Why health care reform matters: This could be any of us

by Karoli on November 5, 2009 · 4 comments

in Patients

(Note: A friend asked me to post this here. She is a real person with a real job who doesn’t want to be identified, for reasons that will be apparent when you read it. Her story is all too familiar. It’s really time for Congress to stop the games and get this done.)

I’m having to face some difficult choices, primarily to decide the winners in some conflicts between my health and every other area of my life.

You wonder why I support a reform? This is why: The fact that between me and the company I work for, we are paying more than $300 a month for the largest insurance provider in the state to insure my health, and it can’t even cover a simple blood test? I pay my copay, I get a bill in the mail from the blood lab, and when I return for a followup visit I receive ANOTHER charge for the blood work?

I thought I was paying not to have this additional stress when I’m fighting the monster that is a stomach ulcer.

I spent 10% of my paycheck last pay period on a medication my doctor had prescribed. The generic form of it, no less. After insurance. I couldn’t imagine what that bill would have looked like had I had to have the real deal.

I guess I’m about to find out, because the thing is, the med isn’t helping. Dr. prescribed something new today. Something stronger. Something not-generic. So I have 21 remaining doses of this other stuff I practically gave my right hand for, and am facing another probably greater bill.

But that’s after I get an endoscopy. Let’s not go there.

I’m finding myself putting off replacing my car brakes. Eating only the cheapest things I’m allowed to eat. Ignoring my need for new razors, and a place of my own to live that’s closer to work than the 62 miles one-way I’m currently commuting. I’ve stopped putting money in my savings account. I’m having to strategically finagle the timing of my tests and medication acquisitions so I can still afford to pay for gas to get to work each day.

I mean, I’m a journalist, but I don’t make peanuts. I make a sufficient amount of money for the cost of living in this area. But that’s only if you’re perfectly healthy. Throw the medical bills factor in, and all of a sudden you face the reality of what people mean when they talk about the average per capita medical care expenditure of $7,500.

The company where I work is, thankfully, generous and covers more of the premium costs than I do. And I recognize that my insurance is helping in some small way, but the additional headache it costs me in my attempts to figure out how much I’ll owe for what services, tests and medications is a nightmare. And this is a relatively minor medical problem — even though it’s miserable. Really.

My little brother asked me tonight why I pay for insurance at all, if it’s not making that much of a difference in my medical costs. I told him I guess I keep it in case of a calamity that could put me in the hospital for a week and require lots of expensive procedures. Because in that case, insurance would make a big difference. But I’m one of the lucky ones. I can afford that.

Healthy people, you have no idea what I’m talking about. Very sick people, you have an idea.

But it’s for the only-mildly ill that insurance truly sucks and utterly fails in a cost-benefit analysis.

I told this story, despite the fact that I am a painfully private person; not because I want sympathy, but because I want the naysayers and the opposition to see a face and hear a story from among the masses of us crying for something better. My story is not extreme. It’s what every middle-class American who falls into mild chronic illness faces every day. And this could be you.

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