Sometimes we hear about the struggles of health care in the USA. At other times we experience it. Our health care system is driven by profitability, even when the providers are not for profit.
In my situation, the reality has hit home hard.
I was informed that my disability benefits were being terminated. We are considering an appeal. Time will tell. However, in the mean time, our family's health benefits which had been provided through the disability benefits were also terminated. We received this notification approximately ten days AFTER they had ceased. Which of course was more than a bit disconcerting.
We are eligible for COBRA. The quoted price for COBRA was $2,666/month for the family or $860 each for my wife and I. Having just lost the income from disability, needless to say, coming up with that kind of cash for health insurance simply wasn't possible.
We are fortunate. My wife can get insurance through her employment. Her's is largely paid for by the employer, mine costs a significant amount, though only a fraction of what COBRA would have cost. I thought, "One hurdle crossed."
Well, not quite.
When I went to pick up my prescriptions this week Regence rejected the claim for two of my meds resulting in my having to purchase a ten day supply at a cost of over $350. My physician will have to make the case for those meds being covered, but even then, because they are not yet available in generic forms, there will be a $500 deductible for both this year and then of course, beginning next year. OK, we'll see how this works out.
Then I went to my psychologist. Gave them my new insurance number. Rude awakening. No mental health benefits. No coverage for the psychologist. No coverage for seeing the psychiatrist. Still waiting to see if this means no coverage for the medications that I am receiving for bipolar disorder.
The bottom line is that we will have to be shopping the insurance exchange. Don't know if we will be successful or whether the coverage that we need will be simply too expensive.
Other options are to have my family practice doctor take over the prescriptions. My psychologist offered to try and work out an affordable fee structure.
The question with which we must struggle is whether I can continue the treatment I need at a cost I can afford, and what happens if the answer to either of those is "No."
The bottom line, is that when we structure our health care system on the basis of capitalism, it will always be in the best interest of the insurance industry to find ways to deny coverage to those most need it, because it is much more profitable to insure healthy people than sick people. At the same time physicians must charge enough for their business to be profitable, which makes paying cash for their services unattainable for those who most need it.
I wonder if there is a need for a good woodworker in Canada?
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