Wednesday, May 10, 2017

Health Insurance and Health Care Access Are Not Synonymous...

... and my own life story illustrates why.

In 2006, I was uninsured. No -- I wasn't shirking on an adult responsibility; instead, I had a pre-existing condition, no employer-provided coverage, and no means to pay for an individual plan at the "high-risk" rate. Thus, when I came down with an intractable infection that landed me in the hospital several times over the course of two months, I was handed a bill that totaled over $20,000. Just for a point of reference, I made about $26,000 – $30,000 a year. My hospital tab was 2/3 of my highest annual salary.

But here’s what happened next: My mother and I informed our local hospital that I could not pay their bill, and they referred me to a hospital charity set up to deal with cases like mine. This charity took a look at my income and my necessary outlays (car payment, student loan, etc.) and decided to cover 75% of my medical expenses. The remaining 25% was spread out over a few years of monthly payments.

During my gap years, I was always able to access care. Not only did a voluntary organization assist me in the instance described above, but I also had an in-town rheumatologist who charged me a very reasonable "out-of-pocket" rate for office visits and an arrangement with a major pharmaceutical company that ensured I could get a very expensive biologic mailed to my house free of charge.

Fast forward to 2017. Obamacare has helped me pay for an insurance plan, and it's pretty generous on paper. Standard preventative care is fully covered, while specialist co-pays are dirt cheap. Trouble is, I can't see my in-town rheumatologist anymore. Instead, I had to start over with a specialist the next county over, and it's damnably difficult to get a convenient appointment with her because she - and my primaries too - are consistently booked solid. In short, while I am now lavishly insuredaccess is now difficult.

Here's the upshot: When crafting health care policy, we shouldn't worry about insuring everyone. That's not the real issue. The real issue is that some people are having trouble accessing medical care -- and simply roping everyone into a national insurance scheme may not actually solve that problem. Please keep this under consideration while discussing Obamacare and/or its possible replacements. 

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