Hi Everyone,
On Saturday, I wrote a neutral summary of Obama’s Health Care Plan. Tonight, I’m going to write two more-personal stories. First, about my experience with health care in America and second, about my parents' experience.
I have a big fear of visiting doctors. Even with health insurance, insurance companies always find ways to weasel out of paying for your visit and sticking you with the bill. Last time I went for a “routine physical,” it cost me $600.
If you want the details, here they are. I called HealthNet the day before my doctor’s visit asking them if they would cover the costs of a routine physical. (In America, you have to call insurance companies before going to the doctor to get approval for the visit, or risk being stuck with a big bill.) The rep I spoke with said my visit would be covered. A month later, I got a bill from my doctor for $600. And that I could pay him using either a Visa or Mastercard.
It turned out that HealthNet RETRO-ACTIVATED MY ACCOUNT. I didn’t know what retro-activated meant until they did this to me. If you go to a doctor on August 1, and the bill is too expensive or the insurance company doesn’t want to pay for it, they it can “rewind” your insurance to July 1, or a previous date, and say that you weren’t covered on the day you visited the doctor - and stick you with the bill.
I did some further investigation and found out my employer didn’t want to pay the premiums for their employees’ health insurance. So they retro-activated their employees health insurance accounts to get a refund on the premiums. All this without notifying their employees. So the employees went to doctors thinking that they would be covered, only to be stuck with big bills. TIP: Never buy into health insurance plans you can't personally control. I learned this the hard way.
This practice is a lot more common than you think. The more people I tell this story to, the more I hear, “that happened to me!” What a disgrace on both employers who do this and health insurance companies who still retro-activate accounts.
I enjoy telling my international friends how insurance works in this country, because they can’t believe that the health industry here is run for-profit, how you have to call insurance companies before going to the hospital, how you can only go to certain hospitals within your “network,” how the more money you pay, the better your treatment and drugs will be, and how you have to nickel-and-dime your doctor and choose what treatments to get because you can’t afford them all.
I write this not to be pessimistic or tell you about my problems. Hopefully, you will have stories to relate to this. If you have frustrations with the way health-care works in this country, you’re not alone.
I’m really fortunate that I’m healthy (although I hate going to doctors and dealing with insurance). I’m really fortunate that my bill came out to be $600, and not $60,000 - which is the cost to treat a heart attack in this country.
What I’m most concerned about is the health of my parents. Probably some Asian-Americans can relate to this. My parents are immigrants, and they don’t speak English. My parents do not know the difference between a deductible, premium, or co-pay. So they go along for the ride - trying not to rock the boat.
My dad is a butcher at a supermarket. His company offers him health insurance, but he has to pay for the premiums himself, and the company plan is not that good. The plan has a $4000 deductible, and doctor visits aren’t covered until the deductible is met. So he pays an absorbent amount of money every time he sees a doctor. Not making that much money to begin with, he spends over $5000 a year on doctor visits and health insurance.
My mom is a home care provider for the county of San Joaquin in California. The county provides health insurance, but only if she works 20 hours or more a week and pays $100 a month for the plan. My mom liked her insurance, until her hours got cut at work. She then lost all her insurance. My mom has psoriasis and takes expensive pills for it. But because she lost her insurance, she stopped taking her pills. I can’t tell you how heartbreaking it is to go home and see your parents stop taking their medications because they can’t afford it.
I can’t tell you how heartbreaking it is to see your parents barely getting by, and having to spend a bunch of money on doctor visits and health insurance premiums. I offered to buy them better insurance and pay for their medications to make their problems go away, but they keep refusing me.
I am so saddened by this situation, beyond belief. I write this not to bring you down, but to give an honest account of health insurance in America today. The health industry is really run for-profit here. The more you pay, the better treatment you get. I hope you can relate with your own personal stories of health insurance in America.
I think the people who say that they are happy with their insurance only say it because they haven’t seen anything better. I understand your frustrations with the system. I understand it’s no fun having to call insurance companies to get pre-approved to see a doctor, or fighting with them over payments, or having to explain to your parents or children that their insurance got cut, and that they could no longer see a doctor or take their medications.
There is hope. Our country is talking about health insurance reform again. I’m glad Obama is bringing up the issue of health care in America so forcefully in his first year. Whether we see Obama’s plan realized, or a variation of it realized, one thing that we all agree on is that our health insurance system needs to be changed for the better.
Thank you for your post. I hope the best for you and your family.
This is a very moving post. Thank you for sharing.
Thanks for your moving account of your experiences with the health care system. My parents were fortunate to be covered by insurance when benefits for public sector workers were good. I would like to think that this time around, more people would understand that the current health care system only works for a few. Rather than ask "What's in it for me?" we should be asking "What's in it for us?"
As for pharmaceuticals, we should have more companies like OneWorld Health -- a NON-PROFIT pharmaceutical company. I think their product lines are limited in scope, but I really like the business model. They're based in Berkeley. http://www.oneworldhealth.org/
Your stories are so disturbing... so much cause for concern. One of the frequent arguments is that our health care is so expensive because it such high quality- also, as it turns out... a myth, according to Elizabeth Olmsted Teisberg, co-author of the book Redefining Health Care...
http://www.youtube.com/watch?v=7fSjfGYCqEw
best!
Kathryn Jones
MSL
Having lived in 5 countries on 4 continents, I can only say that I like the Canadian single payer health care the best (in the 5 years that I lived in Canada, I was able to go see any doctor and to have any test and treatment anytime I wanted, with no restriction whatsoever, best of all, I didn't have to deal with any medical bills at all). I like the American health care the least. Our health care is by far the most expensive, inefficient and inhumane (not to mention most complicated and restrictive) among Western industrialized countries. We spend more than twice as much per capita annualy than any other nation in the world on health care, yet we ranked 34th as to the results.
There are so many outrageous lies and misinfos out there to scare people and fight the health care reform, but the truth is that all the government run health care in other Western industrialized nations are far superior to ours. The reason our health care is such a disaster is because it is controled by private for profit corporations, who are out to maximize their profits ruthlessly and unscrupulously at the expense of ordinary Americans, impoverishing and bankrupting our entire nation in the process and making American businesses less competitive in the world.
Do not believe all the lies and propaganda spread by the conservatives. The facts speak for themselves. When asked, no single Canadian was willing to trade their health care with ours. Neither anyone else in the developed countries, I am sure. Our abysmal health care proves that government can run health care far better than private for profit companies. In fact, our own Medicare and Veteran care are testimony to this. While no health care is perfect and without flaw/problem, our clearly is by far the worst overall.
We must reform our health care right now, we literally can't afford not to.
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