I'm heading into day 8.
My insurance was cancelled last Monday. I've spent a week now learning the disgusting truth about our very broken health care system.
Allow me to digress for a moment, I'd like you to know something that will break your heart and make you angry. My insurance agent told me yesterday that several of her clients who have been cancelled, just like me, were in the middle of medical ordeals. She told me one client was undergoing chemotherapy for a malignancy, another recently had a transplant and requires medication that costs $1000.00 a month. Replacing their insurance with a satisfactory alternative will not be easy, it may be impossible.
Some people with certain diseases require very expensive medications which insurance companies are loathe to pay for. Hence the insurance company offers a prescription drug formulary which will not pay for these life or death medications.
It's important that everyone know that the drug formularies of many insurance companies are
very restrictive. Frequently they only allow sick people unacceptable generic alternatives. Very ill people who should be focused on battling their disease must also fight their insurance carrier for necessary medication.
This is what is happening in America, my friends. Be outraged. Be very outraged.
My situation looks good compared to these people.
Is it appropriate to ask or wonder whether Arlen Specter had to settle for generic alternatives during his chemotherapy? Is he denied, like many in the private sector, top-of-the-line medications by the formulary of the health care plan available to U.S. Senators? Would one of his constituents like to make a polite inquiry?
I am hoping by writing about my own experiences,and shining a light on my excursion into the deep, unfriendly recesses of this national disgrace, more people will become empowered to take back our country and our health care system. Everything, my friends, is collapsing at our feet,
In my quest for affordable health care I have ceased being the hard working, tax generating citizen I was until a week ago. I have been spending all my time on the telephone, searching the internet looking for an affordable PPO for a self employed individual. This does not appear to exist any longer in New York State. My insurance agent offered me one alternative. A BC/BS plan for around $1000-$1100 a month.
The chief of staff of my assemblyperson referred me to a local chamber of commerce. I called them, the person who handles this has not called me back. But the receptionist I spoke to was less than optimistic that they could be helpful.
Health insurance generally flows through your place of employment. I say generally because skyrocketing costs as I am sure many of you are aware, has forced many employers to make drastic cuts to employer provided health insurance. This comes in the form of higher premiums, higher deductibles and and far less consumer friendly benefits. In a word, more of the costs are pushed onto the low wage work force. This is forcing people to choose less satisfactory alternatives, like HMOs, where they are restricted to a list of medical providers and there is little or no freedom of choice.
For young, healthy people who rarely use the health care system an HMO may be a good, inexpensive alternative to going without insurance.
For someone like me, with a medical history and long standing relationships with a few doctors, an HMO is a distinctly inferior alternative.
HMOs seem to be the product of choice of the health insurance industry because this enables them to control costs and control access. They contract with a group of health care providers and pay them low rates for essentially assembly line operations. I don't for a second doubt the integrity of most health care providers, they are as appalled as we are by this broken system. The fact remains that spending a few minutes with a multitude of patients frequently results in less than optimum care. And, more imporatnt than anything, HMOs aren't controlling anything. The system is completely rotten through and through, skyrocketing costs and 46 million uninsured.
Several people commented on other diaries that this situation is exactly what to expect when you relegate the collective health of the nation to a parasitic industry that must demonstrate a strong bottom line to its shareholders. The insurance industry must show strong quarterly profits and the only way they can do this is to deny care, terminate enrollees, send them to Mexico for care, restrict access to vital medication, the list goes on and on. It stinks. Why do we accept this?
We must demand universal coverage.
Health care is our right not a privilege.
