I am feeling better about things in general today, because at least we got SOME kind of health care reform passed. It's a flawed bill and there are probably some things I don't like about it, but what I DO like is that:
- My sister will finally have decent health insurance again, after several years of no coverage or next to no coverage. She's in her mid-50s, worked for nearly 20 years for the same employer, with excellent job reviews, only to be told one Friday not to come in the next Monday. Turns out the new owners were trying to boost profit margins.
- Kids can stay on their parents' insurance until they are 26. This is the only way a lot of young adults will have any insurance at all.
- People will be required to buy health insurance, which will actually go a long way to eliminate those scenes anti-reform people kept talking about, in which poor people walk into the ER and get "free" care. (It was never free--it was just free at that moment, to those people. We all paid.)
That being said, I realize this will be expensive. Affluent families (example: married couple with $250,000 joint income) will see their taxes go up. I also realize that Washington has been known to throw money down some $600 toilets (though there are tons of federal programs out there which never get attention and which do great work--they're just boring to read about, and so you never hear about them).
I realize money doesn't grow on trees, and that we are racking up unheard-of levels of national debt.
I say all these things because the other night I actually had a great conversation with somebody who does not support health care reform, and who is seriously concerned about the cost. This person is not mean-spirited, greedy or ignorant, the way liberals have frequently portrayed their opponents. He's a conservative in the old-fashioned sense, and I saw a great deal of sense in his arguments.
But here's the catch: this person has never required health care that was anything out of the routine. For him, the old system--if you can call it that--has always worked. I belong to a group of people for whom it has never worked particularly well, and who have been the targets of systematic discrimination by insurance companies for decades: people with mental illness. Right now, if it weren't for the fact that my husband has a good job with the federal government, I would probably not have health insurance. I have suffered from depression since my teens, and up to now no insurance company would have touched me with a 10-foot pole, due to my "pre-existing condition." Depression is a common mental illness, highly treatable, frequently deadly when left untreated. I manage my illness and have had a productive life--but back in my 20s, I resorted to selling my blood plasma in order to scrape up the money for therapy, since at that time insurers could, and did, offer no coverage for "mental conditions" whatsoever. Things have improved since then--but even now people with mental illnesses face higher deductibles, more restrictions on their coverage and much higher co-pays than do people with, say, diabetes.
People with depression tend to have a lot of other health problems, too; depression literally wears down your body, so that your digestive system, your bones and joints, your immune system--they can all go out of whack. Over the years, then, I've dealt with insurance companies a whole lot more than I ever wanted to. I've had the experience of falling ill in a public place in a distant city and being mistaken for one of those poor uninsured, and brother was THAT was an eye-opening experience. I have seen perfectly valid claims be denied, only to mysteriously be reinstated once I appealed--a fact I think about every time I hear a story about someone who has been denied coverage. Do they know, I wonder, that insurance companies will tell you "no" just to see if you'll settle for "no"? Do these people have the time and the energy to keep appealing and appealing up the line until somebody says "yes"? I suspect they don't--but I've learned to.
I've learned that policies can be written in a way that looks fair, but isn't; insurance companies say they will cover 80 percent of the "usual and prevailing cost" of treatment for both mental and physical ailments--except that this "usual and prevailing cost" is mysteriously far lower for psychiatric care, with no relationship to what psychiatrists charge in the real world. The result: you either fork over more money out of pocket, or settle for seeing an in-network provider who is reimbursed so poorly all he or she can afford to do is run a pill mill. I've had one of my children misdiagnosed by one of those doctors, who mistook her ADHD for bipolar disorder (in an office where samples from pharmaceutical reps were stacked up in piles so high they were literally falling over). We took her to a different doctor, even though he was out of network and it cost us a bundle. Today, after being appropriately treated for ADHD, this kid is now on the honor roll in school and doing extremely well. Who knows what would have happened if we had had to settle for the kind of care our insurer thought was good enough?
So yeah--after a couple of decades of dealing with a chronic psychiatric illness of my own, and the last five years finding appropriate medical care for two kids who have different, but also highly treatable, psychiatric issues, I'm thrilled to see this country moving slowly, ponderously toward a different system, because the system we have now is a mess for anybody who is actually sick. I don't know this for a fact, and I haven't seen any polls which addressed this, but I have to wonder how many people who opposed this bill have ever faced a serious medical crisis or a chronic health condition--or if they did, if they did so with some kind of financial cushion, a decent employer-paid policy and a health condition which did not involve "mental health." They have no idea how lucky they've been.
For the rest of us, I think things are looking up.