Health care worker denied care

March 17, 2009

I'VE BEEN listening to the reasons politicians of both parties have been giving for why single-payer, "everybody in, nobody out" health reform is off the table.

As a socialist, a health care worker and someone who believes top-quality health care should be available for all, I understand that these are just ideological cover for the real reason: politicians rely on donations from the health insurance industry and other corporations that profit enormously from a system with the twisted logic where the provision of less care means greater profits for insurers.

The reform that seems likely is the Massachusetts model, where everybody is forced or "encouraged" to purchase health insurance. I'd like to share a recent personal experience as a Massachusetts resident with employer-provided health insurance that shows how this model, even if it resulted in everyone being insured, wouldn't guarantee everyone the care they need.

To preface this: I pay $100 a month for health insurance (my employer pays the other 75 percent), plus $30 a month for dental. This will go up by about 10 percent this year, while my yearly raises average about 3 percent. My co-pays are currently $20 per visit, $100 for an emergency room visit, and $500 for hospitalization--and set to go up 25 percent this year.

Reading the above and thinking about the stress and financial strain this causes, I shake my head to think that I'm actually better off than most working-class people in this regard, and that I live in the state with the health reform model that's supposed to be the national fix.

Recently, I began seeing a counselor for the first time in my life, for an issue I consider to be very important to me. It's been a great help already, and long overdue. As a child I was in a foreign country where a battle occurred in the neighborhood I was in, and I witnessed a lot of terrible things firsthand. This is the first time in my life, 16 years later, that I've begun to address the impact that had on me. On top of that, there are the issues that come with growing up working class in a society that doesn't place value on our lives. Continued counseling, I and my counselor believe, is vital for my mental health.

One month after I began those visits, I got a letter from my health insurance company. "Dear member," it begins. I am so "dear" to them that they inform me that they've approved a total of 12 visits (my counselor wants to keep seeing me weekly, indefinitely), but that this approval doesn't guarantee they'll pay even for 12. This, on top of the $20 (set to go up to $25) I pay per visit out of my pocket.

For the first time in a long time, I saw the possible source of many of my demons, and had hope that I could begin to deal with them, and some doctor from the health insurance company who has never spoken to me has decided that 12 45-minute visits are enough to "fix" me. For me to be well enough to be happy? Or to keep showing up to work to fill his pockets? It felt like being punched in the face, because I know I can't afford the full price for these visits.

I'm a health care worker, and I can't afford the health care I need--like the construction workers who built houses for a living and are now unemployed and homeless because capitalists had too many houses built to sell at a profit.

I think also of the many "Reader's Views" published by the person whose father can't get the care he needs because he is undocumented, of people who can't afford college or to pay off their loans. Something is very wrong with this picture, and I hope that more of us will write in to share our stories so we know we aren't alone.

We have to do better than this!
Anonymous, from the Internet

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