Musings of Anna1liese

Dream Hope Breathe Believe
OCTOBER 6, 2010 1:41PM

Health Care: What It Means To Me: Pause

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I realize that I am posting these pieces as much for myself as for anyone else to consider.  I want not to be caught up in the polarization of campaigning.  I want to take time to remember what matters to me and why and then let that and what I understand today guide me when I vote. This time I want not change for the sake of change but more and better attention to us all. I wish more had already been achieved, but I do not want to abandon hope for what, despite my doubts, I think this president may achieve.  I heard unexpected support only hours ago.

 

Yesterday I saw my endocrinologist and when we were discussing the six months of being uninsured I need to wait until I am eligible to apply for the high risk pool, we were not understanding the same thing. My insurance ran out at the end of June. I understood, from the state’s Department of Insurance website that I can apply to the federal pool come January.  They suggest looking at the federal pool because the premiums will be half the premiums my state must charge.  My endocrinologist understands that the federal pool will not exist until 2014.  He and I both want to know.  Information needs to be more clear.  He just kept saying,”Pre-existing conditions.  Pre-existing conditions.  Health care reform. Why would anyone be fighting this?  It will change so much for the better.”  (Children with pre-existing conditions are in the system to be covered as of now.  As far as I know, adults will not be included as such until ’13 or ’14.)  The message is hopeful and some things are already in place, but details are not well known because, as far as I can see, they are not yet clear.  Not being clear and not existing or being taken away are not the same.  How few days remaining until election day?

 

I am incredibly lucky.  A week before my appointment I went to the lab for blood tests.  I was terrified of what they would cost and knew that I might need to walk away with no blood drawn to decide on Plan B.  I told them I had no insurance and that I needed to know first what the tests would cost.  I waited while a calculator clicked.  It was less than half of the lowest cost I had found elsewhere.  I was so relieved that I wept.  I seem to be doing a fair bit of that lately.

 

I talked with the doctor’s secretary the day before my visit.  She agreed to charge me the lowest fee.  I am incredibly lucky.

 

One last note.  I lost my job just before the crash.  I was able to obtain coverage through COBRA for 18 months.  If I had had a job, I am not sure how I could have spent so much time on the phone and looking at websites to keep up with what I needed to know.  

 

Somehow I learned that my state offered a six month state extension to COBA coverage.  There it was in black and white and yet, when I rang the people taking payment for COBRA, they finally admitted to me that the whole thing was so complicated, they had decided not to train anyone to understand the state possibility or how it worked.  This lack of training seemed to exist almost everywhere.  No one seemed to know.  If I hadn’t kept notes together and held my calm, I wouldn’t have finally found the one person who seemed to be the only one who clearly did understand.  Why isn’t his name clearly known to everyone who needs it?  He was wonderful but even then, when I had to continually correspond with my old employer and a new business manager, nothing stayed secure.  For one month out of the six, nothing was covered because the insurance company lost track of which state I was in.  I can only imagine some are reading and nodding their heads.  

 

I am and have been incredibly lucky.  I have not wanted to cry on the phone when I cease to exist as a person because I am clearly a liability who will allow no profit.  I have felt broken by some of these calls and I suppose that is why I have not made one in a while.  I am trying to breathe and find my way through as are countless others.  I have found testing strips I can afford at WalMart, not my favorite store.  I have a new monitor and new strips.  Isn’t it just funny though that when I open the strips they are manufactured by the people who make the strips I can no longer afford.  They are the same strips.  

 

My tablets are generic and so I am able now to pay less for them at my supermarket pharmacy thanks to their “program” than I paid as co-payments.  Hmmm.  Insulin, for me, is the hardest one.  In England, once they became available, we were given pens.  Clearly the company had a contract with the NHS.  Once you have had the freedom of a pen which doesn’t need to be refrigerated and can stay with you all day, you are terribly spoiled.  At least I have been.  I checked with my pharmacist to know what to expect.  $250.00 for a box of 5.  I knew I would need to go back to the vial and syringe that I thought I could afford.  The vial, which I thought would be so much less expensive thinking of days when I bought them for my father, is $100.00.  

