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Health insurance stories: What's yours?

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I don't know about the "I Like Obamacare" meme that the Obama administration is pushing as the landmark legislation comes before the nation's supreme justices. Sure, I like "Obamacare," a.k.a. health care reform, but I definitely don't love it. I'd much prefer a single-payer health care system (a.k.a. socialized health care). All the arguments against it, or most of them, are also arguments against our current system. Take rationing. Today we ration health care to the wealthy and the people with professional jobs. Take long lines. Have you ever sat -- with a legitimate emergency -- in an emergency room? OK, then, you know that long lines are already here. My last visit, for stitches, took us six long hours. The procedure took 10 minutes.

I really believe that many of the woes attributed to "big government" and a "welfare system" could be alleviated with single-payer health care; for one thing, it would be easier to get birth control, so many families could be planned instead of just happening to families not equipped to deal with them. For another, bankruptcies would be greatly reduced; our nation's bankruptcies are more frequently caused by medical bills every year (20% in the first half of 2011, not counting those bankruptcies with medical bills as a factor). Another thing: every time we chat about "radical homemaking" or other ideas that center around the concept of spending more time at home with our kids, health insurance comes up. It hamstrings us, ties us or our spouses to jobs we may not love, because we can't imagine affording insurance without it -- or because we or our kids have chronic diseases that would preclude us from getting good private insurance.

In my helter-skelter, pie-in-the-sky, best-of-all-possible-worlds dream for the way our country could be with single-payer health insurance, we'd have more mobility, more happiness, less debt, more time to pay attention to our kids, and more making choices for the right reasons. More health, of course.

I thought it would be interesting to think about the whole debate going on right now in the Supreme Court -- which, according to pundits watching the courts today, is going to be struck down on very weak legal grounds and very strong political ones -- in terms of our own stories. How has health insurance influenced your life? What decisions have you made simply because of health insurance? What is YOUR pie-in-the-sky idea for how the system should work?

Here's my story:

I found out I was pregnant with my second son, my post-miscarriage lovely hope, the day before I was laid off from a job. I didn't have health care for the job -- it was temporary -- and my husband was working for a catering company, part-time. You can't get health insurance when you're pregnant -- you just can't -- and I got two months of severance, so I was making far too much to qualify for WIC or any other state-assisted health insurance program. With only one child in our family, we couldn't both make enough to pay the bare minimum of our bills (mortgage, utilities, food) and qualify for assistance. What a choice: keep our house or get health insurance!

It wasn't the first time he'd ever thought of joining the military, but my husband chatted with a friend in the National Guard and made the decision a few weeks later: he joined the Army Reserves. He'd be on "active duty" while he was in basic training and the secondary training reservists get for their MOS (his, driving, was the shortest training and would allow him to be back before the baby was born). Active duty = free health care, and it covers you for a few months after you get home; long enough for Truman to be born on Tricare, blessedly, completely, free.

After that, we qualified for a very reasonable rate as a reservist family, with no pre-existing condition clauses, leaving us free to make decisions for reasons other than health care. When I decided to leave The Next Job, when my third little boy was a toddler, I could do so without giving up affordable insurance.

OK, just one more story.

A family friend works at a local emergency room as a "valet," parking cars for people who arrive at the emergency room with more on their mind than finding a parking space. He sees all kinds, but a big portion of the kinds he sees are people without insurance. They either wait until things are absolutely desperate -- or show up with mild maladies that they can't afford to have treated in regular doctor's offices. It's always a mess. He's parked cars a bunch of times for people who were bleeding or inebriated or otherwise probably not in shape to drive. Why?

Who can afford to take an ambulance? The ambulance company knows where you or your loved ones live and can track you down to pay the bill more easily.

So, what's your health insurance story?

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If I didn't have to worry about health care, daycare or college tuition I would have very little to worry about. And as an employer I'd happily pay even more taxes to a big pot that covered us all. A very close friend of mine in Sweden and I joke that if she and her husband ever get a divorce that I am next in line to marry her. Gay marraige is legal in Sweden and health care, daycare and university are all covered. If you want really fast, fancy medical diagnostics and care you can still always buy private health insurance or go to a fancy private hospital like Karolinksa.

