Learn how to put yourself back in the driver's seat where your healthcare is concerned. Uninsured readers will learn how to navigate and negotiate their way through the system to get quality care at affordable rates.
Insured readers will learn how to monitor their insurance companies and the costs incurred on their behalf.
This nonfiction healthcare memoir is a collection of life lessons learned by my family over the past 8-9 years of living well without health insurance.
What we learned was that insurance was merely a financial option and that we could navigate and negotiate our way through the world of healthcare on our own and be completely responsible and accountable for our care without the constraints an insurance company will bind you with.
Although I would never tell anyone they shouldn't live without health insurance I want to educate the nation about what having insurance really does for your healthcare and how it can help as well as hinder true care and be a major contributor to skyrocketing healthcare costs.
The book is full of stories and examples of healthcare situations my family has been through since ditching our HMO. It's an easy read in a friendly tone with tons of great info for helping the uninsured person learn how to find the best quality healthcare at affordable rates as well as helping the insured person learn how to be their own best advocate and not let insurance companies dictate their care.
Many people have read my book and come back to me to tell me how they used information from it to save money, find better care and make better decisions for themselves. To me, that is priceless - that is why I wrote this book.
Chapter 1: Why and Why Not?
Why the Book?
There are many reasons why I chose to tackle the issue of living without health insurance in such a public way. First and foremost because there are about 47 million Americans living without health insurance right now and that number is growing. Itís growing because so many people just canít afford health insurance. Itís expensive and letís face it, if youíre self-employed, unemployed or your employer just doesnít offer it for free or at a subsidized rate it can be an overwhelming expense. Not to mention that while youíre paying large sums of money in the name of monthly premiums you donít always get what you pay for. Many people have learned this the hard way - paying yearsí worth of premiums to HMOs only to find that when something terrible happens the insurance company finds a way not to cover the medical expenses incurred or drops them like the proverbial hot potato.
So, I write this book in the hopes of helping people, regardless of insurance status. I want to help people who donít have health insurance learn how to find the best care they can get at affordable prices, but also to let them know that theyíre not alone. You are NOT alone. Thereís no shame in not having health insurance, the only shame is in not getting proper care when you need it and not being able to afford it if you do. The shame is in being scared of medical disasters, doctors and hospitals because of the stigma attached to not having insurance or because of possible financial ruin. The shame is in letting fear guide your medical care choices. And the biggest shame is in letting the capitalistic ploys of HMOs and the medical profession instill shame and fear into you when thereís absolutely nothing wrong with living without health insurance. In fact, not too many decades ago health insurance was nonexistent and every person dealt with their healthcare choices on their own, just as 47 million of us do today.
The second reason I wanted to write this book was to keep people who DO have health insurance in the loop. There are so many things you take for granted when you have health insurance. I know. I used to be one of those people. I knew what my monthly premiums and doctor visit co-pays cost, but that was pretty much it. Everything else I left up to my HMO to deal with. Insurance customers cannot afford to let their HMO dictate their care and the costs associated with it. I truly believe that the reason why doctor bills, hospital bills and health insurance premiums keep rising to astonishing new heights is because collectively weíre just not being vigilant enough.
My eyes were opened for the first time when my family canceled our health insurance policy. Itís amazing how watchful you become when every single thing you do associated with the healthcare of your family will be paid for out of your own pocket. All of a sudden you become blindingly aware of what things cost. You learn to question everything. You learn to rely on yourself and your research skills. There are so many things that Iíve learned since weíve been living without health insurance. What kills me though, is that I should have been this way all along. I should have been questioning everything, relying on my own instincts, doing lots of research and acting like our healthcare was in my own hands even when we had an HMO backing us.
So, I write this book with the hopes that not only can I help people, but also so I can educate people, regardless of whether they have health insurance or not, because healthcare is a huge problem in this nation and until we all hold ourselves accountable for the care we seek and receive and the costs we allow to be incurred then we will never be able to bring our system into check. And isnít that one of the foundations of American life? A system of checks and balances. WE the people need to start checking and balancing the system. The scales have been tipped too far in the opposing direction. Itís time to be accountable and responsible and to hold those in power to the same standards. I do believe in change, itís a good thing, and itís inevitable, and if we work together we can change things for the betterment of society. We shouldnít need government to step in and make new laws to "protect" us because, letís be honest here, whenever the Big Brother steps in, it very rarely works out in the favor of the average American citizen. If we really want the benefits to come to us, we have to force it upon ourselves to see it through.
