Health Insurance Quandary


I am delighted to share with you some thoughts from another mom who raises good questions about health care.  Thank you, Catie!

– Mom Talks Politics

One of the slap-in-the-face realities of adulthood is that “adulting” is expensive. Very expensive. My husband and I have been married for four years now, and each year we joke (often with real tears in our eyes) about how we tend to get punched in the wallet at least once a year for some policy we weren’t aware of (did you know that a suspended driver’s license can break the bank depending on what state you’re in? Asking for a friend…), insurance issue, or bill. Mind you, we have excellent credit, are well-educated people, who, generally speaking, are very responsible individuals. We figure if this happens to us every year, what must be happening to those with lesser education or resources, who perhaps are new to the country, or are not native English speakers? The image that comes to mind is that they are likely being hosed in a significant way, and politics have a lot to do with it.

The thing that has been weighing on my mind the most as of late is the train wreck that is insurance. I have always been a person that looks at the world with a big “what if [insert worst-case scenario]?” so the idea of insurance actually doesn’t bother me. Bad things happen and I want to be prepared. What I do get extremely bothered by is that, from the little bit of political know-how I have picked up, the policies in this country regarding insurance are a huge drain on my family. I won’t claim for a second to be very educated on this topic (thanks Emily for the invitation to force me to give voice to some of my thoughts on these issues), but here’s what I see. My family has qualified to receive some government-funded subsidies for us to get insurance due to our current family income. I’m really grateful for that because there is no way we could afford it otherwise.  I guess what confuses me is, why does insurance have to be so ridiculously expensive so we need a subsidy in order to both pay our rent and have insurance in the first place?

Since we are now all mandated to have insurance, why is there still literally only one option for state-funded insurance? Where is the competition that is supposed to be giving us options and lowering expenses? Why do we have so little power over our health care? How is it that doctors offices, hospitals, and other medical facilities can continue to raise their prices on any given procedure so that they can get an extra buck, which in turn means, that insurance prices will continue to go up? Why is it that even when we do play the expensive game of insurance and pay exorbitant monthly fees, our policies still require us to pay the majority of the cost out of pocket?

How is there so little collaboration between the government-funded Marketplace and their supposed-partner companies (I’m talking to you BlueCross) that when they provide poor service, double-bill, or lose a claim, there is no one that can be held accountable? Why do I have to stay home sick or with serious medical issues because I am too afraid to get the help I need for how expensive it will be? How is that okay for me to consider as a parent?

Though it did feel good to vent this, the majority of these questions are sincere. How was insurance/medicaid/ACA policy such a big deal in the last elections and I feel like we are worse off than before? For a typical doomsayer such as myself, it feels unsettling to sit down with my husband and seriously consider paying the penalty for not having insurance and paying medical fees out of pocket instead since it would cost us less in the long run (barring some catastrophic health issue).

When I sit with my emotions, I honestly feel sad and worried. Sad that I know that this is something that so many Americans have to deal with and consider, and worried that even with insurance, if something big like cancer, a car wreck, or going to the ER in an out-of-network hospital, we’d still be financially ruined. It happens all the time to good people everywhere, and it gives me a pit in my stomach to think that my government is okay with it.

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