My Story: Why Universal Health Insurance Matters to Me

I know this isn't neighborhood-oriented, but I felt compelled to share:

Senator Kennedy passed away today, and his last unfinished goal was to provide health care (via health insurance) to all Americans, just as the government provides police protection, an army, education, fire protection, roads, airports, a coast guard, and the like.

So many months ago my doctor informed me I had to go to a specialist for treatments I'd rather not go into here. However, to get treated, I had to ask "permission" from my insurance company. You know, so they could decide if I was sick instead of my doctor deciding. After about 10 calls to different numbers (talk about bureaucracy!), I was approved for SOME treatments (not all).

I attended my pre-approved treatments, but had to pay for them myself, then get reimbursed at the rate that my insurance company decided it should cost; not reimbursed for the amount it ACTUALLY cost. Over 50% of the time, when I submitted my (pre-approved) reimbursements to my insurance company, my reimbursements were DENIED. Or lost. Or something else that allowed them to not pay me, even though they had preapproved me (but somehow had misfiled the paperwork... in their electronic system. Under my name. Seriously.).

My last reimursement was denied two weeks ago. I'm scheduled for another treatment next week. Think they're reimburse that one, even though they pre-approved it?

So let's recap: My INSURANCE COMPANY decides if they want to pay for treatments my doctor says I need; then my INSURANCE COMPANY decides how much those treatments should cost; then my INSURANCE COMPANY decides if they're actually going to reimburse me or not. Now, is this my DOCTOR making my medical decisions or is it my INSURANCE COMPANY?

I'm lucky. I have amazing insurance through a great employer. And for the "extras", I can afford to pay myself, though it's not cheap. And I'm smart enough to wade through the paperwork and determined enough to continue to call and re-submit my reimbursements.

But what about the little guy(s)? Those who aren't as fortunate as I am?

Where would we be if an education insurance company got to decide if your child was smart enough to go to school before they'd pay the teachers? What if a police insurance company got to decide how much of the police officers' time they would reimburse if you or a relative were harmed or killed by a criminal? How about if a coast guard insurance company got to decide if they were going to reimburse you at all for the cost of rescuing you from a sinking ship?

What's more important, America? Profits for the insurance companies, or actual people?

Let's have real reform today.