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Over the last year, I’ve had several amazing experiences navigating America’s health care system, and what follows is a true account of that journey.

Like many Americans are wont to do, I switched jobs last August. It’s a good thing I did, because the place I worked for went out of business a couple months later. Unfortunately, my new employer does not offer health insurance. My old insurer quickly got wind that I no longer worked for who I said I worked for, so they sent me a brochure and a letter. "Oh how wonderful," I thought. "They’re going to let me continue my coverage."

The brochure’s cover featured a picture of a smiling, beautiful white family frolicking happily in front of their large mansion on their perfectly manicured lawn. The handsome father in the picture was throwing a football to his light-haired son while the thin, fully-bosomed blonde mother watched approvingly as her sweet, doe-eyed daughter played with a doll or something in the background.  The American Dream!

"Where do I sign up?!?" I thought, ripping open the packet in a frenzy, searching for the dotted line and the box to check that said, "Yes, send me your insurance and this lifestyle immediately."

Well, that’s when I read the letter, which said I’d have to pay them $400 a month to keep my insurance, no lifestyle guarantee included. Seeing that my current employer not only doesn’t provide insurance but, in fact, no real meaningful form of compensation beyond what is required to merely subsist, I sadly declined.

Now, I know, I know, I should have just gone out and got myself a job with health insurance. After all, in this economy getting a job like that is just like going to Walgreen’s and getting a gallon of milk. Anyone can do it. But, I confess, I’m a loser. Instead of getting the job I should have straight out of high school, I instead decided to go to college at one of the top liberal arts universities in the Midwest and then—and this is where I REALLY messed up—get an advanced degree from one of the top five or so universities in the entire world. And do you know what I did next? I got a job—college professor—that requires I have those degrees. I know, if only I’d gone out in the world and made something of myself, none of this would have ever happened.

Well, anyway, after a couple months in my new job, people who care about me discovered that I was just out there in the world, completely unprotected from the massive expenses associated with our brilliant fee-for-service health care system, and they demanded I get insurance.

You know, it says a lot about the system when your family is horrified that you might have to go see a doctor without first purchasing a product from a for-profit corporation. I wonder how many people in other civilized countries have those types of concerns about their health and the health of their family. Oh wait, I don’t wonder, because I know the answer is zero. Every other rich, civilized country in the entire world, which only includes about 50 countries, considers health care a basic human right and, as such, provides it for their citizens. To find a country that treats its citizens like over 48 million people in this country are treated, children included, you have to go to some third-world hell hole, like Somalia, or rural Kentucky, or, most likely, you can just drive around your own neighborhood.

So, as I was saying, my family’s shock and horror, in conjunction with the fact that I actually did have a bit of a health emergency, convinced me that I should get some insurance. I paid for a non-renewable 6-month temporary plan.

That plan expired at the end of last month, so a couple weeks ago I once again had to shop around on the "free market," which made me really excited because of all I’d been hearing on cable news lately when it came to the free market.

"The free market!" I thought. "It’s that glorious place where you are massaged, fanned, and fed treats by nude voluptuous goddesses whilst the ecstatic delight of ‘choice’ courses through your entire body. I can’t wait!!!"

I’m not positive, but I swear I felt the lips of the adoring Virgin herself kiss my head at that moment. I’d never felt so lucky to be an American, to be a citizen in the country with the best health care choices in the entire world!

Well, here are the choices that greeted me in the free market:

• Choice #1: Make a billion dollars over the next week or so and then get back to them.

• Choice #2: Give insurance company 90% of your monthly salary and/or the rights to prima nocturne with your wife in exchange for a plan that, from what it seems (at first), might actually provide decent coverage (after a big deductible, of course, let’s not get crazy here), as long as you're young, healthy, not a smoker, not pregnant or planning to get pregnant (I lucked out there), and as long as you agree to pay for your own "adult well-care" and "child well-care," which means they won't pay for preventive care, physicals, or check-ups for you or your child. They only pay if you get sick*.

