Our healthcare system in America….

This blog is going to be a little more personal than most of my blogs!  I would generally not even post it… and most of my friends don’t even know about all of this…but… here goes.

A few years ago, 2007 or 2008, I woke up to my heart racing in excess of 200 beats per minute!  I had not had a bad dream…was not having an anxiety attack…and really couldn’t explain it, but it was beating FAST.  My ex, lying in bed as well, could see my heart beat pounding just by looking at my chest.  That scared the hell out of me!  However, it stopped quickly thereafter and didn’t do it again so I just assumed it might be stress.  A few months went by and it happened again right when I first woke up.  At that time I had insurance so I went to the doctor and he said it was most likely anxiety related and wrote me a prescription for ativan and ambien.  However, it didn’t stop so I went back.  This time he wrote me a prescription for a beta blocker, without really explaining to me why.  Shortly thereafter I lost my insurance (being a realtor we pay for our own insurance) and because I am generally healthy, I was not overly concerned about it.  Eventually the racing heart stopped.  Also, since the side effects of the beta blocker suck, I stopped taking my medicine.  For the next year or so nothing happened.

A few months ago I tried to get health insurance. I’ll 31 in two weeks and thought it a good idea to go ahead and get it.  The problem is: I was denied.  No rider, no “we wont cover that”, just a flat out denial letter…the reason: “An untreated heart condition.”  The thing is we weren’t sure that it was a heart condition.  While it is true I was not being treated, nothing was happening!  My doctor had never actually told me what he was diagnosing or for what he was treating me. Furthermore, the issue had stopped so there was nothing to treat.  But still, no insurance.

About a month or two ago I woke up to my heart racing again.  Knowing this had occurred before, and would likely go away on its own I didn’t sweat it.  A day or so later I was at the gym on the treadmill and noticed my heart rate was above 200 and climbing.  Honestly I don’t know too much about heart rates so I didn’t know above 200 was very bad. I looked over at my gym buddy and asked his heart rate. It was around 160.  I mentioned that mine was high and he said “180?”  I said higher. He replied “200!?”.. I said “212 (and climbing)” His response was something like “get off the treadmill”.  I honestly still didn’t think too much of it until I mentioned it to one of my friends who’s now a RN.  He was not very happy about it at all.  He insisted I go to the doctor and I did so, reluctantly.   The doctor looked over my EKG, etc and told me to get insurance ASAP.  Well, that’s a problem… I CAN’T!  I told him I had been denied and he didn’t seem surprised at all.  Being self insured basically means that an insurance company can deny me for whatever reason they want.  If I were to go work at Starbucks for 20 hours and get on the group plan, they could not deny me.  Here’s the fun part.  The doctor put me on meds two weeks ago and scheduled a follow up in one month.  In the past week I have had the racing heart issue, what I am now told is PSVT, four times.  I mentioned to my RN friend that it was continuing and he again pressured me to go back to the doctor.   So this morning I went back and they did labs, took me off all of my medicine, and put me on a heart monitor which a friend said it looks like I have a walkman on my side. I have to wear this thing for the next two weeks.

So all of that to get to the main issue….

I ran 7.71 miles Saturday and I’m planning to do the MudRun and the Bridge Run.  I am just as healthy if not more healthy than most of my friends.  I am 30 years old, 167lbs, a non smoker, and rarely drink…but I cannot get insurance.  So two weeks ago the doctor visit was almost $200.  Today it was $550.  When I go back on March 14th it will be another $150. That’s almost $1000 because I am not insured.  If I were insured I would have my monthly premium and my co-pay and that’s it. AND, the insurance company would probably pay the doctor what all of this is actually worth: about $300-400.

One of the things they took this morning was a urinalysis.  It’s a standard test and  I watched as the nurse coded my cost.  The form she read from said

“Insurance Charge: $50.  Our Cost: $25.  Self Pay Charge: $126.00”

As it turns out, this is a two part test. So on my bill are two charges one for $126 (their actual cost being $25) and my premium because I’m not insured is twice as much.  You could make the argument that they charge uninsured people more because they don’t always pay.  That’s partially true, except you are required to pay at the time of service: there is no way I could have not have paid.

This is part of what’s wrong with America.  Seriously.  Obamacare will help but it really doesn’t go far enough.  The original healthcare plan would have been a single payer system which would have worked.  This new individual mandate will not only force me to PAY for my own insurance but it will fine me if I can’t.  Sure they can’t not deny me because I have a preexisting condition, but who’s to say what they are going to charge me won’t be outrageous?  Who’s to say that the fine for not having insurance won’t be cheaper than trying to pay for insurance.

Ironically in 2008, while running for President, Senator Obama was against the individual mandate but was FOR a single payer system.  Why?

Forcing people to buy insurance, especially while insurers can continue to charge as much as they want and still deny needed medical care, further entrenches a broken system, and it’s not humane.

I think Democrats should push to overturn certain provisions of Obamacare next year… and replace it with Obamacare 2.0: a single payer system that removes the individual mandate and gives all citizens access to affordable, comprehensive healthcare.  With that said, Obamacare isn’t perfect.. but it’s much better than the “let him die” plan the Republican Party supports.  It’s a great start.. now it just needs to be made great.

ps.  my birthday is in less than two weeks.  i want insurance. 🙂


One thought on “Our healthcare system in America….

  1. I’m for a single-payer opt-in system. I don’t understand why we don’t hear more about an option like this:

    Any American, anywhere can keep whatever insurance they have now–be it private, employer, etc. Insurance Companies are allowed to keep doing business as usual–denying people coverage for profit. The federal government sets up a European/Canadian-style system, which is not-for-profit, and also morally and ethically sound.

    If you opt-in to the not-for-profit govt system, a % of your paycheck is deducted every month. No one who opts-in is denied coverage, though there may be long waits for non-emergency care, etc. The most important part is that it is an OPTION–an OPT-IN system. No one HAS to opt-in to the government plan. No one HAS to buy private insurance for that matter. Basically everyone can keep doing exactly what they’re doing now, but we create a new, government-run, not-for-profit system that is morally sound–meaning it doesn’t deny care to increase profit.

    The biggest difference between this system and plans in other parts of the developed world is that this won’t automatically cover everyone. No one has to participate. Not forcing anyone into anything will allow the big insurance companies to keep putting a product out there. And people can decide to go the private route, the govt route, or not have insurance at all.

    Again, if you decided not to opt-in, your taxes would never be used for the govt-run system. Only the taxes of the opt-inners would be used. If the plan is losing money, premiums on the opt-inners will go up to cover the slack. That would have to be key. Only the people who opt-in get taxed. Allowing for both systems to exist and let the free market speak. Maybe the govt system would fail–maybe it would get too expensive. The premiums keep going up and people decide private insurance, though not as comprehensive, is the smarter way to go. But it could work, too. It could create competition in the market and make providers more efficient, and drive costs down. Which is obviously the reason private insurance companies oppose it so vehemently. It stands a good chance to give them a run for their money. Powerful interests in the healthcare biz don’t want anything to change, and will do everything in their power to prevent any competition–especially a non-profit govt system–from taking hold.

    Good luck with your insurance, James.

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