Tuesday, August 11, 2009

Health Coverage Mulling Exercise

I'm taking the Challenge that Justine put forth over at Justine's Housewreck today.

I'm supposed to list five things I like about my health coverage, and then five things i hate about my health coverage. Mine; not someone else's. Which is tough, because I have really, really wonderful health coverage through my husband's former employer. Which is going away in April. And so I am about to embark on changing health coverage for me and Mr. Bean and the Bug. I can't get coverage for Daisy Mae yet, as she remains a ward of the state for another six months or so and is covered by Medicaid. I add her on later.

So why is this hard? 1) Because I have nearly perfect health coverage. I mean, seriously. 2) I have $20 co-pays for routine office visits, which is very manageable. 3) I have $5 or $10 prescriptions. 4) I have vision and dental that is good enough that I get my teeth cleaned and whatever else they need twice a year and I usually don't pay much of anything, unless I make a cosmetic choice. 5) I get new glasses every other year, for about $50 a shot.

All the things I hate have to do with the fact that nobody else I know has coverage like this. I feel like this plan -- my plan -- is right and good and that every American needs to have something just as good. We don't need to be able to get everything at the drop of a hat, and we don't need it all for free. Some reasonable co-pay is OK and some reasonable waiting time is OK, and new glasses once every two years is often enough. And I actually think it's OK, that, if everyone has free basic coverage, that those who can afford it can buy supplemental coverage. Just because public education is free to all doesn't mean we have outlawed private schools. This is no different. So with that in mind:

1) I hate that I have friends, like Justine, who -- even with health coverage -- have thousands of dollars in out-of-pocket expenses. 2) I hate that there are good, hard-working people in this country who can't afford health coverage and don't qualify for Medicaid and so they just pray they don't get sick. Or they fake indigence and take cash-only jobs, so they can be on Medicaid. 3) I hate that we've designed hospital systems that won't pay for a midwife to deliver a low-risk pregnancy and give the mother 5 days in a birthing center, so instead we put new mothers in the hospital so they can have their delivery covered, but then boot them out on the street 24 hours later. And it ends up costing both the insurance and the family more than the midwife/birthing center option. 4) I hate that our current system discourages providers and payers from actually TALKING to each other, so it takes months or years to resolve billing issues. and 5) I hate that we have a payer system that believe that mental health is somehow less important or less expensive than "physical" health.

What about you? What do you think, when you take Justine's advice and mull it over a bit? What five things to you love about the coverage you currently have? And what five things just stick in your craw the worst about your coverage?

Be healthy.

1 comment:

Lisse said...

Well, I have this in spades...

I love that I have coverage from my husband's employer. I am one of those "pre-existing condition" people who would be in trouble if I tried to get insurance independently.

I love my Drs. - my PCP and the specialist I see once or twice a year.

I love that I don't have to get a referral to see said specialist once or twice a year.

I don't love, but I can live with, my $25 copay. And I love that one of the therapists we saw in the neuropsych/therapy process my kids went through reminded me that they are tax deductible if you choose to itemize, which we do.

I hate that they are so stingy about the boys mental health evaluations and therapists.

I hate the fact that I had two tests from my specialist that I paid a few hundred bucks for 10 years ago and this time I got smacked with a $7000 bill after the insurance company paid their share.

Why are these things so expensive?