Thursday, July 23, 2009

Story Time

Let me tell you a story. This story is about a woman. This woman got into a car accident. This car accident was caused by the other driver. This woman was seriously injured. She was in serious pain. She was uninsured.

The way that insurance companies work is her insurance (theoretically) would pay her bills. Then her insurance company would go after the other driver's insurance company for reimbursement. Because she was uninsured, she could not afford the treatments. She went to physical therapy as long as she could, but it is expensive. What she really needed was surgery. Surgery may have alleviated the pain that she will now feel for the rest of her life.

She sued, but lawyers, too, are expensive. The lawyer finally told her to settle. It was the best she could do under the circumstances. The settlement was not enough for the surgery.

Let me tell you another story. This story is about a man and a woman. The man is employed by a hospital. This hospital gives its employees good insurance, as hospitals do. The woman got cancer. The man's insurance covered some of the bills. It did not cover enough. The woman is currently fighting cancer. Both are fighting to keep their house.

Here is another. This story is about a boy. This boy is only 19, but has been away from home for several years now. This boy does not have a job. This boy gets some assistance for health care through the state. This assistance does not cover dental work. This boy has immense pain in his mouth. It is more affordable for this boy to wait until the pain is completely unbearable so he has to go to the emergency department than if he went to the dentist. The assistance will help pay for the emergency visit. This boy must wait until it is a medical emergency before he can get help.

Okay. One more. This is about a woman. This woman had some knee pain. She has insurance and goes to her primary care physician who refers her to a specialist. The specialist says that she needs a MRI. He cannot order one, though, until an xray is done. The specialist knows that the xray will show nothing, but must order it because the insurance company will not pay for the MRI until an xray is done.

The xray is done. The MRI is done. The specialist tells the woman to get a prescription knee brace and go to physical therapy 2 - 3 times a week. This woman cannot afford to go 2 - 3 times a week. She cannot afford to go once a week. This woman goes every other week for six months. One of the underlying problems, they find out, is that this woman has flat feet. With the proper shoe inserts, this can be fixed. Then she would not have to go to the physical therapy. The insurance company does not cover any of the costs of the inserts. The insurance would, however, continue to cover the p.t. indefinitely. They would rather spend hundreds of dollars a month on p.t. than a couple of hundred dollars up front.

I could tell you more stories and I am sure that you could tell me thousands of similar stories. These are the reasons for health insurance reform. These people are the reasons for health insurance reform.

People claim that the quality of their health care will go down. First I ask: Is your care really that good? Second I beg these people to listen to these stories. Listen to the people who are getting screwed by the insurance companies or who are uninsured. Listen to your family, friends, and neighbors. I am sure that each person will hear stories similar to mine. Finally I ask that these people to listen to what these bills in congress are actually saying. Not just what they are told that they say by uninformed sources.

Okay, I am coming down from my soapbox for the night. I just believe in this so passionately. It always saddens me when the people who would benefit from change the most are the same who oppose it. For instance, the poor southern states. These lower class people who were being screwed by the republicans, are also their biggest supporters.

The last story, btw, was mine.
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  2. You've brought up a topic that drove me nuts while I was living in the US.

    I've been through the whole x-ray, MRI crap there too. I got all better on my own by the time I waited 6 weeks to see a neurosurgeon.

    I hope the US passes health reform. I've lived with universal health care all my life and it's not perfect, but it's so much better than in the US. I have never had to make a regular doctors appointment here. I will pay more taxes any day for universal health care system.

    This is the quality of health care in the US from an outsider's experience, and it is by no means anything that bad.

    I always had to wait 2-4 days to get an appointment with ANY doctor for anything (although I've now found out Walgreens does walk-ins). I felt like I was in a third world country having to wait 3 days, take the afternoon off of work and drive all the way across town (there are only doctors out in the white suburbs) just for a check up. Then all I got was 15 mins of paperwork, waiting 20 mins to see a nurse, another 20 mins for the doctor (to bill for 1 hour?), and doctors who are too afraid to screw up and need things to bill my insurance to pay for their professional indemnity insurance. So they just put you through the system with all their tests, prescriptions, referrals and follow-ups until you find someone experienced enough to give you some answers.

    Anyway, I don't think I want to work as a nurse in the US unless they fix health care.

  3. Exactly. That is exactly how it is everywhere. I think people don't know that it can be different - that it is different everywhere else. Its really nice to have an "outsider's" point of view.

    Hopefully this passes so you can come work here! :D

  4. Well said. It's sometimes hard for me to understand because I've never had any real health problems. I now have health coverage through my employer, but my boyfriend is completely uninsured and vulnerable. it's too expensive. it is very scary to think of what could happen.

  5. I pay a small fortune for health insurance that doesn't cover half of what I need in prescriptions. What it does cover, I then pay another hefty co-pay to pick them up. I'd rather pay the taxes and help make sure Everyone is covered.

  6. Great post! Don't even get me started on insurance stories since I can go on and on and on and on........

  7. I concur wholeheartedly! And this, coming from a woman whose 2-year-old needed ear surgery because of a series of damaging ear infections. The insurance company denied the procedure FOREVER, claiming the surgery would be cosmetic. Give me a break. Lots and lots of hootin' and hollerin' later, my kiddo got her surgery, and the insurance company paid for it...reluctantly!

  8. I was lying in bed last night after I typed up this novel thinking Ive probably pissed off all of my readers and Ill have none when I wake! :D Silly, I know, but whatever...

    Partly because I took a stupid facebook poll yesterday and it said that 70% of people were against it!

    Melissa, I cannot believe they wouldnt pay for the surgery! That is horrible! My son needed tubes in his ears. if they had said they weren't gonna cover it, I dont know what I would have done. Good for you for standing up to The Man!

  9. Just to give you a little bit more perspective. I get free basic health care for about the same amount of taxes I was paying in the US. I can choose to buy optional private health insurance for $20/fortnight! That covers me for private hospital, ambulance, dental, optical, PT, chiro, and pretty much everything I was covered for $100/fortnight in the US (plus the other $100 my employer was paying).

  10. doesnt that make me wanna move to australia or what.... everyone critizises him for being socialist, but would that be soo bad??


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