Lastly, I wrote this book because I have so many stories to share; lessons Iíve learned, information Iíve gathered, experiences Iíve been through. Iím not a doctor, a nurse, or an employee of any medical organization. Iím just an average American, like you. But Iíve learned to live a happy, nice life without worrying about health insurance or medical costs. Iíve learned to successfully take care of my familyís healthcare without health insurance and without fear and shame.
I am an ordinary woman. I work from home as a writer , I have a husband, two sons, a dog and a house to keep up with along with the usual stack of bills.
What I donít have is health insurance.
Why? Because my husband and I decided not to.
Why? After our first son was born we decided that I would have the luxury of quitting my job and staying home to take care of him. Our health insurance, which we had through the company I was working for, covered my family through my maternity leave and was extended another 18 months through the COBRA program. By the end of COBRA we were on our own in terms of medical care, which panicked me terribly as a new mother.
Immediately we picked up the tab for our own family policy through Kaiser Permanente. We were never thrilled with the fact that Kaiser is an all-inclusive medical care company Ė you have virtually no choice in facilities, doctors, treatments, etc. Ė but it was the most affordable insurance at the time and finances dictated all facets of our life then.
We soon welcomed a second son into our family and were delighted to find that he, like his brother, was healthy as could be. Soon after, though, we fell into very difficult times, financially. We were a one-income family and that one income was unsteady at best.
My husband owns his own one-man construction company. Being self-employed is an on-going struggle in any case, but we had been doing great with two large contracts that came through very close together. Unfortunately, both customers defaulted on their contracts, one right after the other. Our business and personal finances went into an immediate tailspin. As do all good crews, worth their weight, when the ship starts to sink, we began throwing our excess baggage overboard.
The first financial cut was made in the entertainment category Ė no more eating out, going to movies and the like. It was not enough to save us. Then we started cutting back on our bills; no more cable television, no more trash pick-up (we could haul our own muck to the dump, thank you very much!), no more heating the house with propane while the wood stove sat idle all winter, no more long-distance plan when our cell phones would do the same for less. We kept cutting and sacrificing, but it still wasnít enough.
After a careful review of the rest of our expenses we determined that there really wasnít anything else we could cut (we would have cut the credit card bills out, but Visa declined to see it that way). Then my husband asked what we were paying in health insurance premiums Ė I was stunned into silence, which, for those of you who know me, is not an easy feat. I didnít even want to answer him; there was no way we could live without health insurance. Was he crazy? Here I was with two baby boys Ė BOYS, you know the sex thatís prone to roughhousing, horsing around and generally getting beat up and broken just by virtue of their gender. He persisted. Against my better judgment I admitted that we were paying nearly $600 a month for health insurance. "And when was the last time any of us went to the doctor?" asked Mr. Smarty-pants.
I have learned in our decade plus of marriage that when he gets like that, the only way to appease him is to get out all of the paperwork and start crunching the numbers. What I found, however, did not appease him. What it did do was shock and amaze us both. That year, which was circa 2002, we had spent more than $8600 in medical expenses. This is not the shocking part Ė the kicker was that $7000 of that figure was spent in health insurance premiums alone.
Upon closer inspection we realized that each of us had only been to the doctor once that year for our annual physicals. We had also been to the dentist for routine cleanings, check-ups, x-rays and a filling or two; none of which were covered by our health insurance plan so even though we were paying our premiums, we were paying these expenses out of pocket anyway. We also paid about $230 for birth control pills and other prescriptions that year, above what was covered by our health policy. What hit us hardest was realizing that the $7000 we had paid in premiums that year was really just to cover four routine physicals with our family practitioner which equates to $1750 per visit!
As amazed as I was by these realizations, I was still not convinced that we should drop our coverage. As with most mothers, my biggest fear was that one, or both, of my children would become injured or contract a life-threatening disease and that we would not be able to afford the best care for them. (There was, of course, also that nagging fear that the $180 spent on birth control would be in vain and that there would soon be three kids to keep from breaking legs and spraining wrists!)
