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Our Broken Health Insurance System

By G.J. Gregory Thursday, December 06, 2007

Here's a newsflash: Our current health insurance system is terribly broken. Further, I have no idea how to fix it. The fact that I am clueless about how to come up with a solution, given my history of outspoken and outlandish ideas, shows the utter hopelessness of this situation.

 

Insurance is only readily available to those with a "normal" job. For the vast majority of my life I've had nothing resembling a "normal" job, hence I've spent a large part of my life uninsured. For some of the time I've actually been insured, I've been underinsured. In the last 20 years my family has had eight years of acceptable insurance coverage. We've had 10 years without insurance, and two years in which we were under-insured. In this period of time we've given birth to three children, and only one birth was covered. We've had several broken bones, two major surgeries, and countless minor emergency room visits. We've had several emergency dental appointments for broken teeth and lost fillings. We've had much-needed counseling sessions, and paid for many expensive prescriptions out of pocket. As a result, our family may never be out of the red. Our liability at times has exceeded six figures. We rob Peter to pay Paul, max credit cards to pay medical collections, but the medical collections don't stop, so now we have credit card collections on top of medical collections. We would declare bankruptcy, but we got VERY lucky a few years ago and were able to buy a house. We don't want to lose our house. We have five children, the oldest being 25. We would like to be able to help out our children, co-signing student loans, car loans, mortgage loans. But because of our past, that won't happen for many years, if ever. I'd like to think about traveling, even for work reasons. But without a personal credit card it's not going to happen.

 

So now that my financial soul is laid bare, why has my life worked out this way? I'm not a bad person, a deadbeat, a thief or criminal. I am a hard-working father trying to provide for my family as best I can. Today's financial problems have come about solely because of medical insurance issues.

 

Now, look at one of my kids. He's been diagnosed with bipolar disorder. Bipolar disorder is something that often isn't acknowledged or even recognized before late teen or early adult years. By the time my son really needed the treatment, he was an adult and wasn't eligible for whatever insurance I may have had at the time. He wasn't stable enough to hold a job, which meant no insurance, which meant he couldn't get the treatment he needed to become stable - which would allow him to work... Taking him through the public assistance process so he could get medical coverage is an ongoing nightmare that is way beyond the scope of this piece. I'll write about it sometime, but it's not for the faint of heart. People with bipolar disorder have a way of finding themselves in bad situations, and my son is no exception. He found himself in a bad situation a while back and was severely beaten. His skull was crushed, and he very easily could have died. He was uninsured, and while the hospital fixed him up and put a plate in his head, to this day he has sinus issues due to the fracture. Not only would treatment for his bipolar disorder likely have kept him from being in that situation, I can't help but think that with full insurance coverage my son wouldn't be battling his serious sinus problems today. His life is forever changed by his lack of insurance.

12/ 6/07 7:09pm

We have fairly good insurance but find ourselves paying over $2000 for our son's hospitalization.  That's not even taking into account all the therapy appointments and psych visits and meds we have to pay for.

Thing is, I'd never put a price on my son's health.  If it cost a million dollars, I'd find a way to pay it.

He has been worried about how much he's costing us.  It's bad when a 16 year old worries about such things.  I told him that we would pay whatever it was without reservation and that all he needed to be concerned with was getting better.

I just hope when he is an adult, he doesn't find himself not being able to get insurance.  That's my worry for him.

I read somewhere that parents are giving up custody to the state for their mentally ill children.  This is just so the child can be given the treatment they need. That's a horrible message to send to the child.  You're defective so we're giving you up. 

I couldn't do it.  I don't care how much he costs or if we wind up filing bankruptcy over it.  It's only money after all. 

12/ 6/07 11:21pm

Hopeful Mom,

 

I agree with you, no matter the cost, when care is needed, we'll do what we have to do.  But we shouldn't have to make a choice between, for example, medical care and home ownership.  Or medical care and a dependable vehicle.  

 

You talk about your son's stress, I understand this very well.  My son used to stress so badly  about his medical bills, he'd carry them around in a backpack. We're in the process of helping him secure assistance that might provide him some relief from those bills, but that didn't stop him from worrying.  I felt so bad for him.

 

Thanks so much for reading and leaving a comment. 

12/ 7/07 6:59am
We are lucky in that we bought our house 20 years ago for $49,000.  It is a small house but our payments are low.  As far as medical bills go, we can only pay what we can pay.  Every time they send one, we pay as much as we can.  I really feel terrible for people who have no medical insurance at all.  Our emergency room visit was almost $2000 because they did all these unnecessary blood tests.  Then the hospitalization itself was about $6000.  That doesn't even include doctor services.  The psychiatrist charged $2000 as well.  We'd be in much worse shape without insurance.  The states need to come up with a way to help cover medical insurance for people who's jobs don't offer it.
12/ 7/07 8:20am
You are so right on about health insurance and everything else you said. I think your great and have much wisdom to share here and I for one am thankful to read your posts and appreciate them.  its like the have and have nots... the gap is so huge now  theya re cutting out the middle class..
12/ 7/07 2:59pm

Thanks connie, for your kind words.  You are right about the middle class.  Too much income for assistance, too little for any kind of comfort.  Paycheck to paycheck, knowing if you stop dog-paddling for a second you'll sink like a rock.

 

Thanks again for your comment. 

12/ 7/07 1:44pm

You could have been writing about our family, except we have just one son, and he is bipolar.

However, we have been fortunate to at least have insurance coverage, but as you said, not enough...we still pay more than we can afford and it gets worse every time enrollment and benefit options comes around...but at least it is something...

 

Medical collections from 4 different agencies...credit cards owed on and in collections....and a PAID for house that we dare not risk losing by declaring bankruptcy and starting over...

