Gotta Have It ...

Yesterday I signed us up for new health insurance. I HATE doing this. I think I would stick around with bad insurance just so I didn't have to go through the process of having to sign up for something new, even if it would benefit us in some way. I hate the process so much. And before I get ten thousand "Obamacare sucks!" comments on this I should point out that the process was a nightmare way before the new healthcare law was passed. The system was just as bad for us ... just a different sort of bad. I want to just write down a few of my thoughts about my own personal experience, but it isn't meant to be any sort of springboard for political rantings where people throw out the political talking points that have been hand fed to us by either side of the debate. Life is not always so black and white. Healthcare is complicated, and so is healthcare insurance. Things aren't going to be solved with a few cute political memes on facebook poking fun at the other side of the argument. (Please. I love you all so much. It hurts my heart to see so much hatred thrown out in the digital world when politics is involved. Be kind to others, even when you disagree.) There are valid points all the way around. I just want to share my own personal experience. So here goes ...

In the early years of our marriage we were blessed with AMAZING health insurance. Herman worked as a telemarketer for MCI (remember that long distance phone company?), and they offered wonderful benefits to their employees at the time. So even though Herman was working part time while he was in college we were able to have insurance that covered maternity care and our basic needs for little expense. It was a huge blessing. After graduating from college Herman began teaching at WHS, and we received great health insurance as well. It wasn't quite the killer deal that we had at MCI because only Herman's coverage was paid by the district. We ate up a good chunk of our paycheck adding coverage for the kids and me. Still, it was good insurance, and it was worth the expense. We didn't have to worry about choosing the coverage or mediating problems with insurance payments for services because the district had a dedicated employee who mediated for us. Nice. I didn't give much thought to our health insurance. I was just grateful that it existed.

All that changed when Herman decided to leave the district after ten years in order to start his own business. Suddenly we were not under the umbrella of a large employer. We were the employers. Our business was tiny with few employees. We hadn't made any real money yet. But I would not go without insurance, no matter what. For the first time in my life I needed to find my own health insurance options. And, oh my!, what a nightmare it was!! The process still gives me little nightmares sometimes when I remember it. We had to fill out GIANT applications that asked super detailed questions about every single health event of the past ten years for every single member of our family. They had to pull medical records from every doctor we had ever seen. Luckily, our family was complete (well, other than our Minsy adoption) so we wouldn't need maternity care. I don't know what we would have done then because there were no maternity plans available that I could see that wouldn't involve a GIGANTIC increase in premiums. For the added expense we could have paid for our own hospital deliveries of two or three babies, I think.

I became a huge wrench in the process because I had several grand mal seizures after Spencer was born and was diagnosed with epilepsy (a great story for another day, but it involved the scariest wake up call ever as I awoke suddenly at 2 am to see Herman and two paramedics staring down at me in concern. Freaky!). Anyway, because of my epilepsy diagnoses no one would cover me. I was not taking any medication. I didn't see a specialist at all. The seizures were not happening at all. There was no extra cost for me to the insurance company, but I posed a risk, so no one would cover me. We ended up signing up the rest of the family on a plan while I used the COBRA option available to keep the school insurance for six months while I tried to find a solution. For awhile it looked like I would need to latch onto the state high risk insurance pool ... which cost a fortune. I understand why, but still, yikes!!!  That didn't look too appealing. Finally I found one insurance company that was willing to cover me if I would opt out of receiving any reimbursements for things relating to epilepsy. I took it. In the meantime I went to get another EEG for some reason. I think that I was convinced that my epilepsy was gone since it had been so many years since I had a seizure. This is another one of those stories for another day, but I believe I experienced a true healing miracle. I really do. Because when I went to get this final EEG there was absolutely no trace of the epilepsy at all. No trace. My neurologist was amazed. I was given a clean bill of health. All was wonderful in Blauland ... but I still struggled to get insurance. Urg!

Long story short ... our family was covered. We kept our health insurance all these years, even in the year or two when our first business began to really struggle and we weren't getting paid much, we kept our health insurance. It is important to me that our family is covered in case of something catastrophic, so I found a way to make those payments, no matter what. The cost per month was staggering. Absolutely staggering. Our family really doesn't have a lot of medical problems these days. We were definitely a money maker for our insurance company, but I don't mind so much because I wanted to have the piece of mind, knowing that we had some sort of recourse if something horrible happened.

