So. Here's the deal.
For the last several years, I, like most other able-bodied Americans, have been covered under my employers' health insurance plan (various iterations of Premera Blue Cross Blue Shield). I've been lucky in that the last couple of jobs I've held have also given me the flexibility to go to the doctor's/dentist's/ophthalmologist's office when I needed to; as a result, I was able to get the
disaster area that was my mouth patched up as well as getting new glasses.
Theoretically, what you're buying with insurance (as various advertisements love to tell us) is peace of mind. And to a certain extent, it's true; it's a lot less scary to think that you have some help with medical expenses, should you incur any - the cost of care in this country is well-known to be stratospheric. (Sadly, this could have been predicted by basic economics: one of the tenets of the free-market system is that you, the customer, have the choice whether or not to participate in any given economic transaction - if the price is too high, you won't buy. Fair enough, but obviously that's severely broken when it comes to health care, as you literally don't have that choice. If your arm is broken or you're having a heart attack, you can't exactly call around and compare prices, or put off getting care until the prices are better.) So, again theoretically, what I'm buying with my
X number of dollars per month is that peace of mind, and that ability to go to the doctor without having to worry about whether I can afford it.
But here's the thing that I've noticed. Everybody knows that getting money out of an insurance company is like pulling teeth (sometimes literally). To their credit, Blue Cross Blue Shield's dental and vision plans were very straightforward and I didn't encounter any trouble getting them to cough up for those (which totalled in the thousands of dollars). But, thanks to the sinister alchemy of deductibles, limits, coinsurance, and coverage gaps, every single medical expense I incurred (which fortunately was only one emergency one, when I passed out suddenly at work) I ended up paying for the majority (if not the full) cost. Part of this was simply punishment for the fact that I'm a pretty healthy person, all told - I think the only year I even maxed out my deductible was the aforementioned emergency, and even then I ended up paying for more than $800 of a $1500 bill. The only recurring medical expense I had was birth control - yearly checkups and pills. But really (and here's the damning part of it all), most of the reason I barely ever went to the doctor (for checkups, or because I was sick with the swine flu and probably should have), was that
I didn't want to fight the insurance company about it. Which, I'm sure, is exactly their goal by spuriously denying claims and using all those other underhanded tactics that they're well-known for - sure, they'll often cough up if you fight with them, but the more of your time, energy, and stress that they can cost you over it, the less likely you are to want to do so in the future (and, therefore, the more of your money they can keep).
Now, honestly, this all wasn't a huge deal while I was working full-time, because coverage was automatic (and really quite cheap) - an automatic payroll deduction of $10 or so (more when I was working for a small company). True, the City and Borough of Juneau was shelling out $1090 per month per employee for coverage, but since there was no chance of my seeing that money in my paycheck, I just didn't think about it much. But something happened shortly before I left Juneau that left me truly sick to my stomach at the thought of giving Blue Cross Blue Shield (or any of their ilk) any more money.
I've been on the Pill for about seven years now, and while I've not always been as religious about timing it properly as I should have, I've been lucky enough not to have any major problems (or pregnancy scares) with it. However, going to the pharmacy and shelling out $15 every month is kind of a pain, and since we were planning a cross-country move (and therefore my daily routine was going to be pretty upside-down for a while), I figured I should look into something more quasi-permanent. After talking it over with my health care provider (a lovely woman named April), she suggested Implanon, a nifty little matchstick-sized implant that they stick under the skin of your arm, that sits there and releases pretty much the same hormone that was in my pill for the next three years. No muss, no fuss, pretty much no worries until I have to get it removed (it ceases to provide protection after three years, and you want to get it removed as soon as possible after that because of the possibility of scar tissue developing that would make future removal difficult). So I decided to go ahead and go with that, since (according to her office) it's covered under insurance.
Surprise, surprise, a month later I get an "Explanation of Benefits" (a misnomer if I ever heard one) from the insurance company, explaining in their standardized spreadsheet form that this service was not covered at all and I was on the hook for $1500 worth of expenses. April's insurance specialist got them on the phone and argued for several hours, to no avail - apparently, under the supposedly-so-excellent City health plan, "there's no coverage for birth control."
May I just get a gigantic
W. T. F. from the peanut gallery, please. (Thank you, peanut gallery.)
Because she's a good doctor who's not trying to bankrupt her clients, April dropped $500 off the bill, so I'm "only" on the hook for the other thousand, and she was more than willing to work out a payment plan for it. But Jesus H. Roosevelt Christ - I'd been working for the City for a year at that point, which meant that they'd shelled out $13,080 for my insurance coverage at that point (and I hadn't had a single other medical expense that year). And they refused to pay a bill for a fraction of that cost, because a very basic part of health care that nearly every woman uses (and that saves them money in the long run because they don't have to shell out for pregnancy expenses) "wasn't covered"?
Needless to say, when I discovered that Brian's health coverage (which I do qualify for, as his spouse) was through Blue Cross Blue Shield, I wasn't too thrilled. And when we found out that they wanted $140 a month to cover me (for medical alone, and in addition to whatever Brian's employer is shelling out), I practically saw red.
Well, this is America, after all, and supposedly the biggest power you have in this country is the ability to vote with your wallet. So, insurance companies (all of you), here's my vote. I'm the type of customer you
love to insure; young, healthy, productive, no major medical issues, not genetically prone to any diseases that I know of, not prone to risky behaviors. But thanks to your horrendous level of "service" over the past five years of my life, I'm done with you, full stop.* I know it's a gamble, and that if I break my leg or something I might well end up bankrupt. But I'm so very sick and tired of being in constant dread of the next "Explanation of Benefits" that comes in the mail, and I refuse to spend another hour of my life fighting with you over what is and isn't covered under my plan. Since I'm lucky enough not to have any major recurring medical expenses, I'm just going to take my $140 a month and sock it away in a savings account, either until I get another job that offers benefits (and no "take the cash instead" plan) or until Obama manages to cajole/threaten/blackmail Congress into passing a universal health care plan that doesn't suck (which I can't say I'm holding out much hope for, but he worked a pretty major miracle with getting elected, so who knows?). Meantime, we'll see who comes out ahead; but frankly, I'm thinking I'll have enough money to buy a pretty nice car by the time this isn't an issue anymore.
*If anyone's had any experience with a non-evil health insurance company, I'm more than willing to keep an open mind. But frankly, I'm not very hopeful.