I hate to say it but even the medical care I received for free in Mexico was more efficient and less of a wait than our emergency rooms here stateside.

The specter of socialized medicine is a total myth propagated by those who stand most to gain by business as usual.

So, having had children in both USofA and Sweden, it is fun to tell my story.

I had my first 2 children in Portland, at Providence St V. Had "good insurance" from BCBS. Had a great MD, Carol Stull, who I loved. Prenatal care monthly with urine analyses, blood draws, cervical checks, seemed like all the time. Reached my yearly deductables which were something like $1500-2000 and then paid my 10-15% of the bill total delivery bill which was due 1 month before due date of baby (which my German husband could not believe was actually legal! haahaa). Ended up having C-sections with each. So about $2000 more after deductible for each baby. First C section a bit of a surprise, actually had pay by credit card...for the second, we knew C section was in the future, so saved during the pregnancy. And not to forget, no maternity pay AT all for either, first child born at the end of my fellowship at OHSU (so I was no longer "employed" like 2 weeks after she was born) and second child born while I was working 2 part-time jobs without benefits.

Lucky enough to land a job and move to Sweden. Worked a year (have to be employed a year for FULL stay at home pay, if not, still get "lowest level"). Prenatal care was with a midwife. One urinanalysis, 1 blood draw (by finger prick), no cervican exam. 2 ultrasounds (one for nuchal fold measurement, another standard at 20 wks). Now, perhaps less done because I had had 2 uncomplicated pregnancies and it was known I would have C section again (their recommendation). Met my surgeon for first time in the OR...she was "attending level". Fantastic in hospital care. Bill: $0. And well, maternity leve, I will not bother with...it would just be rubbing salt in the wound.

I did have to pay for something: I opted for a tubal ligation. That was "extra". Cost to me: about $50.

This is one topic that really gets me going! I cannot believe how we approach healthcare in this country, and I think part of it is due to just not understanding how it really works for people. Here's the short version of my story.

After my second child was born, I left a county job to work part-time and my husband was with a start-up that wasn't offering insurance yet. We applied on the individual market because COBRA was too expensive. I got turned down for two previous health conditions that were completely stable, one of which only happens when I'm pregnant and one has an annual blood test to monitor. My 2 year old was turned down initially because he had elevated white cells on a blood test, that turned out to be an infection and not present on retest so we appealed and he got covered. So, we had some insurance for the family and I stayed on COBRA hoping we would find something else before I ran out.

My husband's job then began to offer care, so we had that until he got laid off. Knowing I couldn't get coverage, and he wasn't going to either at this point due to a recent surgery, he and I went back on COBRA and the kids back on individual plans because the combined cost was cheaper this way. Thankfully he found employment again so he and I got coverage. The kids stayed on the individual plans, but those plans changed and limited how many office visits you could have before deductible kicked in. I skipped well child checks that year saving the visits for real needs.

Recently my husband changed jobs again. However, this new company wanted us to pay $2000/month for insurance. No way we could do that. We stayed with COBRA for the adults, individual for the kids and were paying $1200/month combined knowing that in 18 months we would have to do something else when COBRA ended and the healthcare reform wasn't kicking in yet. Just recently his company offered a new plan which covers us all for $1100 month. As long as he keeps working, we'll take it and be grateful. But frankly, that's more than our mortgage costs us, deductibles are huge, and I pay a $45 co-pay to see the doctor.

The alternative though, if we didn't figure out how to pay the premium? My brother let his go a few years ago when they couldn't afford it any more. Working family, just self-employed and can't afford it. His wife just had two ICU stays following a stroke and now needs dialysis and a transplant. No insurance.

Absolutely ridiculous. Healthcare should not be a privilege.

I *just* had a miscarriage. But here is the back story...

