Tuesday, March 31, 2009

Insurance

I was watching a special on health care coverage and how those without employer coverage are absolutely screwed. Even states with mandated coverage price out the self-employed. I have been very fortunate in my health care coverage with my employer, and I hope that it never changes. There have been few things that have not been covered - and even those might have had partial coverage.

The insurance industry and people I know have been intersecting lately. My mom has heart disease and type II diabetes, so her health care coverage is extremely costly. Fortunately, she can afford it with her health care coverage.

My best friend gave birth to her third child today. A wonderful event that was supposed to take place at home was suddenly moved to a hospital due to maternal and fetal distress. Now, her baby will be needing extensive care (hopefully for only a few days - I'm praying for no long term issues) due to some nerve damage and listeriosis. She was tested for listeriosis, and the test came back negative. Now, her son is in the NICU, getting antibiotics, and physical therapy. I shudder to think what that would cost without insurance. My friend is a SAHM and her husband is self-employed. It's a good thing he's very successful.

In other sad news, a high school classmate passed away suddenly over the weekend. Apparently, she had some sort of cardiac event, depriving her of oxygen for 30-45 minutes. She was on life support for some period of time, and then lived for some time after support was removed. She was quite a character in high school - a person who was not afraid to be herself, whoever that might be. The world will be a little lacking without her. But, consider, what is the cost of keeping someone alive and what is the cost of hospice while you wait for someone to die? Without insurance, would her family be bankrupted for the cost of the process of dying? That's not exactly something that can ethically be hurried along.

I don't know what the insurance solution is. I have worked for a pharmaceutical company, and I know how much it costs to develop drugs. I do not find that the cost of many drugs is unreasonable. I know that doctors are trained and skilled, and while I frequently doubt their words, I think that they often earn their salaries. I don't think socialized medicine would work for me - there are too many people in my family with unusual complications to their illnesses, and I would not want to be limited in my doctor selection. After watching the Frontline program (available at pbs.org), I'm pretty sure I don't want to leave my employer. I had mention of a possible diagnosis of lupus, and while I don't have any symptoms, and therefore do not have lupus, I think that would be a giant red flag for any future insurers.

I guess it's time to throw all of our research money at the geneticists - let them figure out how to fix our genes to fix our health issues. Then all you'd need is a few doctors to set bones, put in stitches, and perform appendectomies, and insurance would become obsolete.

9 comments:

  1. It's a crazy world where we can spend so much to wage warfare but can't care for our own.
    Great post.

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  2. I hear you. Canadian medicine hasn't limited me in terms of doctor selection at all, but there is sometimes a wait. However, I am learning that for life-threatening conditions or ones that would get that way if left for too long, it's easy enough to get to skip ahead in line. Canadian medicine has also made the cost of pharmaceuticals more accessible to me, for we have to pay that completely out of pocket and their prices are much lower than the US. For people with complicated health conditions, I don't have a problem recommending Canadian healthcare. If you needed a hip replacement or carpal tunnel surgery, well, I'd suggest the States because that's where the socialized method of waiting in line gets yucky.

    Currently, I'm stuck in the States on what was supposed to be a holiday. But more complications from a traumatic childbirth 12 weeks ago have arisen, and I am now battling a painful fistula that could easily develop into a major infection. I need surgery but can't afford the estimated minimum of $6500 that the hospital here would charge, and that's with the surgeon waving her fee. My old OB here waved his fee and saw me for free, but the specialist he sent me to cost us $165 (and that was with her waving part of the office visit fee).

    As one who used to have top of the line health insurance here in the States and now has Canadian healthcare which obviously doesn't allow me to be covered in the US anymore, I am well aware that the US needs some real solution to fix what has become a very mercenary system.

    Canada isn't perfect and my American independent mindset rebels at the idea of giving up my "right" to demand whatever and whomever I want whenever I want them, but I think it's something to consider if we don't want to end up with half the population dead or bankrupt from simply not having insurance. There is no perfect solution, that's for sure. But I have to say that this pregnancy and childbirth (during a time when my husband lost his job and changed to a new one as well) has taught me to be grateful for the "socialized" medicine I have. If I'd been in the States for this whole experience, I would have been screwed.

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  3. It's such an impossible situation, that's for sure. I wish there was a clear-cut answer, you know?

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  4. I don't know what the answer to this is. I do know that it's not socialized medicine. That's another post all together.

    Thanks for stopping by!

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  5. I have surgeries coming up, and my insurance company breaks down the price, like what I would be charged without insurance vs what they negotiated the price to because they have a contract with that doctor or hospital. It is unbelievable how much they charge if you don't have insurance. Like, it was more than double. Thankfully I have great insurance right now, and my deductible is really reasonable, but I too have been thinking how awful it would be to face this without insurance. I simply couldn't afford to have a surgery that I really have to have. But socialized medicine still puts me off because I doubt the quality will be the same. Its scary both ways.

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  6. The thought of being me without insurance scares the shit out of me.

    I'm sorry about your classmate's passing.

    And congrats for the birth of your friends third baby! Even though it sounded scary, I hope everyone comes out unscathed.

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  7. I have very good health insurance at my company. Very close to the "best" you can buy in my state, for my company size. That said, it is still woefully lacking. My husband is an amputee but only $2,500 a year is allowed for "durable medical equipment", which includes a variety of items including but not limited to hearing aids, pacemakers and prosthetics. Also not covered: anything related to infertility.

    Insurance is a racket

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  8. It really is kind of bizarre how tied our insurance is to jobs here in the US. It really makes things harder for entrepreneurs or non-traditionally-employed people, etc. And even the insurance we have through my husband's job is TOTAL AND COMPLETE CRAP. I'm looking forward to moving to Sweden in that regard at least--but I guess you pay more upfront in taxes!

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  9. I also worked in pharma and have worked in other health care related fields. With everything that happened to me in the last year (RE, DVT, birth, hematomas, and Colin's issues) the bills would have been well over 100K without insurance. One of the hospitalizations would have bankrupted us.

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