OPINION

The Flatlander

Health Insurance Is A Quandary

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In a land of democracy where the people supposedly rule, we really should do a better job holding our elected officials accountable.

You can show up once a year at the parade and toss penny candy to the children, or present a flag to the local veteran’s group with some canned speech about freedom and that’s all well and good, but we the people are not holding our public servants accountable, especially those in the state general assembly and the U.S. Congress.

he bar should be higher.

So, we can complain about the system all we want, but the reality is – that’s on us.

As a former Capitol Hill staffer, this has discouraged me for years. It got personal last week.

Earlier this year our family had some thoughtful discussions about the realities of midlife and all that goes with it. I’ve always been a person who pretty much lived life on his own terms, refused to be caged by things like the fear of not having enough retirement money at some distant age, or working a job where I punch a clock with some incompetent supervisor looking over my shoulder eight hours a day.

I’ve seen far too many people work themselves silly for decades in a job they hate, counting the days to retirement, only to experience circumstances that prevented them from enjoying those golden years.
As a good friend of mine with a terminal illness recently said, “Don’t be afraid of dying. Be afraid of not living!”

Amen.

But the realities of midlife are there, and they demand some thought and planning for anyone who cares about his family. Responsibilities to aging parents are a big part of the fifties. Proximity to grandchildren and how you may help to your own children as they raise a young family is another consideration.

As the new year unfolded back in January, Dana and I started serious conversations about healthcare and insurance. We’ve worked traditional jobs where employers provided good health insurance. They are distinctly two different things – the one that should be calling the shots actually taking orders, and vice versa.

There have been stretches when our family had no coverage.

It’s not something that weighs heavy on my mind, but the dysfunctional insurance-health care system we have in a country we like to call the greatest on earth is completely broken and requires some forethought to maneuver its realities. The very idea that a for-profit entity dictates our health care treatment ought to be enough to complain to our public servants every day.

A friend from Canada shared this just yesterday:

“I’ve had five visits to the emergency ward at our local hospital this year, plus a three-day stay in the cardiac ward. Blood work, ECGs, echo-cardiograms, even some prescriptions. Out of pocket expenses? About $20 for some morphine. My health care costs are less than $100/month. Only in Canada you say?”

An American friend characterized like this:

“We live in the last developed country that still treats personal health as a for-profit business, and private insurance exists not to help people, but to take as much money as it can, both from their “customers” and from the health care providers, who have to hire a whole extra staff just to jump through insurance company hoops. The whole American medical system is mind-boggling terrible.”

Double amen.

At the end of our discussion Dana and I made some big decisions and some big sacrifices to conform to the system.

I’m not really sure why.

Dana works a job a hundred miles away and spends five days a week in Jonesboro. Her job provides her insurance. Several hundred dollars a week gets deducted to add my coverage. We meet up on the weekends wherever it’s convenient.

Through it all, I’ve now been recommended for a sleep study for a condition known as bradycardia.
Sleep studies are expensive. Before booking an appointment, I wanted to know how expensive.

Between all the offices that have a hand in this kind of thing it took a dozen phone calls just to get the right people talking. It reached a point where I knew if I didn’t get involved, I’d wait forever. Once the provider and the insurance company did talk, sorting out billing codes and coverages and write-offs, the provider told me the procedure would be 100 percent covered once I met my deductible. That was the answer.

“Can you tell me where I am on that deductible?” I inquired. It’s honestly like questioning a witness on a stand to get to the real answer.

“You’ve paid $400 on a $2,800 deductible, so it will cost you $2,400 out of pocket.” This to have someone monitor my sleep a few hours.

“But if you bypass the insurance and don’t file, it will be $1,064.”

“Huh?” I responded with much confusion. “That’s absurd. Why do I have insurance?”

“Exactly,” she responded, not the answer I expected.

It has me thinking. Why do I have insurance, anyway?

We should demand better.

See you in next week’s newspaper.

(Steve Watkins is a reporter/columnist for the Stone County Leader. Write him at steve@stonecountyleader.com).

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