Portly and the Loony Bin
Wednesday, January 16, 2008
Or "Why I Don't Want Anyone To Force Me to Buy Health Insurance."
Most of the Healthcare "reform" that's being touted by political candidates these days involves some sort of mandate that requires individuals who are not covered by their employers to buy health insurance from a private health insurer. Some of these plans include proposals for penalizing those who refuse by garnishing their wages or damaging their credit.
The following explains why I will be one of those who will face the penalty, rather than comply, if such a plan is put into law.
On April 1st of this year, I will celebrate 20 years of self-employment. Prior to 4/1/88, I had "regular jobs" with benefits and health-coverage (albeit shitty, Kaiser coverage) for my entire working life. After I became self-employed, I did the "responsible" thing and purchased private health insurance (thus foregoing any hope of long, lingering vacations in warm, sunny places, plus an arm and a leg).
I was an insurance company's cash-cow wet-dream -- the only claims I have ever made on my car insurance policy in a 36-year driving history were as a result of being hit by other drivers (which the insurance company recouped from the at-fault driver), I never made a single claim on my home insurance, and I'm generally healthy as a horse.
Except for this one thing that happened 15 years ago, which I've talked about before.
Hence the title of this post.
I'm not going to go into huge detail about my loony bin experiences in this post (hmmmm -- although I may start another series of posts -- "The Bedlam Yarns" -- what do you think?)
Suffice it to say that my first 8 day hospitalization for clinical, suicidal depression (the first time I had been hospitalized since I was born) -- cost $14,000.00.
At this time, $14,000.00 was well over half my annual income.
I didn't worry about that at the time, though -- because I had insurance, you see. Insurance that I paid upwards of $3000/year for. Insurance that was supposed to cover me if something bad happened -- like having a nervous breakdown.
Or so I thought.
Turns out that my insurance plan had a limit on any treatment for mental illness.
That limit? $1000/year.
Oh. Guess I missed that in the fine print (and it was very fine), on page 38 or so of the very lengthy policy.
So now, I was not only a wreck mentally -- I was also facing a $13G hospital bill. At a time when I was, shall we say -- not exactly "suited for work"? Not precisely a candidate for financial mover and shaker of the year?
It was at this point that I began to realize: Health Insurance is not about health coverage. It's about money. It's a gamble between you and a huge corporation.
They're betting that you don't get sick, and you're betting that you do.
Which is all kinds of fucked up, because the only way you "win" the bet is to do something that you probably don't want to do -- get sick.
(Life Insurance is an even weirder bet, since you're essentially betting that you'll die young -- and they're betting that you'll live to a ripe old age -- after they've sucked the bucks from you.)
During the five years I had been paying my insurance premiums before I got sick, I went to the doctor once a year for an annual check-up (which wasn't covered), and purchased a prescription drug called "Naproxen" (now known as "Alleve) for menstrual cramps (which also wasn't covered). That was it -- the entire extent of my need for medical care.
In fact, I had been taking Naproxen for cramps (as prescribed by my physician) before I purchased private health insurance, so the insurance company "rated" me on anything that involved my reproductive organs for the first 3 years of my coverage (which meant that they would not have covered any illness related in any way to my ovaries or uterus had I had a problem in those 3 years).
When I first applied for private insurance, I argued with the person who "rated" me for reproductive issues because I had taken a prescription medication.
I said: "Yes, I take it for cramps. Nearly every woman I know takes pain-medication for cramps."
She replied: "Not everyone takes prescription medication for cramps." (Note: Naproxen was de-regulated and went over-the-counter as "Alleve" about a year later, but I was still shit out of luck on my lady-bits. See how that works?)
But back to my story. I was mentally ill, suicidally depressed, owed $13,000 that I didn't have, and was unable to work. I was ineligible for any type of public assistance until I had been unemployed for four months or longer, and even after that, a social worker told me that applying for and getting medicaid assistance generally took one to three years -- if I qualified -- which meant that I would have to prove a long-term disability -- which meant that I couldn't get better if I wanted any help. The social worker told me, to my face: "You're going to have to look very sick to qualify."
During that first year, I was hospitalized again -- this time through an involuntary commitment process, as I was deeply depressed and ragingly suicidal at the time -- cuz life was looking so rosy, dontcha know.
