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Donna Smith

Donna Smith, American SiCKO, is executive director of the Health Care for All Colorado Foundation

January 31st, 2014 1:00 PM

Yes, I am Thankful for My Insurance Even as I Fight for Single-Payer

Single Payer health care, SiCKO, Medicare for all, health reform

It was the day after Christmas when I fell ill. Just five days before I was due to change insurance policies from the $875/month COBRA/Aetna coverage I had to the new $456/month Kaiser plan I selected from the Connect for Health Colorado exchange site. The Affordable Care Act (with its insurance exchanges) is not what I want in terms of reform of our dysfunctional health system as I am fighting for single-payer, improved and expanded Medicare for all for life. But even as I continue the struggle to reach that goal, I must have access to health care when I need it -- and this was clearly one of those times.

Making the selection of the Kaiser plan and getting myself signed up was no small effort as glitches made it horribly difficult and delayed. But as my fever and other symptoms got worse, I knew I had paid my January premium for Kaiser and that things should be ready to go in terms of the coverage.

If I had stayed on the other plan, not only would my monthly premiums have continued to make it hard to pay our other bills, but the deductible was going to reset and make me immediately responsible for the first $2,500-$3,000 in medical costs. I was not only feeling really sick but also worried and stressed about the financial issues and about securing a new doctor right away should I need one.

Well, by January 2, I was really, really sick. Days of fever interrupted by drenching night sweats and horrible nausea showed no sign of abating. I was so fatigued that even thinking had become difficult. I couldn't work at all. And that meant I had no income and no sick leave. When I first felt ill on the day after Christmas, I hoped it was just some sort of bug that would pass in a few days. But everything seemed to be going in the wrong direction. I grew sicker every day. Sicker and weaker. I had to call someone to help me. My husband wanted me to go to the emergency room when my fever soared to 103.4 degrees, but I was resistant. I knew that in a few hours if I could hang on, the sweating would come, and the fever would break -- at least for a few hours.

I called Kaiser in desperation. I needed help. They told me they had not received my enrollment data from the exchange, but that did not stop them from setting up an appointment for me to see a Kaiser doctor right away. And over the next several days and weeks, Kaiser handled me like I had never been handled before in terms of the continuity of care and moving me through clinic, in-patient hospitalization for a week, and then home with medication and medical equipment -- all done without the proper enrollment data coming from the Colorado ACA exchange. I was flabbergasted. They cared for me though I was new to them and though they had no idea -- except from my word and printed copies of the pages I used to sign up on the exchange -- of the level of coverage I had or even the deductibles/co-pays. They never asked me for a dime. even as they dispensed my medications from the Kaiser pharmacy, they told me, "Don't worry. Things will get ironed out on the enrollment and financial side. We'll send a bill if you owe us anything, and then we can talk about it."

In all my times struggling with the dysfunctional US health care system, no one had ever told me not to worry about the money -- not in 40 years. And I know this is the way a single-payer system would function in an even more humane way. Under a single-payer, there would never be that bill coming. But for now, I am so grateful that I was able to sign up for my new plan. I think if I had stayed on my COBRA plan, I would have resisted going to the doctor at all, and my life might have been in jeopardy.

Now, the diagnostic process is still underway. I have more scans coming up next week and tests are on-going as my symptoms are still there. But at least I have medications and oxygen to make me feel better while we figure out if this is a recurrence of cancer as the doctors suspect and some tests are pointing towards or some other serious problem. I am grateful. I am very grateful.

I will fight on for single-payer, and because I am not quite as stressed about my own access to care, I may even fight on more effectively and with more confidence. To be given care without financial barrier and as a human right is clearly a better way to go than any insurance, market-based, for-profit model. In the meantime, thanks to all who have helped me through this illness.
_________________________

January 31, 2014 -- Today's count of the health care dead and broke for profit in the U.S.:

The 2014, to date, U.S. medical-financial-
industrial -complex system dead: 3,813
The 2014, to date, U.S. health care system bankrupt: 61,318

** These figures are calculated based on the Harvard University studies on excess deaths in the U.S. due to lack of insurance coverage or the ability to pay for needed health care, and the Harvard University study that calculated the high percentage of personal bankruptcies attributable to medical crisis and debt in the U.S. 123 people die daily due to lack of coverage or cash to pay for care; 1,978 go bankrupt every day due to medical crisis and debt though the majority had insurance at the time their illness or injury occurred. This statistic is also based on the 1.2 million bankruptcies in the U.S. in 2012, according to the U.S. Bankruptcy Court, and calculating those medically-related bankruptcies from that number.http://www.healthcareforallcolorado.org/endorse_right_to_health_care

Follow Donna "American SiCKO" Smith's bog: http://donnasicko.blogspot.com/

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