On Tuesday night, July 6th, I watched the PBS NewsHour (on OPB Channel 10 ) segment (reported by correspondent Betty Ann Bowser and funded by Robert Wood Johnson Foundation ) about the new health coverage option for high-risk patients with preexisting conditions . Living without any health coverage myself, I was eager to learn a little more about what this option might offer.
Healthcare.gov is coordinating this insurance plan that has been offered to all 50 states as a means of meeting some of the immediate needs until the entire 2014 health care reform law will take effect. Some states opted out of using the allocation funds due to their concerns about receiving enough funding to cover the insurmountable health care costs facing their high-risk residents. Oregon is one of the states that opted in to using the funds for this new insurance plan and you can find out more about what the program might offer you by going to this Healthcare.gov link.
I know that there are plenty of people in this high-risk category and that it would be impossible (on many levels) to create a plan that offers something for everyone. Although my situation meets the criteria to pursue this option, the fact is that I would end up paying more per month than I do now and I simply can’t afford it. That isn’t by choice, mind you.
The whole idea behind insurance is that we put money into a bucket per month that is supposed to insure us from future medical expenses and I get that. Paying something each month to know that I will have some help paying for appointments, procedures and (heaven forbid) emergency situations is a wise investment. Here’s the catch, however. I paid for years when lupus hadn’t even arrived yet into a large insurer’s pocket and rarely needed any medical services. I was young, healthy and taking the best care to make sure I stayed that way, yet I still paid them for this unused care through my employers totaling several thousands of dollars. Decades later, and without warning, my health took a turn and I needed that coverage. Although my employers and plans had changed, this company had my name and track record on file. In spite of the money I paid and with little cost to them from their profits via my investments, they threw me to the curb. Actually, they threw me to the curb AND sued me for $10, 000 claiming I knew I was sick before I signed up for my health plan. Hello, …my doctors didn’t even know what was going on until my kidneys shut down. But, that’s a nightmare best left in the past.
It is the past, however, that has put me where I am today. I cannot get insurance, even if I could afford it. There are many things about the new Affordable Care Act taking effect in 2014 that has me worried. As wonderful as it feels to think that I will have coverage, even with my health history, I still don’t know how I will be able to afford it. Having options is one thing, but the question about who foots the bill—our government or myself—is what haunts me. I agree that we need to develop a healthier country and providing more health care options is a great step forward. The health care costs are still way too high, though.
Do I want to, once again, put what cash I have into my health care bucket only to have an insurer avoid returning my investment when I need it? Will they hike the expenses and/or claim that I did something that disqualifies my right to the care I invested into? Worse yet, as this news segment points out, what if I put into this plan and they run out of money before I need it? Let’s face it, insurance may be profitable, but managing my own health care is not. There’s something really wrong with that.
As I wait for the industry to be seriously overhauled, I focus as much as I can in making the best choices I can every day to avoid future health woes. There’s no guarantee either way, whether I pay an insurer or myself to put into a savings account, that I will have the care I need when I need it. I can’t control what the insurance companies do, what the government will or won’t provide or how my lupus will progress. There are a few things I can eat, move, try, think and prepare for that might cost me less down the road. Even that sometimes costs me a pretty penny, but well worth the effort.
The gal in this news segment, Ms. Eaton, who is living with the heart condition represents many of the people I work with every day. She also represents my situation very closely. Many of us aren’t disabled, are still working, take care of ourselves and are willing to pay what we can. We understand that health care will never be free and that preventing illness would be ideal. We also know that we don’t ask for diseases like lupus, genetic or congenital conditions, see ourselves as victims or live to frustrate the medial establishment. We are simply going to have to do what we can with what we have until “health” is as valued as “profit”.
Where are you in all of this?
- Have you lost your health coverage through loss of employment or cutting costs at work?
- How well can you manage your illness without care?
- What are some of the things you let go in order to manage your health?
- How do you expect to handle the 2014 shift?
After taking a look at the news segment link and learn more about what the preexisting insurance plan offers, I would be interested in hearing what you think. Share your story, too~ you’re not alone.
