On health
I’m going to talk about my boobs. So, if you can’t handle it, now’s the time to look away.
Generally speaking, I’m a really healthy person. I eat well, I exercise regularly, I don’t drink, smoke, engage in recreational drugs, and I even do my monthly breast exams. Other than surgery a couple of years ago, that I’m pretty sure was necessary because of the miserable and stressful situations I’d placed myself in at work and generally, I’m an insurance dream. I’ve always had insurance, even when I was unemployed (except for two days between coverage when I stayed home from softball practice, just in case). Even without a job, I was able to get a super-cheap individual policy because of just how healthy I am.
So, that brings me to my boobs.
About 6 months ago, after returning from my first trip to Italy, I found a lump. Well, I wouldn’t call it a lump, I guess, but it was something new and strange. I freaked me the hell out. I ran in to Leigh to have her confirm. “That’s not normal, right? I mean, I don’t want to overreact, but that wasn’t there before, right?†Then I found another.
For anyone who has had a similar experience, you will understand the terror that ripped through my head, my body, my everything. There is no history in my family of anything that would lead me to think the worst (knock on wood). And still here I was, poking myself with my ex-girlfriend, trying to figure out if I should call the doctor at 10PM or if I could wait until the morning. And I cried. I slept in Leigh’s bed that night, looking for some kind of comfort, and she did her best to give what she could. The memory is making me tear up now.
The next day I called my gyn, and when she wasn’t available until the next day, I called my GP, desperate for an answer.
I don’t even want to imagine what women go through when they get bad news in this type of situation. My GP poked around, told me not to worry – to come back at the end of the month, but not to worry. My gyn was totally unconcerned as well. I spent about 5 mins in the room with her and she sent me on my way with a smile and a shrug. I went back at the end of the month, and it was the same. There was a thickening of tissue, but nothing to worry about. In the middle of the exam I realized that I had noticed the change after coming back from Italy…where I had been drinking coffee for the first time in about 2 years. I’d continued after I returned. Relief washed over me. I mentioned my theory to the doc, and she nodded. Crisis averted.
Flash forward. It’s 5 months later, and I’m preparing to leave for Italy. I’ve left my job, and with a couple of weeks of insurance remaining I’m applying for new coverage under an individual policy. I’d been covered by this company before under an individual plan. In the background raged the debate over US healthcare policy. Literally. In the background, on the tv while I filled out the online application, the President delivered his healthcare speech to the nation.
While in Italy I’ve had occasion to discuss health care with my friends. It comes up every so often and I patiently try to describe our system. Or I translate the code on the insurance cards that I unintentionally carried to Italy in my wallet – proof in the US that I was part of the elite, those with a good job, able to afford insurance, able to pay for medical services. Here they are meaningless oddities.
“Yeah, so if you get sick, you find an in-network doctor, and then you show them this card, which tells them how much your insurance company will pay and how much you will pay.†“How much you pay?†They look baffled. “Yeah, you have to pay a percentage, depending on what your policy is. You might have to pay like the first $2,500, depending on your deductible, and then 20-40% depending on whether the provider is in-network or out, and then depending on whether the service is covered, and the usual and customary cost of the service. And then you pay your co-pay and insurance is billed. Then you get a bill for what’s left-over. Unless you have a secondary insurance…†Blank stares.
Yesterday I got an email from Leigh. “Regence denied your request for insurance.â€Â Interesting. The reason? “Unresolved gynecological issue.†Really. Well, my surgery was for fibroids, but they’re resolved. The one thing the underwriters asked for? More information regarding my boobs.
When I was filling out the online application, I reached a point where my lawyer alarm sounded. Buried in a long list of common and not-so-common health issues, the form wanted to know if I’d had any consultation with any medical personnel regarding breast health. Now, I realized that, if I checked the yes box, I’d be prompted for more info. I also realized that, if I checked the no box, I was potentially committing insurance fraud, and jeopardizing any coverage I might secure. So I said yes.
Then it asked me for my diagnosis and treatment. Bastards. I didn’t have diagnosis or treatment. I had a smile and a shrug of the shoulders. Does that count? Where’s the check box for that? I wrote in something like “N/A. Diagnosis: healthy†and pushed the submit button. But the letter I received from the underwriters said that wasn’t enough, so my doctor sent over 45-pages of chart notes. Let’s just pause for a moment. I’m a bit curious to know what, exactly, my doctor was talking about in 45-pages. My boobs are pretty great (really they are), but 45-PAGES?!?! I mean, come on.
When I left for Italy, the underwriters were still considering my request (probably debating how great my boobs must be to have my doctor write 45-pages about them). I left for Italy without insurance. I brought a bike helmet and a safety vest, but not insurance.
I’m lucky. I’m an attorney, which means I can pay the $35 or $50 to join the ABA and then I’m eligible for group insurance. It only cost me three years of law school for that privilege. I’ll be fine. What about my friends who have to compromise their happiness to stay in jobs that make them sick, in order to keep insurance for their kids? My softball coach determines who will play which position based on who has health insurance at any given game.
Maybe I should stop doing my monthly exams. I mean, If going to the doctor when I find something disqualifies me from insurance coverage, even when it’s nothing, why check? Maybe I should have consulted the world wide web and made my own medical determination as to whether it was a lump or not. Maybe I should have made an economic determination as to whether removing the fear that kept me awake that night was worth the insurance I would potentially lose.
I’m done explaining the US healthcare system. From now on all I’m prepared to say is “it’s bullshit.â€
November 14, 2009 6 Comments