5 years ago, we had health insurance. I had a baby and all seemed fine. Then my husband's company raised the monthly payments from affordable to more than our mortgage so we opted out. We thought we would just get private insurance. How hard could that be really? We applied for a great looking package and figured all was well. After 10 denials we knew that we were in big trouble.

I went on to apply for state insurance only to find out that there is an income cap and my husband brought in (no joke) $200 too much. So then the plan became hope we don't get sick for 5 years. We knew that not being treated for anything for 5 years would equal a clean record.

So, that is what we did. For 5 years we had no insurance. We didn't get sick often and the few times we needed treatment we went to Zoomcare (thank goodness for them eh?) 5 years later (nearly to the day) we found out I was pregnant. So I began the process of reapplying for healthcare.

I was feeling pretty confident as I had read that, under the new Obama care, they couldn't count pregnancy as a pre-existing condition. Guess what... they can if you are over 34. Guess how old I am.. So, onto OHP. Friends told me that they don't deny you if you are pregnant. Guess what again? Yes, they can.

About the time I was getting all my denials, I started to lose the baby. So now here I am, no baby, STILL no insurance, and mounting hospital bills. (and for the record... I owned my own business ((gave it up in hopes that would help me qualify)) and my husband works full time) We were perfectly willing to pay a reasonable price for health care... "they" just told us no.

I've been lucky enough to be homemaker and always had decent insurance.

One of my kids has a chronic illness and the out of pocket expenses for us can total the mortgage some months. Yikes.

The one good thing about Obamacare we saw for us was that this child can be covered by our insurance until she's 26 years old. Yay. She may need that, her illness slows her down quite a bit, college may be a struggle for her.

I got pregnant with our daughter while I was luckily taking a couple of post-bac classes and was covered under university insurance. Unfortunately, because I was pregnant, I couldn't afford to continue classes and needed to work more. Neither of our jobs offered benefits (I've never had a job that did) and although I paid to extend the coverage I had through the summer, it expired in September. We started shopping for private coverage immediately when we found out we were pregnant, but could only get covered by OMIP with a six month pre existing condition clause for pregnancy (all the other plans had a 12 month clause). At 24 weeks, I was put on bed rest. Fortunately, the week I spent in the hospital was just before my university coverage expired. Unfortunately, I now had no coverage, weekly appointments with a perinatologist at $300 a visit, not including any extra labs or scans or tests, and four months of being unable to work, all in addition to paying another $400 plus a month to OMIP, despite them not covering a dime of the pregnancy. Our doctors expected us to go into labor any minute, with the birth, probable complications and neonatology all falling outside of our insurance coverage. We were terrified we would lose our daughter and terrified we would be buried under a mountain of medical bills. We literally counted off the days for four months. It was a nightmare. But we were lucky. Our six month clause expired on December 2nd. Our daughter was born full term and without complication two weeks later.

I don't have any scary stories--yet. I do work for a company that is part of the healthcare industry. We have a presence in 43 states and 4200+ employees, so you'd think they'd offer something pretty decent in the way of health insurance. The employee contribution for our plan is so cost-prohibitive that I cover myself only, at a $1200 in-network deductible. My daughter is covered by my ex-husband's plan, with a $600 in-network deductible. Covered, that is, if he doesn't screw up the paperwork and forget to include her, like he did one year.

Our middle-to-upper management hold conservative views and are very, very anti-Obamacare. Somehow they think any further movement toward healthcare reform, at least in the direction we are going, will be the death of our company. I don't see it, but I'm just a single mom struggling to make sure we can afford to go to the doctor when we need to.

I guess Obamacare is okay, and its certainly a step in the right direction, but like Sarah, I'm all for a single-payer government plan (yep, eek! Socialized medicine!)

A few years ago a very politically conservative aquaintance of mine was going on about how we need a true free market for healthcare. He supported his opinion by using the example of his own (elective, or course) Lasik surgery. He shopped, interviewed, and found the best surgeon at the best possible price. And that, he claimed, was proof-positive that the free market works for healthcare.