But insurance life was not all puppies and roses for us. At first we decided to go without dental insurance since our dentist didn't accept any private insurance out there that was not attached to some large group plan. We figured we would just pay cash for our visits. No big deal. We could handle it. But I would get so upset each time we got our bill and saw what we were being charged for routine checkups. You know, large insurance groups work out payment agreements with doctors, hospitals, and dentists. The providers charge a gigantic amount on paper. The insurance companies say, "No.We'll pay this smaller amount." The provider says, okay. And everything is hunky dory ... sort of. That's the way the system works. I get the feeling that neither side is totally happy with it, but that is what it is. The people who really get the bum deal in this system are the people paying cash because we don't get the discounted rate even though we are totally eliminating the middle man. We pay directly ... no paperwork, no arbitration. We're paying cash. And yet we had to pay the inflated cost that the insurance companies wouldn't pay. Frustrating. We finally left our dentist, even though we liked him a lot, and headed to a different office where they would accept private insurance, and we found a plan that at least allows us to have the negotiated lower price. I'd love to just pay cash each time, but it didn't make any financial sense.

I would look at our healthcare system as it was ... is ... and think how ridiculously inefficient it is when it comes to how things are billed and paid for. We had the opportunity to go to a luncheon at Phelps County Memorial Hospital in Rolla held for a few community leaders about five years ago. I'm not sure how we got on that list for invites, but we showed up. The hospital administrator talked about the struggles they had with providing services and receiving reimbursement for those services, whether it was from Medicaid and Medicare, private insurance, or non-paying uninsured patients. She made it sound as if the hospital was in dire financial straits. Maybe it was. I don't know. I know that I have heard the same story from insurance companies and doctors groups and every other medical entity out there. I know friends who did not carry insurance and then found themselves in a difficult health situation that required lots of expensive care and medicine. Did they get care and medicine? Yes. And I'm grateful for it. But they did not end up paying for it. Every other patient at those facilities did through increased costs. But I also know friends who do have insurance. They've paid their premiums faithfully for years, only to find that when they really, truly need the insurance, their insurance company covers little of the cost of care, leaving them with thousands and thousands of dollars of expenses that deplete their years of savings and send them into bankruptcy. Do you want to read an article about the cost of healthcare that is really depressing/infuriating? Check out this excellent article from Time Magazine (just click on the magazine cover, and it'll take you to the full article):

Or you can watch this great video from John Green. I like him, but I know his mannerisms drive some people (like Savannah) crazy, but if you can get past that he does offer a good explanation of how wonky our system is, whether you totally agree with absolutely everything he says:

The whole system is a mess. It has been a mess. It continues to be a mess.

But I have to have my health insurance. I refuse to go without. And that takes us to yesterday ...

I had one giant concern about the new healthcare law. A giant concern. I felt as if the insurance companies and their moneyed lobbyists wrote the thing to benefit themselves. That would not end up being a good thing. Not at all. I already have a giant load of distrust when it comes to health insurance companies, and I didn't think that altruism was the reason that those companies exist. They exist to make money. Lots of money. And now it seemed as if they were getting ready to cash out. I was worried.

Up to this year we noticed no real difference in our insurance. We kept the same insurance with the same benefits. The monthly cost went up every year by a lot, but that was happening before the law anyway. We started out paying about $600 a month for our insurance, and by last year it was closer to $900. Like I say, we don't use the insurance all that much, so it was like opening up our wallet and burning the cash in some ways, but we were covered, and that was important to me. But over the summer we got a notice saying that our insurance did not meet the new standards for the law, and we were being dropped. We needed to get a new plan. First of all, after looking at the available plans we were offered there is absolutely no difference at all in coverage for some of the plans. There didn't really seem to be anything that would have required the insurance company to drop the plan we had ... except the new plan with exactly the same benefits was now about $500 a month more expensive. Convenient, huh? And the REALLY cool thing that the insurance company gets to do now? They just tell me that they HAVE to do this because of the new healthcare law. It's not their fault, right? It's Obama's fault. See, that way they can deflect any criticism that might come their way and just tell us that we should just blame the government. They get to get their money, and instead of being angry at them, we'll be angry at the government. It's the perfect plan. Genius really. Maniacal laugh. Maniacal laugh. Maniacal laugh. (You've seen the new Muppet Movie, right?)

