DeAnneUniversal Health Care - "The Change We Need"
June 17th 2009 04:08
The health care debate is heating up. I've posted my thoughts on the issue several times. I'm here to post on the topic again.
So many people seem to thing that those in this country who do not have health insurance do so by choice. I guess that may be true of some, but I can't see why anyone would choose not to have health insurance if it was possible to have it.
What options do we have - most of us anyway. We can have a job that provides health insurance. By far the easiest way to get it. But not always possible. Not all jobs provide it. And if you're self-employed, you don't have the option.
The next option is private pay. This is where it gets tricky. With an employer provided plan, the insurance companies MUST cover you. They don't have a choice. Everyone in the company has the same rate and the same coverage options. This isn't true when you seek private pay coverage. If you have a certain condition (there's a long list - but diabetes is one of them) then they automatically don't have to cover you (unless you're lucky enough to live in one of the six states that have better regulation.) So - if you're lucky enough to NOT have any of those uninsurable conditions you then have to fill out a medical questionairre. Blue Cross Blue Shield wants to know about EVERY time you've been to the doctor for FIVE years. Not just what you went for, but the date the condition began, the date you went to the doctor, the treatment prescribed, the date it was resolved, etc. I don't know about you, but I don't keep that kind of meticulously detailed records of my doctor visits (and those of every single member of my family). Then - if you manage to fill all that out (it better be accurate, too, or they can deny coverage for certain claims if they deem them to be related to a previous condition you didn't tell them about) - they can still deny you if you are over weight, or you work in certain types of jobs, or a whole host of other reasons.
Even if my husband and I weren't diabetic, we wouldn't be able to get private pay coverage through BCBS because I'm over weight, and he works in the oilfield. (Yep, that's right, if you work on an oil drilling rig, or several other types of jobs, they won't insure you!)
So what options are left? Well, in Texas, you can join the HIGH RISK POOL if you are deemed uninsurable by an insurance company (or if you have one of those conditions mentioned earlier.) The ironic thing is that the HIGH RISK POOL is managed by - you guessed it - BLUE CROSS BLUE SHIELD! But - they get to charge DOUBLE the normal rate! Other options include the newer companies that offer not quite major medical insurance. I'm sure you've seen the Cinergy Health commercials. What they offer is NOT major medical. They pay a specific amount for doctor visits, hospital stays, etc. with a limit on how many times they'll pay - for instance up to 5 doctor visits or 3 lab tests per year. Their rates are quite a bit lower than BCBS, but the coverage isn't at all comparable. (That is the option we've chosen for the time being.)
Most people are lucky enough to have employer provided insurance. And, most people don't know how unfair the current system is for those who don't have that option.
I don't really care if the government decides to do a single payer system, or what - but we all need to have insurance coverage available to us. No one should have to worry about bankruptcy when an illness occurs. Something MUST be done, and it must be done soon. Please show your support for universal health care in the United States.
So many people seem to thing that those in this country who do not have health insurance do so by choice. I guess that may be true of some, but I can't see why anyone would choose not to have health insurance if it was possible to have it.
What options do we have - most of us anyway. We can have a job that provides health insurance. By far the easiest way to get it. But not always possible. Not all jobs provide it. And if you're self-employed, you don't have the option.
The next option is private pay. This is where it gets tricky. With an employer provided plan, the insurance companies MUST cover you. They don't have a choice. Everyone in the company has the same rate and the same coverage options. This isn't true when you seek private pay coverage. If you have a certain condition (there's a long list - but diabetes is one of them) then they automatically don't have to cover you (unless you're lucky enough to live in one of the six states that have better regulation.) So - if you're lucky enough to NOT have any of those uninsurable conditions you then have to fill out a medical questionairre. Blue Cross Blue Shield wants to know about EVERY time you've been to the doctor for FIVE years. Not just what you went for, but the date the condition began, the date you went to the doctor, the treatment prescribed, the date it was resolved, etc. I don't know about you, but I don't keep that kind of meticulously detailed records of my doctor visits (and those of every single member of my family). Then - if you manage to fill all that out (it better be accurate, too, or they can deny coverage for certain claims if they deem them to be related to a previous condition you didn't tell them about) - they can still deny you if you are over weight, or you work in certain types of jobs, or a whole host of other reasons.
Even if my husband and I weren't diabetic, we wouldn't be able to get private pay coverage through BCBS because I'm over weight, and he works in the oilfield. (Yep, that's right, if you work on an oil drilling rig, or several other types of jobs, they won't insure you!)
So what options are left? Well, in Texas, you can join the HIGH RISK POOL if you are deemed uninsurable by an insurance company (or if you have one of those conditions mentioned earlier.) The ironic thing is that the HIGH RISK POOL is managed by - you guessed it - BLUE CROSS BLUE SHIELD! But - they get to charge DOUBLE the normal rate! Other options include the newer companies that offer not quite major medical insurance. I'm sure you've seen the Cinergy Health commercials. What they offer is NOT major medical. They pay a specific amount for doctor visits, hospital stays, etc. with a limit on how many times they'll pay - for instance up to 5 doctor visits or 3 lab tests per year. Their rates are quite a bit lower than BCBS, but the coverage isn't at all comparable. (That is the option we've chosen for the time being.)
Most people are lucky enough to have employer provided insurance. And, most people don't know how unfair the current system is for those who don't have that option.
I don't really care if the government decides to do a single payer system, or what - but we all need to have insurance coverage available to us. No one should have to worry about bankruptcy when an illness occurs. Something MUST be done, and it must be done soon. Please show your support for universal health care in the United States.
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