Normally, I avoid discussions on the healthcare system and insurance system in the United States, but I would like to share a story related to healthcare with everyone here because it's a type of story that nobody hears about or talks about when they talk about how the United States healthcare system works or doesn't work.
So.
I'm in my 30s.
For all of my life, I have had a genetic blood disorder that makes me chronically fatigued. Though the body adapts and adjusts on its own, it doesn't take away the fact that fatigue can become a chronic and life-invasive problem, iron overload can end up crippling organs like the pancreas and liver and heart over time, and that in times of sickness, blood transfusions may be needed... which in turn accelerates the body's need for chelation - to remove the excess iron before iron damage is accelerated as well.
Through my father, I had great health insurance and I - and my family - took 'good insurance' for granted... up until the time I went to university.
At the time, health insurance from parents only extended to students IF AND ONLY IF they were full time students... and not all health insurance policies did this. My father's policy did this... as a 'courtesy'.
At that time also, if you were a student, and you had parents, and unless you were working full time to the tune of being able to fully 100% support yourself, you were considered a dependent and any and all government-related applications took into account your family/the people who the government assumed would help to support you.
This applied to FAFSA... and this also applied to things like government-subsidized/funded healthcare plans and systems.
Well, as life happens, I got hellishly sick, and ended up being withdrawn from school by my own university's medical clinic and I was also forced to quit my part-time job and move back home with family.
Desperately sick with mononucleosis while having a genetic blood disorder that already predisposed me towards extreme fatigue and blood-related issues including an enlarged spleen which only got dangerously worse with mono, I lost my health insurance.
No big deal, right? Just buy another policy.
WRONG.
Remember what I said about the pre-existing condition? The genetic blood disorder?
It automatically made me ineligible to purchase ANY individual policies and because the GROUP insurance dropped me and not because my father lost his job or some such, I was ALSO ineligible for COBRA.
Before the ACA, you got your policy one of five ways:
1) Through work.
2) Through individual policies THAT REQUIRE PRE-SCREENING AND UNDERWRITING WHICH DENIES PEOPLE WITH PRE-EXISTING CONDITIONS THE RIGHT TO PURCHASE A POLICY.
3) Through COBRA - IF you remembered to sign up for COBRA at the loss of your job AND it was limited to only a certain amount of time AND it cost 150% percent MORE than the premium once did at full price without company pay-in.
4) And once THAT exhausted... you could get a HIPAA policy... which cost just as much and was more often than not a horrible 'catastrophic' policy.
5) Through the government.
Oh! So then I should have gotten government-subsidized insurance, right?
ALSO WRONG.
My state had government-subsidized healthcare policies at the time that tied in with the federal government's, but because my family wasn't COMPLETELY IMPOVERISHED and because even though I had lost my job, lost my schooling, and was struggling with severe illness on top of a severe flareup of a pre-existing genetic condition, I WASN'T PREGNANT and so I didn't qualify.
Oh! Then disability!
AGAIN, WRONG.
Because I didn't have an 'automatic disability', I was put through the 'alternative' qualifying system and because I was in my early to mid-twenties and though I had worked part-time, I hadn't worked enough hours accumulated to qualify and my condition - though 'a struggle' wasn't 'so bad I needed disability'.
And so for a year and a half until I was able to return to school, I - along with my family who helped - was forced to foot 100% of any and all uninsured medical bills that piled up and that included hospital bills, ambulance bills, and diagnostics bills.
I liquidated any and all savings and went into medical debt by the thousands all in one shot. I went bankrupt without going bankrupt and would live for the next several years on credit.
My bills that I couldn't pay totaled to over 20% of my parents' yearly income (the government thinks med bills ought not total to more than 10% of a year's wages - HA!) and my parents still had a minor who was dependent-dependent on them and mortage payments to pay.
And we weren't done. Far from done.
Eventually, things improved enough for me to return to school and go back to work... but not enough to school fulltime and not enough to work fulltime and not enough to get on the company's policy which only extended insurance at the time to fulltimers, and during this time, my father's insurance policy changed... to include adult children who were students up until they are age 25.
My parents begged my father's HR department to reconsider my situation and eventually, I was put back on the policy regardless of my schooling status as I was deemed 'an adult child who has a disability' by my father's HR and benefits department.
So until I was 25, I had my father's insurance plan again and in the meanwhile, I struggled to finish school and struggled to hold down a job and.
After being so sick for so long, it was hell on earth to do either and a few years later, the GI problems started in the worst of ways like they are wont to do... and RIGHT as my 25th birthday passed and my insurance policy had dropped and RIGHT when I was out of town.
Because of the pre-existing blood disorder, I should have been hospitalized because I was vomiting and having explosive diarrhea that wouldn't quit while also being blown up with bloating like a bullfrog and in so much pain I was cold sweating and had a high fever that wouldn't go down... but I wasn't.
