Health Insurance

Y’all, I take personal responsibility for not paying closer attention to my health insurance policy, which amounts to “We’ll cover $500 and after that, you can’t have healthcare,” at least in my case, because I have no way to come up with the $2500 it would take to get me back into the shit they would cover.

But I was thinking, on my walk this morning, that I have a master’s degree in English.  If I can’t read and make sense of my insurance choices, doesn’t that mean a shit-ton of people can’t make sense of their insurance choices?

I had to sit down with two other grown-ass people, one of whom also works at my place of employment and is familiar with how insurance works, and go through it just to make sure I was getting dicked over as hard as I thought I was (I am) and to help me pick a better policy for next year that will mean I can see the doctor more than once.

I was also thinking of the Butcher’s curly blond friend, whose sister got in a terrible car wreck two weeks ago and was airlifted to the hospital with internal bleeding and how the hospital refused to operate on her because they wanted to see if the bleeding would resolve itself, since she didn’t have health insurance, but wouldn’t transfer her to a hospital that would operate on her, since she would probably die in transit.

My dad was telling me that there’s some kind of investigation going on in Illinois into taking away the non-profit status of a bunch of hospitals (including the one he relies on) because they’re turning away so many uninsured folks.

Also, I’m trying to understand Clinton’s healthcare plan, but I’m floundering on that, as well.  Doesn’t it seem like she’s making it easier for people to stick with insurance they like, opening up the insurance program that the federal employees get to everyone, and then making it illegal to not purchase insurance?  I don’t know.

I do know that people can’t afford healthcare, not even with insurance, so mandating that everyone have insurance seems to me to not solve the problem.

I mean, my employer offers insurance coverage, which I stupidly signed up for, which I can literally not afford to use.  And the insurance plan that I can afford to use (with low co-pays and lots of stuff just covered by the policy) is the most expensive.

Now, I know that from one perspective, that makes perfect sense–the program that gives you the most for the cheapest should cost the most.  But from the perspective of me, it means it’s very difficult for me to afford the coverage I need.

And I’m working someplace with good benefits and a hospital under its control.  They could say tomorrow that sick employees and families are so expensive that it’s worth it to them to offer completely free healthcare in our own facilities to our own people.

I just feel like this is one of those things that is so important and yet I don’t understand enough about it to feel confident talking about it.  It just feels like a mess to me and I’m not sure what we can do to fix it.

It’s one of those things where it appears to be screwed up all across the board.  It’s like some of us are in a slowly sinking lifeboat and some of us are in the cold water.  Does it make sense to put everyone in the lifeboat if the lifeboat is also going down?

No, not unless real help is coming and we just need to buy time.  The lifeboat itself is not a solution.

And I suspect that letting hospitals, doctors, politicians, and insurors get together and decide how to get everyone into their leaking boat is not a real solution either.

18 thoughts on “Health Insurance

  1. Well, B, if you are lamenting the fact that most people do not have the option of coverage that you enjoy, I agree, and thats sad, and I think quite fixable. But to be honest, your current fix with respect to your coverage is because you didn’t take the time to find out what your best option was, even if that meant trudging down to H.R. and having someone explain it to you. Our whole family enjoys pretty coverage for around 137.00 a month. Dirt cheap. I pay that much for my Dish and programming.

    I think Clinton is being pragmatic here, in that people who are happy with their coverage and the price they pay won’t want changes, but there has to be an option for those out of work or who work for employers that don’t offer it. I think the problem for Hillary, as well as every politician, is that before you can help 90% of the country, you have to convince 51% of the voters.

  2. Mack, you know I love you, but bullshit. I made what I thought was my best decision. Turns out that I was wrong and I’m learning the hard way that next time I want to do something different, but bullshit on this idea that “I didn’t take the time to find out what my best option was.” I didn’t realize there was a problem and thought I was taking my best option when I signed up.

    Plus, fine, $137 a month is reasonable for a family of four. It doesn’t make it any easier for the person making $10.49 an hour to come up with it.

  3. I have a master’s degree in English. If I can’t read and make sense of my insurance choices, doesn’t that mean a shit-ton of people can’t make sense of their insurance choices?

    i’m not sure if that’s actually valid logic or not, but i can say i don’t know anybody who can make good sense of their insurance choices.

    i’m a computer programmer by profession. i’ve found that just getting my dirty mitts on some good documentation of what my choices are is like pulling teeth without tools. seriously, it often seems i must have already signed in blood and sent in the money before i can even get a booklet listing the most basic details of the damn plan.

    if i were any more cynical (yeah, as if that’s possible!) i’d suspect it is because insurance companies know computer programmers are usually good at ferreting out important details from boatloads of meaningless junk language; it’s how we survive IBM manuals, after all.

  4. But B, you don’t make 10.49 an hour. The options are there, in black in white, without too much legalese to sort through, and you picked the plan you have. Why? Price?

    I love you too, but I don’t get that you got “snookered” into a bad option for health coverage. I have seen countless plans, and your employer’s is actually quite easy to read and digest.