So anyway, yesterday was the last day we could sign up for new health insurance coverage so that there wouldn't be a gap in our coverage. I looked at ehealhcare.com for some comparison plans, and then I headed over to the healthcare.gov website. It's the much maligned site that had the disastrous beginning last year, and hopefully was going to be a positive experience for me. I was hoping for the best, but wary.

First of all ... the positives:

• It was super easy to sign up for coverage. No more extensive heath histories with contact info for every single doctor who has ever wiped our nose. Even with our giant family I was able to fill out the form in about fifteen minutes. Easy and intuitive. It made sense what I needed to do.
• The phone help line was very helpful. The screen did lock up on me at two different times in the process, so there are still some kinks. But when I called up the toll free help line they were able to walk me through the process and get me to the next step fairly easily. You can tell that they are used to getting angry calls because both times the assistants were apologizing constantly for every single thing (over apologizing really) and when the call was over I was sure that they were going to name their firstborn girls after me since they were so effusive in their thanks for the patience I showed during the call. Those poor people and what they must deal with in healthcare.gov customer service. I'll bet it isn't pretty.
• The entire process really takes very little time. I took a lot of time because I really combed through the different plans and what they covered, but even with that it didn't take more than a few hours. When we got our private insurance a few years ago the process took more than a month with stacks and stacks of paperwork and interviews along with doctor statements.

Now, the negatives ...

• The new health plans available are seem to be awesome if you fall under the income levels where the costs are subsidized in some way. That probably is the majority of Americans. Those subsidized plans are good plans at great costs. Unfortunately (or fortunately, I guess) our income was too high to qualify for those subsidies. We basically were having to just shop the regular market ... a market that seems to have way fewer good choices than before. Choosing to use a HSA as we do actually seemed to give us even fewer options. Ugh! What did we choose with our options? We chose a plan that actually is slightly less than our old plan, but it has a crazy high deductible with no coverage for office visits or routine care until that deductible is met. It really is an awful plan, but it should take care of us if something terrible happens ... hopefully. In addition, we are generally not big users of healthcare, so we're hoping that we don't ever get close to that deductible limit, and our Health Savings Account (which I LOVE) will cover the basics. I just hope we are paying a negotiated rate and not the crazy high rates. We'll see. 
• I guess the other big con is that I still feel as if we are totally removed from any real freedom when it comes to our healthcare choices. I feel like the insurance companies are still in charge, for the most part. I wish there were some way that everything was smaller, more local, more personal. I love my doctor. I trust her. And when things get more complicated, I trust the specialists we visit. They know me. I know them. We could work something out that rewards them for their education, expertise, and experience while keeping my family and me healthy and strong. I know we could. I hate having to deal with the nameless, faceless people out there who are making healthcare decisions based on balance sheets and data collection. I hate having healthcare discussed by television and radio talking heads who make LOTS of money by freaking us out about everything, talking in soundbites, and relaying political talking points from both sides without actually talking about the complicated real life situations that people in the real world are facing. 

But anyway ... this ended up being super long, didn't it? I sure didn't start out meaning to go on for so long about things. I generally try to avoid putting negative posts on my blog. They aren't uplifting, and if there is a choice, shouldn't we be uplifting if we can? Too many people use social media to just rant and complain about things, and nothing positive comes from it. Problems aren't solved that way. And I guess there aren't any problems that will be solved by this post either, will they? I don't know what the solution is. I don't have any answers. What I know is that things are more complicated than our modern media promotes. The new healthcare law is not the most amazing and wonderful thing ever to come out of Congress, but it is also not complete evil and disaster. It is complicated, and our soundbite government (all sides) hates to deal with complicated. 

So anyway, I'd prefer not to get angry rants in the comment section. Direct any angry letters directly to the office of your particular government representatives. They are the people (in theory) who are in a real position to affect policy directly. This is just my own personal experience and my own personal thoughts, not meant to be an indictment of any particular political feelings or leanings. 

So, to end on a good note ... we have our health insurance. We are healthy. We have a great doctor who knows us and loves us. Life is good! And when all else fails ... just dance. It makes everything just a little bit happier.