Too bad it's not that easy for an un- or underinsured person having a health crisis. Who possibly is in the midst of that health crisis because they couldn't afford preventative treatment, or to address issue before it got to crisis levels.

Healthcare should be a right, not a privilege.

I keep hearing from health care companies that Obamacare will be the end of them. I hope they're right. If offering even slightly more ethical levels of care really does destroy corporate health care's profit margins, we need single payer more badly than anyone knows.

Last year, with health insurance coverage, we accrued over $15,000 in medical bills which forced us into bankruptcy. This year I was able to get double insurance-coverage, which also means that I need to work more and be home less with my baby. I know it could be a lot worse...but it still sucks.

Medical insurance has always been a major factor in deciding what jobs to apply for and which to accept. Of course in this economy, most just need to accept whatever offer they can get. Buying an individual coverage is so expensive that my husband and I tend to gravitate towards lower pay/better benefits jobs. I prefer it this way. Benefits are one of the reasons why I don't see myself as an enterpreneur.

My husband goes to a physically and mentally punishing job everyday that he hates because it pays for pretty decent health coverage for the whole family. He likens it to a work release program that lets him go home at night and on the weekends. I feel terrible and wish I could lessen his burden, but the family coverage at my work is in the $1000+ range. Plus it doesn't seem like a good time for him to be looking for work anyway.

I don't know if this is true, but have heard it more than once that Providence Health systems is the biggest property owner in the city because of houses they take for unpaid medical bills. Such a broken, messed up system we have going.

A strong argument for affordable health care from the NY Times. My place of work is the building pictured above. We've been Portland's home of healthcare to the uninsured forever, but it is true, more and more are falling through the cracks. Those without benefits use the ED for primary care. Co-pays are astronomical, so hospitals are losing money because of fewer office visits. Fewer patients are able to pay skyrocketing bills as fewer are uninsured, or even employed.
I have no doubts that there will be the change we so need in the future. What I fear is that it won't come soon enough. This means that not only do we as individuals with families suffer, but that we as a society will become increasingly ill. Very, very ill.
Sorry for the pessimism. Hard day at the office...

Katie P, you hit the nail on the head! Hear, hear, sister!

This is the first time that I am posting here because I am compelled to by this topic. I am originally from Germany and just moved back there with my two little sons after having lived in Portland for the last 8 years. While the health care system wasn't the only reason for the decision to move it definitely played a large role. Even though we were lucky enough to have excellent coverage through my work for the majority of the time in Portland, I could never get over the fact that there was the potential of going bankrupt due to medical bills. Back in Germany I registered for health insurance (you don't "apply" here since you can't get rejected) on my second day upon arrival - filled out a one page form for me and my sons, no questions about any potential pre-existing conditions asked, and coverage started the same day. I pay about $420 a month for the three of us - this includes dental insurance, any sort of emergency, surgeries, general treatments etc. There is a $15 co-pay for adults that you have to pay once every three months for a doctor's visit. Oh, and prescription medication for children is generally free. Between the three of us we have had to see a doctor three times so far but each time I got an appointment the same day if necessary.
Moving away from Portland was a hard decision - it is such a great place to raise a family and we were very happy there. But I have to admit that it feels really good not having to worry about medical bills or the astronomical cost of daycare anymore.

So depressing.... I stayed at my old job for 11 years because of the benefits - I know a lot of people that do this.... I was so hopeful that if we had the public option it would cause a lot more turnover job opportunities in companies.... since people wouldn't feel stuck.

Well this past fall I and 8 others were laid off - 6 of the 8 were 40 or older - don't get me started on age discrimination another topic for another day.... I was lucky enough that my ex compan paid my cobra for awhile... So of course I went & got everything checked out. Had my 1st mammography they saw 2 lumps so I had to have a needle biopsy..... "Simple procedure" as they put it -in the office performed by the radiologist .... Saw the bill that I did not have to pay $7,000.00. Wow. Many plans now only pay @80% so that would have been $1400.00 out of pocket.... and being unemployed that really would hurt.

