TheMommyBlog

Wednesday, August 26, 2009 Family

This morning, a family member forwarded me a post called Why I Get Angry on Musings of a Distractible Mind on “Finding the Waste in Our Health Care System - Low-Hanging Fruit.”

It was refreshing to see a provider actually feel for the patient, and get angry about the status quo:

Something touched a nerve yesterday.  I kind of lost my composure when someone tried to defend the insurance industry and responded out of emotion – perhaps putting aside some reason in the process.

I used to get mad at myself or embarrassed when this happened, but now I stand back and try to analyze my reaction.  What is it that touched a nerve in me?  Why did I feel so strongly?  We don’t feel things without reason, and my reaction doesn’t necessarily betray weakness on my part, it shows the depths of my emotion.  That passion usually comes from something – most of the time it is personal experience; and my personal experience says that insurance companies are causing my patients harm.  That makes me angry.

I left this comment:

I’m a divorced mother of three, self-employed, and will soon be uninsured. I defer or refuse medical care because I cannot afford it. The care I’ve been forced to seek has cost so much that it’s in collections and now my credit is suffering.

I have been repeatedly denied coverage as an individual for reasons such as “having sought fertility treatment” (twelve years ago) or “diagnosed with PPD” (seven years ago). And I was applying for a policy that didn’t even include maternity coverage.

I’ve also learned an ugly lesson about the frailty of coverage: if you have COBRA through a former employer, and that employer goes out of business, there’s no one paying those COBRA fees anymore, which means YOU are out of luck, instantly. Twice now I’ve had a few weeks’ notice that my coverage will suddenly end as of the first of the next month. Because I’ve been rejected from every insurance company we could find, I now go through the motions and check the box that says “please consider me for HIPPA if I do not qualify.” I never qualify, and HIPPA is slow to act. I expect to be swinging in the wind for a while, paying retail prices for medical care out of my own pocket.

By the way, I am extremely resourceful and well-connected; Dr. Val Jones is a close friend, and my stepfather is Dr. George Lundberg, former Editor in Chief of JAMA, Medscape.com, eMedicine, MedGenMed, and WebMD’s now-defunct online, peer-reviewed medical journal (see his new venture at http://lundberginstitute.org/). If I can’t get coverage with who and what I know, what hope do others with far fewer resources have?

What happens when medical bills in collections prevents us from being able to refinance an unmanageable mortgage or qualify for a car loan to replace the clunker that doesn’t qualify for Cash for Clunkers because I purchased responsibly in 1998 and got a car that gets over 18 mpg, the cutoff for qualification?

What happens when we make just enough to be ineligible for unemployment but sail below the poverty line with room enough for a big hat in order to qualify for our children’s reduced lunch programs?

These are the plates we have to keep spinning, and so much of it could be alleviated with adequate, affordable, individual and family health coverage that doesn’t need to be provided through a group plan. The stress associated with not being able to afford proper care coupled with the fear that something catastrophic might happen and wipe out the family does NOT make for a healthy parent able to raise healthy kids.

Wouldn’t it be useful to look at more affordable and generous coverage as preventative medicine and an overall boon to public health? I’d be less of a burden on the taxpayers and the insurance companies if only I could be secure in the knowledge that we could survive catastrophe.

In the meantime, I’m learning to care for stitches and dress wounds myself (or butterfly when I can’t go for stitches), make my own differential diagnoses, and keep a copy of the PDR, first aid book, and Merck Manual handy.

If I can’t find someone to care for us, even when paying painfully high premiums, I will have to become my own family’s primary care provider. And in most cases I can do it much more cheaply and effectively than the system already in place.