In 2003 I worked for a bank. I had insurance through a major provider here in the midwest in the US. I began having back pain. I went to see doctors I picked from that insurer's list of approved/in-plan list and they never once took imaging. I went back and went back until the pain was so severe one day I went to the emergency room twice in a 48 hour period. They gave me pain meds and said I needed physical therapy. I did the physical therapy and wound up back in the emergency room with severe back pain and numbness beginning in my legs. They took a CT of my lumbar spine (the problem was in the thoracic) determined I was having either some sort of muscular pain or was trying to scam for drugs and sent me on my way.
Then I lost my job and found myself doing temp work and the insurance ran out. I had to go to a sliding scale pay clinic here in the twin cities that made a deal to get an MRI for me at very low cost. This was now a year after initial back pain symptoms started. They found that t-9 had been completely obliterated (you can see pictures of this in the
Swift article I wrote for Randi.) I was then instructed to go to MinnCare, a government sponsored program to get health care to the poor. I was told that I could not make more than 500 dollars a month to qualify for the coverage to have my operation, thereby effectively forcing me to not file for unemployment when I told my temp agency I had cancer and they let me go.
I had my surgery. It was done by some of the best doctors in the US, and cost an absolute fortune (most of which was covered my minncare.) After the surgery I had to have radiation and regular checks with bone marrow biopsies and imaging and blood work. Each visit costs literally thousands of dollars. On Jan 1, 2005 MinnCare handed my coverage off to a private insurer, the same one I had when working for the bank. Since the doctors I had now were not the doctors I had on file with the private insurance company 2 years prior they refused to pay for any of my radiation treatments or follow up exams. I could not afford to have a physical therapist help me learn to walk again, I did that on my own. All this time I had gone deeply into debt and was living off kindness of others and what little credit I still had.
The reason they stopped coverage? The original doctor had not referred me to any of those that actually did their job.
I am still fighting debt collectors over medical costs they refused to cover. I am still in a monstrous amount of debt despite earning a decent living now as an IT professional. I make a decent living and can't afford to fix or replace my ailing and trashed 10 year old jeep.
By the time I learned these things might be actionable by attorney, it was too late per Minnesota law to do anything about it (or so I was told by the attorneys I saw.)
Anyone who thinks Private insurance doesn't pull shenanigans is simply wrong. I have been all but bankrupted by this BS, all to live through cancer and a major operation on my spine.
To top it off, I have to sneak in through work group insurance policies because I have a pre-existing condition. So much for choice. The events of the last 5 years have cost me enough to consider bankruptcy.
So it's piss off and die or go bankrupt for the non-rich in this country. And the insurance company does not have the insured's best interests at heart. I am now also limited in amounts of meds per 90 days I can have for pain, etc. This is to keep me from being addicted to not having pain, apparently. If I shop around to other doctors, I break the law. If I tell people I have back pain they look at me as though I am trying to score drugs like some common street addict.
It's broken. The whole system is broken and costs way too much. I don't know what the answer is but it sure as hell is not the status quo.