There is so much to say about the insurance industry and how horrible it is today that I just wanted to share a bit. Now personally I believe in the single payer system, or even the public option when it was on the table. But alas what we have now is nothing but more dollars in the insurance companies pockets to receive less and less.
Follow me and I'll explain.
As a teenager I never really got sick enough to have to go to the doctor and then I went into the Army where my healthcare was taken care of. I was hospitalized twice while in for different things and taken care of.
I got married then got out, my (then) husband and I moved to Guam where he's from. He got a job as a Federal Firefighter and I got a job at the Bank of Hawaii.
So after a year I qualified for health insurance thru the company and the ex and I compared plans, his with the federal govt and mine with the bank and we decided to go with the banks because coverage was better and out of pocket co-pays were affordable. This was 1993. I paid about 200 per month for the both of us. There were then, 2 major health isurers on guam, the one I chose was called FHP or Pacificare. They had their own little medical complex on about an acre property and everything was there. Dentist, Ob/Gyn, radiology, etc.
We got our semi annual dental checkups and cleanings. $7 copay. Annual checkups $7 copay. Meds $7 copay. Quarterly depo shots $7 copay.
In '94 I stopped my depo because we wanted to have a child. And sure enough I got preggers. I had my checkups at the clinic each time with a different OB because their policy was that since all their doctors were on rotation at the hospital as well, they wanted each doctor to be familiar with all the pregnant women they covered (I thought that was great). So when I went in for delivery, my delivering doctor knew who I was and my personal medical history.
I had the kid, stayed for 2 days in the hospital then went home. The second day I got home I got a phone call from someone ffrom the clinic wanting to come over. I said ok.
When she arrived she said she was the "house call" midwife to check up on me and make sure me and baby were doing well. She wanted to make sure I knew how to hold her, how to make her lay down, she checked her out. She told me about SIDS. We talked about breast feeding and I told her with embarrassment that I didn't think I was producing enough because it seemed like my girl was still hungry after I'd given all I could give. She said don't be ashamed to go buy some formula, every woman produces differently. Supplement with the bottle she said. Ok I said. Then she talked to me about me. How was I feeling? What do you mean I said. Are you feeling blue? Angry sometimes? Irritated with the little one at all? Nope I said. She then proceeded to tell me about the "Baby Blues". Post Partum Depression. I was almost 25 and had never heard about this before. Not even from the OB's. She described symptoms to make note of talked at length about it and gave me a pamphlet and some ph numbers and took her leave. She was great. I never gave a thought about this kind of care until I moved back to the mainland after my divorce. But more on that later.
So the baby grew. At 6months she was a wriggly little thing and I had just gotten her dry from her bath and laid her on her bed to dress her. I laid her in the middle of the bed and turned 90degrees to get her things from her dresser and a second or so later she hit the floor. She had wriggled herself off the bed. I panicked called the hub from the kitchen and told him to call the clinic. Her pediatrician was thankfully still on duty but getting ready to leave. His nurse said he would stay till we got there. Of course it was rush hour and a 10minute ride took 20. He checked her out (and it was her actual assigned pediatrcian) and pronounced her unscathed. She had thankfully fallen flat on her back and apparently hit flat on the back of her head so no damage. $7 copay
At 2 years she wouldn't stop jumping in the bath. I held her while trying to get her to stop jumping and she slipped thru my hands and smashed her chin on the tub edge so hard it split open. There was blood everywhere. I was hysterical. The hub and I packed her up while trying to keep the gash closed and stanch the blood. We got to the ER and they wrapped her in a papooselike thing and stitched her up (with me still hysterically crying and berating myself for being a bad mother), calmed her down and sent us home. ER visits were completely covered. No copay.
Years went by, checkups, dentist for all of us. $7 copay. Shots for the little one. $7 copay. Year after year when I went for my annual check up, I told my doctor I didn't want more children (my pregnancy wasn't that great and it was hell giving birth) and she kept advising me (I was still younger than 30) to wait because it was her experience that young women tend to change their mind. I was back on the depo. Quarterly shots $7 copay. In the meantime, I got divorced and took a buyout from the bank because they were restructuring and I wanted to move back to the states, closer to my family. Before I left on my last checkup my doc and I had a frank talk and she said, ok. I think you're ready. We did my tubal ligation as an outpatient surgery. They burned my tubes laproscopically thru my belly button. No copay on surgery.
I returned to Florida in 2000 with my then 5 year old. I found a job with a credit union and they offered insurance from day one. When I got the paperwork and saw the costs and what it covered, I almost had a heartattack right then. They wanted more than 200 per month, with a $50 copay to see the doctor and it was something like 80/20 coverage WITH a like $2000 deductible. I said no thanks, I couldn't afford it. It would litterally bankrupt me if I or the kid needed hospitalization. Well I made friends with one of my co-workers who happend to be a vet and we started chatting about the insurance thing. We talked about the Army being vets and all and he told me to forget the company insurance and go register at the VA clinic. All my medical would be covered. I did and I've been going for the past 12 years with very few negative incidents.
I got Florida Kidcare for the kid. It was hellish trying to find a decent pediatrician from their network list. I won't go into details, but I finally found one that was great. I paid $50per month for medical and dental which was a good deal. As I switched jobs and salary increased I got a notice saying they were raising my monthly prem to $110. At this time her pediatrician stopped taking Kidcare because they were taking too long on the reimbursement. She's literally a small business. Just her and 2 nurses. They can't afford not to get paid. I cancelled the kidcare and started to pay for her stuff out of pocket, because paying $1200+ dollars per year for little to no use was stupid.
I finally found an individual policy from a private broker. Started out at $103 per month. She could see the doc once per year for a wellness check, preventive shots were covered. If she got sick in the same year, I had to pay. Deductible for hospitalization was $250 per day to $1000. It was the best I was going to find. That was in 2007. By 2011 I was paying $170 for that same coverage. When I started shopping around in Jan of 2012, knowing it was going to go up again, I found out that no one was writing individual child policies because of "Obamacare". Because it wasn't going to be profitable. Because, you know..they'd actually have to put some money into actual healthcare for the kid. The one I had was one of the only ones in the country apparently. So it was stick with it or try to get a family plan for me and her which would mean I would have copays at the VA. And the coverage was lousy on the Florida Blue one I checked out. So I re-did the existing plan to get cost down. Still the same basic coverage, deductible went way up (so if she has to be hospitalized, I'm SOL and bankrupt) but I got monthly pmt down 30bucks a mo.
She turns 18next year so I'll be able to look for a better individual policy for her.
How in a nation like ours can we justify and allow insurance companies to dictate our health and care choices while demanding exorbitant amounts of money from those who can barely pay? How is it fair? How is it that in a US Territory I had premium care for me and my family for $200+ per month but in the Mainland US, I pay $140 for a paltry 1 check up per year and eff me if the kid gets sick? Did I mention I also have to pay for labs out of pocket?
Anyways, thanks for reading and If anyone has any suggestions on anything else I can do until next year, please let me know. Also I asked the insurance company about the rebate you're supposed to get back under Obamacare and they told me I didn't qualify. Any insights on that would be helpful. I tried to navigate the DHS site and it was very confusing.
Peace. Diane