*Only paying for people who get sick over providing cheaper preventive care sounds like a weird and backwards strategy—until later, that is, when you realize that they won’t pay if you get sick, either. Then you have an epiphany where the maniacal genius behind it all becomes clear, and a little guy with your money in his hands appears in a dark cloud before you, laughing in your face.

• Choice #3: Pay 80% of your monthly salary for the "fig leaf" plan that will cover 80% of your expenses if you go to the ER (after a $2,000 deductible), nothing more, and only if you go to a certain ER and only if you see a certain doctor at that ER and only if you go to the ER at certain hours and only if you get certain treatments and only if the insurance executive in charge of your health care agrees that those treatments are appropriate for you and that’s only after said insurance executive has exhausted all possibilities of denying or rescinding your coverage for any reason, like not crossing a t on your application.*

*In all likelihood, even after purchasing this plan, you will still end up getting your health care in an animal stall like many other Americans these days.

So, I chose option #3 and, oh man, let me tell you, participating in the free market like a real non-socialist meat-eating gun-toting American felt SO GOOD!!! After I clicked "purchase plan," I immediately put on my cut-off jean shorts, fluffed my mullet, went outside, slaughtered a buffalo, gave small pox to an Indian, phone tapped my neighbor’s house, gave my life savings to Joel Osteen, got a $6 burger at Hardee’s, drafted a love letter to Glenn Beck, heckled a guy exercising by my house (what a fag!), committed some casual elder abuse, and shot off some bottle rockets out of the barrels of my sawed-off double shotgun, "accidentally" hitting my friend square in the face (ok, I was drunk).

And then, when I came back inside, to my extreme delight, I learned that my adventure in the free market was really just beginning. You see, I still had to fill out an application and a health history form, which is the form where you basically tell the insurance company everything down to the last time you stubbed your toe, the feet per second of your urine stream, and the number of wrinkles in your rectum. Oh, and then they take your money.

Then, after they have your money, they tell you that they are reviewing your application. You see, you have to pay them just to even consider you.

Then, after they leave you in purgatory for a few days, during which time you take extra care to buckle your seatbelt, to cut your food into extra small pieces, and to wipe down all public toilet seats, they call you back with a bunch of ominous follow-up questions about your health history, like "Are you still feeling the effects of this?" and "Have any symptoms returned" and "Are you still being treated for this?" Getting these questions from your potential health care insurer is kind of like being on a first date and having your date ask you, "So, do you still live with your mother?"

Now, I understand that insurers don’t want to get defrauded, but isn’t it sad that, when it comes to getting health care coverage, getting sick actually dooms you for future health care coverage the rest of your life if you happen to, oh, say, switch jobs? Or get laid off? Or have your employer drop your insurance plan? Or any number of other things that can leave people at the mercy—I mean loving, soft caress—of the free market?

So, after they ask you their questions, they accept your application (they really want to keep your money, after all), but—hold on—there are a couple exceptions. You see, they have these things called "exclusion riders" (as if you didn’t feel like they were riding you already), whereby they tell you that they'll give you insurance, but not for anything that, based on your health history, you'll likely need to see a doctor for.

So, in review, the insurance companies 1) take your money for an advertised plan, 2) find out how healthy you are, and then 3) give you advertised plan with some advertised parts excluded based on the likelihood that you might actually need to use them.

And then this is the point when I thank God that I live in a country where business executives out to make a profit get to make decisions about my health care and deny me coverage because of something that happened to me when I was 17 so that they can make another $12 million dollars this year.

The free market!!! WOO HOO!!!!!

What a utopia!!

Where’s my assault rifle? Where’s my magic marker? I’m drawing a Hitler mustache on a poster of the president and heading to a town hall!!!

Originally posted to chippens on Sun Aug 30, 2009 at 08:10 PM PDT.

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Comment Preferences

    •  Only in America (5+ / 0-)
      Recommended by:
      Marie, jbdigriz, Lashe, Clio2, StateofEuphoria

      I live in a country where business executives out to make a profit get to make decisions about my health care and deny me coverage because of something that happened to me when I was 17 so that they can make another $12 million dollars this year

      Good diary and so very typical of what's happening to ALL of us in this country. I suppose that because my doctor said I have high cholesterol ANY heart related incident will be denied by my insurance company as a pre-existing condition and my own fault.

