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I y'all indulge me for a moment, I'll give you the story I was going to give at the Town Hall about how the current system is broken and how it allows too much to fall through the cracks. I know some of you already know this.
I work, as a matter of fact I work two jobs. I've always had employer healthcare plans and have never had any real issues with any of them. In 2000, my wife, who at that time suspected something was wrong, was tested and diagnosed with Huntington's Disease. Her father and sister had also had and died from the same disease. As her physical and mental conditions grew worse, she gave up driving and filed for disability with Social Security. She was approved after a yearlong waiting period in 2002.
A few years ago a new drug was made available after clinical trials had shown it to be an effective treatment for the chorea (uncontrolled movement) so her Neurologist wrote a prescription for it. Since it had not yet been FDA approved, we had to order it directly from the European manufacturer via a Canadian drug company. I was paying full-price ($1200 per 90-day supply) out-of-pocket but I was willing to do so. It received FDA approval this year, so now it's covered by my insurance.
As the condition has progressed, it became clear that she would need more and more direct assistance with her ADL's (Activities of Daily Living), so I first started looking into in-home care options. All of these are, of course, paid for out-of-pocket. No healthcare plan covers those types of costs. As we needed them more and more, and as consequently my out-of-pocket expenses kept growing, I started to look for other alternatives. My options came down to four:
- continue with the home healthcare.
- quit work and become a full-time caregiver.
- have her placed into a Nursing Home.
- have her placed into Assisted Living.
For a while, I received approval to work from home, so I was able to continue with the first option for those times when I did have to report to the office. Quitting my job and foregoing benefits, salary, 401K and pension never seemed like a good idea, so I've never considered it further.
Within the last year her condition has detereorated to the point that I knew she would start needing full-time round-the-clock monitoring and assistance. I tried the Nursing Homes first, since some of then will accept payment from Medicare and/or Medicaid. However, with a backlog of available beds in the 7-10 year range, I had to move on to the other option, Assisted Living. I was able to locate a room for her at a facility in Concord, and she moved in mid-January. She has done very well there and I couldn't be happier with the outcome.
Of course, for those of you who know, Assisted Living is private pay only, so I've been paying for her room and board since January. The rate per month is pretty much all of our combined income per month. I have very little left over to pay for my living expenses.
So, as it stands today, the house is heading toward foreclosure. I've lost one car to reposession and I'm barely hanging on to the other. I've not been able to pay anything toward the mortgage, taxes, and any outstanding debt this year. Of course my credit is in the toilet.
With the second job, I've added enough additional income to help cover my costs for food and gas, as well as her non-covered healthcare costs, although the downside is that I'm at work from 2 AM to 6 PM every weekday, and from 2 AM to 6 or 7 AM on the weekends.
I don't honestly know how I can sustain this, but I have no choice. I'm 46, she's 45, and there's no federal or state agency, no charity, no national association (like AARP) that I can turn to for aid.
....Also with government run healthcare, something called incentive disappears. Why do better if profit is no objective? (look at the Post Office, public education, government housing)
There is also something called competiton. This means that two or more parties act independently to offer a service to a third party. To gain an advantage, the competitors in the market have an incentive (see above) offer a lower cost, and/or better service. The fact is government run healthcare (single payer, as desired) would eliminate competition, therefore raising cost, and leave no incentive to provide more or better service..
How is this competition thing you speak of, working for the airline industry? Seems to me people are paying more, getting a lot less and putting up with a huge amount of aggravation these days.
On your first point you contradict yourself. If competition works as you say it does then how can the private options go away? They should be able to beat the government. This is why we have private universities thriving next to state funded ones. UNC sits right next door to Duke as an example.
With Medicare your analysis doe not apply. The government simply says it will pay X amount for a certain service in order to be reimbursable by Medicare. A Doctor, clinic or hospital does not have to take the business if they don't want it under these terms as they don't force it. In addition the people are free to have the doctor do the procedure and and pay the difference if they choose to do so. I don't see the issue here.
There is no health care reform proposal out there that says all medical care will be supplied on a completely free basis.
I don't honestly know how I can sustain this, but I have no choice. I'm 46, she's 45, and there's no federal or state agency, no charity, no national association (like AARP) that I can turn to for aid.
I am so sorry to read that this is happening to you and your wife. Your entire story illustrates those good folks who are falling between the cracks.
Each year 700,000 people declare bankruptcies due to medical costs in this country, yet in England and many other countries the tally is zero. This is patently wrong in such a rich country as ours.
Have you tried calling our two senators, Kay Hagan and Richard Burr along with your representative? It's always worth a try. Does the nursing home offer any suggestions?