We were still paying off all the OTHER &%$#ing stupid medical bills from before that I refused to go to the ER.
If I were to go, I would be billed TENS of thousands, and even if I was already bankrupt (which I was, AND STILL IN DEBT from previous medical) and even if I was working part-time to help support myself (I WAS until that episode)... I would not (and did not, I tried) to qualify for aid of any sort and neither would my family.
So I didn't go and I sat in a hotel's bathtub of cold water with the shower running to keep my fever down and lunged for the toilet to either vomit or have diarrhea or both and I did this for 12 hours until finally, nothing else could possibly come up of substance and I was able to stand a drive back home.
Going back to the insurance issue, I was dropped owing to age, but since it wasn't like last time where I was 'faulted' for causing my policy to drop, my father was able to buy COBRA... at 150% the 100% premium cost.
Again, because my family wasn't destitute and because I lived with them, I was denied any kind of government-subsidized policies or programs and again, because of a pre-existing condition, I was denied access to any individual policies, and again, because I hadn't qualified in my working hours, I didn't qualify for disability.
COBRA was my one and only and very expensive option and I was on COBRA for 3 years - the maximum the policies allow - and after that, I went on a HIPAA plan... where I stayed until the ACA began.
During the COBRA years and beyond, I WENT BROKE, BROKE, AND MORE BROKE, lost jobs because of illness, forced myself to work again despite being sick because I needed to pay for my illness, and got sick, got sick, got sick.
My parents footed my insurance policy because it would otherwise cost me 50%+ of my year's wages and they refused to charge me rent even though I volunteered to pay a little... and I paid for everything else with what I could earn.
When the ACA came around, ONE OF THE MOST IMPORTANT THINGS IT DID THAT THE INSURANCE COMPANIES COULD HAVE DONE SOONER BUT NEVER DID BECAUSE THEY WOULD LOSE MONEY OTHERWISE was remove the %$#@ed pre-existing conditions clause that ended up blacklisting people who had pre-existing conditions from buying health insurance.
Don't blame the ACA.
Blame the fact that insurance companies were allowed to cherry pick and do underwriting and legally discriminate against people who have health disorders that they can't be faulted for.
Blame the fact that because of how insurance works and because of how a broken welfare system works, hospitals and doctors are allowed to and are sometimes forced to hyperinflate the costs of medical care.
There's this assumption that everyone was covered 'just fine' before the ACA went into effect and that's just wrong.
If you had fulltime work or was married to someone who could get a company policy, then you were covered.
If you were 100% HEALTHY or you LIED on the health screening, you could get cheap 'THIS IS ONLY FOR HEALTHY PEOPLE' insurance.
If you were pregnant, destitute, someone who had no ID or social security number because you were not of this country, you could get 'you deserve government aid' insurance and other financial aid.
But if you were a citizen, had a pre-existing condition, was trying to earn wages, was being helped by struggling parents of the disappearing middle class, and NOT pregnant, fat chance.
God, I can still remember the person who helped me at the local government office who joked about me being automatically approved for services if only I were pregnant.
With the ACA - and NO it is NOT perfect - for the first time in my ADULT LIFE, I could apply for individual insurance that didn't depend on my health status or my work status and YES, EVEN THOUGH IT IS NOT CHEAP, it's still CHEAPER than the alternative (COBRA, HIPAA) and better than NOT having anything at all (paying 100% out of pocket) and better than sitting in a hotel bathroom and bathtub in freezing cold water with a high fever while having diarrhea and vomiting and crippling pain.
Everyone's angry about the ACA but the reality of the situation is, I think most people never truly understood the cost of medical care and health insurance in the United States to BEGIN with.
Healthy people got away with paying $50 a month regardless of their socioeconomic status.
Desperately sick people who were denied individual policies and denied government-sponsored care because they weren't drop-dead destitute (or pregnant) but were constantly drowning in medical debt were paying 100-150+% that amount and I was -YOUNG- at the time.
How everyone else got their 'cheap' insurance was because the costs were being footed 100% by those who were sick and those whom the insurance companies could gouge money from... like myself and my parents.
The idea of aborting fetuses known to have debilitating genetic disorders is abhorrent, and yet the idea of spreading out the cost to help support - yes, HELP SUPPORT - the people who are sick through not fault of their own is just as abhorrent and just as abominable - enough to make people want to impeach a president and declare the ACA unconstitutional.
But hey, life's about luck, right, and according to my insurance carrier, privilege.
Being able to afford health insurance is a 'privilege', everyone, not a right.
Guess it must feel great to be born 100% healthy and to never worry about things like this.
Oh well; life moves on.