      It's time to send each and every one of these diaries to the members of congress who are denying us the same health insurance WE provide for them.

      We're number one thirty-seven! We're number one thirty-seven! We're number one thirty-seven!

      Gahzette"At all costs, let's laugh!"~Levon Helm

      by Panda on Sun Aug 30, 2009 at 08:46:38 PM PDT

      [ Parent ]

  •  I've had my own (10+ / 0-)

    not very happy few weeks.  I have insurance.  Luckily, my husband's employer provides it.  Really, though, it's as Obama stated during the campaign...health insurance is really house insurance.  You have it so you don't lose your house in case you get sick.  Since I own four houses, one in which we live in and two which house our children and their families, I have to have the insurance.  I'm also chronically ill and medically disabled from holding down full time employment.

    Almost four weeks ago, I woke up with my hearing totally gone on my right side.  Just gone.  I also noticed several cardiovascular symptoms, which I'm too familiar with.  So, putting two and two together, I realized that I had suffered some kind of cardiovascular event during my sleep that had done the damage.

    To make a long story short, I could not get into see my primary care doctor, because we know, ofcourse, there's a shortage of such medical providers.  I was sent to an ER, where a CT scan was done in order to rule out bleeding into my brain.  Fortunately, no bleeding.  Finally got into see the doctor.  He agreed...something happened.  Ordered a stat MRI and scan of my carotid arteries.  I thought "stat" meant immediately...unfortunately, no.  It meant "as soon as your insurance allows".  So, I waited.  Three days later I called and was told I had to have insurance approval.  Insurance company told me no approval had been sought.  This went on for two weeks.  Finally had the testing done in the past few days.

    So, nearly four weeks out, I'm still missing my hearing, the testing is done, and I hope the insurance pays.  I also hope my primary care doctor finds the time to let me know know if anything turned up and to schedule follow up care.  I'd kinda like to work on getting my hearing back, but red tape seems to be in the way.

    •  STAT=wait for approval? (6+ / 0-)

      You should send a copy of this comment you just wrote directly to your congressthing and senators. The injustices need to pile up on their desks. You must be so worried...that should NOT have to happen!

      Medicare for ALL. We want what THEY get from US or we'll take it away from them...then they'll see just how great this for-profit system works when it's NOT paid for by taxpayers. It's where I WANT my taxes to go...Health, Education, and the freedom to pursue happiness without a vicious pitbull of an insurance company biting on my ankle.

      Gahzette"At all costs, let's laugh!"~Levon Helm

      by Panda on Sun Aug 30, 2009 at 08:53:22 PM PDT

      [ Parent ]

      •  The whole health care system (5+ / 0-)
        Recommended by:
        Panda, Lashe, Clio2, Arenosa, StateofEuphoria

        as it exists is getting to me.  In the past couple of weeks, I've walked around wondering "so this is the 'superior health care' we're supposed to be getting in the US?".....

        We did right a note to the director of the clinic.  He, ofcourse, wanted to hear more, and mysteriously, my testing was scheduled within an hour after he received this message.  This is a "for profit" clinic, mind you....anyway, it's going on four weeks and I'm still waiting and the window on the time in which treatment for my hearing loss might be effective is quickly disappearing.  

        I think I will share this with my congressional representation.  My House member is a dedicated progressive, so maybe it will help her with her case.  My senate members include a progressive and an retiring republican.  Can't hurt to pass it along.  

        I'm fed up.  I talked to a friend of mine in the UK.  He was aghast.  Told me how the situation would be handled there.  So much good sense.  And, mind you, he considers himself a CONSERVATIVE.

