As a child, I never thought twice about going to the doctor. My parents never talked about it, but I assume their jobs provided insurance. If there were co-pays or premiums, my parents never talked about that either. For all I knew, going to the doctor was free.
The only time I was made aware of the hassle of insurance was when I was 14 and accidentally shoved a wad of tissue deep into my ear. We had just taken a road trip from Wisconsin to Seattle that required my whole family to share a hotel room each night. My whole family included my dad, whose snoring was momentous. The wadded up toilet paper served as ear plugs.
When my mom took me to the hospital in the morning, I remember paperwork, photocopies of insurance cards, and several phone calls to our insurance provider. The doctor finally ushered us into his office, stuck a giant pair of tweezers in my ear, and pulled out the toilet paper. All those phone calls and paperwork for that?
I continued taking health insurance for granted until 2007, when, between jobs, I decided to teach in Korea. My COBRA had run out, and I was faced with a $200-plus monthly payment for the medication I’d been on for six years. Being frugal, I started rationing what was left. It was an anti-depressant and, I reasoned, not a necessity.
When I moved to Seoul, I found a nice English-speaking doctor to continue prescribing my pills. Korea — at least when I was there — had a single-payer system. Being in the country meant you could buy into their inexpensive — and comprehensive — government-sponsored insurance.
After my teaching contract ran out and I was back in the U.S., I went online and found an private insurance plan for a low monthly premium. Suffice it to say, I didn’t understand what “deductible” meant. This would come back to bite me in the ass.
Over the next three months, I went to two doctors’ appointments and a few weeks later received two sizable bills in the mail. I was elated to return to Korea and not worry about health insurance, deductibles and co-pays for another year.
That second year in Seoul, I weaned myself off my medication entirely. In the back of my mind was the knowledge that I wouldn’t be in Korea forever. Another year and change passed, and, after returning to the States, I moved to Israel for school.
Israel didn’t have state-run insurance like Korea, but they did regulate prices on pharmaceuticals, insurance and other medical costs. Within a month, the damp air in Tel Aviv had given me my first case of bronchitis, leaving me literally speechless. I hadn’t bothered to buy an insurance plan, but was able to afford the cost of an in-home doctor’s visit (yes, the doctor made house calls) and the necessary medication. After that, I bought insurance and went to the doctor whenever I deemed necessary.
After a year, I was back in the States again, Googling which superfoods have the most vitamin C and how to cure intestinal woes with over-the-counter medication.
I spent one night with searing pain in my abdomen that I assumed was a bladder infection. Google told me that apple cider vinegar provided more relief than cranberry juice for UTIs. I swallowed so much of the stuff that it gave me heartburn. Amazingly, when I stumbled into a Planned Parenthood the next day, the doctor told me I didn’t have a bladder infection. I’m still not sure if I cured myself through sheer will and vinegar, or if the abdominal pain was something else. Either way, I still had to pay $200 for the UTI test. At least it went to a good clinic.
Then came the Affordable Care Act.
At the time the ACA was rolled out, I had just gotten a full-time job and was thrilled I’d be able to afford insurance. I wasn’t thrilled when I saw the price tags. I settled on a “silver” plan, which came with a $218 monthly premium, a $2,000 deductible, a bunch of co-pays, and the worst customer service I’ve ever experienced. The plan was pretty expensive on a $33,000 salary, and I could count on one hand the number of times I used it.
Fast forward six months and it didn't matter: I'd been laid-off from my job. I immediately called up the New York State Health Exchange and canceled my insurance. I wasn’t spending my one-month severance on that crazy premium. My relationship with Medicaid had begun.
The relationship started out rocky. The version of Medicaid New York had confused the hell out of me. I kept calling the number on the back of my card and trying to get names of participating doctors and clinics, only to be told that some doctors accepted it, some didn’t. I turned back to my home remedies.
When I moved home to Wisconsin, I assumed Medicaid would follow me. Not quite. I re-applied, and it turned out to be the best insurance I’ve ever had. The people I got on the phone could explain things to me in simple terms, the co-pays for doctors’ appointments rarely ran more than $3, and there was a clinic that accepted my Forward Card right down the street. I was so happy that I started therapy and eventually got re-prescribed anti-depressants. I pitied people who weren’t on Medicaid.
In the meantime, I’ve gotten two part-time jobs and sometimes teach classes at a nearby college. I make just enough to be over Medicaid's $980 monthly limit, so, for the last three months, I’ve gone uninsured.
Of course I’m lucky to be healthy. And I’m only healthy — and OK with going uninsured — until my luck runs out. Do I think a single-payer system would benefit America? Take a wild guess.
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