  5. Where are the emoticons when I need them?! Is there an emoticon like 8O where I stare at you gap-mouthed? I guess 8O is it.

    Please follow carefully. Just because you can do something and do something easily and it makes sense to you does not mean that it makes sense to everybody, or even me.

    I am not saying, nor have I ever said, that I got snookered into a bad option. I have been clear that the fault was mine for assuming that I understood my options and understood how to make a good choice. From that experience, though, I wonder about other folks.

    I think you want to read this as an indictment of and complaining about how I am getting screwed by the system. If you look, though, that’s not what I’m saying. I, too, feel like I’m getting a great deal and, even with my plan, if some kind of major disaster were to happen, I would be happy to know that everything except $2,500 of it would be covered.

    I’m saying that the system, as it is now, is very complicated and that, even folks with coverage don’t always know how to navigate in order to make sure they’re getting the best coverage, an so, I think that opening up coverage to more people, without other kinds of reform, is not going to magically solve all our healthcare problems.

    I don’t know how many times I can repeatedly say that I know I am in this situation because I put myself here. But I will say it again if you like.

  6. I do know that people can’t afford healthcare, not even with insurance, so mandating that everyone have insurance seems to me to not solve the problem.

    The idea behind this is that with more people paying into the pool, rates will be lowered for everyone. That, of course, assumes that the invisible hand of the market actually works; in my opinion, the great big visible for-profit thumb of hospitals and insurance companies is still on the scales.

  7. nm, all I can say (and I must be very careful what I say), is that the (for profit) providers and the insurance companies are on opposite sides of this issue. There will be no united front from those two groups.

    As Forrest Gump said: “And that’s all I’ve got to say about that”

  8. Slarti, they are on different sides, but not on “opposite” sides in some sense that there are only two sides to this problem. There are a lot of interests here. Both hospitals and insurers, though, are gaming the system in ways that cost their clients (us, the patients, you know) in both money and health.

  9. Pingback: Music City Bloggers » Blog Archive » Do You Understand Your Health Insurance Policy?

  10. I don’t have a master’s degree in English but I can’t figure out exactly what you are bitching about.

    From your cryptic outline it appears your plan pays your first $500 of annual charges in full, then applies a $2,500 deductible then probably co-insures with you at 80/20 or 90/10 until you reach some sort of annual maximum out-of-pocket amount after which they will probably pay 100%.

    If I’ve devined this properly, which part don’t you understand? And, if you are so bent out of shape over your having to pay the deductible, have you quizzed your employer/hospital about their extended payment options?

  11. Sweet Jesus, News 2 Me. Follow me slowly. I am not “bitching.” I made a mistake in choosing plans; I didn’t realize it was a mistake until I actually sat down to think about whether I could work it.

    That’s not the fault of the insurance company nor my employer. Mine is a great plan for people who only need to go to the doctor for an annual physical.

    I, though, have discovered 10 months in, that I need more medical help than that, therefore, I must change plans.

    I find the whole thing hard to navigate because I thought I understood what I was doing, but clearly I did not.

    That is an observation.

    I don’t expect anyone to feel sorry for me or to fix my problem for me or anything at all.

    But, my observations, including this one, lead me to wonder if the problems with healthcare in America can be fixed just by giving insurance to everyone–especially if people don’t understand what they’re signing up for.

    Again, I’m not complaining about that. I’m wondering what can be done about it.

    Your confusion about what I was “bitching” about stems from your inability to comprehend that I wasn’t “bitching” about anything.

    On behalf of whoever taught you basic reading comprehension, I apologize.

  12. What can be done about what? People not understanding what they are signing? How about we teach people reading and mathematics? How about if we tell people that the things they sign are important, even if someone tells them it isn’t important?

    It isn’t only being able to read the fine print; it is also being able to calculate what the numbers mean on a month-in, month-out basis.

    And we don’t teach this.

    This sounds like all of the people who signed up for mortgage loans they can’t afford, with interest payments that adjusted to amounts in excess of their take-home pay, on houses they can’t afford with cars, furniture, and vacations they can’t afford, and a lifestyle they can’t afford.

    “I didn’t understand… I signed something I didn’t understand…. It is the eeeevil bankers/insurance company/employers/ fault … It is my constitutional right to have the government protect me from the consequences of any decision I made.”

    The world is a hard and cruel place, and it isn’t forgiving to people who make mistakes. As far as I know, it isn’t the business of government to protect me from the consequences of my own actions and decisions. I am not sure I want to live in a society where Big Brother or Big Nanny takes care of me anyway.

  13. Hunh. I find all this back and forth over understanding to be… kind of orthogonal to what I see as the real problem here. I mean, sure and all, it’d be nice to have things laid out clearer, or have people have more computational skills, or to mandate big warning signs over bits of fine print that are going to screw you, but … if you’re still getting screwed, what’s the point?

    Seriously. The fact that so many of us get screwed by insurance (or by the necessity of insurance in this country, at this time, in the manner that idea is implemented) is the problem. Whether you read close enough to understand that you were being screwed or you made a sucky choice out of a bunch of sucky choices, or you picked what you picked because it was the only thing you could afford and you got dicked over as a result… those things are all problematic, yes, but not the problem.