I will admit that I do not know enough about the health care proposals to have an intelligent debate with anyone. However, I find it amusing when people say they would rather have a for-profit corporation make decisions about their health instead of the government. I have worked in both private and public sectors and I have no doubt a government plan would do more to benefit the patient whereas a private company has the legal duty to act in the best interest of shareholders.
Thank you, Frank! My experience with health insurance is that the insurance company comes between me and my doctor, and I'm sure my experience does not differ wildly from other peoples'. So it confounds me when people exclaim that they don't want some entity (guv'mint) coming between them and their doctors. As if it isn't already happening.
I y'all indulge me for a moment, I'll give you the story I was going to give at the Town Hall about how the current system is broken and how it allows too much to fall through the cracks. I know some of you already know this.
[snip]
I don't honestly know how I can sustain this, but I have no choice. I'm 46, she's 45, and there's no federal or state agency, no charity, no national association (like AARP) that I can turn to for aid.
Oh my goodness, SuperK! You are in my thoughts and prayers. How can this be in "the greatest country in the world"?
I am so sorry to read that this is happening to you and your wife. Your entire story illustrates those good folks who are falling between the cracks.
Each year 700,000 people declare bankruptcies due to medical costs in this country, yet in England and many other countries the tally is zero. This is patently wrong in such a rich country as ours.
Have you tried calling our two senators, Kay Hagan and Richard Burr along with your representative? It's always worth a try. Does the nursing home offer any suggestions?
You are in my thoughts as you cope with this...
Lori
Lori is correct - a Harvard study done in 2008 found that 62% of personal bankruptcies filed in 2007 were due to medical bills. " ... And in a finding that surprised even the researchers, 78% of those filers had medical insurance at the start of their illness, including 60.3% who had private coverage, not Medicare or Medicaid. ..."
If you are middle class and insured, you are one serious illness away from bankruptcy. And if you are uninsured, good luck.
Lori is correct - a Harvard study done in 2008 found that 62% of personal bankruptcies filed in 2007 were due to medical bills. " ... And in a finding that surprised even the researchers, 78% of those filers had medical insurance at the start of their illness, including 60.3% who had private coverage, not Medicare or Medicaid. ..."
If you are middle class and insured, you are one serious illness away from bankruptcy. And if you are uninsured, good luck.
And what is so awful . . . hospitals and physicians can be very predatory about recovering those funds. NOT that I am advocating skipping out on money owed to physicians and/or hospitals!
Even if you have decent insurance, illnesses that are not even "catastrophic" or chronic can end up costing a lot of money out of pocket. Hubby and I are dealing with that right now. And the bills just keep coming. By the time this is over for 2009 (only for this year - have no idea about next year) . . . our out of pocket expenses at this point represent about 22% of salary. By December, who knows how much that figure will be. Even with savings, there is no way most families can easily deal with medical expenses like that, especially if they are recurring.
Today's Charlotte Observer had an opinion piece on Rep. Sue Myrick's town hall meetings. It's good to see some validation for what I saw on Thursday night. Here's the link for those who are interested:
Today's Charlotte Observer had an opinion piece on Rep. Sue Myrick's town hall meetings. It's good to see some validation for what I saw on Thursday night. Here's the link for those who are interested:
Thank you for posting this! I have written Kay Hagan today and asked her to get with it and do some town halls, instead of having the small conversations and discussions she has been having with small groups. Also asked her, and Burr, to do some together. It may (or may not) be uncomfortable for her, but she needs to get out there! IMO the Town Halls become one sided and political - when they should be as factual as can be.
Maybe we need another kind of presentation? Something like a Town Hall equivalent of Factcheck.org??
And what is so awful . . . hospitals and physicians can be very predatory about recovering those funds. NOT that I am advocating skipping out on money owed to physicians and/or hospitals!
Even if you have decent insurance, illnesses that are not even "catastrophic" or chronic can end up costing a lot of money out of pocket. Hubby and I are dealing with that right now. And the bills just keep coming. By the time this is over for 2009 (only for this year - have no idea about next year) . . . our out of pocket expenses at this point represent about 22% of salary. By December, who knows how much that figure will be. Even with savings, there is no way most families can easily deal with medical expenses like that, especially if they are recurring.
Oh, Ani, that is huge! Are you very careful to ask for the detailed bills, and scrutinize them? I read a couple of articles about easy it is, due to coding error (most of the time it's not purposely fraud), for you to be charged twice for a service or supply, or for a service to accidentally be "upcoded". The Coding and Billing courses I've been taking come in handy to help me understand how the errors can happen. I'm thinking there's a future in helping citizens decipher their bills and challenge ridiculous charges (?)
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