Let's discuss the cost of insurance, Medicare, and healthcare as a whole.. Every year the price consumers pay seems to go up and up, in a manner that can cause financial hardship. Personally, I have no problem with the fact that I have to pay for my healthcare and insurance because that’s just a part of life. What I do have a problem with is the fact that the costs are getting so out of hand. We are at a point that the cost is becoming astronomical. The fact that there are people who are on Medicare or Medicaid who have to choose between medication/treatment or food it ridiculous. There should NEVER be a time where anyone has to make a choice between life saving medication/treatments or food. Why, when we are living in one of the most powerful countries in the world, are our citizens dealing with these issues?
Sadly over the last few years it has become a normal thing for people in the US not to have insurance or be able to seek medical attention because they can’t afford it. I would even go out on a limb to say that most everyone reading this knows of someone who has medical issues that have not been treated because they simply can’t afford the cost. For most healthy people the rising cost probably isn’t that big of an issue because they don’t often use their benefits. That being said it’s not usually the healthy people who are having the most problems affording healthcare. In most cases it is pregnant women, young children, the elderly and the chronically ill who are the ones having problems affording healthcare. Which is problematic because these groups are usually the ones who need to be able to get affordable insurance and healthcare. However, affordable insurance/healthcare isn’t easily found. Several years back a law went into place in the US saying that all Americans had to have insurance or they would be subject to a fine come tax times. However, affordable is a relative term and for many the policies offered under this act were not affordable. So the government made an exception and said that those with low income have the option to turn down said coverage without facing the aforementioned fine. How backwards is this? A program was put into place to help Americans get the necessary healthcare and yet we are still have large numbers of people who are unable to afford it.
For me personally, I have paid more in premiums, co-pays and medication co-pays already in 2019 then I did in all of 2018, since I was awarded my disability and forced to go on Medicare. Let me give you a little background info that I was not aware of until last December. Once you are awarded disability by the government you have to be on Medicare. There is no other option. Trust me, I tried every way possible to defer my Medicare benefits and continue with my carrier from last year. But this is not allowed. If you defer your Medicare benefits you would also be deferring your disability benefits. So in reality being on disability is really a double edged sword that many don’t talk about. Yes, you finally get a monthly income, but, you have to pay out the ear in Medicare costs. The costs might not be a problem for someone who doesn’t have MULTIPLE chronic illnesses that require prescription medication and multiple follow-up appointments. But for me, my monthly premiums, co-pays and medication costs are at least a THIRD of what I make monthly. For someone with a spouse or who lives in a homes with a second income this might not be an issue. But for single moms, those who are not married(like me), or those who have no second income to live off it is HARD! It is hard to live off the amount you get monthly and pay for your healthcare costs. I honestly have no idea how the elderly can afford to live once they are on Medicare. I don’t tell you this to gain sympathy or any such thing. I tell you this because chances are you were like me and HAD NO IDEA the costs of Medicare until I was required to take part.
It seems like at least once a week I hear from a friend (mostly those who are also chronically ill) whose insurance has decided that they can no longer get a medication they need. I also hear many times a month that the insurance company deemed a test or procedure that was ordered to follow disease progression to be unnecessary and will not cover it. I understand that these companies have to try to keep medical costs down in any way they can. One of those ways is to prevent people from having testing they may not really need. The more unnecessary costs are approved the higher the cost of insurance will go. That being said, in my opinion an insurance company should never be the final decision on a person’s medical care. If a doctor orders a test or medication that the person needs the person should be able to get it without a major fight
Being an RN I see things a little different than most patients. During my career I did the best I could to explain to patients why insurance companies denied certain treatments. While also encouraging them to work with the insurance companies to find possible work- arounds. But I can’t, and won’t stand behind these big insurance companies deciding to play GOD. There is only one GOD and I'm pretty sure he's not in the insurance business. Often times the insurance companies won’t ask the ordering physician any follow-up questions to help them the decide if another mode of diagnosis or another option for medication is possible. They just decide that the order will be DENIED!! This insurance issue is getting out of control for everyone, especially for people with chronic illnesses. We are always going to require more medication, more testing and more procedures, it's just the name of the game. I don't feel like these big corporations want to take time to figure out what is better for the patient. They just care about what is best for their companies pocketbook!!
In closing, I have to say that I am truly concerned about the way healthcare in the United States is going! I am also concerned with the trends we are seeing in regards to higher more unaffordable insurance and prescription costs. In my opinion healthcare was heading in much more positive direction a few years ago when the Affordable Care Act was put into place and US citizens were required to carry health insurance. The key word there is AFFORDABLE!! While that system had its definite flaws, it was working toward making health insurance available AND affordable for all. Now it seems that healthcare is heading the opposite direction, a really negative direction. Those of us who have to have insurance should not have to sell my first born, my right kidney, and my great toe to get affordable healthcare. Nor should we have to decide if we will get our medication or eat this month! I am sure there has to be a better way to deal with the rising cost of healthcare other than how it is being dealt with!
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