Thursday, August 13, 2009

Health Care Stories: Western Mass.

Paula gives us her assessment of rural care in the only state of the Union that requires everybody has health coverage.

Although we each certainly tried our best to burn out at a young age, my husband and I believe we are healthier than many of our contemporaries. He’s 69 and I’m 65. So far, so good. Aside from some predictable conditions that accompany normal aging, we’re fine and hope to keep it that way for a long, long time.

That said, I don’t resent paying for health care. Like most worker bees, I paid for insurance throughout my working days and well into semi-retirement. While I worked for a newspaper, I paid anywhere from 10 to 25 percent of my insurance premium. Later, as a freelancer, I bought my own policy for $615 a month for a mid-level HMO plan, purchased at a discount through a business association. Without group rates, I probably would have paid closer to $900 for an individual policy. That’s per month.
When I was young, single, and had an employer subsidizing my health insurance, I lived near New York City, an area blessed with an abundance of medical resources. There must have been a dozen hospitals in my county alone, and specialists were plentiful. Coincidentally, I was treated for one of each on the menu of all those things you-hope-you never-get. In every single case, I sought out the best medical care available, no matter where it was or what the cost. I had no fear of my insurer not coming up with the goods.

Now, I’m older, married, and self-employed, living in a much poorer, rural area. We each pay about $220 for a combination of Medicare and Medicare supplement, which includes prescription drugs. Compared to what we paid before we qualified for Medicare, it’s a pittance. Plus, under Medicare, our co-pays are smaller. Life is good.

Considering my unhealthy youth, I’m thrilled to say that, at 65, I’m relatively fit and healthy. A hearty thank you to all the docs who’ve treated me over the years, and to the health care plans that paid them.

It’s no exaggeration when I say I owe my current healthy state to good doctoring, prevention, and a strong dose of fear. A couple of scares in my early 50s forced me to get my body under control. Now, the only pills I take on a regular basis are vitamins and occasional OTC pain medication for arthritis.

In this household, we adhere to the Mediterranean diet as much as possible, and we’ve been buying the bulk of our food from local farmers for years. That’s an accident of location, not a political statement. Maybe the best thing my husband and I do for ourselves is spend a few mornings a week at the local YMCA, fending off old age.
In spite of relative good health, my biggest concern involves lack of resources. Where we live, there’s only one hospital (and ER) per county, and that one doesn’t offer a high level of care. Most towns have volunteer ambulance corps. If you think you might want to switch primary care physicians, think again because it’s hard to find one willing to take on a new patient. People often travel 40 miles or more to see a specialist, and they may wait for months for an appointment. That's just the way it is, because there are so few docs and so many old people. You have to work hard to stay healthy, and that's probably a good thing. (According to the obits, many people around here live well into their 80s and 90s. Could be the cold weather, or just the hard life.)

It’s my understanding that Medicare and our Blue Cross/Blue Shield supplement will cover our care at a high-level medical center – Massachusetts General Hospital, for example – if it's necessary and our primary care physician refers us. We’ll see.
I should add that the doctors we do have here out in the hinterlands are accessible, well-trained, and devoted to their patients. They’d have to be, because they work long hours and receive much lower compensation than they would if they practiced near a big city.

Western Massachusetts

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1 comment:

mjd said...

Bill, this is a fascinating series of stories you are running! Thanks for the information.

I happen to know a guy whose brother died waiting for a new heart valve. He's a Scot, for what it's worth, and his brother waited for seven months for the valve replacement and then died while still on the list. This single incident probably would have been different in the US - but I recognize that it is a single isolated incident and can't be used as a reference for the whole system.