Tuesday, October 14, 2008

Health Insurance

We finally have health insurance after being without it for five years. Many, many years ago my union allowed the district to impose a 5 year waiting period for insurance in exchange for a bigger raise. I'm sure it made sense at the time. We've finally got it down to four years, so I was eligible in September. (Because I left for two years and that was the period when we lost our coverage, I gave up all of my seniority and had to start over.)

We weren't totally without coverage. We had a pricey hospital only policy, that in fact covered very little but we took it just in case one of us became seriously ill. Thankfully that didn't happen.

Living without adequate coverage for five years has me thinking very differently about how our health system works. I used to go to the doctor and have whatever tests they told me to have without any thought as to the cost because my copay was so low. I would go whenever I felt a little ill, rather than wait until "it" got worse.

I would get my statements that said the doctor charged $100 but they only paid him $65 because that is what he had agreed to take from them. So when I no longer had insurance, I went to the doctor and he charged me $100. I asked him to accept $65 because that is what he had been paid to see me in the past. He refused, I paid the $100 and then I started shopping for a doctor. I found a NP that charged a reasonable amount but I had to call around and ask about prices. I found myself asking why a test was necessary and if other options were available before I would agree to have them. I opted to have a mammogram only every other year. Low cost mammograms are still expensive! I discussed drug options before a prescription was written and then called around to see who could fill it the cheapest. I once saved $55 on a single prescription by calling around.

Just before we lost our insurance I had had bunion surgery on my right foot and the doctor over corrected. I have had pain in that foot off and on ever since. The summer of 2006 I drove summer school and I had pain in that foot every day. It wasn't pain I couldn't deal with, so I didn't go to the doctor. Instead I took lots of ibuprofen. The pain lasted into the fall but did lessen as time went on. It still gives me trouble but the pain is now slight enough that I don't need to take anything for it.

Last week I went to a new podiatrist. I wanted him to look at the right foot but I also have a bunion on the left that is causing me to start to limp. He took x-rays, which revealed that I had broken my right foot at some point. Now I know why I had such a hard time in 2006. For many reasons he doesn't feel that he can do much for the right foot at this time but he does think he can fix the left. I have scheduled surgery for next month. Considering how the right one is I am quite nervous about having the left done but the pain in that foot has gotten bad enough that I find myself not exercising which has led to weight gain and that has led to other problems.

Had I known in 2006 that it was broken I would have gone to the doctor even though I had no coverage for it and I certainly would not have been driving. If I'd had insurance in 2006, I'd probably have gone to the doctor just because it hurt.

How many uninsured people do you know? Maybe it is time that we solve the health care crisis in our county. I'm happy to have insurance again and glad that I am able to get the services I need. But I know there are too many people making the tough choices that I had to make. I will still be asking questions, refusing tests that make no sense and I'll continue to ask for generic drugs.


  1. You've certainly had to learn the hard way on dealing with the lack of health insurance. We changed to a low option HMO due to the skyrocketing premium costs.
    We now give careful consideration (just as you did) to any procedures, etc.
    Health care at a reasonable cost for all Americans should be of the highest priority but it just doesn't seem to be on the horizon does it?
    Good luck with your surgery..

  2. So glad you have health insurance again. I've been without now for several years - as have my boys. We only go when we absolutely have to and don't get anything we don't need. That has meant for me that even basic preventative get skipped simply because up until recently I've not been able to pay for them.

  3. I'm against national health care but don't have a problem if the states want to do it. However, NYS has been clamping down on the income eligibility requirements. Wages have gone down, costs and taxes have gone up, but the income requirements for the state hasn't changed.

  4. I'm sorry you've had such a difficult time with your feet, Apple. We've had only minimum coverage since R left the hospital, so we've had to do the same things you've done.
    Socialized medicine is certainly not the answer, as witnessed in other countries that have use this system. It's taxes that pay for it, after all, and government that runs it.
    Health Care is a subject for debate for sure. I'm sure there's a solution to be had, but I'm not confident that it would ever get past the politicians.
    I'm glad you have coverage now. Good luck with your surgery.

  5. We have been without health insurance for a number of years now. I can't recall how many, I know we had Blue Choice when Josiah was poked in the eye 10 years ago... Our kids are on Child Health Plus, and we did have medicaid for one year. Seems if you are poor enough, or have enough children at home the government will pick up the tab, but since we can't afford the premiums and make too much to qualify for anything else, we go without. Such is the lot of many self-employed.

    On the other hand, I babysit for two teachers (they are married) who are both offered health coverage by their employers. Of course they only need one policy for their family. Dad has suggested it would be nice if those who had the coverage available could "sell" it to those who were without. Now theres an idea that could work!