“You guys are such assholes,” I said to the man who manages my health insurance payments. I wasn’t necessarily meaning he’s an asshole, but rather his industry, including health insurers in general. He’s just a guy trying to do his job, I understand that. So I guess this makes me the asshole for calling him an asshole when what I really meant was that his industry is full of assholes.
Thanks to my cancer, I’ve logged enough time on the phone with these people that I could turn the conversations into a drinking game. For every time I call them an asshole, drink! If I actually did this, at this rate, I’d probably be leading my local Alcoholics Anonymous group.
People like me — and there are a lot of us — are ecstatic that January 1st came and the Affordable Care Act (henceforth referred to as Obamacare – lovingly) has gone into effect. We’re all aware that the GOP hates it and that Ted Cruz can talk about it for 16 hours for no reason at all. Congress wants to make this a polarized issue, and so do many Americans, but where are the real life voices? Voices of the people that just want something, anything, to free them from the economic slavery they’ve been pushed into? According to the Department of Health and Human Services, there are at least 50 million Americans that have some type of pre-existing health condition that either did or would get them denied health coverage, and possibly upwards of 129 million who have been denied insurance because of …(insert any number of ridiculous ailments here). Where are these guys?
So sit back and let me tell you a story of two Americans that have been denied coverage. It’s the true story of two brothers, living in two different healthcare economic enslavements, and how they are navigating their way to, what’s that? Yeah, freedom. Well, a kind of freedom. Basically the free version of the Freedom App.
It was the best of times, it was the worst of times, it was the age of wisdom, it was the age of foolishness, it was, uh, well, just another day in the United States of Don’t Get Sick Because You Won’t Be Able to Afford It.
In June of 2012 I was pretty much your typical young American. I had a full-time job that paid well enough, offered health insurance, and allowed me the freedom to explore my creative endeavors. On the cusp of turning 30, I was healthy, ate right (Linda-McCartney-level vegetarianism), a marathon runner, barely drank, never did drugs. Basically I was the model of perfect health. If my parents had not insisted on my needing health insurance, I probably would not have joined my employer’s health plan. I didn’t need the extra money it would have saved me, but still, who doesn’t want extra money, right?
Then I got cancer. Seriously? I was the healthy one! Nobody in my family had cancer. In the matter of a month I had surgery, lost some teeth, and started chemo. In no time I went from being the model of perfect health to being the model of “FML!”
The presidential election was underway while I was in chemo. I would listen to Romney and other Republicans talk about ending Obamacare, how it would ruin the country. As I heard them talk, my medical bills piled up. Even with insurance, the bills were too much for me. Did you know that a tooth pulled because of possible infection during chemo is covered, but replacing it post-chemo is not? You can still chew and stuff, minus the tooth you lost because of chemo, so you don’t need it covered by the cancer coverage that caused the chemo that lost the tooth. Following me? Yep, I was lost too. So basically, in my chemo brain, the Presidential election came down to Republicans thinking I didn’t need to chew and Democrats thinking I deserved to chew.
All the while I was making payments to a system set up by a jelly bean loving President.
COBRA (Consolidated Omnibus Budget Reconciliation Act of 1985) was signed into law by President Reagan to ensure that employees could continue their health insurance coverage after leaving their employer. What this basically did for people with serious health issues was end the dead-end loophole of people getting sick and not being able to work, then losing their health insurance while simultaneously being denied across the board by insurance companies for having a pre-existing condition. Sounds great, right? Sort of. COBRA can often cost 100% of the premium. Sometimes it can cost upwards of 150%. What’s that mean? I’m glad you asked! Let’s have a breakdown party, shall we?
– Like most sassy single young professionals, I had no idea what my portion of the health insurance premiums I paid. My employer took it out of my paycheck, I was still able to afford Netflix every month, and if I had a toothache or cold, I could go to the doctor and be covered. Happy, healthy, financially-ignorant H. Alan!
– Then I got cancer. And lost my job. Fortunately, I didn’t lose my insurance because of COBRA, but unfortunately, I learned my monthly payment was going to be $700. This is because I was now responsible for that mystery part of my premium that was being deducted from my paycheck and the hefty package of nickel and dime fees from the COBRA administrators.
– So, because literally any other insurance plan (in other words, cheaper alternatives) would have denied me due to my supremely wicked preexisting condition (CANCER), I had to choose between insurance that cost $700 a month or no insurance at all (i.e. adding on to the $30K in medical debt I already have).
– Because of that wicked condition, I couldn’t work. So I went on disability. During chemo that meant I was making a whopping $680 a month!
– Wait! That’s $20 less than what your COBRA costs. I’m glad you noticed this, I did too. That means I had $20 spending money a month. Anyone got a deal on a $20 apartment? Can you eat air?
– Credit cards become your bestie because like, you have zero other sources of money and have always been looking to be on a first name basis with debt collectors.
– If you’re lucky, you can get a bonus from your employer (I was lucky).
– If you’re extra lucky, you have the support of friends and family to help out (I was extra lucky).
I had to swallow my deeply rooted, stocky German-bred pride of never asking for help. It was humbling, and didn’t taste anything like sauerkraut. But guess what? A lot of people aren’t as lucky (or German).
