Sunday 3/22/2015 ~ Impacts of Health Insurance on Health CARE Decisions

     In a perfect world I don’t personally believe that health INSURANCE should have ANY impact on our health CARE choices, yet my reality is quite different from my belief.  The circle of income and/or health insurance vs. health care has been nothing but a viscous and daunting circle for me these past few years.  When I FIRST became ill I remained employed for a number of months and therefore my insurance carried through for a while, and then of course it ended.  With COBRA I certainly could “continue” my insurance but without $800 a month for the premium that was simply not an option.  So then later in 2012 after being without income for a while, I was eligible for NYS Medicaid but of course I made the decision (ultimately a bad one) to return to work, and I was no longer eligible for the Medicaid, and was not eligible at my new employer for six months so I was again without insurance.

     Keep in mind that “Obama-care” was not yet in effect.  So once I became unable to work again due to the illness and the ultimate suicide attempt, I did in fact become eligible for Medicaid again.  I received it for a period of time but then I was approved for disability.  As inaccurate as it is, the state of NY felt that once I began to receive disability that I was now making enough income to afford my own health insurance.  Anyone with a lick of common sense combined with even limited knowledge of 1.The Cost of living in the state of N.Y.  2.The amount of disability income one normally receives and 3.The general cost of health insurance ~ knows that my ability to “afford” health insurance was a joke.

    By this time though Obama-care was in fact coming into effect, and I was told to go to the NYS of health marketplace to obtain health insurance.  Keeping in mind that I am ill ENOUGH to be on disability the reality is that to live without health insurance is just not realistic, so off I went to the marketplace.  When I first went to the marketplace at the end of 2013 the beginning of 2014 it was not “such a bad deal” for me.  My “disability” was received for a short enough amount of time, and I had not worked and had no income for several months prior to that; so the “help” I received was enough to allow me to get a “halfway decent” plan.  Granted it was a real blow that because my doctors and motility clinic were in the state of Ct. and I live in N.Y. I would not be able to continue seeing them, but hey at least I “could” get health insurance.  (Of note that I live directly on the Ct. border, literally less than a mile away to the state line.)  So I did, and honestly the help I received due to my months of being penniless helped make it “affordable”.  Once again I “changed insurance”, and changed doctors and once again for the fifth time in three years my “health insurance” and income (or lack thereof) rather than my actual “health” dictated my course of treatment.  

     I was not pleased about this, but by this time I had come to terms with the fact that this ENTIRE process was not going to be an easy road to travel so I kind of “sucked it up” and made the best of an ongoing bad situation.  That would not be the LAST time that this would happen to me though.  In January of 2015 I had to “re-up” on the NYS of Health Marketplace, and choose an insurance for the “new year”, that would be this year.  My disappointment came when I realized that now that I had a “full year” of disability income that NYS and the “Marketplace” would once again decide that I could afford to pay a MUCH larger portion of my health insurance premiums.  My “assistance” in paying the premium dropped to almost nothing and my ability to actually make a CHOICE about my health insurance, and therefore my health CARE was once again going to be impacted by the almighty dollar.

     So as of January of this year I was forced because of the financial aspect to choose yet “another” health plan, the “worst one on the list”.  I don’t say “worst” because of any ill will towards the company, but what I mean is that I now had to choose the lowest premium plan which means the highest deductible and 50% co-insurance.  For me to choose a plan that actually offers some real level of coverage I would have to pay between $ 400 and $ 800 a month in premiums, and that is simply not even a consideration.  Seems like it’s almost “not worth it” but really what if I end up in the hospital ~ I HAVE to have it, and the “law” now says I HAVE to have it.  So what am I to do?  I took the plan that offers the “least” coverage because that allowed me the “lowest” possible premium, which considering I now “earn” less than 1/6 of what I earned when I was able to work is really no “gift”.  I now have a six THOUSAND dollar deductible, which I obviously cannot afford to pay, along with a monthly premium, AND I have to pay 50% of everything AFTER that deductible and the premium are met and paid.  Needless to say I literally cannot AFFORD to go to the doctor at this time.  

     In November I do believe I become eligible for Medicare in conjunction with my disability (the waiting period is 24-months); and so I am LITERALLY paying the premium on this sham policy to be able to say “I have health insurance”, and I am doing my BEST not to use it because I cannot afford either the deductible nor the 50% co-insurance after that first six thousand dollars.  I have “good days” and I have “bad days”, I’m sorry to say that of late the bad days have far outnumbered the good ones.  In the last six weeks I’ve spent better than 80% of the time sick enough to be vomiting, in pain, unable to eat and just in bed crying or wishing I’d just die if this is going to continue.  **DISCLAIMER ~ no I’m not suicidal, I neither want nor plan to end my life over this but I feel justified in my frustration and depression over being forced to live this way. Gastroparesis is difficult to live with when you ARE able to freely seek and obtain the limited treatments that are available, to have to live like this just suffering with no options but to continue suffering is not easy and my quality of life at the moment sucks.

