2017 has been the year of people visiting us in Colorado. It’s also been the year of health care.
This year we’ve re-established primary care and have been hunting down a strange set of symptoms I’ve been experiencing. None of it is particularly concerning. I don’t have a terminal condition. It’s really just run of the mill going to the doctor stuff. But it is all stuff I probably wouldn’t have done without the great health insurance we get from my employer. We have pretty low premiums in the grand scheme of things and we only pay for part of it. We had the option of choosing a plan with a higher premium but a lower deductible and we hit our out of pocket limit pretty quickly. Since I’m a federal employee, we have a flexible spending account (FSA) we pay into pre-tax which reimburses us for co-insurance, copays, and other fees we still have to pay despite the fact we pay a damn premium every month.
We’re fortunate to be so well taken care of but not everybody is. My term is up at the end of the year and when I research potential future employers, I notice few of them offer as good of health plans. Many only offer a high deductible plan. Many of those plans don’t have out of state coverage, and prohibitive out of network costs. People who aren’t fortunate enough to have a full time job don’t get the privilege of sharing the costs of their healthcare with their employer. More still don’t get access to cost-avoiding tactics like FSAs or Health Savings Accounts (HSAs).
When we had worse health coverage, we coped with the higher costs by avoiding going to the doctor. That doesn’t make any sense!
Employers only offering shitty plans to their employees, and paying a diminishing share of them, is a problem older than the Affordable Care Act. the ACA only made them a little better. Before, even good employer based plans would still leave some basic, preventative measures uncovered or force you to pay an outsized co-insurance or copay for them. If you wanted a flu shot, depression screening, immunizations and vaccines, your insurance company could charge you a copay or force you to share some of the cost.
Health insurance is stupid. You pay hundreds of dollars each month only to have to cough up even more when you go to the doctor. At least with the ACA these basic things that keep people healthy are covered. But it’s still stupid. If you’re on a high deductible plan and need to see a cardiologist about chest pain, you might be on the hook for the whole visit despite the fact you’re paying your premium every month. Let’s say you’re pregnant and think you miscarried, you might have to get blood drawn once every 48 hours until your HCG hormone goes back to 0. Maybe your kid got a concussion playing high school football and needs to see a neurologist. Any myriad of unexpected health problems can happen to even the healthiest people and if it happens to you, your family could be on the hook for up to $13,000! That’s assuming every doctor, hospital, or urgent care is within your health provider’s network and isn’t dropped from that network while you’re still a patient.
Maybe you have an FSA or a health savings account to help you cover these costs. Maybe! But the point is you shouldn’t have to guess about how much of your paycheck you can sequester away every month just to pay your health bills. You shouldn’t have to worry about whether you can afford to take your kid to the neurologist, or whether you can afford to verify you miscarried.
The insane hoops I’ve seen people jump through to get the care that need has led me to only one conclusion: Medicare for all. It’s the only solution I’ve seen that provides coverage for our most vulnerable populations and keeps costs contained. There are plenty of things Medicare doesn’t cover that people will still buy insurance to cover (elective surgeries for example, aren’t covered). Taxes might have to go up to cover it but the people most affected by that tax rise aren’t the people deciding which is preferable going broke going to the doctor or staying sick and getting sicker.
Every doctor with a license to practice medicine should be in network and every person on American soil should be able to access them without going broke. Medicare for All is the best way to get there.