Monday, October 12, 2009

Health Coverage Crisis

I found myself in a horrible position last week; that of the the inadequately insured. Let me tell you, it was not a good place to be.

Ironically, I was a Canadian in Canada without proper medical insurance. In the land of "everyone has health insurance" I was facing a $1000 medical bill. Who knows how much more if hospitalization had been required?

It was all my fault and, quite likely, entirely avoidable. I called our insurance before travel and learned we had emergency coverage and I was duly warned that "emergency" was defined by them, not me. I didn't like the sound of that, so I did a bit of browsing and explored purchasing additional coverage, but it was like reading Greek and I couldn't for the life of me figure it all out in the tiny amount of time I had to devote to the search.

I raised my hands in defeat and said "we'll be fine" and away we went. We'd always been fine before right? One hour before we landed in Calgary, Lucas was burning up. Oh oh.

Friday was bad. Saturday was bad. Saturday night was the worst. At 5 in the morning, I emailed our insurance company, called an ER in Calgary, called the airline to see if we could get home earlier .... no one was telling me anything I wanted to hear.

Things always look better in the light, but Lucas' fever was still lingering so on Monday a Doctor's visit was necessary.

Some really good people helped me that day and I was so grateful to get Lucas the care he needed. It was a virus followed by a nasty ear infection. I was grateful we only had to pay a total of $55.

Because of the Calgary Region Health Authority's H1N1 protocol, Lucas should have been shuttled off to the ER because of his fever and congested cough, but they allowed us to avoid that cost. I worked with a nurse practitioner, a front desk clerk, a nurse and a Doctor on call - each one helped me when they didn't have to.

My lessons? Don't travel to Canada unless fully protected. I'm startled by how nervous and anxious I was about being unprotected in my own country. I received a four day glimpse at how millions live in the US.

I am dismayed by how I had to balance my son's health against my bank statement. I resented the requirement to ask "how much?" before I could consider moving ahead with what my son needed. I was aware that really no one could help me and I could feel myself being backed into a corner. Of course I was willing to pay any amount for Lucas to be okay, but the pressure of possible back-breaking costs was daunting.

My US insurance company assured me they would "consider" my claim "if" it met their "emergency criterion". They made it abundantly clear that it was their main priority to find a way to not pay my claim.

My fellow Canadians, however, restored my faith in humanity. They showed me that they live in a country where the health and protection of their neighbours matters to them. They do not withhold their tax dollars from the sick, nor do they spend their time finding ways to deny coverage to illnesses that don't meet certain definitions. I am proud of the Canadian mindset that willingly gives to others.

I am nervous about living in a country that has many, many people determined to turn away from their fellow man, woman and child. It is my impression that the US is populated with those who do not want to extend help to others. Perhaps I am wrong. Perhaps there are many, many Americans who would have been motivated by good-will to help me out of my bind. Somehow, I think this is not possible in light of the huge resistance there is to universal health care.


Maria said...

And for many of us, the list of restrictions gets longer every year, while the premiums we pay get higher each year at an astronomically rate. Mine will go up about 70% (I know you know since you are looking at the same booklet I am). In order to maintain current premium levels I pay bi-weekly, I will have to accept less coverage and more out-of-pocket up front. As a single person with no responsiblities for anyone but myself, I can squeeze out the increase for next year. But, I truely feel for those who have families and are already struggling to keep from drowning. For these people, this is a nightmare. And for some, they will make the scary choice of going without any insurance because they have to buy food, pay rent, buy clothes for kids who outgrow their closet on a regular basis. But, we all should have known this was going to happen. The health insurance industry has been threatning ever since the national political dicussion started. And, before anything has yet been passed in Congress - and it may all fall apart in the end - these blood sucking enterprises have thrown out the daggers. It is amazing to me how many people believe the "rationed care argument" if were to have a single payer, central healthcare system. At the rate we are going now, next year, the government will be reporting 60 million people in the country have no or little insurance.

Catherine said...

I simply can't see a way through the complex layers of government, drug companies and insurance companies. The individual doesn't have a hope.

Being uninsured feels awful to my Canadian sensibilities - I don't know how families make it seem "okay".

MythicReader said...

I am glad you wrote of this example in your blog. I think there is a detachment for many individuals who have never experienced a health care dilemma like your described. They seldom have to ask any significant billing question at the doctor's office. But I also think that they forget that their salary pays for this coverage -- most employers take it out before you get a check and you don't have to think about it much maybe. Fortunate individuals.

Many with lesser employer benefits, older people with less coverage and those without jobs would probably think about health costs every day of their lives though. How can we argue that health care reform isn't needed? And if it isn't enacted now, when should it be? I haven't heard those who seem to be against the current reform answer the above questions.

Catherine said...

From what I understand, even those with adequate coverage still encounter huge expenses when serious illness/injury hit.

This isn't covered, do you want it? What an awful question when someone lay suffering.