I recently wrote about How Obamacare Forced Me To Be Dependent On The State . Despite trying to avoid the grasp of government subsidized health care, I ended up on my state’s government funded health insurance. On paper, it seemed great despite my philosophical ambivalence. Free medical care, free prescription drugs, tests, etc. But what I saved financially was not worth the price I paid in substandard care.
My first lesson was in the enrollment process. I mistakenly understood that I would be able to be part of one of our State’s large health organizations and asked for that as part of my application. I was then told that I had to get permission for the health plan. I drove down to the offices of the Health Organization only to be told that unless I had been part of the plan within the last two years or had an immediate family member in the plan, I could not be enrolled. I then tried to obtain a primary care physician through the University run program I previously had care with. I was told I needed to get permission from that program to be accepted by my new insurance. After sending information to the doctor I had chosen and several phone calls, I was told that unless I had a life threatening illness, they could not take my new insurance.
So, I opted for one of the three plans I was eligible for as the reality of my new program sank in and I could have none of the kind of care I was used to receiving with my private pay insurance. When I got my new ID card I found that I was assigned to a Clinic. When I called the clinic , they could not see me for 3 months due to the overwhelming back log of patients assigned to them. I knew that this would mean that I would run out of my refills on my prescriptions before I could be seen by the doctor. I had to beg and plead my previous doctor (who would no longer give me care under my new insurance) to give me an extension on my refills to cover me until my appointment. At one point, the doctor wanted me to pay $70 out of pocket to see her just to get the refill. There was no justification for this since I had just had a complete physical with her a few months prior.
Then, I got sick. I had bronchitis that was impairing my breathing and causing asthma that could not be controlled. I was also coughing up blood. I went to the nearest Urgent Care which is what I always did with my previous insurance after trying to get an appointment with my clinic. The clinic would not see me until the next week, although it was an urgent medical need. The Urgent Care wouldn’t take my insurance. So I called my insurance to find out where I could go. They couldn’t tell me anywhere to go and suggested the nearest ER.
One of the positive outcomes of the increasing rolls of the insured is supposed to be less uninsured using ER’s. Apparently for those on government funded programs with 3 month waiting lists to see doctors, if you are sick you are forced to go to the ER.
I spent 8 hours at the University Hospital ER and had a battery of tests revealing a spot on my lungs and bronchitis. I got two breathing treatments so got some relief from the asthma. The ER recommended I be seen by my primary care physician within 2 days. Needless to say there was no availability for that so I just continued to self- treat my bronchitis.
Three weeks later, I was due for a follow-up chest x-ray and my bronchitis was getting worse. I managed to get an appointment with the Clinic because I needed to be seen by the doctor to get an order for the x-ray.
I had to park several blocks from the clinic because there was no parking available nearby. My breathing was not great and the long walk was tough. When I got to the clinic, I was told I could not see the doctor because the computer system was down and I was a new patient who had to have my information entered into the system. I trudged back to my car as my breathing worsened.
I decided that I better go back to the ER, but there was no parking available, so I decided to try back the next day. I had more tests a breathing treatment and was given more meds for my worsening bronchitis at the ER the next day. This time it only took a couple of hours not 8.
The day after that I was finally able to see the doctor at the clinic. I got necessary orders for my x-ray and some blood work that needed to be done for a specialist I had been referred to by my previous doctor.
The clinic doctor was also supposed to get my refills to my prescriptions updated at my pharmacy and a referral from my new insurance for the specialist. I made a follow up appointment in one month to get the results of my chest x-ray and be sure that the referral was accepted.
When I went to the clinic one month later, my doctor was not there that day and they were supposed to cancel my appointment. Luckily, the on call physician was willing to see me. They, of course did not have the results of my x-ray so I had to wait until they could get the report.
The referral for the specialist that I was supposed to see in three weeks had not been done. The on call physician put in the request for the specialist. I later found out that my prescriptions had not been sent either. The clinic was only open 10 hours a week and I was unable to contact them about my prescriptions.
Three weeks later I was able to see the specialist who was able to write a prescription for two of my three medicines. The specialist wanted to order some tests and after a week I am still waiting for insurance approval for the tests. Yikes!!!
