Saturday, March 20, 2010

And Then It Got Personal

Laura and I had health insurance when I first started supporting health care reform. I had already been laid off from my job of 19 years, but because of my former company's generosity, I still had insurance. I spoke in support of reform measures even though it strained many of my personal relationships and even though the proposed bills were far from ideal. I criticized and supported because I was convinced that something needed to be done soon about the lack of health care options for many and the inadequate, unsustainable options for most Americans.

When my health insurance ran out, my wife and I went without for a while, but we eventually bought temporary insurance while I still had a steady income, again thanks to my former company. Good thing. One day very shortly after we purchased insurance, my wife came home from a cleaning job in extreme pain. I took her to the ER, and we learned that she had blood clots in her lungs brought on by treatments for menopause symptoms. She was in the hospital for five days.

The stay would have been much longer if not for the unrelenting efforts of a hospital community worker who negotiated and manipulated the insurance company and drug company, playing them against each other and finally securing thousands of dollars of treatment that Laura was allowed to receive at home. Had we stayed in the hospital longer, insurance would have cut us off.

That hospital worker's efforts were not lost on us, because in reality, it is the rare patient who gets that kind of treatment. God alone knows why that grace was wasted on us. And we will never forget it. But it is no substitute for comprehensive, reliable, responsible health care. Hope for special attention is not the answer for millions of Americans. I maintain that it should not be the answer for ANY Americans.

In a few weeks Laura felt sharp pain again. She was able to see her doctor who, after some testing, determined that she needed gall bladder surgery. We contacted a surgeon, and as we were awaiting an appointment date, our insurance lapsed. When we can afford it, we can purchase new insurance. But Laura's surgery will not be covered, as it is now a "pre-existing condition."

We've asked our friends and have learned that we do have options: We've been assured by a health care professional that we can

1. Wait for a painful, life-threatening gall bladder attack, then rush Laura to the ER where they MUST treat her (and fight about the payment later)
2. PRETEND that Laura is experiencing a painful, life-threatening gall bladder attack and they MUST treat her (and fight about the payment later)

None of the options available to us offer the peace of mind that we need to care adequately for our health.

One (on again, off again) friend of mine and opponent of the current health care reform measures reminds me that this discussion is truly about health INSURANCE reform. He is right. Unfortunately even for those with insurance the current system steals the peace of mind that a word like "insurance" seems to promise. Premiums continue to go up as benefits go down. This is why I maintain that, while the current House health care bill falls woefully short of what Americans truly need, it deserves support because it  moves us in the right direction. The bill

1. brings down costs for citizens and businesses
2. covers nearly all Americans
3. is deficit-neutral over the long-term
4. bans rejection for pre-existing conditions.

These are the criteria the President set forth at the beginning of this process. Specifically, the current House bill

* expands health insurance coverage to 32 million Americans, guaranteeing that 95% of Americans will be covered.
* makes health insurance affordable for middle class and small businesses -- including the largest middle class tax cuts for health care in history -- reducing premiums and out-of-pocket costs.
* strengthens consumer protections and reins in insurance company abuses.
* gives millions of Americans the same types of private insurance choices that members of Congress will have -- through a new competitive health insurance market that keeps costs down.
* holds insurance companies accountable to keep premiums down and prevent denials of care and coverage, including for pre-existing conditions.
* improves Medicare benefits with lower prescription drug costs for those in the 'donut hole,' better chronic care, free preventive care, and nearly a decade more of solvency for Medicare.
* reduces the deficit by more than $100 billion over next ten years, and by more than one trillion dollars over the following decade; reining waste, fraud and abuse; overpayments to insurance companies and by paying for quality over quantity of care.

What can you do to support this reform? Urge your congressperson's support!

Why We Can’t Wait | The White House

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