In the past year, while Congress has debated health insurance reform, millions of Americans have lost their jobs, and with it, their employer-provided health insurance. Millions more have fallen ill and fought with insurance companies over treatments, reimbursements and so-called pre-existing conditions.
The stories below were submitted between December 24, 2009 and today. They reflect the ongoing burden of our broken health care system on working Americans.
What's happened to you in the past year, while Congress debated reform? Have you or a loved one lost a job or insurance? Have you fought with an insurer over receiving necessary treatment? Submit your "year in health care" story to Congress, here.
This first story, from a father in Missouri, illustrates the immediate need for one of the Senate and House bill's key components - mandating coverage of preventative care by insurers.
About 4 years ago, when I was 53, I called my wife's health insurance (I'm self-employed) to inquire about a colonoscopy. My dad died of colon cancer at age 74...I thought I was attempting to do the right thing.
The insurance company...told me my colonoscopy could not be covered. They said the fact my dad had colon cancer, made that a "pre-existing condition" for me. So all of my colonoscopies would be at my expense. No matter how I argued that logic, they stood firm.
Rather than come up with $1,000 for the procedure, I decided the $1,000 for a colonoscopy was better spent on my three sons' education. All three were in a private high school at that time.
How could I challenge the insurance company? I did not want to threaten my wife's job status by making a stink....Clearly, the health insurance industry is using their bottom line, to ration our health care under the rules they create to protect themselves.
This next story from Florida illustrates how insurers delay and ration care, often without any accountability.
I worked my way through college for six years to earn an engineering degree. After working in the field for three years with three different companies...
... I quit engineering to go back to devoting all my time to my own business in arboriculture, [and] I tried to do things right. I paid for health insurance and thought I had a good policy. When I fell out of a tree (my safety rope caught me, but not before falling 10' or so) herniating a disk in my lower back, I needed to see a chiropractor immediately and often. My policy was supposed to cover such treatment. However, the insurance company made it so difficult to get payment to the doctors that I eventually gave up and those good doctors that worked on me never were paid and I had to stop getting treatment well before I should have.
They got out of paying a dime simply by using their typical stalling tactics. You call them to find out the status of the payments and they tell you that you need to fill out a different form or the forms you did fill out were not done properly or they don't even have the forms you sent in or they don't believe the treatment received is related to the accident that should be covered or the accident is not covered or any number of things. They transfer you around on the phone so you have to start at the beginning explaining the situation to a new person every time and you end up spending more time on the phone than if you had just paid for the treatment yourself out of your own pay. These are all typical insurance company tactics and we all know it. Meanwhile, the patient/customer has real dire physical ailments going untreated because the doctors won't work on you anymore because they aren't receiving timely payment.
Now I have degenerative disks in my lower back, my neck, and scoliosis in the middle of my spine because I didn't receive timely treatment and had to keep working on a bad back to pay the bills that never stop coming. I will be in real trouble as I get older because of this.
This next story demonstrates how lifelines like COBRA do not go far enough for the millions of Americans out of work, unable to afford even the most basic coverage.
I am blessed to have full health insurance coverage through my work. Unfortunately, my sister and her family do not. Her husband lost his job over a year ago and has not been able to find work. He is currently enrolled in our state's "back to school to go back to work" program. This means he receives unemployment payments only.
They have two teenage children, who are enrolled in the MI KIDS insurance program. This has proved to be a blessing as my niece suffers from migraines and is able to receive treatment.
However, my sister and brother-in-law have no insurance. They could not afford COBRA payments. [My sister] has...a Parkinson like disease that causes constant tremors...[Her husband] has had...nerve damage in his hip and leg, which has gone untreated because of lack of insurance. They worry every day about getting sick and not being able to go to a doctor. I can't count the times they had a sore throat, ear ache, cough, things that I would call my doctor about and get medicine or at the least his assurance that it was nothing to be concerned about, and they wait it out and hope it's nothing serious. The fact that they have pre-existing conditions is also of great concern, since right now insurance companies could refuse to cover them.
...I think it's shameful that there are so many people in the U. S. that are in similar situations.
SEIU District 1199 WV/KY/OH is also spotlighting member stories underscoring the need to finish healthcare reform right. Read Barbara Montgomery's story here.
