Uninsured in America

It's a bummer being uninsured in America. I don't mean not having auto insurance (my state requires that), or life insurance, I mean health insurance. My position as "psalmist" (music minister) at my church is part-time, with too few hours to make me eligible to participate in my conference's health plan. My "day job" (also part-time) offers no insurance. It's been this way, or a variation of this way, since I lost my job working for a hospital system over three years ago. I had a couple of health issues that mean I can qualify only for "risk pool" insurance, which is WAY more expensive than a lower-income person could possibly afford. (Paying over 1/3 of one's monthly salary on health insurance just isn't possible at my income level.) And the really insane part of it is, I'm a basically healthy, asymptomatic person when I take a couple of prescriptions regularly. At least in Texas, insurance companies can and do tell people who aren't in an employer group, who could be perfectly healthy on less than $200 per month worth of prescriptions, that they're uninsurable. (You can imagine what they do with people who have life-threatening conditions.) All we want is to be able to afford to particpate in a health plan that will protect us from total financial collapse if, God forbid, we ever got seriously sick or injured. I don't expect free healthcare and I don't think most Americans do. It also shouldn't be so expensive that only the wealthy can afford it. And more and more, that is the case. If we're also not below the poverty level in income, there's not much we can do except self-pay and pray to God that we don't become seriously ill or injured.

Anyway, now one of my conditions has started figuratively kicking my hindquarters. I won't go into the details, but it's making it very difficult to function well. I haven't been myself in a long time, but I'm *really* not myself now. I'm taking steps to deal with it, and is it ever eye-opening. I discovered not too long ago that I could have been receiving very affordable care through the VA system all this time. (I was under the mistaken impression that the closest facility was a hospital over an hour away.) The only trouble is, I don't have an official copy of the paperwork necessary to get me registered for care. So it's that familiar "hurry up and wait" with getting a duplicate from the agency that handles military records. Meanwhile, my "day job" employer's physician's office manager kindly squeezed me in to see the physician yesterday, and while I couldn't get samples of what I had been taking, I got a sufficient quantity of another drug that I'm hoping will also be effective (takes a while for blood levels to build up and show improvement), until I can get started in the VA system.

I think about people a lot like me, in similar circumstances, who are not veterans. Honest people, working wherever they can to keep the income coming in, not wanting to defraud anyone or accept handouts, wondering what they'll do if they or their loved ones need medical care. Forget about dental! Forget about anything elective! Just plain "major medical" would be a blessing, if only the insurance companies would accept them for less than the amount they are paying for mortgage/rent.

In the big picture, we do have the most advanced, amazing medical care in the world here in America. Delivery of it is, however, a serious problem. I often wonder if nationalizing healthcare could screw up the delivery more than it already is. Providers' hands have been tied for years by insurance companies whose goal is to keep from paying everything they possibly can. Their reimbursement rates from the insurance companies have gone down, rather than up, for years now (that's a dirty little secret the insurance companies who're raising your rates won't tell you). The only way a physician or other provider gets paid anywhere near the full rate for his/her services is when people self-pay, as I did yesterday. I don't begrudge that doctor his fee, even though it is more than I make in a day. I do have a big problem with insurance companies making record profits while lowering reimbursement rates and denying coverage and dropping members in order to make those profits. They're also often not reimbursing providers according to the "take it or leave it" contracted rates they strong-armed the providers into accepting; the tactic seems to be that if they delay long enough, providers will either give up or they'll delay to the point that the appeals period has expired. States like Texas give their insurance commissions nothing much in the way of enforcement teeth When companies encounter regulatory resistance in a state, they tend to stop doing business in that state and focus on more insurance-friendly states.

I think members of Congress ought to suddenly find themselves uninsured. You want to serve in Congress, representing us (your uninsured constituents), you try walking in our shoes for a while. See how you like paying for your check-ups, cancer screenings, surgeries, emergency visits, dental treatments, lab work, and so forth all out of your own pocket. See if your long-time physician will still see you without insurance (actually, he or she might just welcome that, since that's the only way he or she gets a full fee). See how your hospital admission process goes when there's no insurance card. Get that sticker shock at how much your prescription drugs really cost. Maybe, just maybe, you'd decide that the how-many millions of us who face this every day, deserve a little creative thinking on your part on how we might be sure that the greatest healthcare in the greatest country on earth, gets to all its citizens without bankrupting them.