What the Heck Happened to Healthcare on Sunday Night And Why I Care

This BIG HEALTHCARE BILL PASSED.  But before we get too confused, I’ll share a personal experience that I also sent to Congress and President Obama back in August.  It is certain not of the caliber of some of the horror stories that have circulated over the last year, but I’ve always had healthcare. I’ve only had glimpses through medical school and an experience in April into the seedy underbelly that is a lack of healthcare.  And I DID NOT LIKE IT ONE BIT.

An excerpt from the letter:

I have become more concerned over the state of healthcare and health insurance in our country.  I had an experience in this last year that has really encouraged me to support your efforts on healthcare reform with letters to Congress.  I gave birth to our second child in April 2009.  As you know with two children of your own, the first month of a having a newborn (and a toddler!) is hectic and we forgot to add our new daughter to our insurance within the allotted time period of 30 days from birth.  I only realized my mistake when I started receiving bills from the hospital that insurance wasn’t covering the $12,000 in medical bills.  I called them and was told that because it was outside the 30 day window (by two days), it was up to their discretion whether to cover our daughter.  I was very upset by this.  The policy of only giving 30 days to add a child who clearly was born alive and well since the doctor bills are arriving at our insurance’s office is not very consumer orientated.  I was post-cesarean and still hobbling down the stairs after my toddler at 30 days!  We did contact my husband’s human resources’ coordinator and she submitted our new daughter’s insurance form.  We were very blessed to be retroactively covered.  However, I still had to make multiple phone calls and have each claim resubmitted in order to have our insurance carrier pay.

I thought it was all over when I started getting new bills totaling over $1000.  I called my insurance company to ask why my claims were being denied again.  I was informed that those were my co-payments.  I was shocked.  Not only is that an exorbitant amount of money, but we had chosen to pay for our hospital room out-of-pocket and had left after two days instead of the average post-cesarean recover time of three days.  Had we stayed a third day our bill would have been closer to $1500 in co-payments.  All I did was have a baby!

I have had health insurance my entire life, but I have noticed that it is getting more and more expensive to see a doctor even with insurance.  We are blessed with enough money to still make every visit necessary to our health and the health of our children, but my heart goes out to the 47 million Americans who do not have health insurance.  I can’t even imagine how fearful I would be of failing ill if I did not have health insurance or a reasonable income. I thank you for thinking of those people and their families.

Good healthcare should be affordable and available to all Americans.  Please do the right thing by my family and the families of the 47 million Americans who are suffering under our current system.  Give them a meaningful option for healthcare from our government and please compel the health insurance companies to develop humane policies.

My family is willing to sacrifice our income and wait a little longer if it means that more people will be able to access quality healthcare in times of health as well as times of crisis.

And although the H.R. 3590, as passed by the Senate, also known as Patient Protection and Affordable Care Act, is not what I would have chosen, (i’m a universal healthcare kind of doctor, mother, Christian, liberal, human being), here are the benefits:

  • Children will not be denied for pre-existing conditions effective within 6 months of enactment.  And by 2014, no one will denied for a pre-existing condition (My two cents: so N would have been put on our insurance at any time with NO PROBLEM.)
  • Prohibition against health insurance companies from dropping people from coverage when they get sick within six months of enactment
  • Prohibition against health insurance companies from placing lifetime caps on coverage within six months after enactment
  • Prohibition against health insurance companies requiring prior approval for patients to see gynecologists or visit the emergency room
  • 32 million uninsured persons will be covered persons by 2019, a 59 percent reduction in the number of uninsured
  • Dependent coverage will be provided for children up to age 26 under all individual and group policies (My two cents: My kids can live with me FOREVER… Oh wait…)
  • Increased funding for the National Health Service Corps and the nation’s community health centers
  • Medicare Part D coverage gap for Medicare beneficiaries, who have surpassed their prescription drug coverage limit, will begin to close
  • Co-payments for preventive services will be eliminated and exempted from deductibles.  For Medicare patients starting Jan 1, for new private health insurance plans within six months of enactment, and for all insurance plans by 2018 (My two cents: It won’t cost $50 a pop to see my gynecologist.  And $25 for my PCP. Maybe I’ll be willing to go as many times as my health and doctor suggest.)
  • Individuals must carry health insurance or pay a penalty that would be the greater of $750 or 2 percent of income by 2016 (My two cents: Remember the people who don’t have health insurance cost taxpayers LOTS of money when they show up at the emergency room. Because even healthy people get sick.)
  • 50 state-administered insurance marketplaces will be established by 2014 to allow small businesses and people without employer sponsored coverage to buy insurance that meets new federal standards
  • Medicaid expands to cover everyone earning less than 133 percent of the federal poverty level, or $29,327 for a family of four.

And I chose not to include cost information.  Not because I believe that it will bankrupt us as I believe that the bill will reduce our deficit in the long run.  But because I am unwilling to put a price tag on my friends, family, and poorer American lives.

I am grateful that over 30 million Americans have a chance to live longer and fuller lives.  We are one step closer to treating our most important commodity, our citizens, with the respect and dignity that we treat our businesses and gadgets.

The information above is a conglomeration of American Medical Association FAQ on HCR, American Academy of Family Physicians, and graphs are from Ezra Klein’s Op-ed in the Washington Post.  I figured doctors know the most about the human cost of inadequate healthcare while standing to lose the most financially with an expansion of government aided healthcare; thereby making them the least biased.  Although in full-disclosure, the AMA and AAFP (eventually) supported the bill.

