Yesterday, I was listening to the Brad and Britt show while I was out running errands. They’re an entertaining duo, kind of a more reasonable and subdued version of Hannity & Colmes – before Colmes got the boot. They do their homework and offer intelligent commentary on the issues of the day. Lately, they’ve been talking a lot about health care.
When I tuned in, they were taking phone calls, asking people “do you love your health care?” And, a surprising (to me, at least) number of people were answering “yes.”
The one call I was able to hear in its entirety (it's annoying, getting caught up in an interesting discussion on the car radio, only to wonder what I’ll miss because I’ve reached my destination), was from a father whose disabled daughter had passed away last year. Now, I realize everyone grieves in their own way, but this guy sounded too matter-of-fact (or, as Mark noted, “chipper”), given his situation. Brad and Britt sounded dubious, too, hesitantly offering their condolences.
But I digress.
The father said he loved his health care (via United Healthcare). As his daughter’s health had declined, UH had covered everything, except one ambulance ride – and that was because it had been coded incorrectly. He went on to knowledgeably describe how you can’t get all your health care services up front. You need to pace yourself. In other words, know how to work the system.
And that’s when I had my (albeit belated) A-Ha! moment.
Americans are complacent about our health care system. It’s become second nature to us to “work the system,” and if we don’t know how, our doctors guide us through it.
As noted in a previous post, it shouldn’t be this way. It’s time to turn this country around, and get us on course with the rest of the industrialized world – those countries who make it a priority to offer everyone the quality health care they need, when they need it, for an affordable price.
I embraced Emily’s story because I could relate to it on multiple levels: 1) I also have scoliosis; 2) I totally “got” her mom, Suzette, and her will to fight for the best medical care for her child, and 3) like most Americans, I have my own health care horror stories.
Most recently, my husband, Mark, was recruited for a great job opportunity. He wasn’t even looking, but the timing was right. He felt stagnant where he was. The new job was a terrific career move with a good company, and it even paid a little more. And yet we agonized over whether to accept. Why? Health care.
The new position is a contract job through an agency that offers group health insurance to its employees. But how did this plan compare to what we already had? What were the deductibles and co-pays? How much would it cost us each month?
We couldn’t get these answers until Mark actually “accepted” the job and was entered into their system (Mark told them up front that if the health care didn’t pan out, he’d have to walk away). Only then did we receive access to the details we needed to make a final decision.
Once the decision was made, you know what comes next -- a one-month waiting period (October) until the health insurance kicks in.
Since Mark has an uncanny sense of knowing when to leave a company (his resume is a list of places that have either gone out of business or drastically downsized), I’ve become somewhat of an expert at this dance. I rescheduled dentist and doctor visits to occur after Nov. 1. When my son, R, did need to go to the doctor’s office last week, I told them we’re temporarily without insurance and they usually knock off the administrative costs of the visit to reduce our bill. We’ve asked for free samples of medication and, barring that, have received coupons to refill our prescriptions.
And then there’s the switch from Blue Cross / Blue Shield to Aetna. Ironically, the plan with Aetna will be less expensive, cutting our co-pays by more than 50 percent. But, are all our doctors in-network?
Yes, except for the rheumatologist I was planning to see for my hip. So now I need to postpone that until I can research who IS in-network and check to see if my internist has ever heard of them.
We also learned, right before our old insurance ran out on Sept. 30, that Mark has a torn meniscus in his right knee. He needs surgery, but we’re postponing it until we’re covered again in November. Hopefully, he’ll be able to get by with the help of a cortisone shot or two.
Sadly, nothing I’ve said here is out-of-the-ordinary. I’m sure you’ve encountered many, if not all, of these scenarios yourself at one time or another. But it shouldn’t BE this way!
