What Happened to America's Healthcare?

I am 67 years old and concerned out the future of my healthcare status. My wife and I are on Medicare and enrolled in a Medicare Advantage program. We are pretty much satisfied with the benefits and feel the extra premium is worth the investment. Is this going to change? On one hand you hear the President say that if you like your current plan you will be able to stay with that plan. On the other hand I have heard that the Medicare Advantage programs are going to be gutted or scrapped completely.

One of the hot topics today is healthcare reform. For months the public has been bombarded by proponents and opponents of the healthcare reform bill. As of now, no one really knows what is in the gigantic healthcare bills. HR 3200 is over one thousand pages and contains language that any normal human cannot understand. The Senates bill is just as confusing and vague. What will the final bill be? Who knows?

Recalling the years of my life, I remember when doctors made house calls. When I had Chickenpox Dr. Clark came to our house to check me over and gave me a shot of Penicillin. A day later I broke out in a rash all over my body. They came to the conclusion that I was allergic to Penicillin and I haven't had that antibiotic since. I don't know if I still have that allergy or grew out of it. There were other occasions that I remember that the doctor made a house call but I can't recall the ailment.

My father worked for Gates Rubber Company at the time and the company had a company paid clinic down on South Broadway across the street from the tire manufacturing plant. My parents never complained about the cost or expense of health care. All health care insurance carried was catastrophic events which meant stays in the hospital. Office calls were paid by the patient and there was no such thing as co-pays. My father had a heart attack when I was in the 5^th or 6^th grade. It was mild but they never commented how much that event cost them. In 7^th grade I had an infected kidney and used the Gates Clinic for treatment and my parents never complained about the cost of the treatment.

When I became the age my parents health insurance no longer covered me my mother told me I should get health insurance for myself in case I got sick. I took the responsibility and signed up for health insurance and also took out a small life insurance policy so that if I died un-expectantly my parents would have some money to bury me. At the time this was just hospitalization insurance. Office visits were paid by the patient. I have had health coverage ever since.

All my life I have been blessed with good health. Because of this I cannot recall when the health care industry started to change. In the late seventies I was married and had two sons and the insurance covered these medical events. If I remember correctly the birth was classified has one event and all pre-natal visits and post natal visits were included. In any event I felt the expense I had to pay was not that outstanding. The only expense I personally had was an occasional physical exam and the amount was paid totally by me and insurance was not involved.

When did insurance coverage change? Somewhere along the line co-pay came into existence. It seems that when co-pays appeared healthcare became an issue. All of a sudden healthcare expenses started to skyrocket and the subject became more of a common discussion item. It appeared that insurers became harder to deal with.

I have had my issues with health insurers. In the early nineties my son had a seizure and I dialed 911. The Denver Paramedics came and transported my son to St Anthony ER. A week later I receive a bill from Denver Health and Hospitals for the emergency service and ambulance ride to St. Anthony. I file a claim with my insurer at the time and according to the insurance manual they would pay the provider directly. The following month I receive a past due notice from Denver Health and Hospitals. Contacting the insurer they say payment is in the system and will be paid shortly. The third month Denver Health sends another past due notice and starts to become more aggressive. Again, the insurer is contacted and states that payment will be made shortly. Fourth month comes and Denver Health is demanding their money, stating that the amount will be put up for collection. Since I value my credit standing I pay Denver Health. Contacting the insurer I inform them that I paid the bill and they should just send me the reimbursement directly to me. They said they will. I continued to contact the insurer for about three or four more months and they always had some excuse. I finally gave up. Today I am still waiting for this payment. Do you think I will ever see this money?

Another event happened in the spring of 2005. My wife needed a colonoscopy. Your PCP does not do that kind of procedure therefore he gave us a list of three gastro specialists. Not knowing which one to pick we pick one. The procedure is done and the co-pay is made. Thirty days later we get a bill from the Anesthetist stating that payment was due. Contacting the insurer we were informed that the Anesthetist was not in the network of approved providers and we must pay for it ourselves because of that reason. Here we are in a situation that we did not even know that this Anesthetist was used until after the fact. Who do you blame? This situation did leave a sour taste in my mouth for health insurance companies.

Here it is the fall of 2005, two years from being eligible for Medicare. During an office visit to our PCP I happen to ask the doctor if we can continue with him when we go on Medicare. His response was, "we will discuss it when we become available for Medicare." I didn't really feel comfortable with his answer. On other visits I noticed there were not any seniors in his office waiting for treatment. I became suspicious that when we went on Medicare this doctor will tell us to take a hike. This happened to my wife's mother. When she was in here seventies her doctor told her that he was no longer treating Medicare patients because of the low and slow payments from Medicare and she would have to find a new doctor. That was a situation I wanted to avoid if possible. To help avoid this problem for the year 2006 we changed insurers because the HMO that my employer used did service Medicare patients. At least this way we could get accustomed to a new doctor before going on Medicare and help eliminate the possibility of trying to locate a doctor after we were on Medicare.

This brings us to today. My wife and I are on Medicare and enrolled in a Medicare Advantage program. It serves us satisfactorily. I am happy with our current health care situation. However, this health care reform makes me very concerned on how this reform is going to affect our situation.

I am concerned about the public option because it is a known fact that government run operations have a tendency to not be the most efficient. The Postal Service, Social Security, and Medicare have huge financial problems that are not being addressed. What assurance is there that a public option or government run health care will be any different?

I have never heard any one explain how you can insert 47 million new patients into the current medical system and not create the need for rationing. In the past the waiting time to see a specialist was usually four to six weeks. What will it be when 47 million more get into the same line?

In addition to rationing there is the cost factor. How is this going to be paid for? Proponents say that money will be generated by eliminating the waste in the current system. I am suspicious of that statement. Why can't this so called waste be eliminated now before one sixth of the country's economy is changed to an unproven system? Opponents say that it is going to be paid by higher taxes, taxes on medical equipment such as stents, artificial joints and pacemakers. Others say doctors and hospitals will pay for reform by receiving lower reimbursements for services.

These and other issues make me very concerned about our healthcare situation. In my opinion Congress has not been transparent and they just want us to shut up and accept what they think is best for the country. Sorry, I cannot accept this premise. Many in Congress have forgotten that they work for the voters and the voters can fire them in 2010 and 2012

In conclusion, I have had health insurance all my life and have used it very little. I am very concerned that when I need treatment the most, satisfactory healthcare will not be available to me or my wife. If this concern is not resolved before the 2010 election need I say who I will not vote for?