Dave, Desiree, Beer & Wine

This isn’t beer related.  It isn’t wine related.  We will classify this as one of Desiree’s extremely rare posts that she feels a need to publish.

I’m not a political person.  I tend to keep my opinions to myself.  I don’t like confrontation.  For the vast majority of my life I voted Republican because I really do believe in fiscal responsibility.  But this year I voted for Obama.  Why you ask? Well, the biggest reason for me was healthcare reform.

Healthcare reform isn’t about giving those moochers (aka welfare bums) even more. It’s about ensuring that EVERY American living in this amazing and wonderful country doesn’t have their life destroyed because they got sick.  We are the only industrialized country that doesn’t provide this most basic of human rights.

Let’s look at the preamble of the US Constitution:

“We the People of the United States, in Order to form a more perfect Union, establish Justice, insure domestic Tranquility, provide for the common defense, promote the general Welfare, and secure the Blessings of Liberty to ourselves and our Posterity, do ordain and establish this Constitution for the United States of America.”

See it?  It’s there. It says promote the general Welfare, and secure the Blessings of Liberty to ourselves and our Posterity. Americans, every single one of us, has the right to be taken care of when we are sick, regardless of wealth or stature.  That is not the way it is in America.  Not by a long shot.

So rather than getting on a soapbox and just upsetting a lot of people, including some dear friends, I thought I would tell my healthcare story.  These are experiences that happened to me and three of my friends.  This isn’t a, “I have a friend who knows this guy who works with a person that has family in Canada and they come to the US for all their healthcare” story. This is what I have gone through and what has happened and is happening to 3 friends here in good ol’ Tulsa Oklahoma.

First, let’s talk about my friends.  Several years ago my first friend, we will call her Jane, was going through a divorce.  She was a stay at home mom and had to find work.  She did find work but the pay was low, less than $13,000 a year.  She had no health insurance.  She was going through a very stressful time.  Late one night it reached a point where Jane thought she was having a heart attack.  An ambulance rushed her to the emergency room.  Thank goodness it was just a panic attack or the hospital bill would have been unmanageable.  She received the bill and it was quite large for Jane but she was determined to pay it like a responsible American citizen should do so she made small monthly payments towards the balance. We’ve all heard that as long as you are making a true effort to pay your medical bills then you are safe, right? Wrong.

Jane was sued by the hospital and was taken to court to pay the bill.  Did the judge care about her circumstances and that she had made a monthly payment every month without fail? NO.  The judge ordered her paycheck garnished till the bill was paid off.  How much did he leave for her? $75 a paycheck.  This meant that Jane would not get a true paycheck for FOUR MONTHS. Four months without enough to feed her child or pay her bills.  This is how a person becomes homeless.  This is how fair our judicial system is.  Outrageous you say?  You don’t believe me you say?  I got the phone call after the judge made his ruling and had to listen to Jane on the other end, quite hysterical and upset.  Luckily, her priest was so appalled by the event that he very generously paid her hospital bill.  This is not how it is supposed to happen in the United States of America. Outrageous is right.

My second friend, I will refer to her as Debbie, lost her job 2 years ago.  She has a history of depression and a chronic disease that I will not give details on out of respect for her privacy.  She of course lost her insurance and this pre-existing condition has kept her from getting coverage.  Debbie finally found a job but the company is very small they don’t offer any company coverage.  Two months ago she had a serious internal injury and was in ICU for 4 days before having to have surgery to repair the damage.  Her hospital bills are over $45,000 dollars.  Her credit will be destroyed because her current financial situation makes it impossible to pay these bills.  She is starting the process to file bankruptcy.  She will lose everything that she has left, including her dignity.  I’m saddened by the whole thing.

Now let’s go friend number three, Kate.  Kate went for 4 years with excruciating hip pain.  It was a genetic deformity that was aggravated by a car wreck.  In the US, her only option was a hip replacement.  The downside is that Kate is young.  Hip replacements only last for 10 to 15 years.  Kate isn’t one to just live with that so she did research and discovered a technique that has been in use for over several years in Europe.  It is called a hip resurfacing and can last for 30-40 years.  She was a perfect candidate but it wasn’t approved to be done in the US so she waited.  She was waiting for the procedure to be approved or live through the pain till she was old enough and only had to have one hip replacement.

Quite a choice huh?  Wait, it gets better. The procedure was finally approved the US.  Kate was ecstatic.  She researched all the locations in the US that had preformed hip resurfacing.  She narrowed it down to 2 hospitals.  Both had performed around 200 of these surgeries.  She went to her insurance company.  I’m sure you can see this coming.  Her request was denied.  It was still considered “experimental” and wasn’t’ covered.  The cost, over $40,000.  Kate, undeterred, decided to take things into her own hands.  She refused to spend that kind of money.  She contacted a surgeon in Belgium that had performed over 2000 of these surgeries and arranged to have the procedure done there.  The cost was $16,000, which included the flight and 6 weeks of housing, recovery and daily physical therapy.

I don’t hear these stories in the news.  All I hear is the opposite but this isn’t just a story I heard, I know this person personally.  She is one of my best friends and is happily recovered and playing tennis again without any pain.  Her life had been transformed. It was because she is a tenacious go-getter that didn’t stop at what she was told was possible.  She researched and found a better alternative, saving herself $24,000.  Sadly, it shouldn’t have cost her that much.  Thank goodness she had the financial ability to have herself taken care of.

