At some point, the debate over healthcare is really going to heat up. Sure as shit, we’ll start hearing about long waits in other countries, ‘rationing’, and other tales (I put rationing in scare quotes because the U.S. rations healthcare: if you’re lower-middle class, you don’t have it). With that, I bring you this post by John Aravosis, who recounts his experience–and why, I think, we need a public option for healthcare:
As I’ve written before, in detail, my prescription drug coverage is a joke. Blue Cross hasn’t increased my drug coverage in 14 years – I have the same $1500 limit I had in 1997, even though $1500 bought you a lot more drugs in 1997 than it does in 2009. Oh well, guess I’ll just die, or go bankrupt, if I ever get sick. And the thing is – and this is important – there is no better plan at Blue Cross that I can buy. So even if Congress were to help me, and they clearly won’t because I’m not “poor,” but even if they did help me buy into a plan, the plans suck.
I am self-employed. I bought, what I believe I was told, was the best self-employed health coverage I could get, from the local CareFirst BlueCross BlueShield. And the bastards just tried to charge me $250 for two prescriptions I had filled last month, and paid at the time something around $20 to $40.
I called BlueCross to find out what was up. They told me that I hit my annual limit of $1500 coverage for prescriptions. $1500? First I ever heard of that one. What other little surprises are hiding inside my $340/month health insurance package? I have numerous prescriptions I have to fill between now and the end of the year (not to get into too many details, but my allergies have finally gotten to the point where they’re impacting my lung capacity – and the allergist tells me that’s a bad thing long-term, not being able to breathe and all). And I’m on Vytorin for cholesterol control.
So, my choice is:
A) Skip my cholesterol medicine for December, and skip all (three, I believe) of my lung/allergy medicines for the next two months, or…
B) Pay somewhere between $500 and $1000 out of my own pocket because BlueCross BlueShield has super duper double secret limits on how much prescription coverage they’re going to give you.
This is scary. I haven’t been unusually sick this year. Yet I’ve already reached my limit of coverage. What do people do who are actually really REALLY sick? Who come down with cancer, or HIV, or some serious months-long illness?
In the end, I’m fortunate. I can spend $1000 out of my own pocket to try to ensure that my lungs don’t collapse at the age of 60, and to ensure that I lessen the chances of having a heart attack shortly thereafter. But what kind of health care system do we have when you’re told you’re buying the best plan you can get, and the bastards have so many loopholes in the unintelligible fine print of the contract that you literally have no idea what your plan is, no idea what is and isn’t coverage, no idea what limits you face on an annual basis or a lifetime basis. (I have a law degree from Georgetown and I can’t make heads or tails of my coverage.)
As I’ve mentioned before, private health insurance is so byzantine, and the ability to determine what level of health insurance you need is inherently impossible to determine (because you don’t know what you’ll need), it leads to substandard care. And, as Aravosis points out, he’s not even that ill.