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tsegat01's Journal
Posted by tsegat01 in General Discussion (1/22-2007 thru 12/14/2010)
Tue Mar 02nd 2010, 03:10 AM
I am going to try to tell my story as clearly as I can.

I experienced our current health care system from three totally different vantage points, though the illness was always the same. I saw it from:

A. Being insured with top-of-the-line insurance coverage.

B. Being unemployed/uninsured as such categorized as "indigent".

C. Medicare recipient

We moved to California at the end of 2001. I hadn't had any medical treatment for over 25 years, but evidently I was extremely sensitive to the air quality in Sacramento. After a few years I started to have breathing problems and ended up in the emergency room unable to breathe. I was treated and released and my nightmare began.

I had good GOOD insurance and could afford my medication. There were frequent visits thereafter to the ER and a lot of frustration when I was released was from the ER feeling just as badly when I went in as when I left. One time I got to the car, ready to go back in, wondering why they didn't admit me. I know now that the fight with the insurance company was a primary consideration. As a result, I ended up in the ER over and over again.

After many ER visits, I was admitted to one of the best hospitals in the area. The young hot-shot doctor put me on every medication available, determined for some reason to release me as soon as possible. The medication changed daily and the nurses, as well as my family were concerned that he was trying to release me too quickly, as I was in terrible shape. Fortunately a very knowledgeable and understanding nurse fudged some numbers, which kept me in the hospital another day.

I was released and the the ever-changing medications were different when I left. I had been given mega doses of medication I'd never been on before with total disregard with my susceptibility to blood clots.I went home and was up until 5 in the morning with my heart pounding. The next day I was back in an ambulance to a another hospital with blood clots.

Emergency surgery followed and I was in the hospital for a week. Had the former doctor been paying attention to my medical history, this probably wouldn't have happened.

During this time there were MANY out-of-pocket expenses that had to go onto credit cards, thousand of dollars and I will soon be filing bankruptcy because of it.

Time passed and I lost my job, as well as my insurance. The Iowa Caucuses came and went, and we experienced some horrific forest fires here in CA. We went for long periods of time where we couldn't see the sun AND I couldn't breathe.

In March of 2008 I ended up in an ambulance yet again, but this time things were different. I was officially classified as "indigent", but somehow I was admitted quickly and easily to the hospital. People came to my hospital room and helped me with all the necessary paperwork for medical assistance. I saw doctors frequently and I never had to lift a finger to work out the financial details. Someone came in and did all the paperwork for me. What the HELL was going on. I never got this kind of treatment when I was insured by one of the biggest insurance companies in the country. In the beginning the county paid for pretty much everything and the doctors were free to just be doctors. One could sense the relief that they didn't have to justify every decision to an insurance company.

When I went home, it was planned that oxygen would be available at the same time. If they gave us any problem, we were to give the phone number of the woman who helped me in the hospital.

Medicaid took over nine months to kick in and it only covered expenses after the first $875 a month, so I pretty much had to pay for a lot of prescription medication on my own.

Through all this I found it interesting that I seemed to get BETTER medical care without insurance than I did with it.

Unfortunately thoughout all this I never really got well. I got better for periods of time, but the condition itself was always there and I was limited as to how much medical care I could pursue.

Last December was a major turning point in my life. Another frantic rush in an ambulance to the hospital and much of it is a blur for me. I have few memories of the experience as I ended up in the ICU and they gave me huge amounts of "milk of amnesia". I only know what people have told me. I do know they saved my life, but I never talked to a doctor. I am so grateful for what they did to save my life.

After four days in the ICU, I went into a private room and then was released with no pain management program and no consultation with a doctor. My daughter was a basket-case and my son was 3000 miles away. I went home without any clear idea what all had happened. I was still very sick and could not leave the house for weeks.

I went back to my doctor, who I adore. Once again he prescribed the same medication he had prescribed years ago. When I was insured, the steroid inhaler was expensive - $75 and with insurance $25. A year ago the medication had gone up to $143.00. I just couldn't afford it. Now it was $250.00! I just tried to stretch what I had left.

Being I never fully recovered from December, I ended up back in the hospital in February. February 1st Medicare kicked in for me. I planned this trip carefully. I couldn't handle another panic-stricken ambulance ride to the hospital. I had taken the steroids and a few hours later we drove to the hospital and I was able to WALK into the hospital.

So now we're at Part C of my medical story. They tell me they want to admit me and a doctor comes and asks me about my insurance. I tell him I have "Medicare" and he says something to the effect of, "No problem, you're good to go." Everything, everything was SO different at that point. I had a Public Option and it was like a red carpet.

I am better now, MUCH, MUCH better. I saw a doctor one or two times a day and on the fourth day a doctor actually asked me if I wanted to stay another day!!!! I immediately said "yes". As much as I wanted to go home, experience had shown me what a difference a day or two made. No one had EVER asked me that me before.

So I went home and my daughter went to fill the prescriptions. The steroid inhaler was now $250.00 and it cost me $3.33. $600.00 of medications cost me less than $40.00. It has made such a huge difference. I went weeks without ever leaving the house because I was so ill. Now I've gone out several times a week for hours and I am fine.

My children have been through hell and that has been the biggest toll for me. I cannot believe what a huge difference Medicare was for me. With high-end insurance I got decent care, as an "indigent" I got better care, and with with Medicare, I got extraordinary care. What does that tell you?

We need a public option and we need it NOW!

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