This is a meta-diary. NCrissieB is too disheartened by the general vitriol of the discussion on Health Care this morning to feel like posting Ask Ms. Crissie.
So, in the interests of giving the Kula Krew our morning gathering place, I am standing in and will explain something that I left hanging in the wind yesterday, something which, unfortunately fits with the Health Care debate. <sigh>
Sorry I can't do the humor. All I can do is try to explain the rationale of firing my health insurance company.
Yesterday I said something which, in retrospect, I realized could have used some explanation. It sounded like a toss-off when indeed it was far more agonizing.
Five years ago, I fired United Healthcare. I didn't reach that decision lightly, happily, or even easily. In fact it took 18 months for me to work through what was really a rational decision.
I had already learned the hard way that insurance companies can drop you retroactively if they catch even a whisper that you might have a major problem. Okay, so I knew rescission existed, and that it could potentially come at the worst possible time (and did simply because a test I had put up warning flags even though it proved I wasn't ill). Unfortunately, silly me, I didn't know that all insurance companies did the same thing.
So I moved to United Healthcare. Great policy. Low premiums the first year, a lovely "stop-loss rider" promising my maximum out-of-pocket each year after deductible would be $2500, and promising to cover emergency situations as if all providers were "in network."
Boy, did it sound good. I hadn't realized yet that in addition to rescission they could simply deny claims in violation of their own policy.
I went merrily along paying premiums, never reaching my deductible or my stop-loss. Well, when you're healthy it's pretty hard to reach your deductible when it's $4000. So that wasn't surprising.
Then I had an emergency. I was carted to the ER in the middle of the night with an intestine that had gotten infected and somehow perforated. By the time I reached the OR I was in the so-called "Eleventh hour," where such a situation usually results in a lower than 20% survival rate.
I survived, obviously. I got home, started recovering and then learned the truth about insurance: they don't have to pay anything they don't want to, policy bedamned. United coughed about 20% of the total bill. The games they played with the deductible were especially interesting: it got applied one way or another to every single bill.
I appealed. Nope. Still denied.
All of this pushed me into bankruptcy. I won't bore you with the details.
Despite this (mis)treatment, I struggled to meet my rising insurance premiums for more than another year. You see, the terror of not having insurance is so big that even with my experiences I was still scared to death of not having it. Even if it meant I was struggling to pay for food and shelter for my kids.
But gradually I escaped fear and found reason, and finally I asked myself: Did I think this policy would cover me in case of serious illness? Well, actually no. I'd already learned they wouldn't. Not for much. Not enough to save me. If they wouldn't cover an appendicitis-type illness, what made me think they'd cover cancer? Or heart attack? Something that would require ongoing treatments?
So I finally asked myself, facing yet another 30% rise in premiums that would have carried me from $12000/yer to closer to $16,000/yr... would I pay anyone else in the world that kind of illusion? Hell, I wouldn't pay David Copperfield that much to make my idiot neighbor's house vanish.
That's when I realized that fear was holding me hostage to the biggest legal scam on earth. Even though I had insurance, when I had needed it I had discovered that I was, in truth, self-insured.
Yup. And realizing that (consider it only took me 18 months to escape operating on my limbic brain and move to my forebrain) set me free.
Now those of you who get your insurance through large corporations pretty much don't have to worry about this. Your companies have enough clout and enough lawyers to keep insurers honest. For the individual policy owner, or the average small business, that is not the case. For them, waking up to the racket called insurance usually comes the same way it did for me: Rescission and denial.
Yes, I live with fear on a daily basis, not having health insurance. But I discovered the hard way that having it was no better.
Fear can hold us hostage. Or fear can set us free.