Hmmmm healthcare reform.
This is something that's been brewing a blog within me for quite awhile... Keep in mind, this is my blog so it's my opinion. Like it or not, this is what this mama thinks about the whole situation! I worked in the healthcare industry for several years. My niche was geriatrics. Those of you that think the system isn't broke, it doesn't need fixed, there's nothing wrong with it, etc etc well I think you're wrong & here's a few examples why...
Pre-Existing Conditions...
My family is drenched with pre-existing conditions, which is why this is a biggie with healthcare for me. The new healthcare bill will make it "illegal" for ins companies to deny coverage for people with pre-existing conditions. Not for 4 more years for adults, but still. Even then, however, it's still a slippery slope full of loops I'm sure. I do plan on reading more about this in the bill before the end of the day, I hope!
Three examples of pre-existing conditions just that are close to home. I could think of beyond SEVERAL more examples but we'll all get the drift and all know someone who's had a pre-existing condition. If not, go ask someone & I'm sure they can fill you in...
My mom. My mom is one of the most dedicated, hard working, selfless people I know. She's busted her butt for 25+ years as a well awarded teacher in this country. She deserves a golden halo when she's called home because all but two of those years have been spent teaching special ed. My niche was helping the elderly, hers was helping the most special of the big guys angels. Unfortunatly she's a walking billboard for pre-existing conditions. My mom didn't choose to get rheumatic fever when she was very young. She didn't choose to spend months upon months a full days very expensive train ride away from her family nearly two states away. But she did get rheumatic fever. That rheumatic fever is the suspected cause for her mitral valve prolapse. That resulted in mitral valve replacement surgery 20 or so years ago. It's also caused a miriad of other heart related issues for her. She's had a few small strokes. She's had her blood so thin that she'd lost so much blood unbeknownst to her, her doctor was wondering how it was she was even still walking let alone alive. Even through all this my mom still taught every single day. She was there by 715 at the latest and never left before 530 or 6 unless one of us drug her home. Thanks to all of these issues, plus knee replacement, plus ankle surgery, and other things she's a classic "pre-existing condition" case study. My dad's health insurance was MUCH better than hers when he started his job, but his ins denied her coverage because she had pre-existing conditions. She stuck with her school districts coverage which is still pretty good. A lot of hoops for basics but still. It's insurance. Now my mom is considering retiring early due to health reasons. No retiree benefits if you retire early. We've called nearly every insurance company known to man to see if she can get insurance through them, and they've all denied her a policy. The only company that would give her one wanted nearly $1500 a month in premiums plus all the bs $$$$$.
So now mom has to choose... work for another 4 years, hoping she makes it that long, so that the new healthcare initiave will cover her maybe, or bite it in the butt & work another 11 so that medicare will cover what her retiree benefits won't cover...
My dad. Due to where he worked 20+ years ago, in a betonite plant, his insurance company wanted to consider that a pre-existing condition when they were initially enrolling him. They said that an environment like that is just a medical claim waiting to happen. After a week of testing, finding him oober healthy, they finally approved him. He was on "medical probation" for the first 2 years but he still had insurance. He was, afterall, a healthy guy other than his weight and a few other typical, as you get older, ailments. However, they did throw a microscopic clause in there that if he were to get some type of illness that might be potentially be related to his work with the betonite, that all claims have the potential to be denied. Guess when we found out about this little addition... when my dad found out he had cancer. The first 6 mo. of treatments were all denied by his insurance company because he might have gotten melanoma from esposure to betonite. WTF?!?! That first 6 months alone nearly bankrupted my parents. They nearly lost their home, everything. All because of what some jackass behind a desk deemed a pre-existing condition. And then, after we thought it was gone and it came back the second time, the insurance company actually had the gall to tell him they were going to drop him. Finally, after 3 leading oncologists from Mayo clinic sent numerous letters to the ins company stating that his prior working conditions had nothing to do with his being stricken with melanoma, they finally started to cover his cancer treatments. It was all in vain however, but a lot of lessons were learned from that experience.
Me. I might by far be the most rediculous of the three cases of "pre-existing conditions" LOL My prior blog explained our ins woes. Well, here's why I'm not on his insurance. I'm considered to have a "pre-existing condition". Do you know what my pec is? Any guesses? Well, it's the fact that I'm of child bearing age, had two kiddos and a third on the way. Yep, with that company it's actually a pec to be a mom. It would nearly double our premiums. All for being a mom. Seriously?!?! WTF So we had to make the choice, line the silk pockets of the insurance gods or pay the occasional $120-$200 for a dr. visit for me. We decided that being a mama aka pec soooo wasn't worth the extra amount taken out of the paychecks every month. After all, that would've left us with only a thousand or so to pay all of our bills, and possibly less those months where there are three paydays.
So, my question on pec's is... Who gets to decide what a pec is? Why does it vary from company to company? Why is something you were born with allowed to curse you or your family for years to come? Why is something completely out of your control a reason to deny you the ability to get insurance? Anyone have the answer for that? Anyone???
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