     Yes it’s both realistic and fair to say that my CONDITION is not the fault of Obama-care or our system, my illness is not the fault of either of those things.  However I believe that it is also fair to say that my lack of treatment and my shitty quality of life at the moment is 100% impacted by Obama-care and the system.  At the moment I’m trying hard not to dwell on that though and I’m just sucking it up and saying, well only 8 more months; if I can “manage” like this as horrible as it is for just 8 more months then I can get help again.  In the meantime I’m just praying that I don’t get ill enough to require another hospital stay, that my tube does not get infected, that I don’t have an issue with my tube and that I’m able to “maintain” enough nutrition and hydration to just stay home and muddle my way through it.

     On the whole I’m not a terribly “political” person; and I’m aware that so many who work feel that Obama-care is a “hand-out” to the lazy and unfit people of the world.  If I were to be 100% honest I’d have to say that had this not happened to me and I were still able to go to work every day it’s most likely that I’d be one of those people.  Perspective is such a great learning tool though isn’t it?  For me Obama-care is as much of a “curse” as it is to the working stiff who feels as if they are “paying the way for the unfit”.  It has dictated my health care choices, and dictated my LACK of health care over and over again.  I did not follow the entire development of it because I am in fact NOT a political champion one way or another.  I can tell you that though I think the “concept” may have had it roots in good faith efforts to make “health care affordable”, the REALITY of what is out there is anything BUT affordable though.  I guess the one thing that helps keep me sane is that I’ve joined a few support groups and I realize now that it’s not “just me” there are THOUSANDS out there in my SAME exact boat.  With the gastroparesis which by itself it a painful and horrifying oddity to deal with, but that also have their lack of health care dictated by the system.  There are also thousands more with other ailments, illness and diseases who suffer much the same fate at the hands of the government and finance and I think it’s disgraceful.

    I looked briefly on line for the presidents income, and the list I found showed numbers from 2001 as $ 400,000, with a $ 50,000 non-taxable expense account, and another $10,000 expense account.  I guess in my mind when I combine that with no rent and the “all expenses paid” kind of living, I can understand how they might think their plan has a legitimate value.  If just received the non-taxable expense account and didn’t have to pay rent or electric or buy food, I’d be more than able and happy to pay the premiums required for decent healthcare under the whole Obamacare plan.  The reality is that I barely come to his taxable expense account amount, and I do have to pay for housing, heat, transportation etc. etc. etc.  I swear I wish he could come live my life, with my sickness and my income for ONE month and then ask him to look me in the eye and tell me that he feels he’s “made a difference” with the entire health insurance thing.  I know that’s unfair, I know that it’s not “just him”, it’s not a personal attack because I am in fact not political and I am very much about seeing “both sides of the coin”.  

    As I sit here nauseous in my sixth straight week of pain and full blown sickness from my condition and without any real and affordable access to help or actual “health care” I have to tell you though I’m jaded.  I’m disgusted by the fact that we are one of the “premier” societies in the world and yet we are so far off base on not just this but on SO MANY things, it’s embarrassing to think that “this is our best”.  Again, I don’t have any personal ill-will towards the current president, the “system” was intact long before his arrival and will remain so long after his departure.  I’m not political, and I do not follow nor generally engage in political discussions.  In this particular instance though the pain and suffering is on such a personal level for me that it’s become less of “something out there” and more of “something that is real and has significant impact on my life”.  My heart breaks for those that are so much worse off than myself, though on my worst days when I’m in my bed for 24 or more hours, crying and sick and in pain my heart breaks for myself too.  I think it’s shameful that in our “forward” world here in the United States that we continue to allow people to live this way and go on television in our thousand dollar suits and spill politically correct bullshit and smile for the camera, I find it honestly just disgraceful.  That’s my two-cents on “Obama-care” and the current state of the health of our nation and it’s health care “system” as it were.  


2 thoughts on “Sunday 3/22/2015 ~ Impacts of Health Insurance on Health CARE Decisions

  1. When the plan was first introduced I expected to see something more in line with Canada’s health care system. It was later that I realized that the plan was just a way to increase profits for the Insurance companies as everyone has to have a plan. Very disappointed.


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