My Health Insurance Horror Story

I guess I should weigh in on this subject since the left is documenting the Obamacare Clusterfuck atrocities.  Be sure to visit Lambert at Corrente for the latest updates in the series.

So, my horror story started in February, right after I made an offer on this house.  I was looking forward to moving to PA because the cost of living here in Pittsburgh is orders of magnitude less than it is in NJ.  While that might be a slight exaggeration, the most significant savings I was anticipating was going to be in the cost of health insurance.  My COBRA, already at a whopping $987/month, was running out at the end of April and I couldn’t find an affordable substitute in NJ.  Every plan I looked at was about 50% higher than I was paying in COBRA *with* cost sharing for two healthy people.  I mean, it was absurd.  So, unless I moved to PA where the cost of insurance was about 1/4th the cost, I was looking forward to going without.  You just can’t do that when you have kids.

Enter the kid.

The kid developed a health condition in February that required several trips to the hospital.  We’re still not totally sure what is wrong with her but it was very serious and scary.  She’s missed a lot of school because of it.  Thank goodness I had health insurance at the time because I honestly don’t know how I could have afforded it.  It would have bankrupted me for sure.  We have learned since her hospitalization that CHIP would be unavailable for her in NJ because to be eligible, she would have had to be uninsured for 6 months.  I don’t know what hard assed Republican in NJ dreamt that rule up but it screwed us when the insurance ran out at the end of April.

I scrambled to find a replacement policy in PA.  Now that I’m a resident, I could qualify for the lower rates.  But since she now has the dreaded “pre-existing condition”, my rates were going to be higher.  I started shopping around before the insurance ran out, because as we all know, you can only get insurance, jobs, loans when you don’t need them.  Almost all of the insurance companies I called did not cover her condition.  I finally found one in Pittsburgh that is probably designated a “silver” policy next year.  There’s a steep deductible, 20% cost sharing and her drugs are covered only partially.  But there was one other catch.  She could not be denied coverage as long as she was on my policy but they reserved the right to charge me double for the policy on my portion because of her pre-existing condition.  So, I am paying $870/month for this individual policy.  I’m looking into a CHIP option for her in PA because my income is pretty low right now.  Maybe that will take the sting out of this plan.

The thing that ticks me off about Obamacare and health insurance policies is that there is an underlying assumption that the higher prices of the policies and mandatory cost sharing is going to teach us a valuable lesson about the cost of healthcare.  And you know, I get that.  I’ve worked with people who are in the upper middle class bracket who think that just because they have insurance, they must see the doctor every couple of days and then detail all of their ailments to their colleagues.  Or senior women who get attention they crave by visiting one specialist after another for vague maladies.  There’s something about relating these ailments to an audience that gives them satisfaction and a reason to live but, frankly, these people bore me to tears and I resent having to shell out money on their fibromyalgia and third course of antibiotics for a cold when what they really need is 30 minutes a week with a psychologist or a vocation.  We also shouldn’t be spending money on chiroprators and acupuncturists.  I don’t want my insurance dollars going to your back cracking quack when you should be seeing a physical therapist with a scientifically proven track record.

Hey, if you’re offended, go read someone else’s blog.  I have no obligation to support your fondness for quackery or tendency towards exhibitionist hypochondria.  Insurance is not for fun and games.  My employer provided health care was there for my and my family’s health.  It is not supposed to be an all-you-can-eat buffet like the kind you get on a Royal Caribbean cruise.  You know, where people gorge themselves on heaping piles of food that their already bulging waistlines suggest they do not need?  But it’s there and they paid for it so they feel entitled to overindulge.  That’s wasteful and people who abuse their health care should be ashamed of themselves. Health care is a necessity, not a fricking free-for-all.  Take it seriously.  Chalk my unsentimental attitude up to my no-nonsense, efficient military health care childhood where there were no bells and whistles and no one was there to give you unnecessary attention.

But my experience is not about appreciating the cost of care.  My experience was about getting care, period.  I wasn’t looking for the most expensive hospitals or drugs or doctors and we certainly didn’t seek them because we were feeling neglected or indulgent.  We sought them because the need was great and urgent and there was no opportunity or possibility to shop around. And for that, we are getting slammed with this insurance policy that will seemingly never decrease in price.  Furthermore, I’m healthy as an ox but the cost of my share of the premium has doubled so as to cover the kid’s share which couldn’t be rejected.  Maybe you think that’s fair but it’s certainly not “spreading the risk”.

She’s fine now, or at least she’s getting better.  We still need to see some specialists and that will be paid out of my pocket until the deductible is reached.  I’d pay it no matter what, reaching into my IRA for her if that’s what it takes.  But we shouldn’t have to do this.  From what I know, the cost of services are not controlled at all by Obamacare.  All the burden of spending less is on the patient and their families, even when such costs cannot be avoided.  And yes, some people will still go bankrupt until we as a nation get our collective brains and wills together and tell the health care industry that we’ve had enough of exploitative profit mining.