Tuesday, June 15, 2010

The Doughnut Hole

So this one's been coming for a while. Yes, friends, it is time for a rant about US health care.

I never realized how horrendously awful health care in the US was until I moved to another country. Now, I know the NHS has some problems, but the point is that every citizen (or visitor) to a country has a fundamental right to at least basic and emergency health care. I thought the US had a decent system in place. I really did. (Chalk it up to upper-middle-class naivete.) I was under my parents' insurance until I graduated college, and then I immediately got a full-time job with health benefits, after which I moved to another country where I didn't need insurance. Then I moved back to the US.

Before I rant, I will say this-I understand how a person could not see the problems with the health care system in this country. Much of the population is working-class union members. Mr. Bob Everyman who joined the Steel Worker's Union (or whatever) right out of high school, worked for 40 years, retired, and had union insurance for when Mrs. Everyman got pregnant, little Johnny Everyman fell off his bike, and little Suzie Everyman had her tonsils out, probably sees no problem with the system. And I get that. It works for most people.

But then there's the doughnut hole-the 16% of US citizens who receive no health benefits and are ineligible for government aid. I am a prime example. I work 3 jobs at upwards of 65 hours a week, but as they're all part-time, offer me no insurance. I applied for private insurance, which is slightly cost-prohibitive, but I am fortunate enough that I can afford to pay for basic insurance. Like most people, I am a generally healthy adult-I have asthma, which is an easily managed and fairly inexpensive condition. Otherwise, I have no health problems to speak of. I just need insurance to get 2 monthly prescriptions and see my doctor twice a year. Sounds simple, right?

Think again. First and foremost, the fact that there is no government health program for people who earn too much for welfare is a huge problem. As the insurance companies are independent, they can do things like what was recently done to me: I applied for insurance. A full month later, I was approved. Then, a week after I had already paid my first installment, I received a letter telling me that due to my health condition, the cost of my insurance would multiply by 4. A week after that, I received another letter saying that the insurance would still cost 4x the amount originally quoted to me, but they would not cover any syptoms or medications related to asthma, allergies, pulminary disease, chest pain, or cold and flu. Namely, all the symptoms and dangers I need insurance for. Now tell me-how can that possibly be legal?

I stated above that I understand how some people cannot see the problems with health insurance. But the fact that cases like this (and infinitely worse) have come to light in the news time and time again, and the GOP refuses to acknowledge the problem, claiming that a public health care option is "socialism"? Give me a #$%&ing break! There's a difference between socialism and caring for your citizens. Buy a bleeping dictionary and look up "socialism", for God's sake! Because the GOP refuses to allow Obama to pass a public option bill, I now have to drive 3 hours and back to see someone for 10 minutes so that they will write me a prescription, and then pay upwards of $200/month just to get a couple of inhalers. And I'm lucky-the only reason I was able to find a doctor at all was because my boyfriend's mother works in a doctor's office and could get me in without either insurance or having to pay a few hundred dollars for the privilege of having a prescription written for me. Imagine if I wasn't so fortunate!

Something else that rankled me-yesterday Congress overturned a law stating that an employee who is fired or layed off can remain on the company's health insurance for 6 months. Their reason? There is no system in place to help the unemployed, and it's unfair for a guy who's fired to have insurance while his neighbor next door who can't find a job in the first place has no access to health care. So the solution is not to give aid to the guy without, but to take away the benefits of the other guy? What are we, kids on a playground fighting over a piece of chalk?!?!?!

Am I the only one who is seriously pissed off about all this?


Anonymous said...

Well. Let's see. There are actually some options out there. The utopian NHS has its flaws, but at least you acknowledge that. What options do we have here in the US?
1. Urgent Care Centers. For a fee, (usually under $100) you can receive medical care. Prescriptions would be in addition to that.
2. The Emergency Room. The US DOES have a mandate to provide basic emergency care to everyone, even those not from this country. Unfortunately, it's quite expensive. However, if you are uninsured, you can often negotiate discounts either at check in or with the billing office after you receive your bill. In many cases I'm aware of, it's upwards of 50% off of the services provided, but it is a long wait and not the most efficient care.
3. Your primary doctor. Even if you are not currently insured, for a condition like the one you mention, if you have seen a doctor in the past and have a relationship with him/her, you can often contact their office and ask for a routine prescription to be called in. You would pay for the prescription, but would not need a doctor's visit. In most cases, doctors will oblige, especially if it is something they have written for you before.
4. "Basic" coverage. States such as California and I think Pennsylvania offer basic adult insurance plans (not necessarily private and not income based). These plans are usually funded by tobacco settlement funds. There are often long waits before coverage begins, but it is an option.
5. College. If you are a college student, you can receive care from your college's health clinic.
6. Prescription discounts. Walmart, Costco, Walgreens, etc offer prescription discounts, either through a membership fee or for free. Often with membership, you can get a prescription at a reduced cost, even a name-brand prescription.
7. Stock up. Get your doctor to write refills of commonly needed prescriptions so that you do not need to see a doctor when a routine illness occurs.

Is it easy? No. Does it work? Usually. Considering the US provides more than 86% of the world's medical research, the cost has to come somewhere. I don't believe the answer is a NHS-type program, but health insurance pools are a good idea. And you knock the GOP, yet McCain ran on the platform of providing tax credits directly to individuals to purchase private insurance. It was not an entirely workable plan, but the premise could work if implemented correctly.

By the way, I lived in Germany for 3 years, so I see how the "other half" lives. The US system has flaws, but if it was bad enough, I would have stayed in Germany rather than come home.

Anonymous said...

Random reader...

OK, I understand your frustration, especially with the private insurance market. Let me address a couple of your points though that I think you might have overlooked.

First, you state that Americans don't care about public healthcare because we're all in unions with cushy health plans. Did you know that under 8% of private sector workers are unionized? Public sector workers are under 38%.

Second, rather than working 65 hours a week at three jobs, why not just get one job that provides health insurance coverage? Even the convenience store chains pay reasonably decent and offer health benefits. Shoot, cut one of the part time jobs and pick up some hours at McDonald's, you can get insurance from them...

Finally, after blasting the GOP for being the sticking point in this glorious government health care program, you go on to point out that Congress recently passed a law eliminating health care benefits for employees fired or laid off. Who controls Congress? It's not the GOP.