 

Our son is 17, will be 18 in June and has already told me he will go off his meds...he works at a oil changing place, loves his job...but insurance is only offered to management, and this kid is still struggling through high school, let alone becoming a manager of local business for a national chain...

He does not think that insurance is a big deal...medical or auto...

 

I am SCARED TO DEATH of what will happen to him when he goes out into the world...no insurance...no meds...I have shed more tears over my anger and frustration and fears for my son, and the situations that he will be forced into, than anyone will ever know...

12/ 7/07 3:29pm

Tambrey,

 

Thanks for reading and taking the time to comment. 

 

I understand your concerns about your son.  It's not much comfort, but we made it.  You made, I made it.  Wherever and whenever it was, you emerged from your youth and succeeded.  Somehow I did the same.  We not only made it, we thrived.    The thought of my son doing it on his own scares me to death, but when it comes right down to it, I think he'll make it if he has to.  It's hard enough to sleep at night, and I choose to believe that it will work out.

 

Thanks again Tambrey, I always appreciate your comments. 

12/ 7/07 3:19pm

We need only to look to the recent episode in Rochester, New Hampshire to see the system is broken.  Can you imagine all the money spent on responding to Leeland Eisenburg's holding campaign workers hostage.  My goodness, what he did was wrong.  But, I live in N.H. and NAMI gave NH a "D" for the mental healthcare.  His method of expressing frustration was wrong.  However, his voice was heard by me! 

 

My daughter is bi-polar and I understand the pain first hand.  I can barely work through the system to assist her and I am not fighting mental illness. 

 

I would like to know what the plan is that is presented by the politicians.  I don't want the brief "we have a comprehensive plan".  I want the granular details before I vote for the next U.S. President.

12/ 7/07 3:36pm

OMC,

 

A great comment.  I so feel your pain about getting a child through the public assistance nightmare.  There is NO WAY a person with a disorder could EVER navigate the system on their own.   The people that most need the help can't get the help due to the nature of the system.

 

Hillary had some innovative and interesting health care ideas in the past, but she seems to have abandoned them for this election.  I'm going to keep an eye to the candidates for signs of promise, but I'm not seeing much yet.  What are your thoughts? 

12/ 7/07 6:55pm

Our therapist told us about something called "Wrap around service" that's provided in our community.  They help with psychiatry and meds as well as preparing the child for living independently.  We have the application sitting on the dining room table and I will probably tackle it this weekend.

The problem is, they don't have the resources to take on everyone who needs them.

We need more services like these for our bipolar children who will likely have trouble paying for meds and care when they are older.

The thought of my son choosing to go off meds when he graduates, scares the crap out of me.  He's already made one suicide attempt and I don't wish to see this incident repeated.

12/ 7/07 8:21pm

Hopeful Mom - how great is that, to be in a community that values mental health like that.  I wish you all the best in getting your son into the program.  Stay in touch and let us know how it works out.  

Anonymous
tabby
12/ 7/07 7:52pm

I've had good insurance through employment over the years here and there and I've had no insurance even though I was employed.  I've also had no insurance and no employment.

 

Currently I work but have no insurance because I can't afford the out of pocket portion of the premium each month.  It is almost equivalent to one NET sum of a paycheck. 

 

So, if and when I do find insurance it will be as, if not more, expensive (may not even qualify) because of pre-existing conditions now like Bipolar and my auto accident.  So, even if I find something and I somehow manage to pay the premium I won't be covered for what I seriously need coverage for - up to 18 months.  My Bipolar related stuff - zip, my auto wreck injury stuff - zip.

 

So, what do I do when I can't get insurance and I don't qualify for public assistance because we make $150 GROSS more than the maximum for our family size and yet we can't buy insurance nor pay the electric bill each month. 

 

It is sad when you look at what is coming in the month and have to decide - food or medical bills - electricity or insurance - life or paying true necessities (roof, electric, food, etc.) you simply don't have the money for.

 

So here I am with Bipolar, suicidal at the moment by the way, have a torn up foot that has arthritis now, and a surgical adhesion that formed after 3 major abdominal surgeries, chronic pain in foot, and horrendous anxiety.

 

I can not go inpatient cause of the hospital bill and the very real possibility of losing my home.  I can't seek a pdoc because I have no insurance and no money, and I can't buy meds because I have no insurance and no money.

 

On top of all this, an attorney is filing suit because I didn't finish paying my last psych hospitalization in which I had no insurance and my daughter can't get 1 Santa gift - just 1.

 

Insurance is neither a right nor a privilege for those who aren't financially wealthy.  Even if I had insurance, I wouldn't be able to make the deductible, coinsurance, or copayments.

12/ 7/07 8:56pm

tabby,

 

I am so sorry, things sound pretty overwhelming right now.  I'm sure you have no lack of advice from well-meaning people, so I won't presume to give you advice.  I'll keep you and your family in my thoughts and prayers.

 

Hey - email me would you?  Click on my  profile and you can email me through there. 

Anonymous
Judy
12/10/07 10:24am

Hello everyone...I can certainly relate to every post.  Our health care system is in intolerable condition, and it has affected my family as it has many of yours.

 

Our insurance pays only 50% for mental health and drug abuse, as do many insurance companies.  This has been going on for far too long.

 

Our politicians aren't listening, or at best arre not doing.  Where do our candidates stand on mental health insurance issues and what about parity?  It certainly would be nice to know.

 

Guess I'll try writing my politicians once again.  Hope springs eternal.  Thanks for listening.......Judy

12/10/07 11:30am

Judy,

 

Thank you for taking the time to write your elected officials, it's something so few people do.  Thank you for being involved, and for taking the time to share your experiences.

 

GJ 

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By G.J. Gregory— Last Modified: 12/11/10, First Published: 12/06/07