Monday, April 24, 2017

A Lack of Healthcare Story

When I was 21 I was kicked of my parents' insurance.  I had a job, but it was for a tiny company and I was paid monthly and not always super timely even though one of my job duties was to print the checks. I absolutely meant to do something with the COBRA packet I received and then I got busy, and there were the holidays, and so, yeah, I missed the deadline.  I probably could not have afforded COBRA without help, but that was small consolation because in February after standing for days on a convention floor, my knee dislocated as we finished packing up and my elbow broke my fall.  My knee (somewhat ironically) was fine.  My elbow ended up requiring surgery because I broke off the edge (not the center pointy bit, the side pointy bit which yes probably has a better name than that) and needed pins to put it back where it belonged, and months of physical therapy to regain range of motion. I was really lucky that I had family who was able to help look after me, drive me to all these appointments, and help me pay for this.  
Obviously I realized my error in letting my health insurance lapse and once things were on the mend started looking into getting my own insurance.  And guess what I ran into.  Pre-existing conditions.  Even though I had already had surgery, even though I had already attended multiple physical therapy sessions and had regained most range of motion, the insurance company didn't want to cover me because I had a known condition that might cost money.  
Again, I was really lucky and managed to push through that and get coverage.  But we are talking lots of time on the phone. Nowadays a series of laws, HIPAA and ACA have made such stories go away.  For now.  Right now I have heath insurance through my job. So the fact that I have injured my knee several times, suffer from seasonal allergies, have asthma, and other various conditions are all covered by my insurance.  
Prior to the ACA, my day job had me reading a lot of companies summary plan descriptions.  And some of them covered pre-existing conditions. And some of them had a waiting period.  Something along the lines of six months or a year before the employee or the employee's covered dependents could be covered for pre-existing conditions. And a pre-existing condition can be anything you've ever been treated for. Any time you had a visit about a thing, that maybe visits and visits later turns into a diagnosis.  
And really, it's easy to fault employers and insurance companies on this.  But insurance is capitalist by design. Their job is to save money.  That just happens to be at odds sometimes with our goal of getting good health care.  It is a clear case of the system working as designed even as it fails many. I do think ACA is imperfect.  I do think we could come up with a better solution.  But repealing it and replacing it with something that covers less people is not the right approach.