Essay: My healthcare journey.

When I was a freshman in college, the country was abuzz about the potential Health Care Plan proposed by President and Hillary Clinton.  I was interested in the plan and followed the story through various media sources.  I remember one news magazine reported that if the plan passed, coverage would begin in 1997 and it even had a mock-up of what the medical cards everyone would carry.

“That’s perfect timing.” I thought to myself.  “I will just be getting out of college and my national health coverage will begin.”  The moment when I had those thoughts came back to me again and again in the nearly 20 years that have passed since then.

Growing up, I always had health insurance.  Both my parents were teachers and they made the same trade off so many teachers have over the years:  less pay, better insurance.  The first time I ever heard of someone paying a $10.00 co-pay I was shocked.  All our co-pays, for everything, were $5.00.  Overall, I was pretty healthy growing up, and my health care “needs” only really began as a teenager, when I started to take medication for acne.  While acne is not a life-threatening health care need, in our society, a teenager with acne is treated differently than a teenager without acne.  Both my parents had suffered through adolescence without a dermatologist, so they were happy I had the option.

My post-college years included a patchwork of health care options.  Like many people in their twenties, I tried on different jobs.  Sometimes I had coverage (of varying capacities) through my employer, sometimes I did not.  I also had some luck.  At a time I did not have health care I was diagnosed with major depression.  Because I lived in Massachusetts at the time and I didn’t make a lot of money, nearly all of my treatment was covered.  This was before Massachusetts had moved toward universal coverage, but even then, the state seemed to fund health insurance more than others I’ve lived in.  It was a great feeling of relief when the nice man at the hospital took my pay stubs, crunched some numbers and told me that I would be paying about $40.00 per month for my treatment.

Aside from that, my health care needs were few.  When I had a boyfriend, I paid for my birth control myself—I usually went to Planned Parenthood for that.  I had an accident involving wisteria and my eyeball that involved an emergency room visit, some drugs, and two visits to an ophthalmologist.  That was also in Massachusetts and also nearly fully covered.

Then I turned 27 and soon after had a mysterious patch of flakes appear on my scalp.  It wasn’t dandruff, because it was isolated and somewhat scabby. I had no idea what it was.  I moved to Oregon, leaving Massachusetts’ excellent health care for the poor behind me.  In Oregon, I started temporary work, and preparing for graduate school.  My head got worse, much itchier and more scabby and flaky and finally, I looked up dermatologists in the phone book, called a few to find out how much they cost and took a long bus ride to see one of them.

Psoriasis.  It seemed I had an auto-immune disorder, never a good diagnosis for someone with health insurance, much less someone without it.  He proscribed a solution for my head, I wrote him a check for $150.00 and the pharmacist another check for $50.00 and entered into the non-health care, non-healthy world.  The solution dialed back the itch and the flakes, but it didn’t stop the spread.  As I continued temping and continued waiting to begin graduate school I watched as the mysterious scab on my knee never healed.  It turned out to be psoriasis too.  And slowly but surely, the psorasis spread from my head onto my body.

Once in graduate school, I happily paid the extra fee for health insurance and went to see the campus health services.  They gave me a steroid cream for my legs and referred me to the teaching hospital on the hill.  The doctor there saw me and prescribed four different creams, none of which were covered by insurance and all of which were more than I could afford as a graduate student.  I didn’t fill them, left the pharmacy in tears and never went back to the specialist.

As graduate school ended, I found myself in a panic about the end of my health insurance.  The term “pre-existing condition” was featured strongly in the health care news.  If I didn’t do something quickly, I was going to be one of those people with a pre-existing condition and no one would ever cover me.  Someone told me that if I had continuous coverage I would not have a pre-existing condition, so I bought a catastrophic health insurance plan. I paid $125.00 per month through six month of unemployment, and crossed my fingers that this continuous coverage plan would work.

I did get a job and entered the land of the fully insured with relief.  It was hard to see a dermatologist—my health insurance company is great with preventative care and great with computer records and skimps on the specialists.  When I did see one, he proscribed creams and solutions and I began to beat back the scabby skin that had spread while I was uninsured.

That was in 2005 and I’ve been insured for seven years now through my employers.  I’m incredibly thankful, for I know what it is like to not have health insurance. But the insurance also holds me hostage to my job.  The job I had in 2005 was not a good fit and it took me 18 months to find another one.  Those were a very long 18 months.  Every day I wanted to quit and every day I got up and went to work because I didn’t want to lose my health insurance.  Right now, I’m looking to change careers again.  It would behoove me to quit my current job and to take a part-time job in my preferred field.  I could do this, and find another part-time job to make up the difference.  But I don’t do this, partially because neither one of those part-time jobs will give me health insurance.

I’ve also flirted with going back to school for a degree in a different field.  I won’t be doing that because the program would have me finishing with a crazy amount of loans and also because I would have to buy my own health insurance.  I've done the research and obtained quotes.  If I buy my own coverage, I would be paying $150.00 per month for a plan that did not cover prescriptions.  I know the full cost of my prescriptions, for my insurer lets me know how much they have covered every time I fill one, I would have to pay over $400.00 per month into health insurance to ensure I could fill my prescriptions.  That wasn’t going to happen.

So I’m partially held hostage by my insurance coverage.  I know I’m not the only one.  How many would-be entrepreneurs stay in their jobs because the jobs provide the health insurance for their families?  We are not a nimble and quick nation in the realm of health care.  I write the check every month for my employer health care plan and I know how much it costs to keep the eight of us insured. It is an incredible sum.

What would I like?  I would love a single-payer system, as no one has yet convinced me what the point of keeping insurance companies if everyone is insured.  Talk about wasteful spending, just think of all the money that could be saved without all the complex coding.  But I’m happy to settle for living in a country where my health insurance does not seem like the incredibly tenuous thing it is now.  I’m hoping the Affordable Health Care Act will move us in that direction.  But nearly 20 years as an adult with a health problem has made me wary.