things that keep happening? so my parents said no thanks and quit the coverage. so when i was hospitalized, that was out of pocket for my parents.
the second issue is the financial burden imposed upon people who cannot afford health insurance or are not covered because of preexisting conditions.
as i said before, my dad owned his own business (a tavern/restaurant). it took awhile before he could afford to provide health insurance to his employees and himself and family but he finally was able to get something together in 1986. the policy would begin to take effect on 1 may 1986. this was after a 3 month waiting period. (i believe the waiting period is to give the health insurance company time to see if there is anything they can exclude from your coverage but that’s just my speculation.)
on 28 april 1986 my father was stricken with pain in his head that was beyond anything that i had ever seen before or since. it’s fuzzy but i remember him laying on our living floor holding his head in his hands wailing. now, my dad was a man’s man; he didn’t cry…wasn’t a wimp or a wuss…thought pain should just be shaken off. to see him like this was incomprehensible.
my mom (and maybe my brother…it’s fuzzy) called an ambulance and the emt’s decided to take him to a local area hospital to figure out what was going on. fairbury hospital was a small hospital…extremely small. he spent spent 3 days there in a drugged haze (for the extreme pain) but the hospital was unable to figure out what was wrong with him so sent him to a larger hospital in kankakee (st. mary’s). dad didn’t remember much about the fairbury stay except for a porridge that they gave him which he said was awful! (dad was always a joker.)
in kankakee, they finally diagnosed him with a brain tumor just behind his right ear. it had gotten large enough to compress the area and that is what caused the pain. the were able to perform some procedure to relieve the pain but weren’t comfortable operating on him there so referred him on to northwestern in chicago. (a cute aside…a limo was cheaper than an ambulance so, with the ok of the hospital, dad rode in a limo to northwestern rather than an ambulance.)
dad was able to receive surgery from a top neurosurgeon, leonard cerullo, and was tumor free soon after. it was large cell lymphoma so dad was in line for chemo and radiation.
here’s the kicker…since he entered the hospital on 28 april and his insurance waiting period wasn’t up until 1 may….guess what??
preexisting condition!! the tumor was preexisting even though it wasn’t diagnosed until after he applied for the insurance and even though he had NO medical visits related to the tumor before applying. even worse….
he wasn’t covered for the tumor, the surgery, the chemo, the radiation, the hospital, the ambulance, the doctors visits…nothing. boy were we in trouble now!
of course my dad didn’t have health insurance coverage for any of these things…that’s the way of the insurance industry going way back. that didn’t mean he could just ignore or let those things go. he still needed treatment….it was cancer after all!
my parents had to go through all of their savings, be denied medicaid (because they owned a home, car and life insurance {on a sick man no less!} which they wouldn’t/couldn’t sell or cash in) and file bankruptcy on the more than $100,000 worth of medical bills associated with this tumor. (the amount may be higher…i’ll have to ask mom.)
i have absolutely NO faith in the health insurance industry. NONE! what good is insurance if it doesn’t cover preexisting conditions? what good does the health insurance industry do if denies coverage and forces americans to run through every dollar they have?
a public option is a necessity if for no other reason than to keep the health insurance industry honest! if a patient is uninsured and ignores their disease (say diabetes for example) until the point that they are no longer able, of course the costs are going to be high. you’ve allowed major problems to evolve because of the lack of care. now this person has to be seen (or die in some instances) whether in the e.r. or a dr’s office. it’s now no longer preventative care (obviously) but is like trying to put your finger in the dike to stop the leak…almost impossible. (there are better sites out there that can give you the cost figures.)
i did read various sites that say preventative care costs more because then everyone wants to be screened. let’s get real though…do i need to be screened for diabetes when no one in my immediate family (back to grandparents) has had it and i show no other symptoms related to it? no, be realistic.
ok…cute aside on my pneumonia hospitalization. as i said, i went in on christmas…that evening. my mom and aunt sharon took me to the e.r. and i was admitted. i had a roommate…she had to be well into her 80′s at the time….by the name of zelma speed. i’ve never forgotten her. she was sweet as could be. she had her pastor pray with me everyday since i didn’t have one to visit me (i was still lutheran at the time) and was just really sweet everyday. i saw her obituary a few years laters and was saddened to see that she had died. she was so sweet and i just loved her name.
ok, maybe that story only appeals to me…
