Sunday, August 30, 2009

At Least 52 Million Americans Have No Healthcare ... I Am Just One Person Who Truly Needs the Public Option. NOW.

I am an RN of 20+ Years. I have worked to take care of hundreds, maybe even more. I have never ever refused anyone care for anything, I have worked it all from community health, to AIDS to ER to hospice ... home care to hospital care. I took an Oath to care for people, to deny No One Care and to do No Harm.

As a Nurse I have always tried to teach others to be proactive and take good care of themselves. I never thought I would be UnInsured or not able to have access to care I need. I have been Uninsured since 2006, this is my story of why and how it happened ... and it is personal, and I am sharing it because it matters ... it is Reality. It is a Reality for me and 52 Million other Americans. Below is merely a piece of my Healthcare-Less story...

In 2005 I went through a Divorce, and therefore needed to find Insurance on my own as a single mom. My son still did and does have coverage, and that was my top priority. I set off to find a job that would offer benefits and also to find Health Insurance. The Cheapest Single Payer plan I could find was $480/month. I contacted more than 14 companies, and only ONE would take me. I was denied coverage by 6 of them for having MVP (Mitral Valve Prolapse-a simple heart valve deformity that millions of Americans have and it is a structural issue).

That was the beginning of seeing the dimensions of the ability of Insurance Companies to deny care. I called the Insurance Company and learned that many conditions are Exclusion-worthy. It was a long list. Even someone being ordered for an EKG or an Echo or other test that indicates Heart Monitoring would have people be cancelled.

Doctors cannot properly monitor for Heart Disease without restrictions and being overpowered by the Insurance Companies. So people with Insurance could also be cancelled at any time for a test or X-ray being ordered, without warning or notice. What bothers me about this process is that Insurance companies don't have to follow or abide by any HIPAA laws, they can do demand access to your Health History and records BEFORE they agree to accept you. It is like a Club that does not have to follow ANY laws ?

(By the way-that is just part of the Heart Story ... but it was the beginning of learning about being Denied care ... I do have valve issues, BUT the bigger picture is that I take good care of myself, I walk everyday, use a treadmill, and don't smoke or drink ... I am proactive, but no one ever asked me that. Bottom line: someone with an enlarged heart and valve issues SHOULD have Monitoring and Regular Screening, ie EKGs, etc.)

So that was the beginning of the struggle. Finally, after many months, I found a company that would cover me, and I was willing to pay the $480/month until I could get a job with benefits. So I paid for the insurance for 3 months, then I went to get my first Breast exam in many years, thinking I was going for a routine mammogram.

I got there, and there was a lump--actually a cyst the size of a small plum. Ultrasounds were done, and the cyst was aspirated ( 9 cc's...). And I was sent to a follow-up to a Breast Expert. He was very thorough. He did a History, he asked about my family. I explained that my grandmom had died of Breast Cancer and Lung Cancer. I also explained because he encouraged me, that before I had gotten pregnant with my son, I had had the BRCA test when I lived in another state. He asked me to try to get those records, so I did, and could not--they were archived or lost by the Institution. So he did what any doctor would do and ordered the important blood work be redone. It is important for monitoring and screening for breast cancer. I asked him not to. I told him when it was ordered that it would cause me Insurance Problems. He said it was worth the risk.

So within weeks, I was Cancelled for not providing a FULL Medical History, and ALL of the care for the Breast Appointments I had to cover myself, over $1500.

Now it is 3 years later. I am underemployed, with 3 part-time jobs. The One job that is not even a Nurse job is at a market. I took it because I was told that, within a year, I could be Eligible for Health Insurance.

NOW for the Truth, the Market Job will review my situation at one year and submit my name and start paying in. But that is a Probation period, and THEN the Actual Plan review is Not Until Spring 2010 (though I have worked there since 2008). And then, at that time, I can and still could potentially be denied, even after paying in during the Probation period.

The Nursing work here is all part-time or per diem with NO Access to ANY coverage--so that is my ONLY Option. (The Hospitals here have a hiring Freeze or only are hiring per diem or part-time, if at all, and this has been the case since 2007).

So here is where it gets very interesting.

For the past year I have been battling 98% of the Symptoms of MS. Thankfully, my Brain is fine and working at its usual speed. BUT my muscles are failing, and I am losing strength and coordination. I have constant pain and muscle spasms and stiffness and my gait is effected. I have NO meds for this. I have received some free medical "advice" and guidance about what I "need", (which vitamins and supplements to try).

I need a Neurologist, but cannot find one, single one that is willing to take me Without Insurance. I have contacted all the right people and organizations. I even found one group willing to donate a $2,000 MRI for me, but without a doctor or someone to offer me care, it is a meaningless gift.

MS means that, for work, I get up 3 hours early so that I can get "Unstiff" . I do have a Doc in the Box I go to when I am desperate for care, but I cannot go there for this. I have only been there this year when the Recalled Cookie Dough left me so sick and dehydrated, but I had to pay out of pocket for everything.

Another time, when I needed antibiotics for a respiratory infection, I ordered Fish Antibiotics from a Pet Company. And this winter I had a stress fracture in my foot. I used Duct tape to treat it. And, about the Breast Cancer Risks and History, there was never a follow-up or another test done. I did try to get care at the Free Clinic and was denied because they are not taking ANY new patients. Other low-income clinics would not take me without Insurance or MediCaid. I am out of Options.

So there is a Piece of my Medical Story ... Beyond Broken ... and I am just one of 52 Million that has such a Story ... I am one of 52 Million Americans that Needs a Public Option ... Now.

This piece was originally posted at Enigma4Ever's blog, Watergate Summer. Check it out.

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