 

A friend asked if I had looked on Amazon.  I thought she was out of her mind.  Sure enough, there they are.  Within my reach they are again.  How many of us are playing whatever games will help?  I am incredibly lucky.  I have been hospitalized only twice and long ago - once here and once in England- because of flu.  Insurance, then, covered me here.  In England the words “bill”, “invoice” did not exist.  

 

I am lucky.  I hope we all can be lucky. I hope for a future that allows us all not to be afraid to fall ill because we may receive no care.

 

Pause concluded.  For now.

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Comments

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It's good to be able to open a post and read a first hand account of 'what it means to me'. Thanks, annaliese.
Sorry to hear that it's all uphill at the moment. Here's hoping your ride down the other side will be breezy. Rated for honesty.
It is a scary proposition to think that some people will have to wait until 2014 before they find any comfort or peace of mind. Thank goodness you are relentless to learn what you need to know and a wink and a smile to that angel that sits on your shoulder. xoxo
You have been lucky, but you have also been determined, relentless and always looking for the glass half full. 2014, good Lord, let us hope it is not that far off. At least that is a better prospect than not having health care at all and there are those "on the Hill" that are pleased to think that is the answer. Thanks for your courage.
There have been times in which I've compromised a bit in terms of what I can afford health-wise. But I haven't been down your road. And it angers me that you must be on it.
I hope things get better and that the American people realize that allowing all Americans medical access is the patriotic thing to do.
A lot of pharmaceutical companies have assistance for people who need meds for life, like insulin, but don't have the funds. Here is the link for the Novo Nordisk program, they are the top maker of insulin and diabetes research in the world. You may need the help of your physician to get this. It's worth a shot, ahahaha!
http://novonordisk-us.com/Images/PDF/Diabetes_PAP_OAD_with_HIPPA.pdf
Your essay makes me heartsick. I have worked inside the healthcare system forever and yet I am baffled by what is going on. I am also not optimistic that the new system will help anyone. People who are employed can get insurance at an incredible cost, and people who are not employed go without because the exchanges as you said are still three years away. I was out of work for a year and was lucky to carry on with COBRA but our cost with my new job is almost ten times what I paid before. I am grateful that I have it as both my partner and i have the dreaded pre existing condition.
Thank you everyone for your comments. I am aware of how incredibly lucky I am and only posted this as an example of what so many face on the moment and into the future. How many of us are in this same boat or are facing so much worse? Yet it all seems to be missed in political nonsense. I am diabetic, but fill in the blanks for whatever condition is in your house or your family and then look at all of the pieces as it does or may affect you.

Right now my focus is simply on voting from the heart, I suppose.

For the moment at least I am fine and hoping that, as Fay says, the angels on my shoulders will see me through.

I am also blessed with an endocrinologist who hears me. It doesn't hurt that we are both something of outsiders in this funny place where we live. I am from Boston and he is from New York. He understands my accent and I understand his humor. Laughing is a somewhat underestimated ingredient in all of this and always when I see him, we laugh. He does listen and he does hear me. We probably work more from a European ethic than one normally finds here. Things take time. Solutions are not always quick and tidy. Sometimes we need to play around until something works. When we talk, we have a comfortable kind of shorthand.

I wish there were a way for everyone to have hope. Listening to him yesterday, I wondered why I was the only one hearing his voice, his belief, his concern. I think that if we all stop and think and allow ourselves to feel whatever it is we honestly feel about health for ourselves and our families in these weeks before the election, we will make better informed decisions about the way we hope things will go once new people are elected.

I hope all will be well for all of us. Thanks so much.

