America’s health insurance system is rigged to prevent people from getting the benefits they pay for. I just found that out the hard way. And that’s why I have decided to support Medicare for All and Bernie Sanders for president of the United States.
I was a supporter of Bernie in 2016, but this year I decided to support Joe Biden, because I thought he would have the best chance to beat Trump — and beating Trump no matter what is the most important thing.
Another reason is that I was skeptical of Medicare for All. I thought Biden’s modest reforms to the health insurance system, such as strengthening the ACA with a public option, were the more reasonable way to go.
I have changed my mind, and I’d like to tell you why.
In December, I had an auto accident and my car was totaled. I was able to walk away from the wreck but had severe back pain. I went to an urgent care clinic and they took X-rays and found that I had two broken ribs and a possible issue with vertebrae in my spine. They sent me to the emergency room at the hospital for a CT scan, which revealed that indeed I had a compressed vertebra. Fortunately, it was mild, and there was no neurological damage. The neurologist who examined me said I was lucky — if the compression had been worse, I could have been paralyzed from the waist down.
Because I am self-employed and not very well off, I have a Bronze plan under the ACA — the cheapest health insurance available. The only time I ever use it is for emergencies, because I am generally a pretty healthy guy. So, the only reason I buy health insurance is for situations such as my recent auto accident.
Last week I was informed by my health insurance company — one of the biggest ones in America — that they denied my claim from the urgent care clinic. The reason is, it was coded as a regular “office visit” instead of “urgent care.” My insurance company told me it was probably miscoded and I should try to persuade the clinic to change the code. So I called the clinic, and was shocked to learn that they have a “legal contract” with the health insurance company to systematically code everything as “office visits” instead of “urgent care” — even though their clinic actually has the phrase Urgent Care in its name, and the services they provide are for emergencies.
This sounds to me like fraud.
My health insurance company told me they will have an adjuster look at the claim on their end, for possible approval, because the urgent care clinic is legally unable to change the claim code. But they told me there is no guarantee that the claim will be approved.
The employee at the urgent care clinic told me this is a “common issue” for people with my health insurance company — which is, nevertheless, a very large and well-respected company in the industry. In other words, the system is rigged, through dubious legal agreements among the private corporations involved, to make it as hard as possible for sick or injured people to actually use their health insurance coverage.
If this is how the private health insurance system works (or doesn’t work) in America, perhaps it is time for a government takeover. At least then there wouldn’t be profit-driven, fraudulent billing practices such as what I experienced.
I have heard various horror stories about health insurance in America. I have always thought, “yeah, the private insurance system is screwed up, but Medicare for All would be going too far. We just need better regulation of private industry.”
After my own experience — which is pretty mild compared to what some people go through — I no longer trust the government to adequately regulate private health insurance companies to prevent fraud and abuse. As long as the health insurance system is a for-profit industry, even after major reforms such as the ACA, it appears that the insurance companies are systematically corrupt in some of their business practices. As long as they exist and can lobby politicians with huge campaign contributions, the abuses will probably continue.
When people are sick or injured, they shouldn’t have to worry about whether their health insurance will pay for their legitimate claims. The profit motive is too much of a corrupting influence in a field that’s supposed to be about matters of life and death. Let the government ensure that everyone can get the basic health care they need, just as the government provides other essential services such as roads.
I understand why many Americans are skeptical of Medicare for All. And I don’t think it should be the focus of the campaign — the focus should be on Donald Trump’s unprecedented and extremely dangerous corruption and abuse of power in the White House.
But I will say this: I now believe, after learning the hard way, that it’s not good enough to preserve the status quo of health care in America with some modest reforms. We need major change, or at least we need to fight for it. Bernie Sanders is more liberal than I am, but he understands that the system is fundamentally broken. If he is elected president, he probably won’t get the really radical health care overhaul he wants, but he will take the toughest negotiating position to push for necessary change.
Biden may be somewhat more electable than Sanders. I have argued before, using data, that Biden would be the safer nominee. I will vote and volunteer for whichever Democrat is nominated — as should everyone who doesn’t want to flush America’s future down the toilet.
But, as a concluding thought, I will share this shocker: My father, who was a conservative Republican until the rise of the Tea Party, and who now considers himself a moderate Democrat-leaning independent, told me that he will vote for any Democrat who is nominated to run against Trump — even Bernie Sanders. My dad has always been strongly anti-communist, and knows about Bernie’s long history of socialist rhetoric and his past friendliness to the Soviet Union.
So, maybe Bernie isn’t as unelectable as people think. I don’t know, and I still am worried that it could be a close race if he’s the nominee. I still feel like Biden would be the safe choice, and I like him and think he’s a good man. But maybe things are just too screwed up in this country to play it safe anymore. We have a sickeningly corrupt health insurance system; an economy that looks good on paper, thanks to unsustainable corporate tax cuts and stock buybacks, while millions of Americans are falling further and further behind; a president who is a con man and a crook; and a Senate that, in the sham impeachment “trial,” has abdicated its responsibility to be anything more than a rubber stamp for the autocratic oligarch in the White House.
I think the public would like to go back to the way things were before Trump, and that is a big part of Joe Biden’s appeal. I wish it could be so. But my gut is starting to tell me that there’s no going back. We may be headed into an era of populist politics on both sides of the aisle. Sanders 2020.