As I type this, I sit here in pain. I sit here suffering. And it’s all my fault. I’m an idiot.
I am 62 years old. I ought to know better. But obviously I don’t. Indulge me for a moment while I regale you with the silly, but painful, healthcare insurance story told by an idiot.
Once upon a time, last year, I had great health insurance. It was through my wife’s government job. Then my wife decided she wanted a divorce. So we got divorced in April 2016.
I have always been healthy. Oh, sure, I’ve had the cold here, the flu there, strep throat once in a while, but never any broken bones, cancer, heart disease, nothing “serious”. And I’m within striking distance of 65, so ….
At or near the time of divorce, rather than researching my health care options, I figured that since I was almost 65, when there would be Medicare available to me, couldn’t I just gamble? I thought I was too busy with work to deal with carrying over any pre-divorce healthcare coverage. Besides, there was ObamaCare. And Hillary was certain to be elected President, right?
I decided to “game” the system. It turns out that was a big mistake. But then, I’m an idiot.
The ACA open enrollment for 2016 arrived, but, “What? — Me Worry?”. Alfred E. Neumann certainly applies to me. He’s an idiot, too. We’re both idiots.
Then it happened. I lifted an object a bit too bulky. A bit too heavy. A bit too unwieldy.
The pain was immediate — and sharp. Right down at L5-S1.
Luckily, I was still within the ACA open enrollment period. Better sign up at once.
But have I mentioned to you yet that I’m an idiot? I digress.
I jumped on my computer and busily filled out the required information on the ACA website. I then ran into the part about “proving” I’m a “US citizen”. No problem, I can do that. I’ve got plenty of ID, long-form birth certificates, and whatnot.
After open enrollment closed, I uploaded my “proof of citizenship”. I had until May 1st to do so, but my back wasn’t getting any better, the word “microsurgery” kept popping up, so, in early February 2017, I got the “proof of citizenship” into the wire. [I would note here that that the ACA people I talked to over the phone were extremely patient and helpful — great folks, them.]
Long story short, during open enrollment I didn’t choose a plan. When I bumped into “proof of citizenship”, I stopped. Big mistake. You have to choose a plan first, then provide “proof of citizenship”. But I’m an idiot — did I mention that earlier?
My hard lessons exploring the murky world of the American health care insurance system were about to begin.
You see, what I found out was that there are all kinds of policies out there in the “private market” of which we all have “access” to.
Don’t like your ACA plan? Your ACA plan won’t let you keep your doctor? Your ACA plan is “too expensive”? No big deal. Dump it. The “private market” is sitting right there ready, willing, and able to take your monthly premiums from you, completely outside of the structure of the ACA.
So yea ... it’s not necessary to have coverage through the ACA — not at all! If you can afford “private market” insurance, go for it. No IRA penalty either, if your plan is “true” healthcare (which is an entirely ‘nother topic).
You know what else I found out?
Refusal to insure because of pre-existing conditions still exists. Denial on account of pre-existing conditions exists right there outside of the ACA in the “private market”.
Absolutely, positively — denial on account of pre-existing conditions is alive and well in America. It’s not dead. Outside the context of the ACA, every private insurance company I have been in touch with denies coverage for my back. Won’t cover. Pre-existing injury, you see.
It’s only within the context of the ACA that an insurance company lacks the ability to deny coverage due to pre-existing conditions. And even in the ACA you have to get signed up during open enrollment.
I can’t tell you about lifetime caps, coverage for kids until they are 25, and all the other advantages that I’ve heard about within the ACA, but I can doggone sure tell you if you have a pre-existing condition, you can almost certainly forget about getting health insurance coverage for it outside of the ACA.
I still need insurance, though, right?
Well, of course I do!
What if I have a car accident? What if I develop some insidious disease, malady, or other ailment? What if, what if, what if?
But, you see, now I can’t afford healthcare insurance — at least not right now.
Right now, I’m spending about $300 per week on “conservative treatment” in an attempt to decompress the 4mm bulge at L5 that is impinging the nerve root. And believe me — $300 is cheap.
And doctors? I can’t even get an appointment with a microsurgeon at any of the major Texas cities without healthcare insurance. It’s a rat race. I don’t blame the doctors, though. Those folks don’t have time to waste on some yahoo who may or may not be able to pay. Doctors have bills, too.
So here I sit, between treatment days, at a pain level of about 4. And that thanks to two naproxen sodium at 220mg apiece. Not especially good for the kidneys, and I take 5 of those pills per day. And all because I’m an idiot.
The “Accu-Spina” decompression machine seems to be “working” (wishful thinking?), and I hope and pray that it does.
Because when the ACA goes away, “hope and prayer” are all that our Republican “friends” are going to give us.
As noted on the front page, all Republicans want to talk about is “access” to healthcare insurance. Well, we’ve all got “access” right now. “Access” is stupid. I have “access” to win the MegaMillions, too — so does that mean I’m about to be a millionaire?
And the problem is, the middle class and below cannot afford the cost that happens after we are gloriously given “access” — which we already have.
Hello, pre-existing injuries. Hello, pain. Hello, inflammation.
At any rate, I hope you are amused by this sad tale of an idiot, full of sound and fury, signifying something; which is to say, a lot of pain and inflammation. I just hope it does not lead to premature death.
I am an idiot.