Thursday, August 20, 2009

My Healthcare Stories

My blog posts aren't usually so personal about my life as this one is going to be.

I have two main stories about my struggles with and without healthcare insurance that illustrate problems in the system. The first is when I had a major injury--a broken vertebra--when I was not insured. The second is trying to move jobs and switch insurances when pregnant.

The first situation, the broken back, occurred when I was fresh out of college. I graduated and stayed in the Detroit area doing temp work. I quickly found a job through a temporary employment agency, where they placed me in a "permanent temp" position working for Blue Care Network, an HMO of Blue Cross Blue Shield. Now, I don't know about you, but I think one reason companies hire "permanent temps" is so that they don't have to pay benefits, but ironic as it is that a health insurance agency doesn't want to have to provide all their employees with health insurance, that's aside from the point I'm trying to make. Anyway, when I first started working with them, I was still covered under my parents' insurance. That lasted until January of the new year. That was the deal back then--you were carried on your parents' insurance until the January after you graduated from college or the January after you turned 22. I don't remember which exactly was the rule, and I'm not sure how it worked for students today. In January, however, I was offered a full-time job (with benefits) with Blue Care Network, where I would be working directly for them rather than for the temp agency--they would buy out my contract with the temp agency to hire me on directly. The job was to start in early February.

On my first day of work, I slipped and fell in the shower while getting ready for work. I did, basically, a back-flip out of the shower, something I don't recommend. And I broke my first lumbar vertebra, and I ended up in the hospital. I wasn't yet actually an employee of BCN, so I lost the job. I wasn't yet insured (which wouldn't have kicked in for 3 months anyway), either. The hospital social worker worked with me to get some of my costs covered by the government--basically my hospital stay itself. I still had to pay ambulance costs, doctors' costs, and drug costs, which amounted to several thousands of dollars. Hospital stays only last a few days, so despite the fact that I was unable to care for myself, having to lay constantly on my back for a few months to recover, I was sent home to my apartment that I shared with a woman I had known only a few months (I had answered her advertisement looking for a roommate). She quickly asked me to move out, despite the fact that I continued to pay rent--having a roommate who was recovering from injury didn't suit her lifestyle. So here I was, jobless, homeless, uninsured, and still recovering from a broken back. Fortunately, I have parents who were able to take me in and who didn't charge me rent and board, so that I was able to pay off my medical debt with my income after I was able to work again. I had a safety net. But what if you don't have such a safety net? What happens to you then?

I'll finish this first story by saying that while I received immediate hospital care, I think I did not receive the same care as I would have if I had had insurance. I did not get the follow-up care that might have helped me. I got only emergency care. And I continue to suffer from this injury today. That might be true under any circumstances. On the other hand, maybe it would be less if I had received more care then.

What this story illustrates for me is just a few of the ways how the system is broken--full-time workers don't always have health insurance; employers don't stand by their employees once they get sick; if you don't have health insurance, you don't get the best care.

My second story is one that I told in a sermon on universal healthcare in January, 2008. Rather than rewrite the experience, I'll share those words:
At the recent community forum that our church hosts, in conjunction with the library, on healthcare, I shared some of what I, and this church, went through in trying to find healthcare for me when I came here. I assume that the board was informed of some of this, and the search committee of some of it, but that probably most of it was known only to Alice D., Bob L., and myself, as we struggled with the situation. I was, when I started work here, a little less than eight months pregnant. Both the people at church, and myself, I think had not thought it would be as much of a problem to switch healthcares as it turned out to be. I couldn’t just stay with my existing healthcare, because it was a regional plan for Massachusetts, and delivering my baby here would be “out of network.” Every plan we could find here, at first, considered my pregnancy a “pre-existing condition.” We finally found that if we joined as a group, as a business, rather than getting individual coverage I could be covered, but only if my current insurance was part of a group. Fortunately, through sheer luck, it was. I had to go through some work to prove that, we had to switch insurance agents, because one said it couldn’t be done, and in the end I had pretty much continual coverage. To get the healthcare insurance, I had to show proof of ordination—which involved a quick trip to the framers, who had my certificate of ordination for framing at the time, and I had to show my marriage license. I had never had to show my marriage license for any purpose, and, in fact, didn’t have a copy. Fortunately, Chicago will let you order an emergency copy by phone, but at first they had lost the record of our marriage! They found it in the nick of time, and I was able to get our whole family covered.

What did I learn from this? If you have the time and energy, and some good help, and are willing to spend a month hassling with the system pretty much continuously—I spent my entire study leave on this project, while Peter packed boxes—then you can sometimes, with a great deal of luck, work the system. The good news now is that we now have a denominational health plan, so ministers in situations like mine can carry their insurance from church to church—a major bonus for those professional interims, for example.
What does this story mean to me? Again, it shows several ways in which the system is broken: even if you have insurance, if you move or switch jobs, your pre-existing conditions may not be covered; if you have insurance and it's not an employer-provided insurance, if you switch insurances your pre-existing conditions will not be covered; with some insurances, if you go "out of network," you're basically uncovered; if you're covered by insurance but you need to move to providing your own insurance plan that's not employer-based, your pre-existing conditions will not be covered. Basically, in most cases, you cannot lose your job or switch your insurance, or any pre-existing conditions will not be covered. Again, in order to find coverage, I had two volunteers, myself, and two insurance agents working on the situation constantly for over a month.

Lastly, I know my stories are not nearly as horrible as others out there. But having experienced these myself, it is clear to me that we are desperately in need of healthcare reform. I believe we need a "single-payer" system. I will settle for a strong "government option." But leaving it all to private insurances will leave us with a system as immoral and unethical as the one we have now.

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