Did you know that when you are denied private insurance coverage by one insurance provider, it makes it difficult to obtain insurance by another provider. It's kind of like bad spots on credit reports. One mistake can affect your credit with others, even if you are in good standing with them. That one mistake can also cost you credit with others.
I'm going to admit that what sold me on voting for Barack Obama was his stance on healthcare. I was concerned a healthcare bill wouldn't even pass, and as it worked itself into legislation, it started as something that could be good for our country, but quickly snowballed into perpetuating the problem. When it comes to health insurance, this healthcare plan provides for subsidies to those purchasing their own healthcare plan, requires citizens to have health insurance or pay a fine, pre-existing conditions are no longer grounds for denial of health insurance, and insurance companies must allow children to stay on their parents' plan until age 26. The aforementioned aspects of the plan will be phased into effect over the next few years. Also, a government health care plan will be available(There are also aspects relating to business' requiring health insurance, and while related to what I'm discussing, it's relevant, but as far as actual content, it has nothing to do with my point. As for abortion, again, while it is related in subject, it's not related in content.) While this is good news in regards to expanding health insurance coverage, this reform bill is just treating one symptom of many problems related to healthcare.
In some cases, people without health insurance go to the emergency room for non-emergent ailments because emergency rooms will not turn a person away for lack of insurance or inability to pay. This creates a drain on funds directed to emergency rooms to treat emergency situations for those who can not pay, as well as a drain on the emergency room's ability to attend to true emergent cases. Also, those who do use the emergency room for non-emergent ailments will be billed a large amount of money later on, which is a drain on a person who is struggling financially. To those of you who do this, please do not be insulted, but do consider what you are doing. Emergency rooms are for emergencies. The health department and charity hospitals are available for non-emergent cases where a person might have difficulty paying for treatment. Some medical practices will even work with you on payment if you do not have insurance. I advise calling to find out before showing up, though.
Opinion: Health insurance is the biggest problem in regards to our nation's healthcare system.
What led me to this opinion: Have you ever been to the doctor and been told, "Well, since your insurance doesn't cover that, then let's do this instead,"? Or has the pharmacy refused to or tried to refuse to refill a prescription because of insurance rules? If you're relatively healthy and it's not an emergent situation, chances are, it's not the end of the world for you. But what if something is wrong, possibly gravely wrong and this happens? When you aren't very informed and not an assertive person, you might let this slide, especially if it's not life-threatening. But what if it is? An example of something seemingly monor, but is actually very serious is, in women, ovarian cancer sometimes masks itself as uncomfortable GI (gastrointestinal) symptoms - like feeling full after eating a small amount. Women brush off these symptoms, maybe go see a GI doctor eventually, and get treated for the GI symptoms, while the ovarian cancer spreads and gets out of control. When, and if, they finally discover the cancer, it can be too late to be cured. Feeling full after eating a small amount is a seemingly minor thing, sometimes even welcome in that overeating seems to be cured. But, there is something gravely wrong that is being overlooked. A personal example of how insurance dictates healthcare I have is last year I was going to have an endoscopy done, but my insurance at the time wouldn't cover it because I'd already used up my three diagnostic tests the insurance would cover for the year. The doctors' staffs aren't always paying attention to exactly how much (or in my case, how little) insrance covers for medical tests, and they also aren't always looking at how much of other things the insurance will allow. The nurse called me to schedule me for an endoscopy to be performed under general anesthesia so that the insurance would cover it as surgery as opposed to a diagnostic test. Having had an endoscopy before, and aware of how much diagnostic tests cost (because my insurance would only cover $100 per test - and that ain't a lot!), AND knowing I would more than likely be having a more serious surgery later on (and my insurance would only cover one surgery per year), I discussed my situation with the nurse. It was cheaper for me to pay for the endoscopy done with conscious sedation out of pocket than what it would have cost me to do it under general anesthesia. So, I scheduled the endoscopy, knowing it probably wouldn't turn up anything, but also knowing it could (and if so, would be a cheaper alternative to surgery, and possibly be the end to my illness). Had I scheduled my endoscopy so that insurance would cover some of it, I would have been out thousands of dollars when it came time to have my gall bladder removed. Also, I would have been put under general anesthesia unnecessarily (which, when I had my surgery, I realized was not as pleasant as other methods of sedation I had been administered). An example with pharmacies is one of my doctors wrote my phenergan prescription as "Take one pill everyday for nausea," even though he knew I took one half a pill every six hours as needed for nausea, and told me in his office to continue doing so. Because of the way he wrote the prescription, I had a really hard time getting the pharmacy to refill the prescription after one month, because my health insurance wouldn't cover it. Health insurance dictates what kind of care we receive, not what kind of care we should receive. This happens because plans dictate what will be covered by insurance and medical professionals don't often consider the patients' ability to pay.
