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Friday, July 01, 2011


Really, Nothing Wrong With Our Health Insurance America!?

I have many friends, family and co workers who think there is nothing wrong with our medical system and insurance. Well I am going to tell you a true story and I want to hear what these people suggest!

Healthcare Background

I have had continuous insurance coverage since I was about 16 years old (never a days lapse). About 8 months ago a I had an issue where my back/shoulder hurt. The pain was so severe that I had to go to the ER on Thanksgiving morning. I went to the doctor and she prescribed some pain meds and such. Later she suggested physical therapy and an MRI. Well the insurance would not approve the MRI so I never could get an accurate diagnostic of what was wrong. But, after a few weeks, the physical therapy seems to have done it's job and I am fine again.

Current Healthcare Situation

I recently decided to start my own business (Sit Means Sit Austin dog training). So I changed over to my wife's insurance through her company. There was one last physical therapy session and I ended up having to pay that out of pocket because it was a preexisting condition (even though insurance coverage never lapsed).

A few months later my wife decided to join our personal business so we had to shop around for our own health insurance. We found a policy we could - barely- afford and completed the application. A couple days later we were approved but told there were riders on the policy that we could review when we got the packet. When we finally got the packet there were different riders in different places in the policy including:
  • They would not cover any work for a bunion I had a doctor look at years ago and have not gone to a doctor for since. Now if it gets worse and I need surgery I am expected to pay that fully out of pocket. Does this make sense? No, but okay fine, that is a particular diagnostic that is easy to see cause and effect on if I do get something done with it in the future.
  • They will not cover any neck or spinal related injury. Please note, it is not that they will not cover a re-occurrence of the previous problem - which would still be unacceptable - but they will cover nothing. If I fall down the stairs, get in a car accident, fall off a curb, anything! Not covered. How shitty is that? Fine, don't cover the bunion but do you seriously expect me to accept an insurance policy that will not cover something so incredibly important such as my spine?
Think abut this. We are in a "recovery" from a recession. People are always saying we can grow because Americans don't stand around; we start our own businesses; we grow them and hire people...But the entire system, not just healthcare" stacks the cards against the entrepreneur!

The Question

What are we supposed to do now? What kind of situation am I risking putting my wife in if I do hurt my back or neck? How is she supposed to pay for it? This is why the preexisting condition loophole needs closed. I am not some person who went without insurance until something happened to me. I have always had insurance!

Really, THINK about this!! Are you always going to keep working for a company that has a group policy? What if you are diagnosed with cancer and have to stop working and get insurance? Yes, you MIGHT be able to get insurance but they either won't cover the cancer or it will be very expensive and you likely won't be able to afford it!

Again, what do you suggest? What did I do wrong? Do I just fall through the system now? Come on people, help make me a believer in the current healthcare system.


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