Finally I have my story.  I’m a type I diabetic and was diagnosed when I was 21. I produce no insulin and have to take 4 shots a day to stay alive. For most of my adult life I didn’t give health insurance a second thought.  Why should I? I worked in the corporate world and had great coverage.  When I would hear about health reform I would shout, “No way! I have great health insurance. It isn’t broke so don’t try and fix it.”  Fast forward to 6 years ago.  My husband Dave and I decided to open our own business.  We were making a HUGE leap.  We were leaving two excellent paying jobs to follow a dream, the American dream.

I very quickly discovered that I could not get health coverage.  I have a pre-existing condition.  It made no difference that I was a very healthy diabetic.  I take pretty good care of myself. No high blood pressure.  No heart disease. No diabetic complications of any kind.  So I researched further and found that if you have company group health insurance, by law insurance companies have to cover you if you switch to another company group coverage within 90 days.  “Great!” I thought.  Well, not so fast. It sounds good but it isn’t so straight forward.

We were leaving a company of 7000 to start a company of 2.  The way insurance companies work is that they take the health of everyone covered and divide that estimated cost across all the employees to determine the cost of coverage. I was leaving a company where the cost was determined with a large percentage of healthy people (not to mention the company covered half the premium).  Now I was in a group of 2, one of those 2 being a type I diabetic.  They had to offer us a company policy but they got to determine the cost of the coverage.  The cheapest I could find was $1100 per month.

We were a new retail store with very little revenue coming in as we were trying to build a customer base and still pay our mortgage. $1100 a month was simply not possible. So what did we decide to do?  We decided that we couldn’t afford health coverage.  Terribly frightening I must say.  All my life I never had a second thought about going to the doctor.  For the next three years I paid full price for my test strips, my needles, my insulin.  I’m supposed to see a doctor every three months to make sure I’m doing ok.  That changed of course.  I only went to the doctor when they refused to refill a prescription because I hadn’t been to see them in so long.

To make matters worse, because I didn’t have health insurance my bills were three times higher.  I was told that they have deals worked out with the insurance companies at lower rates and that they have to charge people without insurance more because they never pay the bills.  Can you believe that! They actually make it HARDER to be a good decent citizen by making it so expensive you have no choice but to NOT PAY your bills.

Three long years let me tell you.  Well, finally the Holmes Organization went to bat for me and convinced PacifiCare that I was worth covering.  For the first year they didn’t cover any doctor’s visits that were related to diabetes but at least my prescriptions were being covered and the insurance rate was at a price I could swallow.  The second year of coverage I finally was able to see a doctor for my diabetes and saw her on a regular basis.  What a relief to finally feel secure that I was being taken care properly!  Our third year of coverage started this July.  I was notified in June that my rates were going up 22% because of the increase in doctor’s visits. Ugh.  I increased my deductable by 50% to keep the rates the same but at least I still have coverage. My biggest fear is that when, and I mean when because sooner or later as a type I diabetic I will have diabetic complications, they will drop me like a hot potato.

So here are my points in all this.

• We already don’t control our health coverage.  We don’t get to choose our doctors, the insurance companies do.  We get a list of “In Service Providers” to choose from.  If we don’t like it, we don’t get the savings promised by the insurance company.  What difference does it make if it is the government or the insurance companies making these decisions?
• We already don’t get to choose what procedures are best for us.  The insurance companies get to decide that for us.  What difference does it make if it is the government or the insurance companies making these decisions?
• NO ONE should have to worry about losing their home and way of life because they get sick.
• Just because you have health insurance doesn’t mean what you need is going to be covered.
• I’ve read the health bill (yes, actually read it) and nowhere in this bill does it say that you are going to be forced to choose the government run option.
• I have 5 employees that I can’t afford to offer ANY coverage. If this government plan allows us to get our employees coverage, then who is to say that is a bad thing.  They don’t have ANY coverage right now.  Isn’t that better than nothing?
• I’m not a slacker.  I work hard.  I pay my taxes.  I don’t live off the system.  I deserve to be treated like a decent human being and not like a leper that is too scary to touch. Every American deserves this.

I know this is complicated.  I know people are scared of big government. I am too but health reform is something that America needs.  It is so easy to sit back and think everything is fine but it isn’t.  I found this out personally.  THING ARE NOT FINE! Far from it.  Any day it could happen to you.  You could lose your job, which means losing your coverage.  You can get sick and your insurance company can drop you even if you are paying your premiums.  If you switch jobs your coverage changes.  It shouldn’t be that way.

Links of interest:

Politifact.com

Summary of Health Care Bill

Full version of the Health Care Bill

My last comment is that I would like you to read the following article that looks at other countries and their philosophies on health care.  All are very different but all offer basic health coverage to every one of their citizens.  Something we do not do and should be ashamed of.  No Country for Sick Men

Whatever your view on the subject, please consider mine and my friends experiences when you think about healthcare reform.  There are so many sides to this issue and it isn’t “us vs. them”.  It is much more complicated than that.

Cheers,

Desiree Knott

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This entry was posted by Desiree Knott on Sunday, November 8th, 2009 at 4:40 pm and is filed under Random Thoughts. You can follow any responses to this entry through the RSS 2.0 feed. You can leave a response, or trackback from your own site.