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Health care in America: one person’s story

Guest post by Stan K

I will not give statistics, or make sensational claims about health care. For me this issue is personal.

People with pre-existing conditions, and those who cannot afford health insurance– the sick and the poor– are on the outs under the present American system.

First the sick:

My business partner has a kidney disorder. Due to her “pre-existing condition,” in order for her to get any insurance, we had to set up a group policy for our company. She felt lucky to be able to get insurance at all. Here are the highlights of the policy that I had to accept due to her condition (I harbor no animosity towards her, only towards the system).

–Must use doctors approved by insurance company.

–Insurance company can deem recommended procedures unnecessary, and not pay.

–Procedures will only be paid for if requested by approved doctors, even if the procedure is carried out by an approved clinic, hospital or doctor.

–No alternative therapies or treatments covered.

–Yearly deductible: $2,500

For this plan, I pay $7,200 per year.

I tried to use the plan for the first time in the seven years that I have had it. I needed an MRI of my lower back. The cost of the MRI was about $1,000. I had the procedure pre-approved, but after the procedure (on review), the insurance company refused to credit my deductible, as the physician requesting the procedure was not in their system. On top of that, when they first approved the process, I had to sign a paper giving them access to the results. They have the right to raise my premiums due to any new medical conditions. After they refused to pay I called the hospital and told them to not allow any medical records to be sent without my direct consent. It is unclear, whether they have my records or not.

I have looked and looked for better plans. There simply are none for people who have pre-existing conditions. In other words, people who are sick are also screwed.

One of the complaints against the Obama medical plan are the supposed death panels. I can only imagine the death panel that I would have to face if I had a life-threatening disease with my present insurance. Kafka would have a field day with this subject.

Now the poor:

My sister-in-law is poor; no disgrace in that (or maybe there is). She was never able to afford health insurance or have a job that offered it. When she turned 65 and came under Medicare, she went for her first medical exam in a very long time. She had been aware of an anomaly in her breast for several years. As a result of the exam, it was found that she had advanced cancer. I have no further information at this time as this all happened very recently. One thing for certain is that if she did not have to wait until age 65 for Medicare to kick in, her prospects would be dramatically better. But hey, what the hell. At least she won’t have to face a death panel.

In much of the world health care is considered a right. In America it is a privilege. We have a system that specifically victimizes the sick and the poor. We can do better. Much better.

I’m not sure this posting leaves much room for debate (what we love to do at Harry’s Place). But it would be interesting to read people’s personal experiences with different health care systems around the world.

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