Blog · August 29, 2015

What Doesn’t Kill You Still Requires a Co-Pay

http---www.pixteller.com-pdata-t-l-166052I never once thought much, if at all, about insurance co-pays until Nicky was born. I went to the Doctor rarely, and a $20 here and a $20 there never broke my bank account.

Then Nicky was born.

Leaving aside the cost of bandages which the insurance refused to pay for (an ungodly amount which drove us into bankruptcy within a year), I remember clearly as if it was yesterday the day that the Doctor gave me referrals for the Physical & Occupational Therapists which he felt Nicky needed to see weekly (twice a week each), and more, including an ENT (Ear, Nose & Throat) Doctor, a local Dermatologist (which I refused to see because he knew nothing about EB), a Hand Therapist, a Speech Therapist and a Plastic Surgeon. And of course the EB specialist at Stanford-a 12 hour drive, with an expensive hotel stay. The hotels in Palo Alto are anything but cheap, even Motel 6 was $99 per night. Months later, in the bankruptcy lawyer’s office, he added all our income and subtracted all our expenses, and was aghast and asked us: “How in the world can you afford to pay for just the $400 co-pays a month for all the Doctors Nicky is seeing, let alone the bandages and everything else!?” That was the point of us even being there. We couldn’t.

Even after my husband had a stroke, they wanted a $35 co-pay each time we went to see the Physical Therapist. The Doctor wanted him to go 3-4 times per week. We couldn’t afford that.

Hence, a MAJOR flaw of the Insurance industry is exposed. Absurd co-pays. But the insurance industry doesn’t see it that way. They want to make sure people don’t “abuse” them, so in turn, they abuse us. You see, copays have only one purpose–to place a financial disincentive in front of you before accessing healthcare. If you’re required to go out-of-pocket and spend a large amount of money on healthcare, you’ll think long and hard before going to a doctor.

This is fine and dandy for someone that is never sick or goes to the Doctor rarely, but for patients that are chronically ill-like Nicky-copays are a gigantic burden. My husband didn’t ask to have a stroke. He was an athlete, always ate well, some genetically abnormally thin artery in the brain caused the stroke, and yet, he’s punished for it anyway, just so some other joe-blow might not “abuse” the insanely profitable insurance companies. Or, how about the co-pays for my son’s g-tube supplies that keep my son alive? He didn’t ask to have RDEB and need a g-tube. $275 a month co-pay it’s absurd. Why bother? I can buy the items outright for cheaper. The disincentive works, for profit bastards! Why can’t insurance companies realize that they make sick people sicker by making their care unaffordable?

Because they don’t care. They want your monthly premium and gloat to the fact that their subscribers are easily deceived or intimidated. There is no reason for them to comply with the rules of the policies they sell because, apparently, morality and responsibility are not part of what you purchase when you buy insurance. Their main responsibility rests with the stockholders & CEOs, and they make tons of money denying or requesting gigantic copays for needed things from the people that pay their premiums.

I only have one piece of advice. Stay Healthy, and God Forbid, if you do get sick, don’t expect the Health Insurance Industry to help you. They are NOT in the business of caring. I learned that the hard way… two bankruptcies later.

Just my 2c from my personal experiences, for what that is worth…

Love and Light,

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