Also, a patient's health insurance status affects their course of treatment. The latest doctor I am seeing (for recently diagnosed hyperthyroidism) changed her mind about what diagnostic tests she wanted to run on me when she realized I didn't have insurance. Originally, she wanted to repeat blood work (to see if I was still hyperthyroid), have me get a thyoroid ultrasound, and get a thyroid uptake test done. When she realized my insurance status, she dropped the uptake test to be performed later, depending on the results of my bloodwork and ultrasound. I told her I did not want my lack of health insurance to dictate what kind of care I received. I must wonder if providers assume it's okay to do as much as insurance will allow, and, also, to limit what they would do given a lack of insurance. If so, doctors would be increasing costs to insurance companies, as well as patients, if the former is the case, regardless of necessity. If the latter is the case, are patients really getting the care they need?
Lack of health insurance is used a tool of discrimination. In Birmingham, I haven't been refused to be seen by a doctor for not having insurance (yet), but in Auburn, I have. Some practices have even taken to holding an exorbitant deposit on patients without insurance. I spoke with a manager of a medical practice about this. He justified this practice of charging deposits by saying they take co-pays for people with insurance. I countered with, "Co-pays are generally much cheaper than the $100 deposit I just had to pay. Also, just because a person has insurance does not mean (1) they have a co-pay, and (2) that the insurance will cover the treatment." I understand that practices need money in order to continue. That's a simple, unpleasant fact of life. However, by charging a deposit to patients without insurance, regardless of ability to pay is not fair in the sense that they don't charge a deposit on patients who have insurance, but may not pay the balance that is due. There's a big difference between charging $100 (deposit)and $25 or $30 (co-pay), but expecting the same results. In Auburn, I made a list of all the internal medicine practices in the area, called my first choice, and was turned down due to lack of insurance. I called a few more practices until I found one that would see me. They informed me I would have to pay everything the day of the visit. My reply? "That's the way I prefer it anyway. As far as finances go, I am going to be your favorite patient. You get your money and you don't have to deal with waiting on insurance or having to bill me." Just because a person has insurance does not mean that person will be able to pay for their medical treatment, and just because a person does not have insurance does not mean a person can't afford treatment. Therefore, lack of insurance should not be a reason for refusing patients.
People without insurance sometimes prolong medical treatment (and go without routine and preventative care) because they assume they can't go to the doctor if they don't have health insurance. Let's do some easy math here: if your insurance premium is $1200 per year, and you are a perfectly healthy person, getting an annual physical (and, ladies, a physical is often included with your annual OBGYN appointment), and going to the dentist twice a year, having dental x-rays done once, totals about $700, give or take. What's cheaper? Not having insurance. Health insurance really comes in handy when you have ongoing medical problems. (Unless you pay over $200 per month to have some fly-by-night insurance company "cover" you, and they only cover about $100 per visit or test, and limit the visits and tests to five and three, respectively.) The longer treatment is prolonged, the harder it is to treat, and therefore, more expensive to treat. For example, if you have a cavity, what would be relatively simple to remedy and cost about $175, give or take, prolonging the situation can lead to a root canal (more painful and more money) or even having to have the tooth pulled (even more painful, more involved, and of course, more costly). When situations get out of hand, this again creates a drain on the system. In cases where patients rely on assistance to cover their medical needs, a filling is much cheaper than pulling a tooth, thus the latter costing more money to tax funds allocated for those in need of assistance. For women, getting a routine pap smear can detect abnormal cervical cells, which can lead to cancer. Again, getting the abnormal tissue removed costs much less time and money than treating cancer. And what if the cancer spreads and you find yourself terminal? Is a visit to the health department or about a $200 doctor visit worth your life?
Some (if not all) medical practices offer DISCOUNTS to insurance companies. If practices are so concerned about money, why do they offer discounts to the companies that have the money to pay for it and not to private pay citizens who would benefit from saving a few bucks? Why do they even have a full price and a discounted price? Fortunately, a couple of practices recently have charged me the discounted rate. If you go to a doctor to do private pay, and wonder if they offer the insurance discount to those opting for private pay, just ask. It may help you out a little.