Several people have been writing pieces about the importance of thinking this through and deciding calmly whose ballot we mark. If we all think rather than simply react, all might be well. If we simply stay home because we have lost faith or vote on a whim, what is the reality that we may all face. That terrifies me. That is why I am offering these pieces in hopes of reminding us to think of what matters most and then choosing the candidate, candidates who one hopes will stand firm and work for what will benefit us all.
This was a very sobering look at a problem many face.

When my husband died they cut off my healthcare....even though I took his job over they made me terminate, go on Cobra for three months and then I'd get covered again, same plan, same everything except now I was a widow. It made no sense to me then, still doesn't.
I feel fortunate, but shouldn't have to.
Thank you for writing this, anna1liese. xo ~r
I am so sorry for the battle you must face and feel very fortunate to live where I do. I don't know what I would have done this past year if I would have had to pay for any of it. I know you through your posts and I know you to be a strong person who goes after what is important. I wish you the best and will be thinking of you often.
I am sorry that you have to wait so long! I am glad you have been able to manage, though. I am not sure where you live, but many large hospitals do lab tests and appointments on a sliding scale or for no payment. If you haven't explored this option, maybe you could try! Keep vigilant about your health because you have been doing the right things to keep on top of your disease! R
THis is such a reminder about the state of these things. oof. Now I want to go and check on my own insurance, etc. rated
Once again, thanks so much for your thoughts. I will not add another piece from last year today. This one seems to hold the moment for now. If, at the very least, these tiny bits help us to think and allow the general to become our own, then perhaps those will be the thoughts we will hold when we go to vote.

I think about a later piece if I can put the words together. The election looms. There is much at stake. I think there are other ways to address all of this. I worked for a long time in a hospital business office and carry what I learned there always. I started in ER billing. ER charge was $7.50. Chest X-ray was $15.00. Prothrombin Time was $4.00. When we first offered CAT Scans, they were $2,000.00. So many were done that we paid for the machine much sooner than had been predicted. Cost was immediately lowered. $40.00? Perhaps $200.00. Both come to mind. Perhaps one first and then the other. I know I am 300 years old, but costing doesn't really change. Charging does. I may try to play with this and then perhaps others might pick it up. I have been thinking about entrepreneurs and magnates for a long time.

The downside of not having a paycheck is ... well, not having a paycheck. Loved ones help me live. The upside is that though the world would see someone sitting, doing nothing, thoughts come and go and swim and float. Peter Elbow called it "cooking." Sorry. Writing teacher voice rising there.

I believe in upsides and I believe in hope. There are days when I feel victimized by some of what exists, but I will not see myself as victim. I won't. My father didn't give me a disease. My father gave me a gift. Perhaps this is a way to share that gift if only to a very few.

Thank you all for finding this and for taking it to your hearts.
2014 is a long way to go without coverage. Its not a health care plan in the US. It was just a bill signed by a conceited man who wanted to make history with a bunch of different pens.
r
Poppi, You may be right. I just have to hope that you are not. I have to hope that his debt to Ted as much as his own awareness keeps this issue real for him.
No, no, no! The Pre-Existing Insurance Plan is in effect RIGHT NOW. I applied for it in July (it was very quietly rolled out July 1st) and my coverage was effective August 1st. Here's the website: https://www.pcip.gov/

I hope this helps, and I hope things start to get better for you. Always thinking of you here.
Late Again, So glad to hear from you! Thank you for this. I've just had a look and will go back to look at more details. I am just starting my fourth month without insurance and so I think I need to wait until January to apply.

I have avoided looking at the government page but this link and your words have helped me do it right now. I think I have been avoiding needing to have someone outright reject me. Should have had my previous insurer e-mail the words spoken on the phone, but that was too soon for this.

Honestly, you have so much on your own plate. I so appreciate your reading this and sharing what you know. In a way, I think the bottom line here is that we are all in this together and together we can find ways to move forward. Thank-you.
anna1liese, I just wanted to be certain you didn't think you had to wait until 2014 for the federal pool. In the case of serious illness, that belief would lead to despair.

I'm not sure why there wasn't more fanfare about the coverage beginning three months ago.