Luck has a funny way of impacting your life. Take the tale of this next dude. In 1978 a woman went into labor four months premature on an army base in Washington state. An ambulance was called, but never showed. It was just the mother and her pet Labrador Retriever. The baby survived, though not without being left severely disabled with cerebral palsy. Once at the hospital, the baby wasn’t supposed to live, the damages to the brain were too severe. But he did. Some 40 surgeries and 35 years later, he’s close to getting his Associate’s Degree in St. Louis, MO. He’s my brother, Jason, and very, very lucky.
What does someone do to get insurance when they’re born with a preexisting condition? Well, you have a Mom that will yell at anyone for starters. Secondly, you and your mom accept that the healthcare system is broken. Sure he was just “OK” while covered under our parents’ insurance, but once Jason came of age, he had to go through a long process of being denied by every single major health provider. As these denials came left and right, his arms and legs begin to feel the effects of someone aging with cerebral palsy. So you just try your best to not go into all-consuming debt. Basically, he’s had to watch where he’s walked for the past ten years or so, because God forbid something happens — he trips, for example — and that’s all folks! Goodbye house. Goodbye car. Goodbye to the life you thought you had and welcome to the Insurmountable Healthcare Debt Planation.
Eventually he joined the Missouri State Health Pool. This mostly gave him the basic coverage he needed, but with none of the “special” things (so deemed by the Insurance Gods) that he needed in order to age gracefully. That brace he needs? Can’t afford it, and it’s not covered – sorry! A functioning left hand? Who really needs a left hand anyway?
He’s in Missouri and I’m in California. Both of us were eager for January 1st so that we could finally have affordable, reliable coverage that will protect us in a time of crisis. I started out healthy and something really bad happened to me. He started out with some bad luck and has basically had to make the best of it for 35 years.
California has received great reviews for how efficient their healthcare exchange has been operated. I can attest to it. I was covered under Blue Shield of CA, having received most of my care at Cedar-Sinai. But because Cedar-Sinai doesn’t accept the CA Exchanges health plan that I can afford, I can no longer stay with my current doctors. Before haters cite this as another fault of Obamacare, it actually has nothing to do with it, and instead, has everything to do with Cedar-Sinai and their money making operation. You see, a hospital is a business, one that likes to make money. It’s not profitable for some hospitals, especially in urban areas, to accept people in need of financial assistance for their healthcare when there are plenty of rich folks willing to pay for “quality” healthcare. Sure, they have to accept some poor folks, but people at high risk (i.e. Jason and I), no no no, we have to go to a hospital far away, separate from the people who can afford the top notch coverage (but equal, yeah, equal, that’s it).
Regardless, when I logged into healthcare.gov for the first time, I found I had more than seven insurance carriers to choose from, not to mention various plans under each carrier. Sure, I might have to travel a bit for my healthcare, but it’s nothing compared to what I’ll be saving in healthcare costs. It was as if all the insurance carriers were waiting for me, screaming for me to join, “Yes, bring us your cancer, we love you!” After weighing my options, I decided on Kaiser Permanente because they offer comprehensive coverage for all the things my not-as wicked preexisting condition requires at a cost of no more than $300 a month.
So what about Jason? Because Missouri opted out of creating a state healthcare exchange, he’s left with the option of, “Well, I guess if this is all there is, I’ll take the less moldy version,” AKA the federal exchange. He typed his information into healthcare.gov, and there it was, all on one page, his two options. Just two. Correct me if I’m wrong, but isn’t part of capitalism having an open marketplace where companies should be allowed to compete and offer purchasers options? I guess two means options — it’s more than one I suppose.
Even with his lack of options, he was able to find a healthcare package that not only covered his needs, but also at an affordable price. And yes, he’s finally getting that brace (thanks President Obama).
Obamacare isn’t solving the mess of healthcare, but it’s a start. The pre-Obamacare system was set up so that insurance companies could use people’s health as a way to give them a gun and say, “Surprise, you’re playing Healthcare Russian Roulette.” Usually in the case of a Russian Roulette metaphor, no one really dies. But in Healthcare Russian Roulette, people do. They die!
Before January 1, 2014, the millions of people like Jason and I that benefit most from Obamacare were enslaved in an economic trap that the health insurance industry built and Congress helped maintain, slowly working every penny out of us through rising medical costs until we died, either financially, or in some tragic cases, literally. Yes, I’m aware my language is dramatic here, but it’s my livelihood that’s at stake, so talk to the hand (snap).
Remember how I mentioned how healthy I was in June 2012, a month before I got cancer? Yeah, that’s reason enough for all you healthy young people, the ones who have never had anything more than a toothache wrong with you, to go to your state’s exchange or healthcare.gov and get covered. Because it only takes one day for everything in your world to change (hello, I have one testicle). Sound scary? Damn straight it is. #GetCovered, and don’t listen to the noise of Ted Cruz and the Tea Party. It’s just fear that maybe, just maybe, we might be on the path to giving people a little more freedom to live their lives, live healthily and therefore, ohhhh I don’t know, give back to the economy? Is that a Republican idea? (A little.) No. It’s an American one. Get it? Got it? Good. Get covered.