Health Insurance Navigator

By Lisa Zamosky

Last week I wrote about a recent poll conducted by NPR, the Robert Wood Johnson Foundation, and the Harvard School of Public Health, which highlights how illness often goes hand-in-hand with big money trouble. It also found that people who deal with ongoing illness aren’t all that happy with the quality of medical care they receive.

In response to that post, many of you left comments and stories about your own experiences dealing with illness within the U.S. health care system, which I felt important to acknowledge and share.

High Cost, Poor Care

One reader spoke of a hip replacement gone awry. She talked of getting test after test (for which, she notes, doctors are repeatedly paid), along with medication, but no substantive follow-up treatment to relieve her pain, and no acknowledgement on the part of her doctor, she says, that her surgery hadn’t gone well. After three years, despite having health insurance, she says she’s spent $20,000 of her own money.

Another man wrote about his long-time back problems that have caused him to lose his business and live on disability and food stamps. He describes his efforts to purchase disability insurance to protect his income years earlier, to no avail. But perhaps most difficult to read is his description of a health care system that leaves him feeling as though he’s to blame for his condition. “You get sick, they take everything you have and then you get blamed in the end for doing something wrong. They have no idea how ruthless this system is,” he says. “It’s like being sentenced to hell. After all the work I put in to live the American dream this is what I get in return. Now I live below the poverty level,” he says.

Another reader living with a number of chronic illnesses expressed gratitude for her full-time job, health insurance, and a flexible spending account that helps her cover some of her out-of-pocket medical costs. Still, however, she’s left to pay over $3,000 each year in co-payments for her care, and she describes her financial situation as “precarious.”  She goes on: “I currently have a mountain of credit card debt…it never ends.”

Yet another woman in her 70s says even with Medicare and her husband’s employer retiree health plan she’s been forced to file for bankruptcy several times as a direct result of her medical costs. And she complains of the poor quality health care she’s received. “I am not getting adequate treatment due to a lack of money AND the disinterest of doctors,” she says.

Another reader describes himself as having a “Cadillac Plan,” the kind of health care coverage most of us associate with the promise of good medical care and financial security. Yet, he writes about out-of-pocket expenses that run him well over $10,000 a year to manage a serious chronic illness. “Co-pays, deductibles, etc. don’t count against the $3,000 max out-of-pocket limit. You never realize what your cost is until it’s too late,” he laments.

Us Against Money

Although everyone’s medical and life situation is different, a common thread is woven throughout each of the comments: The perception of a medical and health insurance system in this country that is all about the money and too little about the patient. Insurers are often seen as nothing more than deniers of care collecting a high monthly payment, and doctors were called out repeatedly in readers’ comments for denying their own medical errors, protecting other doctors who make mistakes, and treating patients with the primary goal of generating the greatest amount of money.

Whatever your personal experience with the health care system, there’s no denying that many people in this country who face chronic illness are overwhelmed by medical expenses and often unhappy with the quality of care they receive.

Big Month Ahead

We’re now in the month of June. Within the next few weeks, the Supreme Court will issue a ruling on whether or not the Affordable Care Act (a.k.a. health reform or Obamacare) will remain the law of the land. One of the law’s biggest promises is to make health insurance coverage available to most Americans. Measures to protect consumers against health insurance abuses and to alter the way medicine is practiced so that better care is delivered and costs are better controlled are also included in the law. The future of health reform is currently in question. If it stands, so too is whether it will be successful in all it sets out to accomplish.

We have no way of knowing at this time which way the Supreme Court will rule. But I’m interested to know how you feel about the upcoming decision by the United States’ highest court. Are you optimistic that health reform can help with the high cost and poor quality many people in this country face when accessing medical treatment? Will the stories of readers like those of the Health Insurance Navigator become fewer? If the law is overturned, where do you think that will leave us?

Please share your thoughts in the comments section below.

And for an entertaining take on one person’s perspective of health insurance and the health reform law, check out this Kaiser Health News cartoon, An Open Letter to the Supreme Court About Health Insurance by freelance artist, Jen Sorenson.