After all of this I found myself with an increase in income due to relocating for a new job to work along with my business. This was my opportunity to opt out of this horrible insurance. I am now among the privately insured again (with premiums partially subsidized). I was never so happy to pay the price of my insurance so that I won’t have to experience the high cost to my health and well-being of free insurance.
I am more convinced than ever what an anathema socialized medicine is.
cindybiondigobrecht 
After relinquishing a well rounded health insurance plan as a benefit of my job with a large internet networking company in 2002, I sailed through my COBRA period without a hitch. My next employment was taking over everything IT related for a newly partnered insurance industry TPA. (basically a small private business that contracts various services to insurance companies and government entities requiring this like fraud investigations for claims against municipalities. It was a great job, with good pay and a professional gig. I was, however, a contractor. I didn’t get health insurance, and spent the next 9 years uninsured. (ironic considering my job was running a network processing thousands of property claims a month, but I digress…) The company ended up getting bought by another firm from another faraway state, and I was cut loose shortly thereafter. (they did have a big lunch for me and gave me hugs and presents.)
In 2010, I began to notice I was getting winded more often than I used to. I figured I was just getting out of shape. By 2011, my family suggested that I apply for ACHHHS (Arizona State Medicaid) I began seeing a doctor, a heart specialist (I had open heart surgery at 5 years old.) I also began seeing a pulmonologist regularly who worked diligently to find out why I was getting really low blood oxygen levels. Finally, a DNA test answered the question: I had a rare genetic condition called Alpha-1 Antitrypsin Deficiency. My own immune system has ravaged my lung tissue for over 35 years. I need a dual lung transplant within 5-8 years, have to get weekly infusions of a blood plasma product, and require oxygen 24 hours a day, for all intensive purposes. The cost of the transplant and peripheral pre-post care will easily exceed $600,000 if it goes perfectly. My monthly medication costs currently exceed $20,000 a month, and have at least a decent volleyball teams worth of active physicians providing me with medical care. I have only been refused 1 referral (to a podiatrist I had already seen several times, but had been dropped from the list of doctors covered by AHCCCS.)
I began Medicaid in mid-2011. My doctors were in the same office as my father’s (on Medicare) they were EXTREMELY good (and still are) As per Medicaid’s guidelines, my copays for every doctor visit were $5. (same with E.R. and referrals) Copays for my medications were $4 per prescription.
January 1, 2013 brought sweeping changes to my care. The copay for all services and medications was dropped entirely. I have not had a copay since. I have had hundreds and hundreds of doctors visits, had nearly 150 infusions of Glassia (the blood plasma product, made in Israel) and thousands of bottles of oxygen, as well as two concentrators, a CPAP and BIPAP machine for severe sleep apnia, and a major surgery to correct apnea as well. Except for some complaints about the throat surgery that have produced adverse coughing and sense of smell loss, I have had PROFOUNDLY EXCELLENT health care thanks to my doctors and family, and the relentless efforts of MERCY HEALTH CARE as a provider for medical insurance coverage… I assure you that I probably have been provided one of the most outstanding levels of care you will find anywhere.
I am now on SSI/disability under the Social Security Administration. I was shocked that the mental health care provider who supplied me with antidepressants stopped prescribing them INSTANTLY instead of letting me draw down gradually under some kind of supervision, but that was because of SSI, not AHCCCS.
I wish to take a moment to offer my deepest gratitude to AHCCCS, Mercy Care, all of my doctors, my family, and EACH AND EVERY American who helped me survive this through paying their taxes. I owe you all my life, and also to Arizona Governor Jan Brewer for adding lung transplants to the Medicaid payable procedure list to make AZ compliant with the ACA.
So don’t assume welfare supplied health insurance is substandard. In my case it provided better service than private insurance could have possibly done. They wouldn’t have touched someone with my condition with a 10 foot pole. Not-for-profit insurance has paid at least $500,000 towards my medical bills so far. That will easily double before it’s all over.
P.S. The statistics give me a 51% chance of living 5 years beyond my transplant. Wish me luck. Whew, my hands hurt from typing all of this…
Thank you for your comment on my blog. Now that I have been diagnosed with a more serious health condition I am back on Medicaid .It appears that the more ill you are the better the care you receive because you are referred to specialists. Glad it is extending your life I hope it is for me as well.