Health Care Access and Affordability in the US

One of the biggest issues facing the United States economy today is our health care system. Costs have skyrocketed and we have more uninsured people today than ever before. Something must be done soon or many people will die for lack of access to care.

In my family we have had healthcare in the last fifteen years through Kaiser, COBRA, Blue Cross, MediCal, Medicare (for my disabled husband), and Aetna each at various times.

For a long while we had Kaiser's HMO coverage. When we first started with them back in the late 1980s there was a lot of negative press about Kaiser. We saw the good and the bad about their system, but overall I would say the care was good and we were kept healthy. I think most of the negative press was caused by customer service issues with staff and physicians rather than with the HMO model of care itself.

When I left the position that afforded us Kaiser coverage, I elected the option of COBRA coverage. My disabled husband is uninsurable as a private pay consumer and his Medicare did not pay for things like prescription drugs or diabetic supplies. Our COBRA coverage, back in 2001, was $850 each month for our family of four. This did not include our co-payments and also meant driving 300 miles to the nearest Kaiser facility for routine check-ups.

While on COBRA we moved to rural Siskiyou County in the far northern portion of the state of California. Jobs with benefits being hard to find in the area, and trying to live on my husband's Social Security payments of about twenty thousand dollars per year, we swallowed our pride and accepted MediCal coverage for a little while. (MediCal is California's Medicaid program for low income people with little or no assets.)

Being on MediCal was an interesting and eye-opening experience. We accepted the coverage because we we needed access to affordable care. What we found is that we were systemattically treated like we were ungrateful, lazy, unhuman, welfare slobs. I have never felt more like I was being treated like livestock than during that time. I even had both a doctor and pharmacist during that time tell me that if I got a job our lives would improve. Keep in mind that these "professionals" knew nothing about our life or how we came to accept the MediCal coverage in the first place!

Here in our county we only have a couple of providers that will accept MediCal. Because MediCal doesn't pay the providers well, they are forced to book more and more appointments and treat more and more patients each day to make a living. We generally waited hours, even when we had made an appointment ahead of time, and once we got to see the "doctor" it was usually a nurse practitioner who would take a quick look, write you a prescription, and run out of the door as fast as possible. On to the next lazy welfare cow…

After the MediCal coverage I got a job with a local charter school and was covered by Blue Cross. The job didn't pay very well, but they covered $12,000 per year of the premium for our family's healthcare. Our out-of-pocket premium cost was another $150 each month and deductibles and co-payments for office visits and prescription drugs. Blue Cross was good coverage and I always had positive expereineces with the way they paid the bills. No complaints with them at all.

I left the charter school recently and now have coverage through Aetna. My out-of-pocket premium is about $350 per month and our prescription drug co-pays are much higher than they were at the school with Blue Cross. However, my new income is higher and off-sets the difference.

My husband has had Medicare for most of our married life. It has seriously saved us for those times he has been in the hospital or needed medical equipment of some sort or another. The Medicare RX coverage is horrible, and we have so far opted out of it, but Medicare itself has been good for him.

When you have access to good quality healthcare you really don't think about those people who do not. I strongly believe one of the biggest hurdles to health care reform in our country is that our elected officals, and those in corporate power positions, have (and can easily afford) the best insurance coverages out there. They just don't have the motivation to change a system that is working for them.

One of the reforms I would like to see is that all providers be required to accept both Medicaid and Medicare. You should NOT have to go to a crappy clinic or a crappy doctor just because you have a lower-income! To me this is just plain unacceptable. Also, if all physicians had to split the lower income generating Medicaid and Medicare patients it wouldn't be such a drain on those select providers.

Somehow we need to also contain the costs of both coverage as well as prescription drugs. I am not sure what the answers are, but I know this is a topic we need to be talking about and fixing sooner rather than later when people are dying!