The Health Insurance Conundrum

Good Insurance can make life difficult.  My daughter has recently discovered this dirty little secret.  Now, before you start composing those nasty e-mails to shoot my way let me explain.  Good insurance, my friends, can open the door and shove you head-first into a no-man’s land of frustration, confusion and added stress in the midst of a medical emergency.

In my daughter’s case it involved immediate in-house treatment for her six-year-old son who has an array of newly diagnosed mood disorders.  The terrain of childhood emotional disorders is a frightening one we have only begun to grope our way around in the past few months.  Since my grandson required immediate hospitalization the door to no-man’s land swung open and swallowed us whole.  The hospital chosen by the psychiatrist didn’t take my daughter’s health insurance.  Unfortunately, there are not many options when it comes to quality in-house treatment for young children with psychiatric problems in this area.  Cook’s Children in Ft. Worth was the viable option left to us. 

We live in Plano; my daughter works in Dallas.  She had to take a leave of absence without pay in order for us to drive back and forth daily for several weeks to visit my grandson and have family therapy.  There was also a five-year-old brother who was in tow for the daily trips.  The three of us were exhausted; the expenses and frustration mounted.  My daughter is a single parent, sole support for her boys.  The temporary loss of income was significant. 

Partial hospitalization was the next step for my grandson.  Children’s Medical Center of Dallas and the insurance company came to an agreement to take him on a one-time basis. That facilitated the situation temporarily.   Beyond that, we will once again be slogging around in the coverage quagmire.

If my grandson had no insurance, if my daughter had no job, the State would probably pick up the tab for his hospitalization somewhere.  If money was no object we could put him in Children’s Medical Center of Dallas and choose to pay out-of-network.  Instead, my daughter has good insurance but limited options when it comes to her child’s special needs.

 Health insurance can pose a conundrum for the insured.  When it comes to your child the stress of being hurtled into this no-man’s land of coverage here, no coverage there, partial coverage if you can defray the costs is overwhelming.  All you want is the best care you can find.  It’s your baby, for God’s sake!  If a working parent is the sole provider and the only available option is a hospital in another city, and that involves lengthy travel, expense and the inability to work, it compounds the stress and highlights this insurance conundrum.

As a parent you do, of course, whatever you have to in order to meet your child’s medical needs.  My wish, when it comes to the treatment of children, is that insurance companies and children’s hospitals would find a way to come together and make the process as painless as possible for parents.  I wish the children’s hospital planned for Collin County was up and running.  Some 26 to 28,000 children from Collin County are treated in Children’s Medical Center of Dallas each year.  They plan to break ground for the full-service facility to be located here in Plano next fall.  This will be a boon to the area and the parents who currently drive to Dallas for treatment of their children.

Don’t get me wrong, I’m not whining about having insurance.  I’m simply pointing out that having insurance coverage is not a panacea in all cases.  There has to be better way when it comes to our kids.