    The problem is that the system sucks, and there are a lot, an awful lot, of choices and options that will screw you over. And, that due to geographic and socioeconomic constraints, not to mention societal structural issues like practical money management education and the way healthcare has become obscenely intertwined with employment status, people don’t always (I’d say often) have the wherewithal to avoid getting screwed over. Not just choosing something that doesn’t quite fit their needs or slightly overpaying, but actively getting screwed over. That’s the problem.

  14. I pretty much had the same reaction – substituting business for English, which may have felt worse – when re-enrollment came around for my husband’s insurance and I did a cost-benefit analysis for him.

    Never mind the libertarian arguments about the cold, cruel world taking a turn with each of us without the Astroglide every now and then. That may apply to those who signed up for the McMansion mortgage on the McDonald’s wages, or those who have the luxury of a 401(k) but didn’t pay attention to what was in the portfolio. Health care is a basic human right, and I shouldn’t have to draw on a 600-level operations management class to make sure I’m not getting screwed instead of insured.

  15. Isn’t this not only about the insurance–which is a problem, no matter how you slice it–but about the fact that this youth-obsessed society doesn’t really prepare anyone (especially female anyones) for what happens as you age.

    And I don’t mean “turn 70” age. I mean the vast differences in what your body needs between 25 and 35. Women change a lot physically between 25 and 29 and again between 29 and 35.

    So most of us don’t understand that a maintenance health plan which would have been perfectly fine 18 months ago is no longer going to be suitable for our present health needs.

    We don’t prepare women well for the senility of the 30s. Hormone levels shift radically, metabolism slows down, immunity shifts, eyes and hearing age, etc.

    So while we’re discussing plain-language health care plans (good) single-payer coverage (maybe good maybe bad) and B’s reading comprehension (better than some of the commenters, me included) let’s also include the fact that a health plan which works fine for a woman of 29 may suck for a woman of 32 and that’s all there is about that.

  16. Ooh, that’s a good point too, Kat.

    And it’s one of the things that single-payer coverage could either help tremendously (by allowing a person to find and stick with a doctor they like in a true long-term patient-care relationship, which hopefully can evolve with the participants without being threatened by employment changes) or exacerbate significantly (by allowing a person to get stuck with a doctor and a plan they may like at one age, but which doesn’t evolve to suit their needs, and which takes out the element of chance one gets with frequent change), depending on how it’s implemented.

    It’s also one of those things that I’d argue is part of a bigger problem – the fact that so much of our structural (and okay, just plain physical) stuff in society is built around the needs of a relatively small subset of men (white, able-bodied, relatively well off and relatively well educated, and in certain distinct phases of maturity, economic development, and marital status). Not just a privilege thing, but an actual design issue. Joan Williams remarks on that in UnBending Gender – a lot of jobs have most of the equipment designed for those male bodies (piloting, construction, mining etc.), literally gendering the way they can be performed without even going into the social construction of whether or not they’re ‘suitable’ for women.

    Not to mention the fact that in creating work schedules (and, okay, in popular perception), the default is that employees don’t get PMS, or have cramps, or need to express milk, or have bodies that are otherwise inconvenient. Which largely affects women (how embarrassing is it to admit that you missed work because your reproductive system felt like it was trying to exit your body at speed? I find it mortifying. Others might find it impossible. Or not, but it really varies.), but is also part of a still bigger issue that… we designed things around bodies that are never inconvenient, never changing, and never yoked to other bodies (except in certain pre-approved ways that somehow never really become inconvenient because other people can take care of them). Most of us don’t have those bodies.

    We’re not well equipped to deal with what happens when they change or break down, and because we aren’t, we come up with increasingly inane insurance issues, policy problems (if we really valued adapting to this shit, we wouldn’t have these problems. Sure, we’d still have some problems, but not this ‘Oh, I only get one day of sick leave a quarter and I can’t roll it over if I don’t use it, so I’m screwed if I get anything worse than a mild stomachache’ crap.), and needlessly stupid accessibility issues.

  17. “On behalf of whoever taught you basic reading comprehension, I apologize.”

    An apology is definitely necessary, but you should look in the mirror for the person to make it. Your post is too convoluted about why you are bitching to be comprehensible.

    If you claim you didn’t understand the terms of the agreement you signed, your reading and comprehension skill need a ton of work.

  18. Oh, that’s right. I forgot the moment when I signed up to blog where I had to agree that all of my posts would make perfect sense to you and, if not, that I should beg for your forgiveness.

    Please, please, News 2 Me, I throw myself on your manly lap, begging for mercy. Forgive me for not keeping you in the forefront of my mind at every second. Forgive me for not being more clear. Forgive me for not making it apparent that I was mulling over a bunch of tangentially related stuff. Forgive me for responding to your hostile tone with hostility, when clearly you just have no patience for ladies as silly as little ole me.

    Sorry, sorry, sorry. Please, forgive me.

    Boo hoo hoo hoo hoo. etc.

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