    •  Today my wife got sick (5+ / 0-)
      Recommended by:
      Marie, Sychotic1, Lashe, Clio2, Radiogabs

      My wife got very nauseous and disoriented today while we were painting an apartment.  Being Sunday, our Walk In Clinic was closed so we went to the nearest emergency room.  She is sixty so we did not want to ignore her symptoms.  We live in a small town so it's not a big ER. She was seen by a triage nurse, had her temperature and BP taken.  She had started to feel better by then.  After about 40 minutes wait she was taken to an examination room at about the time that 2 very serious cases were brought in.  When she was finally seen the doctor gave her a full examination and ordered a series of tests which were taken immediately.  She waited a while for the results and was seen by the doctor again who told her it was nothing serious, all of the tests were negative.  He prescribed an over the counter anti nausea drug and gave her her file copy so she could follow up with her own doctor on Monday.  She's now fine.  
      The total time was about 4 hours which was expected due to the 2 serious cases brought in while she was there.  The anti nausea drug cost $7.49.  The emergency visit, doctors consultation and exam along with the test taken $0
      We live in Canada. You really need to fight for at least the public option if not single payer.

  •  And you're one of the lucky ones... (2+ / 0-)
    Recommended by:
    Lashe, StateofEuphoria

    I got excited b/c I saw a good family "plan" on the website for BCBS, so I got into a conversation with a nice young man about signing up my family, since it was a lot cheaper than my plan with Aetna.  So I explain my pre-existing conditions, which of course will be excluded, but that's okay since it's under control and I'm on a generic...

    The kids, no problem with them.

    Get to my dh, nice young BCBS salesguy hears about his health issues, his height, his weight, the meds he's on right now.

    He says, ruefully to me, oh, he'll be declined.  So sorry, no family plan for you!

    So, just be happy you didn't get rejected!  

  •  People need to understand (7+ / 0-)

    that the last thing any insurance company wants to do is pay a claim.  You'd have more luck getting back that money you let your brother borrow.

  •  The status quo is very very good to them (5+ / 0-)

    But mandated coverage would be even better. Make everybody pay premiums, be underinsured, and subject to their rules.

    Republicans: Their only tool is a hammer, and every problem is a thumb.

    by Sue Hagmeier on Sun Aug 30, 2009 at 08:46:08 PM PDT

  •  We live on $1200/month. (2+ / 0-)
    Recommended by:
    Sychotic1, Clio2

    They want $800 to insure both of us with a junk insurance plan.

    So pretty much we're uninsurable because we're both going to need surgery in the next five years for various orthopedic issues.

  •  I am so glad this got rescued (0+ / 0-)

    This is by far the funniest, most truthful and in a way, most tragic health care story so far.

    Repubs - the people in power are not secretly plotting against you. They don't need to. They already beat you in public. (Bill Maher)

    by Sychotic1 on Mon Aug 31, 2009 at 10:54:45 PM PDT

  •  In the same boat (0+ / 0-)

    I am always reminded of the "Soup Nazi" on Seinfeld.

    A preexisting condition?  

    No Health Care for You!!

    The cost if we do nothing about health care? I will die!

    by ArtemisBSG on Mon Aug 31, 2009 at 11:41:34 PM PDT

  •  Rural Kentucky hellhole? (0+ / 0-)

    I live in rural Kentucky, and it is indeed a hellhole sometimes, but it hurts to see someone not from here put it in writing. Ouch.

    Great diary; too late to tip/rec it (I shoulda clicked on it when I saw it yesterday!). Thanks for writing it - and may we pass reform that's effective NOW instead of 5 years from now!

    We no longer have Ted Kennedy to fight the Good Fight or Walter Cronkite to tell us about it. Each one of us must now wear a small bit of their mantles.

    by SciMathGuy on Tue Sep 01, 2009 at 02:51:46 AM PDT

    •  Sorry about that (1+ / 0-)
      Recommended by:
      SciMathGuy

      My point was just that in terms of health care access there's not much difference between a third world country and our own. "Hellhole" only applies to rural Kentucky, and parts of everyone's neighborhood, in that respect. If the topic were beautiful landscape, tasty alcohol, and rich music, well then rural Kentucky would be anything but a hellhole.

      •  No apology necessary... (0+ / 0-)

        ...I was more-or-less agreeing with you, even though I do live in rural KY!

        We no longer have Ted Kennedy to fight the Good Fight or Walter Cronkite to tell us about it. Each one of us must now wear a small bit of their mantles.

        by SciMathGuy on Tue Sep 01, 2009 at 11:14:36 AM PDT

        [ Parent ]

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