The more I read about the health care debate the more my blood boils and I've just got to get this out there before my blood pressure goes through the roof.
Here's my basic opinion: The health and welfare of me and my loved ones (And my loved ones loved ones. And their loved ones. And any other loved ones you might want to put onto the list) should NOT be determined by a profit motive. Because then the decisions are going to be made based on what will earn the company money rather than what will help maintain your health and well-being.
Sweetie and I have insurance. Damn good insurance. When we moved to the 'couv we signed up for the Cadillac of insurance plans available to us. We knew we'd be working on the hedgehog, and wanted to make sure we were covered for that. We pay to get the Cadillac. We consider it money well spent.
Not many people know this, but the Hedgehog is actually Hedgehog v3.0. I suffered two miscarriages prior to this pregnancy. That's part of the reason we signed up for the Cadillac of insurance plans, because we didn't know what type of care would be required in order to keep the Hedgehog in there for the duration.
When we arrived in Vancouver I went through tests. Usually they don't want to start with the tests until you've suffered three miscarriages, but because I am old (by pregnancy standards) they let me cut in line and start with the tests after two miscarriages.
Thanks to the tests (all covered by our insurance without question) we came up with two potential issues that could have been causing the problems, and a plan of attack for both of them. One of the issues is potentially low progesterone levels. This is an easy treatment, you just take progesterone supplements from the moment you discover you are pregnant through the end of your first trimester. (The other issue is not treated quite so easily as it requires a daily injection of blood thinners, but that's another story for another day).
So, I get myself knocked up with the Hedgehog and I get a prescription called in for the progesterone. When I go to pick it up at the pharmacy I'm told that insurance isn't covering it at this time, that there's some paperwork that needs to be completed by my doctor's office before insurance will foot the bill. Which I don't have a huge issue with, except it's Friday afternoon and the Doctor is gone for the weekend and so they won't be able to get the paperwork completed until Monday morning.
And I'm sorry, but when you've been through two miscarriages and the drug that could prevent your third miscarriage is sitting on the other side of the pharmacist's counter from you but they won't let you have it for three days because a piece of paper needs to be filled out... yeah, that doesn't quite work. So I called the insurance company to ask "Hey, if I pay out of pocket for the first batch of the drug will you reimburse me for it later, once we get all this paperwork sorted out?"
The answer was not only a resounding "NO" but "Don't bother with the paperwork, we will NEVER cover that drug for you. Because it is a fertility drug."
The drug costs $400/month. Money we don't necessarily have sitting around - in part because we are paying for the Cadillac of insurance plans. And my insurance company doesn't want to pay for this drug because they won't pay for fertility treatments. Except I'm not having fertility treatments. Know why I'm not having fertility treatments? Because I'm already knocked up. I even have the test results (both at home and at the doctor's office) to prove it.
Want to give a pregnant woman a nervous breakdown? Throw that scenario in front of her. Thankfully I have a saint of a husband who knows when to step in and take over the reins AND knows how to deal with customer service. And he basically fought his way through the system until he found a person who agreed to cover the drug. No need for the paperwork from the doctor now, by the time you get to the pharmacy everything should be taken care of.
The kicker? The labeled use of the drug is for regulation of the menstrual cycle.
So, to quickly review: My VERY GOOD insurance policy did not want to cover a drug that is manufactured to help women regulate their menstrual flow, that my doctor had prescribed to help preserve my pregnancy because there are women out there who use it as a fertility drug and my insurance policy does not cover fertility treatments. And the only reason they DID cover the drug was because my husband works well with customer service AND does not like it when his wife is in near hysterics, so he just plowed his way through the system until he got someone to agree to cover it.
I'm sorry, but vulnerable people should not have to fight for things they are entitled to because someone tries to find a loophole to get out of their obligations. And as long as the insurance companies are out there trying to make a profit for their stockholders that's what they're going to do as long as they are permitted to do so. Because for every person like me who fights until she gets what's appropriate there are probably scads of other people who just acquiesce and just pay the $400/month.
If I won the lottery and had the financial ability to sign up everyone in the nation for my very good, non-governmental insurance plan the system would still be broken because they would be more interested in all the profits those new subscribers were interested in rather than helping provide us with medical care.
THAT is why I support health care reform, and why I think you should support it, too.