If the bill gets killed in the supreme court I truly have lost hope in this county. How can we be the only westernized country no. Have this, an maternity/ paternity leave?

America - where the commodities are cheap and the necessities exorbitant.

My husband has been at the same job for 20 years, because it has a "good" insurance package - but he is ridiculously underpaid for the work he does. If he didn't have a life challenging illness, he could make 3-5x more as a private consultant. But we can't afford to make the transition.
He became Type 1 diabetic in his 20's, and was uninsured at the time. And get this, he (20 years later) can't even get a SECURED credit card, because he incurred too much medical debt before he had insurance.
We are lucky to have "great" insurance, that my husband pays 1/3 of his income toward. But we paid for prenatal care and birth (for both kids) out of pocket, because I could not handle having our babies where we were covered. Our co-pay for an in-hospital ultrasound was $200, but we could walk in to Natural Childbirth and Family Clinic and pay $100 out of pocket.

I could go on for days, it is all so maddening. Makes me want to start a Monkey Wrench Gang... ....and I have insurance that people are *dying* to have.

I'm due with our first and only baby on April 22nd. I'm almost 100% certain that I am going to lose my job as a teacher in Beaverton this coming fall as we're facing a $40 million dollar budget shortfall. My husband's company does not offer health insurance. It's been a real source of angst and I have no idea what we're going to do.

Katie P, have you considered for a while that the insurers could cover anything you want if they increase the premiums accordingly? I don't think the insurers are the main problem (thought some have made unpopular and questionable decisions lately). It is the pharmaceutical companies with their too high drug prices, as well as doctors practicing defensive medicine. The doctors would stop performing unnecessary procedures (30% c section rate??!!) if we limited the lawsuits. Right now the only winners are the big pharma and the lawyers.

I have a slightly different twist on the insurance story -- in this case, it's my mom. At age 50, her husband of 19 years suddenly left her. He'd been underpaying their taxes, etc etc ... short story is, she was left with nothing -- zero assets, zero retirement -- except for a monthly alimony. He brought her to court five years after that settlement and with a good attorney succeeded in getting his alimony payments drastically reduced, and in two years, totally eliminated. So, at age 63, my mom will have zero income, zero retirement savings, zero assets. During the lengthy divorce proceedings, she struggled to earn a BA thinking it would make her more employable after decades of being a stay-at-home mom, but in this economy, she is at the far back of a long line for entry level jobs that offer horrible pay and no benefits. Several career counselors have told her flat out to not even bother applying -- she should just start her own business, etc. ?! So now add in the student loan debt and no way to pay it. Social security? She'll eventually get an amount equal to half of his amount -- a few hundred dollars a month. With prexisting conditions, no one will insure her. Up to now, we paid about $800 a MONTH for OMIP so she could have coverage, but we can no longer afford it given that she now needs a way to pay rent, groceries, and out-of-pocket medical care, including a huge bill for cataract surgery needed so she could see to drive, read, etc. Who knows what the future holds for her. Right now, she's simply uninsured and keeping her fingers crossed every day. If she ends up with big bills, they'll just go unpaid.

Wow, this is a topic that I too have strong feelings about. My husband owns his own business and we have been paying about $1200 a month for our family. This year, our premium was going to go up AGAIN about $150 more a month. This was even with a high deductible. We finally decided enough was enough and we switched to Kaiser which would "only" cost us about $1000/month. If we didn't have constraints of his co-workers, I would try an pay out of pocket for our doctors visits/tests and only have emergency insurance. I can't get over how much we pay for insurance every month.
I feel like the insurance companies are taking such advantage of everyone's fear, especially now with the economy doing so poorly. I don't think that it would be rocket science to fix this right? At the risk of sounding naive, other countries have done it ..... we don't need to reinvent the wheel, just take what works and make it work for us. Even with all of our specialists and cutting edge technologies I am pretty sure that we could come up with something better than the existing model.
All I will say about the birth of my 2 children was that it was *reallly* expensive even with insurance and that is even with one of them born super quick at home so we just had postpartum care. Next time we will just stay at home!

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