We live in strange times; we will talk about the most intimate details of our sexual lives with virtual strangers. We will share pictures of ourselves and our families with any and every one (I am on Instagram, so I am guilty of this myself). Yet we will avoid talking about our financial lives because well…it’s not polite, it’s tacky, etc. This inability/unwillingness to discuss fiscal matters means for some of us we are living in a silo of shame because we assume everyone else is far better off than us and has mastered financial matters when in fact many of us are hiding some type of private shame when it comes to our economic status or handling of money.
Living in the shame closet is painful and frankly it is tiring, so I am taking the door off the hinges. I recently had a conversation with a friend where I divulged that I don’t have health insurance. It turns out neither does my friend nor do several other friends we have in common. What made me pause was the fact that my friend is a business owner and holds advanced degrees…just like the Man Unit and I.
For those who are privileged enough that they have access to health insurance, the idea of not having health insurance seems scary and even irresponsible. I used to be one of those people until life brought me to a state where things were no longer simple and straightforward. In Maine, unless you have employer sponsored coverage, your options are extremely limited when it comes to healthcare. Pretty much there is only one game in town and that is Anthem and they make you pay dearly for buying an independent policy. The cost of coverage is just high enough that most people who do buy coverage opt for a high deductible policy, which as I learned the hard way is only marginally better than no coverage. In the years we had a high deductible policy, I accrued a number of medical bills because I never reached the deductible (not even when I ended up giving birth in a hospital which I had not planned) in any given year so I was out of several hundreds of dollars every month for a policy as well as the out of pocket expenses including my allergy meds that run $2500-3000 a year. In the end our finances couldn’t handle that so we made the painful choice to go without insurance.
Choosing to go without health insurance is not a decision that one makes lightly, in fact I have had many sleepless nights over this decision. Yet real coverage for our family is cost prohibitive and would mean that we would not be able to weather the storms of life that always happen…squirrels in chimneys that need to be removed, ailing parents and so on. So we simply pay out of pocket for our medical needs, thankfully some providers are happy to accept cash. Though, with our family doctor going back to a group practice it remains to be seen whether or not he will continue to be used. I have learned over the years, bureaucratic medical facilities are the most annoying about accepting cash. After all no one knows what anything costs, there is a great piece in today’s New York Times about this practice.
If you have never experienced the joys of not being able to be told in advance what a medical procedure will cost, well you are lucky. This has been my one complaint since accepting our uninsured life (funny thing is while we lack health coverage, home, car and life insurance are still affordable and accessible for us) is that getting a price quote or even a range at times is damn near impossible. There is also the fact that at some facilities trying to access care without coverage is also hard. Hence I am in need of a mammogram but since I am not low income, simply uninsured yet willing to pay for it, my referring doc is stumped on how we can make that happen. Um, make an appointment and send me a bill. Sorry, that is too damn easy.
Thankfully there are healthcare providers like this physician in Maine who are also tired of dealing with the bureaucratic bullshit as well and decided he no longer will accept insurance and he actually posts the prices on his website. Apparently this simple and straightforward approach is now so revolutionary that the good doc has been swamped with media requests from all over the country.
If you think you hate insurance companies, well you aren’t alone; most physicians don’t care much for them either. Since in the end the insurance company pretty much sets the price they will pay and in most instances the good doc if he/she participates in that plan, really has no say. Clearly this country needs healthcare reform and while the Affordable Care Act/Obamacare will help many, it is just the beginning.
So my secret is out of the bag and its okay because I am still me. That said, if any of y’all have a mammogram machine I can borrow, bring it on over! Seriously, financial issues are loaded yet living in secrecy over matters beyond our control is also loaded because of the damage it does to our psyches.
3 thoughts on “Shame and closets…they don’t feel good”
You should not be ashamed that you don’t have insurance. We should be ashamed that our country allows it. A great documentary on Frontline documents how five countries, like ours, in the mid-ninties managed to cover everyone and changed the paradigm about healthcare (Sick around the world: http://www.pbs.org/wgbh/pages/frontline/sickaroundtheworld/ ). I have a relative who not only does not have insurance or a job, but has suffered a major illness that requires expensive medications and a lot of “choices” about which medications or tests to have. Recently, for ourselves, we learned that while disputing a $100 co-pay for an ER rabies shot (required by Mass state law that the first one be in the ER even though there was no “emergency” and we would have prefered to go to the doctor’s office), we discovered that the ER visit for four injections for rabies was billed to insurance for $9500+. Upon further investigation we found that the hospital accepted $660 dollars for the visit. As an uninsured family, ALWAYS insist on paying the “customary” reimbursement for care that the doctor or hospital would get from insurance. It galls me that the people who can least afford it pay more than anyone! We didn’t have dental insurance for 15 years and when I finally got dental insurance from a job I was horrified to see that we had been paying so much more than they now got from our insurance (as much as 3x for preventative care).
I hope that Obama care 1/1/14 will allow you some more choice around your healthcare coverage. It may take another 50 years but I hope we get to single payer coverage (i.e. medicare or whatever it will be called) eventually. Then we’ll really start to effect costs and health.
Bravo on your honesty and courage discussing this. I assure you, you are not alone.
Check out CarePartners, (207-662-7000) a nonprofit healthcare access program (set u up with a provider and script assistance) based on 175% FPL limit, partnered with MaineHealth system and Mercy. MedAccess is a sister program to this for only prescription assistance, statewide. Also, NeedyMeds.com for diy prescription assistance. Every hospital has a freecare or sliding fee program as well. The prescription assistance programs are generally pretty accessible, most at 300% FPL or higher.
Good luck and take care!
I’m originally from NY but relocated to Houston 6 years ago and have worked in Healthcare since 1996. Each hospital/institution I’ve worked for have always listed there fees and even give cash paying customers a 20% discount. The only caveat is you pay at the time of service. Most group practices/hospitals/independent providers will not bill a patient after they leave (especially if they are uninsured) because it it virtually impossible to collect once the patient leaves the premises. My current place of employment collects payment upfront (B4) services are rendered for cash patients as well.
One good thing though, I have seen cash paying patients negotiate up to 50% discounts off there physician’s fee for procedures.
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