Sunday, March 20, 2011

Health Care

Health Insurance, oh how this one makes my blood boil. Health Insurance for a family can vary depending on what plan you have and who you have it with. Regardless it continues to rise, Every. Single. Year.  (Inflation! Which I plan on having a post about soon, because you have to love inflation!)  And you don’t ever get a discount because your healthy and don’t need to see a doctor too often, or because there wasn’t some major accident that required major medical attention. Nope no discounts, just an increase of what medical insurance costs every year.

Our insurance one year cost $1500 for a MONTH for three children and two adults. That was 18 Thousand Dollars for the year. 18 thousand dollars is nothing to sneeze at for an average American.  We all aren’t Donald Trump so it’s not pocket change.  I PROMISE you I did NOT use 18 THOUSAND DOLLARS in health care that year. Heck I would be SHOCKED if I used $2,000 but let’s say I did, the company we have insurance with made 16 THOUSAND dollars from us for that year. Just us. Of course IF we had a major medical emergency then we would have easily used much more then that. Seeing as a Tylenol in the emergency room is $10. Heck I can buy an entire bottle for that in the market or the drug store. And of course they won’t allow your spouse/relative to whip out the Tylenol out of your purse and give it to you, and record it in your chart that you had it. And if you take a certain medicine and are need of it while at the hospital, the hospital has to provide it and give it to you, even if you have it with you. Nope you cant take whip it out and take it and have them put it in your chart while your there so they know, they have to give it to you and charge you an arm and leg for the little pill you already have. I am getting off track here, we didn’t have a major medical emergency, and therefore didn’t use anywhere near what we paid in, but our insurance the next year was RAISED!

And the Co-Pays, honestly, after paying $1500 a month for insurance WHY am I paying $40 to the doctors office every time I go to the doctor? $40 is covering at least ½ of what my bill is! I brought my daughter to the doctor once for a regular check up and she needed her immunization shots that were due at the time, and our final bill was $100, $60 more then my co-pay. I have gone to the doctor to find out I have a sinus infection, after my co-pay of $40, I paid ½ of the bill. Then of course I was off to the pharmacy, where I spent another $15 for antibiotics, so *I* paid $55 total for a sinus infection, and really what was the total for the insurance company? Of course I don’t get a copy of the bill from MY insurance company as some may, but I am almost willing to bet there cost was less then mine!

And medication, good grief, $15 for each, after paying my $1500 a month for insurance, and of course I ALWAYS end up with generic (which I don’t really care about) so it costs MUCH less, I bet my $15 covers the REAL cost of the medicine I get. And I can’t imagine WHY some scripts are NOT covered; I have to pay FULL PRICE for certain prescriptions! Who decides what prescriptions are covered under insurance and what ones are not? After paying $1500 a MONTH, I have to pay full price for a prescription my doctor says I need because someone says it’s not covered under my insurance plan? Honestly? Something is NOT right about that. For example when I get sick with a simple cold I have problems breathing, so I need an inhaler. An inhaler is NOT covered under my insurance plan, and the cost at the pharmacy is $50-$75 depending on what one you get. Seriously? Not covered? So my choice is to pay for the inhaler out of my pocket so I can breathe on top of my $1500 a month to have insurance, or struggle to breath.

And WHO are these people who decide if a person can have a medical test or if they can see a specialist when there doctor says they need too?  Are there really more qualified people then a doctor who has physically seen me? If my doctor who is a general practice doctor says you need to see a specialist for this issue I have to wait, on average TWO weeks to find out if my insurance company will pay for the specialist? Of course I still have my co-pay and if he gives me any prescriptions I have that cost as well! And then to have the insurance company say I can only go to the specialist ONCE. Honestly, what can the specialist do seeing you ONCE? So after you have seen them once, you have to get permission to go back.  This makes me feel wonderful! My $1500 a month pays someone to decide IF I need to see a specialist and how many times.

Now mind you I understand there are people in America who have had major medical problems come up. I am not saying these people should be punished in any way for having these problems arise, since it’s really uncontrollable. Please note I have a friend who has a child who was born with some medical problems, and another friend who went through a battle with cancer recently. Neither asked for these medical problems, and if given the choice, they wouldn’t have them. They weren’t given a choice. Yet they are charged up the wazoo in medical expenses daily.  For some people a major medical problem even WITH insurance it can cause major finance problems.  These insurance companies who they pay monthly an outrageous amount of money to do not pay there medical expenses, they pay a portion of the bills, and of course each person or department bills you. So just say you have a major medical problem arise and you land in the hospital and the hospital bill is 100 Thousand Dollars, because they charge you for every little thing, the insurance company is only going to pay part of it, you could easily see a bill for 10 thousand dollars for that medical emergency. And that isn’t the total bill of course because everyone bills, don’t forget the doctor bill on top of the hospital! While paying that 10k you have to continue to pay the insurance company monthly for your insurance, and any medication you need and co-pays for follow-up check ups, tests or what ever else is needed. This can cripple an American family WITH insurance. If you do not have insurance, forget it, your going to loose everything you worked for all your life and you may never recover. Well honestly chances are you are NOT going to recover depending on the emergency. 

I don’t have an answer for the rising medical costs in our country….However I can say whether you have insurance or not, you’re going to pay, and every year it will increase. Every year you will pay more to the insurance companies, and every year they will decide what they will give and what they won’t, and we don’t get much of a say in the matter. While there are other companies out there you can switch to, there isn’t always a choice. My family cant switch, as our insurance is provided through my husband’s employment, so his employer decides who we have our insurance with and if you go out to buy your own insurance it can cost even more or they can deny to insure you. It’s a dammed if you do and dammed if you don’t situation.

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