You Don’t Get What You Pay For

It’s a crappy time to be an American. The economy is in the toilet, and despite what a few obviously¬†over-medicated¬†cheerful economists are saying, it’s not going to change any time soon. Poor Kim Kardashian may even have to sell some of her Birkin bags on ebay! Certainly the downturn has most consumers looking to get the best bargain on every purchase. I’m not much of a shopper myself, but I when I do crack open my wallet I want to get the best possible deal, which is why I get really irate when I spend money on something I can’t use. Something like… health insurance.

Now, I know you thought I was going to say one of those fancy-schmantzy smartphones that are supposed to do everything but pick up the dry cleaning and instead make it impossible to even make a phone call, but no. I’m talking about the hotly debated subject of American healthcare. You see, I have a job that fortunately puts me somewhat above the poverty line (although it usually doesn’t feel like it), and each and every time I get paid a nice chunk of my earnings goes toward health insurance. Health insurance that I can’t afford to use. Yes, I realize I’m lucky to even have health insurance. Nearly 50 million Americans have none (yet). Still, I’m left wondering if I’m getting what I’m paying for.

Gel capsules filled with shredded currency

Photo by Lisa Yarost via Flickr

A few months ago, I tripped going up the stairs to my condo (it’s Snark Diva, not Graceful Diva, you know). I came down directly on my right knee and bruised the heck out of it. A couple of days and lots of swearing later it stopped hurting, so I forgot about it. That is until I went to kneel down to pick up my kids’ toys off the bedroom floor a few weeks later and an excruciating pain shot through my entire leg. Realizing this was not a good thing, I made an appointment with my doctor who charged me a twenty dollar co-payment to “manipulate” (torture) my knee and order an MRI, since she was fairly certain that I had torn a ligament or something equally as ominous.

I took the order for the MRI, called the radiology facility and made an appointment. Two days before my appointment they called me to tell me the insurance company had denied the MRI. Okaaaaayyy. Now what? I contacted the doctor’s office and they suggested I come back in to have it looked at again. Hmmm. What was she going to see now that she didn’t see before, besides another twenty of my hard earned dollars? I politely declined and decided to simply not kneel down ever again. That should solve the problem, right?

A month or so later I found myself again shelling out co-payments for my “well woman” exam (such fun!) and a mammogram. While I was in the office I again asked about my knee. This time I was given an order for an x-ray. If the x-ray was negative, the doctor would again order an MRI. Of course the x-ray showed nothing, and the insurance company still won’t pay for an MRI (presumably because I am not yet to the point where an amputation is imminent). So apparently what I have to show for the many dollars I pay each month for health insurance is a bum knee that isn’t going to get better anytime soon. American healthcare at its finest.

This is the situation many low to middle income families find themselves in. If they are fortunate enough to have health insurance available to them, they often cannot afford the copayments, or even more commonly the prescription costs. As a result, appointments are canceled, medications are left on the pharmacists’ shelves, and we as a population become sicker and sicker until we can no longer avoid seeking care. Of course, by that time the costs are likely to be exponentially higher than they would have been if we had been treated much earlier.

The truth is, no matter how well we take care of ourselves (and admittedly many of us don’t), people are like cars, they’re gonna break down once they get some miles on them. We get injured, we age, and sometimes we just want to prevent ourselves from getting sick in the first place. Our government has finally been pulled kicking and screaming into the 21st century by passing the Patient Protection and Affordable Care Act, but just how “affordable” will it be? Will Americans actually be able to use the health benefits for which they have fought so dearly, or will we remain just as unhealthy despite having coverage? Just thinking about it is enough to drive a Diva to seek therapy. If only I could come up with the forty dollar per session co-payment!

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