Health Insurance In This Country Leaves A Lot To Be Desired

Discussion in 'General Discussion' started by The Good Doctor, Apr 14, 2021.

  1. The Good Doctor

    The Good Doctor Golden Member

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    I was an ICU nurse for 17 years, and it was during my last two years of my career when I was diagnosed with lung cancer.

    Going into and out of the hospital for my chemo sessions. Going into and out of the clinic for my follow-up appointments with my oncologist was the most harrowing times of my life.

    At this moment, I realized that my own health insurance refused to pay for parts of my care.

    I didn’t have the money to hire a lawyer, so the legal team at the hospital I was getting treatment stepped in. They fought the insurance company. And they won.

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    All of my care was covered, and I got better. But it was a hard-fought battle and back-and-forth.

    ***

    This story is one of the millions. Health insurance in this country leaves a lot to be desired.

    You are living without health insurance because you can’t afford the premiums? Scared for your life when you fall ill? You’re not alone.

    Insurance companies denying children mental health access? It’s happening.

    You have insurance but still find yourself paying hundreds of dollars for your insulin? Diabetics nationwide feel your pain.

    You need a medication, and your plan covers it, but you need to somehow pay your $2000 deductible out of pocket before coverage kicks in?

    Suddenly found out your PCP no longer accepts your health insurance while you were waiting for your appointment? Tough luck.

    Health care is run by insurance companies who have every incentive and motive to collect premiums from everyday Americans and make billions of dollars in profit. Still, they will fight tooth and nail to pay as little or nothing at all in reimbursement. Doctors are left in the dark despite honest work for their patients and find themselves being dropped from insurance networks so that insurance companies can reduce their costs while they continue to raise premiums.

    Without health insurance, millions are crushed by medical bills. For those who lose their insurance, many are willing to endure whatever happens next just short of death because it is more cost-effective. This is horribly wrong, and honestly, I don’t know what can be done.

    We hear Medicare for all, but is it feasible? It’s clear that health is not viewed as a right but a privilege to gain if you’re able to get and keep your insurance. It may take widespread health insurance literacy campaigns so that people will know what is available to them based on income and their health care needs. But would that even be enough and even feasible? No insurance company is the same, and a person can only learn of the intricacies and the pitfalls of coverage once they are on their plan. Legislators have by far the best health insurance out there, so how does that reflect on the middle class?

    So far, over half a million people signed up for Affordable Care Act coverage on the federal exchange in mere weeks of President Biden’s special enrollment period. And this is great. The ACA truly expanded coverage to those who wouldn’t have had insurance before, but the “affordable” part is a dubious claim as premiums, deductibles, and any out-of-pocket costs you can think of are still too high for millions to afford. Plus, insurance companies have set their deductibles higher than what the average person would encounter with employer-based insurance. So, why even have health insurance at all? Simply put, millions of Americans can’t afford health insurance, and we need solutions from Congress that are truly sustainable (whatever those could be). We need more action and less talk.

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