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Tuesday, October 23, 2012

My Adventures In Health Insurance

I’m uniquely qualified to talk about healthcare.  In the past 25 years I’ve been disabled and non-disabled, diabetic and ex-diabetic, insured through employers, Medicare, and no one.  In the past couple of years the subject of socialized healthcare has been a divisive issue here in the U.S.  Aside from brief discussions with a few people I’ve kept quiet.
But the time has come for me to jump into the fray.  Lucky for me, I’ve got insurance if the fray hurts me.
My Type 1 Diabetes was a pre-existing condition (from age 12) which meant my employers’ insurance chose to ignore that area of my health needs.  I paid for the testing supplies, disposable syringes, alcohol swabs, and two kinds of insulin myself—when I could.  There were a few times when I had to use the syringes twice, risking infection.
And that was when I had insurance.  There were times when I had to cough up (pun intended) the cash to pay for every doctor’s appointment.
When I was 27, the diabetic complications started.  My vision and my kidneys started failing.  I had no problem proving I was in bad enough shape to get Social Security Disability.  Not long after that, Medicare became my only health insurance.
This is the part most lifelong healthy people miss.  If someone with a chronic health condition can’t get the help they need to take care of it, they can become disabled.  I went from paying into the system to being a consumer.  Maybe it was inevitable, but it could have happened later and I could have paid more to Social Security before needing it.
To keep from losing SSDI and the Medicare that comes with it, I worked part-time at a number jobs for which was severely overqualified and under challenged.  A diabetic with failing kidneys can’t expect a private insurer to go near them.  A VOUCHER WOULD NOT HAVE MADE ANY DIFFERENCE.  A voucher does no good if no one will take it.
Medicare paid for the kidney/pancreas transplant.  I was lucky enough to have people willing to help raise the money for the unpaid part of the surgery.  Not everyone is so fortunate.  I don’t even want to think about how a private insurer might have tried to dodge the whole issue.
Medicare also paid for a second transplant, four major eye surgeries, laser treatments, dialysis, and a host of other less serious procedures.
In 2004 I landed a state job and employee health insurance started paying for the deductibles and copayments.  Now that I’m a retired state employee, I’m covered by Medicare and private insurance.  I’m one of the tiny percentage of disabled people fully covered by insurance.
I can remember when my situation wasn’t so comfortable, which is why I don’t have that “I’ve got mine, Jack” attitude I hear too often from the chronically healthy.
Even if you don’t have a chronic health condition, an accident or sudden illness could make it impossible for you to work.  Then where would you be?  You’d end up with socialized healthcare.  You would be persona non grata to the private insurers.
You say you’re really careful?  You eat right and exercise?  Great, but your luck could run out.  Yes, luck is a factor, too.  A drunk or distracted driver could crash right into you.  Don’t let luck make you smug.
There’s an old saying, apparently forgotten my many: An ounce of prevention is worth a pound of cure.  Keeping people healthy is so much cheaper than playing catch-up later.
Not only do most healthy people work, they further their education, volunteer, and some even start businesses.
I’ve heard people say, “We can’t afford to cover everyone in this economy.”  With two-thirds of us overweight, we can’t afford not to.  Here is the Land of the Free it’s “eat now, pay later.” 
Well, I’ve seen the bill myself.  Millions of us won’t be able to stiff the restaurant and do a Dine-N-Dash this time.

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Web site JimFairbanks.net

 

6 comments:

  1. Hear, hear, Jim! Health care always costs someone. What we need is the most efficient delivery system possible that makes sure everyone gets care as soon as they begin to need it - not postpone until it's expensive to treat and they've lost a lot of quality of life. It's a pretty inhumane system if you ask me. Thanks for sharing your experience and dismay.

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    1. Thanks Kim. Too often quality of life is the least important issue of the whole mix.

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  2. This is a great read, Jim! I strongly agree with you that prevention is much better than cure. Sadly, I think it has become a much neglected fact these days. It seems you really had a roller-coaster ride, dealing with your health insurance. Good thing that you were able to overcome all those adversities, and I hope you're all good now! :)

    Regards,
    Elnora Cowger

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    1. Thanks Elmora. I'm doing well but have my ups and downs. I hope you will be a regular follower of my blog. Happy Thanksgiving.

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  3. A lot of people say that healthcare system these days is so expensive and they consider it as one of their main reasons why they don’t have health insurance. This is not good as we all know that a health insurance help them with their hospital bills and medication costs. Because they are uninsured, most of them are unable to access proper healthcare.

    Barry Bates

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    1. Thanks for you input Larry. I agree healthcare costs would be lower if we could keep people healthy in the first place.

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