Here are two summaries of the bill (neither of which I used for this post. But hilarious that both parties had to create there own summaries of a bill that exists in BLACK AND WHITE): Democrats (website) and Republicans (pdf)

Alex Iwashyna

Alex Iwashyna went from a B.A. in philosophy to an M.D. to a SAHM, poet and writer by 30. She spends most of her writing time on LateEnough.com, a humor blog (except when it's serious) about her husband fighting zombies, awkward attempts at friendship, and dancing like everyone is watching. She also has a soft spot for culture, politics, and rude Southern people who offend her Yankee sensibilities. She parents 2 elementary-aged children, 1 foster baby, 3 cats, and 1 puppy, who are all Southern but not rude. Yet.

19 thoughts on “What the Heck Happened to Healthcare on Sunday Night And Why I Care

  1. Alex, Thank you for being articulate enough to express the things I get too flustered to say in the face of righteous opposition to healthcare reform.

    My favorite quote, “My family is willing to sacrifice our income and wait a little longer if it means that more people will be able to access quality healthcare in times of health as well as times of crisis.”

    Thank you.

  2. I remember before health insurance covered so much. My first child, I was still paying off her birth when she was in grade school. My second child? I don't think I paid a dime for the birth. Now the circumcision was another matter …

  3. I hadn't thought of that… It's like a form of population control: only wealthy people, those willing to pay for the next eight years, and those willing to go bankrupt could have children… Glad it's changed. I'd miss my children.

  4. After getting no straight answers when I was trying to buy a policy, I am thrilled that we will require more of the insurance companies. And we are another family willing to pay more and wait longer for social justice to become part of our medical system.

  5. I keep looking for verses in the Bible that talk about NOT helping others and KEEPING money, etc. to oneself. Alas, all I keep running into are things like, helping the poor and needy, and being crushed if we don't help others, and blah blah blah. Am I really suppose to think we're to HELP others and be responsible for those that can't do it alone? Certainly, they are not just disagreeing to be poopheads…right?

  6. My favorite line you pulled out of the BIble? “Being CRUSHED if you don't help people.” Talk about incentive! Your open-mindedness is so refreshing my dear. What a good example you are TO ME!

  7. I appreciate your honesty in your blog, however I have to respectfully disagree with you.
    I don’t think you understand how our economy works or how much this is going to cost us. The pre-existing clause is a great idea– but that along with the federal mandate to have coverage will allow someone to hop on and hop off after they take care of their ailment/surgery. Who will be stuck with the cost of covering that person who got a 15 K dollar surgery? The insurance company at first and then it will be you and I.
    I don’t understand how someone in the US could actually want universal healthcare. How would we pay for that? Oh yes, that is right…raised taxes. Pretty soon our paychecks will be dwindling away to nothing. We will become a nanny state….if we have a problem— financial or health- the gov’t will solve it, right? How can we sustain paying for this gov’t mandated health reform acts without hurting the economy even more. How could it promote good and innovative care? Every other nationalized healthcare system in the world is worse than our current system– long waiting periods or complete denials of coverage. I am surprised that someone as educated as yourself wouldn’t have read up on the other nationalized healthcare systems or heard nightmare stories. I am not at all saying that I am against safety net programs for those Americans in need, but this whole idea is unsettling. This bill is awful and the majority of Americans know it. Why can’t we reform malpractice suits-Tort reform? Why can’t we create a more competitive marketplace by opening up insurance bids across state lines? I am sure you have taken a basic economics class and learned about competition and how it naturally protects against overpricing. Also, if taxes go up to pay for this reform then more of our money will be given to the gov’t and will be OUT of the economy. This is especially true if the current tax cuts do not get extended. I do not kow many families that could afford to pay around 4-8 thousand more dollars a year in taxes (from 300 more dollars each month). If that money is taken out of our personal paychecks each month, then that is a ton of money out of the local economies. For my family our taxes might go up around 500 more dollars (we just live off my income since my husband is unemployed). That 500 dollars is our grocery and eating out money— imagine that affecting every family across the nation– can we say worse recession?
    Government is never the answer—- it is the problem.
    I think you need to seriously re- think and research your thoughts on this. It is so easy to get caught up in the warm fuzzy ideas surrounding the idea of since we are the strongest nation in the world that we should provide healthcare for all…..it is not that easy.
    Sorry, I don’t mean to offend anyone. I just think people need a wake up call on money and our country’s financial future.

    1. I doubt you’re tracking this, but figured that I would respond, since no one else took the time to debunk your ill-informed rant. You realize that if you have employer health insurance you’re already paying a decent percent of your income towards that, right? For instance, to cover my family of three, I pay $350/month for my share of my health insurance, and my company pays a little over double that, for a total payment of $1100+/month. For me, that breaks down to a total payment of over 10% of my salary towards health insurance. If you got rid of the private health insurance market, and instead instituted a flat 4% tax to pay for health care, according to the free market people, our wages would rise to cover the rest, so I’d end up with an increase in salary, net-net. You do know that currently we pay for the uninsured through higher premiums, right? You also left out the mandate part.

      You’re also leaving out the facts, which isn’t too surprising. Almost every other first world country has UHC, and not only do they spend substantially less than we do on health care, they have equal or better outcomes, and a happier, healthier populace.

      Tort reform is a red herring. Some states have implemented it (Texas), and you don’t see a corresponding drop in health insurance costs for the consumer, but you do see a bump in profits for the private companies.

      Selling across state lines leads to the exact same situation we’re in with credit cards; a race to the bottom. Every company would “move” their headquarters to the state/states that would have the least amount of consumer protections and regulations, and sell from there. The end result is that the consumer is injured.

      Lastly, your right-wing talking point rant doesn’t work when you look at health care. Most of us can’t afford to shop around for health care. When my father had a cardiac event (he’s a GP, btw), could he stop and ask which hospital to go to, or which doctor at which hospital? Of course not, that would have been stupid.

      You don’t respectfully disagree with Alex, you’re condescending throughout. I don’t respectfully disagree with you, I just flat out disagree.

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