I’ve talked a lot about the need for serious health care reform on this blog, but I want to share my own health care “horror story” to put into perspective exactly why I feel we need a public health care option in this country.
Though I have excellent health care coverage as an employee of the State of Wisconsin, I’ve seen first-hand how broken our current health care system really is. Due to a life-threatening health condition that jeopardized my wife’s health, my son Nicholas was born 7 weeks premature. Prior to my son’s birth, I contacted my health insurance company to confirm his birth would be covered by my health insurance, due to the fact that my wife had been admitted to an out of network hospital, and my insurance company assured me everything was covered. My son spent nearly 8 weeks in the neonatal intensive care unit, and the day he came home was one of the happiest days of my life.
However, shortly after Nick came home from the hospital, my wife and I began to receive billing statements from the hospital and various doctors who had treated Nick while he was in the hospital. Upon contacting the hospital, I was told my health insurance company had denied all claims relating to my son’s birth, and that I would be responsible for paying all my son’s medical bills, which totaled over $250,000. I immediately contacted my insurance company, and they confirmed denial of the claims, and they also denied the appeal I filed. It was until I filed a formal complaint with the Wisconsin Officer of the Insurance Commissioner that my claim was finally paid by my health insurance provider, but if I had not known my full rights, I likely would still be paying off my son’s medical bills 6 years after his birth.
If my wife and I had to fight this hard to make sure our insurance company did what they were supposed to do, I can only imagine how difficult things must be for folks who aren’t as well informed – or who simply don’t have any insurance. My story – and the thousands of similar “horror stories” – is exactly why we need health care reform.
It’s time for a health care system that provides coverage to all Americans, but what’s more, it’s time for a health care system that puts patients first – instead of putting the financial bottom line of a health insurance company first. Health care should not be a “for profit” business, especially not when the health – and lives – of individuals is at stake.
Thank you for sharing that story Zach. It does highlight the falsity of the anti-health care zealots that the current system is best.
Thanks capper.
I’m glad it all worked out. I had a similar instance when the on-call doctor wasn’t in network once.
Perhaps I’m confused, but wouldn’t the current proposal leave you with exactly the same situation? From what I’ve heard, I think Obama isn’t proposing a NHS like England’s – he’s proposing coverage for those without. Some would have a government coverage option, but lots of others wouldn’t. (Maybe in your case since you work for the state you’d be put to the government system?)
I stand to be corrected, though.
Zach, I was with you all the way to the end. Then you lost me. You said, “Health care should not be a “for profit” business, especially not when the health – and lives – of individuals is at stake.”
Here we would disagree. Nobody will build hospitals, invest 12 years in higher education to be a doctor, and invest billions in research just to lose money. It just will not happen.
The issue is insurance and not healthcare. The concept behind insurance is to bet that the pool of people paying for insurance will exceed the demands for payment. To mitigate that risk, insurance companies screen subscribers, seek network doctors who have agreed to fixed rates and fees for average maladies, and they ask that subscribers seek pre-authorization before seeking remedial treatment. These are all reasonable approaches to reducing risk.
However, you were caught in the ‘screw-the-consumer’ game. That game is played like this: Q1: Did the consumer follow all our rules? Q2:Did the consumer follow all our rules but the bill is still too expensive for us to pay this willingly? Q3: Is the consumer a lawyer, congressmen, or married to a doctor? Q4: Can we likely get away with not paying? The wrong answers to these questions will net you a “Will Not Pay” reply.
There is a similar game played out for healthcare facilities by the insurance industry.
And President Obama is seeking to turn over all healthcare to insurance companies. This will not end well. You can see why I prefer choices rather than insurance-only options.
I favor national healthcare. I think this is what government should be doing to “promote the general welfare”. It is constitutional in nature (Pre-amble) and, in my opinion, an unenumerated right in the Ninth Amendment.
“I favor national healthcare. I think this is what government should be doing to “promote the general welfare”. It is constitutional in nature (Pre-amble) and, in my opinion, an unenumerated right in the Ninth Amendment.”
You do realize that “promote” is not the same as establish, nor is it the same as any of the other verbs in the preamble such as form, establish, insure, provide for, secure, and ordain. Which one is not like the others? Um, “Promote”…which bascially means to encourage, you know, like a cheerleader. So you belive that the government is not only supposed to be a cheerleader for the general welfare, but also is supposed to provide it and establish it for us. Wow.
Next: The 9th ammendment means that government should NOT deny or disparage other rights retained by the people. It means that you and I have the right to your own health care and our own insurance and the Government can not deny that. In other words it is the exact opposite of what you advocate. The government should not disparage our rights which is exactly what they’d be doing if they get into the health care business.