Anyone with health issues is held hostage by their insurance carriers. One of my favorite insurance policies is the amount of money each body part is assigned by an insurance provider. Once someone reaches the maximum amount for a specific body part, like a shoulder, the provider will no longer pay for treatment. Physical therapists have to deal with this issue all the time. A person is obviously in need of treatment, but the insurance company will no longer pay because the person has 'tapped out' the amount of money allotted for that particular part.
What about those who have preexisting conditions or who are denied coverage for an illness they don't have? My husband had a staph infection three years ago. He is completely cured, and yet he cannot get health insurance because he's been flagged as having 'chronic arthritis of the shoulder.' He's been trying to get ahold of someone who knows how to fix this incorrect diagnosis. He pays an exorbitant amount of money each month for a paltry insurance plan that covers very little.
My current insurance plan is a huge waste of money...at least for me. I have the privilege of paying for the plan each month, and then I have a 2000.00 deductible to make. This means my prescriptions are full price! If I need testing or blood work I pay full price. On top of my cut in pay, this is ridiculous.
After my husband and I have had several necessary surgeries, we've also learned about insurance negotiations. Insurance companies negotiate the price they'll pay for treatment and surgeries, so doctors get hosed when it comes to billing for their services. It's no wonder doctors have more patients than they can care for, or the fact most double and triple book appointments. They can't provide quality care because they're trying to cover their losses from insurance companies. Because insurance companies will only pay so much, I've found that doctors are also passing those differences onto their patients. Negotiation is unfair to both doctors and patients; those who win are insurance companies. Since insurance companies make it difficult for doctors to make a living, it's no wonder many have to join existing practices, or they form practices with established doctors. They cannot afford to have their own offices. My last surgeon, for example, belongs to two different practices and has three different offices. I don't think we spent more than three minutes with one another over the course of multiple appointments. He doesn't have time for patient care as he's too busy trying to cover his overhead.
What about those of us in the midle class or lower class? Many of us are barely making ends meet as it is, plus we have to pay for our insurance and additional costs from treatment. Some cannot afford insurance so they allow months or years to pass without seeing a doctor. I knew a man who had uncontrolled diabetes and whose foot had gangrene. He lost two toes but had no way to pay for his hospital stay or his medication.
I don't understand how we can live in the US and feel fine with our healthcare system. Many argue that it isn't their problem, but it is. We passively allow insurance companies to dictate our medical needs and treatments, and in the end, we lose. Being denied a prescription the doctor determines I need because the insurance company determines I don't is wrong. Denied coverage for preexisting conditions like high blood pressure or diabetes is wrong. Creating a system that makes insurance unaffordable for millions of Americans is wrong.
The question is: what do we do about it?