The second hospitalization cost around $8000, which the hospital billed to me, even though I had been involuntarily committed. (They also booted me out much more quickly, because they had figured out that my insurance company wasn't going to pay up.)
I was able to work only very marginally for the next three years. I survived, during this time, through receiving generous help and support from loved ones (my ex, with whom I had purchased a house, cashed me out on what little equity I had), scaling back my life to nearly nothing (I lived in a used RV on community land where I paid $180/month for rent, and was able to raise a lot of my own food), and living on credit (which didn't last long).
Two years after my breakdown, I ended up declaring bankruptcy. Ironically, even though I had now learned the hard way that the insurance company was not my friend, I continued to pay my health-care premiums for four more years after the bankruptcy (like I said, I used to be crazy).
When they hiked the premiums to a level which I absolutely could not pay, I dropped my coverage. Since I was no longer grandfathered into a plan, and now had a history of mental illness, I became "un-insurable". To this day, I remain pretty much un-insurable -- at least in terms of insurance I could remotely afford (even though all this occurred 15 years ago).
I don't have health insurance now -- and I don't want it. For one thing, even if I had it, it wouldn't cover the type of health care that I focus on today (I see a naturopathic MD when I need a doctor, and focus on cultivating my wellness and health rather than "fighting" disease). I focus on preventative care, diet, and activities that tend to keep me away from the doctor's office.
I want to make very clear that I'm not "anti" traditional western medicine. There are some things that TWM does very well -- if I'm having a heart attack, or I cut my arm off -- for sure, take me to a well-equipped, traditional western hospital.
I'm just not convinced of the following: That the majority of western medical institutions, pressured as they are by the need to "show profit", inextricably intertwined as they are with private, for-profit insurance companies and Big Pharma interests who are more responsive to their stock-holders than to the people they are supposedly "helping" -- I'm not convinced that these institutions really have their eye on the ball concerning "health".
That's why I'm incredibly disturbed that the politicians of today, with rare exceptions (like Kucinich) seem to be focusing their health care initiatives on expanding a system (privatized insurance) that is already not working. ("Something broken? Let's do MORE of it! Yipee!!")
The only way a mandatory, privatized health plan would work for the customers/consumers would be if health insurance was incredibly regulated, and companies were forced to cover their customer's medical needs -- and if you're going to do that, why not rebuild the fucking system from the ground up?
The reason that they want everyone enrolled is that it broadens the "risk pool". That makes sense -- but in fact, it's just a form of socialized medicine, which is one of those "third rail" words that you will never hear falling out of a candidate's mouth. I'd be happy to pay into a system that honors my health choices, and let my "healthy-as-a-horse" condition subsidize someone who isn't as fortunate in their genetics or circumstances -- but not if my subsidy is doing more to line the pockets of some board-room fat-cat than to get a low-income kid an annual check-up, or a new kidney, or to help some working stiff get his back repaired after years of lifting garbage cans.
What I learned through the loony-bin insurance fiasco was this: The insurance company is not my "friend". It isn't there to "help" me. I haven't forgotten the lesson of that harsh thump against the Reality Wall -- that all those years I paid my premiums, we were just engaged in a particularly vicious little card game.
I won my bet. I got sick. Lucky me. But then, the company wriggled and squirmed and fine-printed its way out of its commitment to me.
Let the buyer beware.
And that is why, in matters of health care, the game must not be one of sellers and buyers, but of providers and patients. Providers who are well remunerated for the invaluable service they bring (and I'm not just talking about Doctors, here), and patients whose health is the paramount focus of the entire system.
In my state alone, the biggest three health insurers nearly doubled their profit from 2003 ($243 million) to 2006 ($431 million), while the number of people that they actually covered dropped by 16.9% in approximately the same period (2002:2.37 million covered, 2006: 1.97 million covered).
Yeah. Let's take that as a national model. Yipee.
You can probably tell how moderate and calm I am about this topic -- and it is in that tone that I hope you'll receive my last sentence:
If the fucking government wants to fucking force me to buy fucking private health insurance, then they had better fucking BY GOD guarantee me that the fucking insurance company has to fucking cover my treatment -- every . . . fucking . . . . bit of it.
That is all.
(Please vote in comments if you would like to read any of The Bedlam Yarns -- don't worry, they're not all grim. The mental ward can actually be kind of funny . . . . after 15 years have passed.)
Posted byPortlyDyke at 8:20 PM