End of the Month Controversy: Obamacare

I love this man.

Sixteen hours after he proposed to me, M awoke in an ambulance, rushing from his company softball game to the emergency room.

What looked initially like a stroke turned out to be a seizure, caused by several masses in his brain.

Six days later, an exploratory surgery told us that those masses were stage four astrocytoma- an incredibly malignant and aggressive brain cancer.

Three days after that, my fight with M's insurance company began. He was on an HMO, and while he had elected into "emergency" coverage, the company wanted to deny any payment for his surgery or cancer treatment.

Because the surgery wasn't an "emergency." And because, once he had the surgery, the cancer became a pre-existing condition.

We were lucky. I'm absolutely bloody terrifying, and I managed to frighten enough HMO representatives that I actually reached a person who could do something, anything, about the $100,000 bills coming in the mail for the surgery alone. That didn't even begin to cover the week he had to spend in the hospital, recovering. In fact, the only way I was able to secure their coverage was to convince M's primary care physician- a man pre-approved by the HMO- to tell his employer that he had been negligent with M's care.

The radiation guide/shield that kept M's head affixed
in the correct location to irradiate his tumors

The fact he was willing to do that still amazes me. I am grateful every day.

So there we were, newly engaged and spending every minute of every day dealing with doctors, insurance companies, and hospital staff. As I waited in lobbies day after day, I read articles in magazines about how many people were beginning to use bankruptcy to cover their cancer treatments.

They continued their treatment, going deeper and deeper into debt, and if they succeeded in saving their lives they lost their savings, their homes, everything.

But really, that seemed like a small price to pay to be alive.

Only it's not. Last month CNBC covered a study- the findings were that the most common cause for personal bankruptcy in the United States is medical debt. "Medical Bankruptcies," they're called.

But back to 2007, when M was fighting for his life.

He was in chemo and radiation, but he could not quit his job. Without his job, he would lose insurance coverage. And the minute he lost coverage, he could never get it again. And so despite the fatigue, the nausea, the pain... despite the frustrations and humiliations of going to work and suffering through seizures, he kept at it. Not because he was so tenacious (although he was), but because he had no choice.

For eighteen months, he went to work through chemotherapy. We only paid hundreds of dollars a month for his medication. Without insurance, his anti-seizure drugs would have run to the hundreds per day.

Each dose of his chemotherapy had a "street value" of more than $30,000. Each dose. That meant that over eighteen months, M's chemo alone would have cost approximately 17.2 million dollars.

And miraculously, he got better. For a whole year, things were stable, until the economy collapsed and M lost his job.

I was pregnant with DD and SI, and I couldn't walk let alone work. We both needed medical coverage- it wasn't optional. So we paid off the outrageous COBRA bills every month on credit cards, going deeper and deeper into debt. We had no choice, it was debt or death. When I rushed into the hospital in the middle of the night, hemorrhaging through a placental abruption. it was crystal clear. Having insurance was mandatory.

Handsome bald devil.

Through the first year of parenthood, M and I watched each session while Congress battled out whether or not they would extend unemployment benefits. And each time they did, I cried with relief. Even when M got a job, they did everything in their power to avoid paying for insurance. We kept shelling out thousands of dollars a month to keep our medical coverage. We tried to find other insurance, cheaper, private insurance. They would cover me and the kids, but not M. Not with his pre-existing conditions. And later, after my melanoma diagnosis, they wouldn't cover me either.

M will always have a pre-existing condition. I will always have a pre-existing condition.

Until Obamacare went into effect, just being a woman WAS a pre-existing condition.

This past week, the GOP in Congress tried for the fortieth time to get rid of Obamacare. It was an empty gesture, but one that spoke volumes.

"We don't care about you at all," they said.

"We, politicians who have accepted hundreds of millions of dollars from insurance company lobbyists- we care more about that than whether you live or die."

"We don't care if you have to lose your home, your savings, everything. It should be WORTH IT just to be alive."

So what are they trying to ban?

Starting on the first of next year, a ban on denial for coverage based on pre-existing conditions.
A healthcare marketplace for people without insurance to find coverage, and subsidies for people like us a few years ago- unemployed and uninsured.
And coverage that must include prevention services- mammograms, prenatal care, the neural pathway test that could have diagnosed M as much as a year earlier.

...so where's the controversy?

The controversy is that everyone wants to make sure that this is paid for. They want to be certain that this isn't going to run the country into the ground. And yes, it is paid for. In fact, it's going to save this country (and individuals) millions to billions of dollars.

But here's the truth- the country is already being run into the ground with medical debt. Not just because of the two million people this year alone who have filed for medical bankruptcy. It's also because people who don't have coverage still get sick, and those sick people flood into publicly funded hospitals, and we as a society are paying for it anyway.

Everyone alive and healthy.

If I didn't have insurance, would I have run into a hospital, 35 weeks pregnant with twins and gushing blood? You're damn right I would have. And the hospital would have treated me, and then had to make up the difference in the $89,000 I wouldn't have been able to pay them.

That's me- one pregnant woman. And five days in the hospital cost me two years of M's gross unemployment. And that is absurd.

The controversy is that the way we buy insurance in this country is ludicrous- we never know what anything costs, what anything is worth. You go to one hospital and they charge you $2,500 for an MRI to find out if cancer is growing in your brain, you go to a different hospital for the same kind of scan in the same month and they charge you $20,000. And there's no way to know until it's happening.

You can't waltz into an ER and say, "I'm shopping for the best deal on emergency care. How much do your ambulance rides run?" or "Does YOUR mammogram come with a complimentary radiologist evaluation, or is that going to be extra?"

It's as far from free-market economy as anything gets.

So now the GOP is going around, trying to scare people away from signing on and getting coverage, now that the Obamacare marketplace is going to open up.

Don't listen.

Instead consider what you have to gain.

Life, AND livelihood.

When cancer, or diabetes, or lupus, or a car accident, or pregnancy strikes- don't tell yourself that it's worth it if you get to stay alive.

You deserve both.



Learn more about the healthcare marketplace here: HealthCare.gov