Wednesday, November 14, 2007

Insured, sort of

Ok, with all of the political campaigning going on lately, one of the big issues to stand out of course is health care. 2 elections ago I would have had no clue and probably didn't even think about it, after all I was just out of high school, still covered under my parents health insurance. But this issue is quite significant, not just as a mom to two now, but as a person who has elderly grandparents that may need help some time in the near future. Today it dawned on me how this "issue" is not just something to fight about in congress or to talk about from behind a podium at a campaign stop. This effects people daily in a significant way.

Yesterday, Braydon got a fever, and I let him try to fight it off to see if it was just a 24 hour bug, or if I needed to take him to the doctor. This morning, he woke up and had a fever of 103, so I knew I had to take him. Ugh, I dread going to his pedi for many reasons. You may not know our situation, so I'll try to explain it briefly.

Braydon's biological father is responsible for his health insurance, as a part of our child support agreement. He was in the military full time up until about a year ago, and so Braydon had tri-care health insurance. The only doctor remotely close to us who accept tri-care was a doctor in Tarboro, about 20 minutes east of us. I had no choice, and we made the drive out there whenever he was sick.

As I said, this was up until about a year or so ago, then he got out of the Army, and was in the reserves. He went for a while without insurance, but finally got insurance through UPS, which is where he works now when he's not active duty. Just as his doctor had gotten the insurance figured out through UPS, his father got orders for active duty, which meant they had to switch his insurance to tri-care. This is a huge ordeal, because not only do we have to change it at the doctor, but at the pharmacy as well. It's a major pain in the butt for me, but I put up with it because what else am I supposed to do? Well, after his 3 months of active duty, he went back to his job at UPS, and just recently got the insurance through UPS back again. I've been bugging his father to send me a card for months now, and of course, I have no card to show for it. He swears up & down he mailed it to me, but it must have gotten "lost in the mail".

Ok, well now that I've brought you up to date on the background junk, let me tell you about the day. We arrived at his doctor's office at 9:30 in the morning, just to find out that they can't see him without the insurance card, which is still mysteriously floating in the USPS somewhere. I could pay the $65 fee up front and just let him be seen until we got the insurance paper work filled out, but I've done that so many times before, and have never received any sort of money back. They also mentioned that there was a balance on his account from previous visits that were when he went w/o insurance.

So, here I am, calling the father, who of course doesn't answer even after calling him 15 times in a row. I know that I don't have $65 in my bank account because I don't get my paycheck til Friday. And we didn't have any extra from the last check because we had to replace Kenney's car battery unexpectedly. But I knew that he had to be seen because he's obviously sick. Not only that, but I've wasted all the gas to come all the way to his doctor. I thought maybe I could call my parents to see if they could help me out until Friday, which they would have if I could have gotten ahold of them. On any normal day, my mom is always in her classroom and I can get in touch with her at any time. Same with my dad. But today is anything but normal and my mom wasn't in her room and my dad was in a meeting. I decided just to write a check because he had to be seen, and hopefully I could get my pay check in the bank before they cashed my check from the doctors. After scavenging my purse, I came to the realization that my check books were sitting in front of the computer. I had decided to balance my check book this AM before I left for the drs and had forgotten them.

What would any sane person do in this situation? I'm not exactly sure, as I just broke down in tears. I felt like the worst mother in the world, because my baby is sick, I have no control over the insurance stuff, he won't answer my calls, and I've literally got no way to pay for him to be seen. I seriously felt like the worst mother.

Apparently, the sight of a sobbing, pregnant woman and a sick little boy are pitiful enough to break even the meanest business office worker's heart and she approved us to be seen without the $65 up front fee. She told me if I could send in a payment at the beginning of next week that it would be ok.

Braydon was indeed seen, and had pictures taken of his "bones" *x-rays of his chest* and indeed he again has pneumonia. In the past year, I think he's had pneumonia like 5 times, crazy huh? But on the way home, I began thinking about the people who just didn't have insurance. Or the people that don't have anyone they can call to ask for help to hold them over. What do these people do? More importantly, what do their sick babies do? It makes me sick that we have a country that pays pharm reps a ridiculous amount of money to try to push drugs legally, but we can't even take care of basic needs of many Americans.

So, here I stand, as one American, with one vote, and ask, who can do something to help fix this crisis?

7 comments:

emily said...

a lot of people go to the emergency room. if you don't have insurance, the hospital generally doesn't make you pay.
there are also clinics around that are low-cost. I have been volunteering at a free clinic in Roch that people come to if they don't have insurance.
but yeah, the whole system is pretty much a mess : P

Aprille said...

I would be interested in Rachel's opinion on this since she is in a country with free health care now. There is a lot of discussion about switching to this in the US. I wonder if you have used it much Rachel?

Aprille said...

Have you tried NC Health Choice? Check it out. http://www.dhhs.state.nc.us/dma/cpcont.htm

laurahill said...

hey, i lived in canada for almost 4 yrs with socialized medicine. yeah, it sounds good, BUT it's not all that.. you have to WAIT,(sometimes a VERY LONG TIME) to see a doctor, and you don't just wait a week or two. i had to wait for 5 months to see a doc for a physical!ugh..and when i finally got it, it was so minimal it was a terrible waste of time.
my mother in law(who lives in Canada)waited 9 mo. to see a Specialist after being diagnosed with cancer...
so before you go and long for the "greener grass" of socialized medicine, remember there is always a payoff somewhere.
i'm so sorry you have had such a difficult time with your darling Braydon's insurance situation. sounds like someone needs to get his act together for the sake of that little one...aunt laura

laurahill said...

hey, i lived in canada for almost 4 yrs with socialized medicine. yeah, it sounds good, BUT it's not all that.. you have to WAIT,(sometimes a VERY LONG TIME) to see a doctor, and you don't just wait a week or two. i had to wait for 5 months to see a doc for a physical!ugh..and when i finally got it, it was so minimal it was a terrible waste of time.
my mother in law(who lives in Canada)waited 9 mo. to see a Specialist after being diagnosed with cancer...
so before you go and long for the "greener grass" of socialized medicine, remember there is always a payoff somewhere.
i'm so sorry you have had such a difficult time with your darling Braydon's insurance situation. sounds like someone needs to get his act together for the sake of that little one...aunt laura

Melanie said...

I'd like it if we switched to the system that the UK has. You can use the public health care system, or you can pay for your own. That way everyone has a choice.

Rachel said...

I've always had good experiences with the NHS. BUT - I've never had to use it for myself. It's always been for Noah or for pregnancy, and both of thoe situations provide immediate care with no waiting. I have heard horror storeis from other people though. Lots of incompetant staff (mixing up reslts, giving wrong meds etc), ridiculously long waits, and serious debt. Although the debt thing annoys me because the NHS will pay for sex changes, IVF, and wierd surgeries like hymen replacements for girls before they get married (heard that on the news this morning). So all in all, I'm a huge fan, but it's always been good to me. If I had to have something done for myself though, it might be different.