President Obama’s health care reform law has made my life better. Of course, it wasn’t just him. But he seems to be taking most of the unconstructive criticism for it. So, I hope, we can also give credit where credit is due.
I have been self-ensured for a long time, out of necessity. Self-employed, I had a “pre-existing condition,” depression, so the best deal I could get was $160 a month, from Care First.
Every 6 months or so, I got a letter saying my premium was going up, so when the health care reform law passed, I was paying $220 a month.
And getting nothing.
It was a supremely frustrating situation, especially since I’m generally very conscientious about money. I like to think of myself as a responsible consumer. But I had a friend in similar circumstances and he decided to go without health insurance when his COBRA ran out, and promptly developed gastroenteritis and now owes the hospital hundreds of thousands of dollars.
So I paid the premium and I learned to keep my mouth shut. Evidently health care existed in the same alternate reality inhabited by Comcast and Verizon. It was going to suck, it just was. You don't really have a choice.
At least, I didn't. See, I deal directly with the health insurance company.
And they don't answer the phone.
Say, for example, that, oh, I don’t know, your gynecologist moves his office to Vienna, Virginia. You don’t have a car but you do have a job and you’re going to have to take a personal day to get your annual exam.
You search the Web site for a DC-based gynocologist who is covered and can’t find one. They are all in Virginia or Maryland, miles away on the Metro. This appears to be a new development. Again, you have a job. AND you’re paying $220 a month. It has to be a glitch.
So, hypothetically, before you take a sick day and voyage to Vienna, you decide to call the health insurance company and find out what the glitch is. And let’s say you, oh, for example, sit on hold for 45 minutes and then get “transferred to somebody who knows the answer,” only to wait 45 more minutes before somebody else picks up and says, “Care First, how can I help you?”
I don't know what you would do, but I eventually gave up. It was part of the parallel universe in which "9 a.m. to 4 p.m." is a "service window." Fighting it was a waste of time and energy. I went to Planned Parenthood (a few blocks from my office) for my exam and paid for it myself.
So let's say this sort of “glitch” arises fairly regularly and you can’t call to ask questions because you have PTSD.
Around the time the health care reform law was being debated in Congress, I finally went to the dentist for a (long overdue) annual cleaning.
But first they looked me up and said I didn’t have dental. I assured them I did, in fact, have dental, that there was a line on my bill each month that said "Dental" and "$10." I called the insurance company and waited on hold for 15 minutes before the receptionist said, “Ma’am, do you still want the appointment?”
For the cleaning, check up with an actual dentist, and x-rays, $435.
You think you would take a stand or do something, but you know what will happen if you call. Just like you know what happens if the technician doesn't show up in the given service window -- you take another day off and wait for him again.
I said to hold the x-rays and the dentist and arranged to pay the rest in installments.
Just two months later, I was charged $430 for one of my prescriptions. It must have been “the straw,” because I did not pay the money. I went back to my office and called Care First. One of the janitors, leaving the building, was surprised to see me in the hall. “I thought you left for the day,” he said.
“I have to call Care First,” I told him.
“God help you,” he said.
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