What finally convinced me was a combination of my husbandís voice of reason and a bit of research on my part. My husband rationalized that the money we were GIVING to the health insurance company was really just money down the drain Ė money we didnít have to give. Not only would that money be better spent helping to get us out of debt, but it would serve us better to invest that money on our own behalf and then, God forbid, should something catastrophic happen, we would pay for it out of pocket from our nest egg.
Itís now been several years since we decided for the daring lifestyle of being health insuranceless and we havenít regretted it yet. In fact, on many occasions we have been thankful for our choice. Being independent of the health insurance industry we have gone about our healthcare in a much more cautious, resourceful, conscientious and curious manner and have learned a great deal about the medical marketplace.
After my sonís oral surgery in January 2007, which constituted weeks of grueling research on my part to ensure my sonís safety and well-being before allowing any procedures to take place, my husband suggested that I write a magazine article about what I had learned. He put a little bug in my ear that I had a social responsibility to share my experiences and knowledge on the topic of healthcare with the other millions of Americans who do not have health insurance, whether by choice or not, as well as with those who do have health care. For those who have healthcare Ė I would begrudge you nothing, you deserve the best care you can get as well, but you, too, should be aware of some of the lessons I have learned so that you can decide if your policy is worthwhile as well as to be alert to the "real" costs of your healthcare. My goal is to teach everyone how to navigate the healthcare industry successfully; how to find the right healthcare professionals, how to determine what the proper care should encompass, how to ensure proper billing takes place (whether itís addressed to you directly or through your insurance company), how to find good financial deals and discounts and how to dispel the myth that living without health insurance is shameful, dangerous or indicative of not being worthy of the best care available.
So, I wrote a great little magazine article on the topic and touched lightly on each of several lessons I had learned. But there was so much more to it. The article was really just a drop in the bucket but I was happy with it and proud of it. I met with a literary agent who took a look at my notes for the cutesy chick-lit books I was hoping to work on and was unenthused, to say the least. While I had his ear, though, I felt compelled to show him some of my other work. He took one look at my healthcare article and declared, "Now thereís your book!"
I was so excited to hear that something of mine (even if it was my husbandís idea Ė and donít think heíll ever let me forget it!) was worthy of the literary world. I immediately started doing the research for this enormous project. As much as I have learned about healthcare I knew that there was so much more that I was yet unaware of. The first place I went was to the U.S. Census Bureauís web site to find out how many of you out there are like me, in regards to health insurance. I found that, according to the 2005 census, nearly 47 million people in the United States do not have health insurance, which equates to approximately 16 percent of our nationís population. What surprised me even more was the fact that a significant portion of these makes a good living. One common myth about people without health insurance is that they are living on or below the poverty line. According to that same census, of the 46.6 million Americans without health insurance, more than 17 million have a household income greater than $50,000 annually and of those nearly nine million earn more than $75,000 per year. Thatís a lot of people CHOOSING to live without health insurance. This certainly did not fit the stereotype I had in mind of the average family currently living without health insurance. I envisioned all of the other insuranceless families to be inner city dwellers of considerable poverty. My eyes are ever opened wider the more I delve into this topic that seems to have grabbed me by the shoulders and screamed, "Talk about me!"
The numbers continue to astound me. The majority of people in the United States who are not covered by health insurance are white, middle-aged, native-born Americans with a moderate income and living in the suburban south. And here all along I mistakenly thought that we were so different from the community around us in this respect.
This is why I wrote this book. The poor, yearning masses, the working class and the financially comfortable are all in the same boat. Their reasons may be different but the result is the same Ė we are all fighting the same uphill battle for decent healthcare at affordable prices.
Nothing that I present to you in this book is a secret, but some of it may surprise you and hopefully all of it will interest, educate and improve you and your quality of healthcare.
The other reason I wrote this book is that, well, SOMEONE had to! All other books on healthcare deal with politics, social issues, medical jargon and can typically cure insomnia by page two. Iím hoping that I can supply interesting stories about my experiences, invaluable information based on what Iíve learned and present it in a friendly, interesting, easy-to-read format.