I have insurance and I have a story (maybe not "horror" but horrible) to share. All my life I've been active and led a healthy life. I'm vegan, a non-smoker, no drugs, couple glasses of red wine/week, have low blood pressure, low cholesterol, healthy weight -- in short, no health issues. I'm a good risk and I've rarely even used my insurance. However, 3 years ago, at age 57 and 10 years of training for then walking full marathons, I finally had to have total hip replacement surgery because a congenital pelvis malformation prematurely destroyed the right hip socket and I could barely walk, let alone sleep through the night, because of pain. I was elated and relieved when my insurance provider approved the surgery. The insurer told me the $1500 deductible was met for the year and all but about $2000 (which I would pay) of the medical costs would be covered. The debilitating pain of 4 preceding years was finally going to end.
However, the provider actually paid less than half of the total costs despite what what I was told. After surgery they found reasons to refuse coverage for anything other than the actual 1 hour surgery: no doctors fees, no nurses fees, no post surgery toxicology, no blood work, no medication, no anesthetic, no x-rays, no follow-up visits, no administrative costs. I was left with over $50,000 in unpaid medical bills spread out between about 20 different entities. I used all of my $15,000 savings to help pay off the bills then started paying with my 2 credit cards. Then the APR on the cards skyrocketed as the banks who issued the cards were bought and sold. One card went from 14% to 30% the other went from 15% to 28% and soon I couldn't pay the minimum amounts even though I didn't add anything else on the cards. The credit card companies would not work with me to reduce the monthly payments. One card payment was 2 days late, the account closed and sent to collections. Less than a year after surgery my health insurance increased 30%, my work hours cut from full time to part-time and new unpaid medical bills related to the surgery were still arriving. I appealed the provider's decisions to no avail. All these related service were done by out-sourced entities who were not signatories of PacificCare (my so-called insurer). The 2nd card was closed and sent to collections when I missed one payment. My credit since the surgery has gone from 750 to "deadbeat" even though I've never missed or been late with my rent, utilities, insurance or car payment.
When I turned 60 this past March, my health insurance increased another 40%. The premium is now equal to 40% of my income. For the past year I've been looking for a new job or at least another part time job but the two credit card collections on my credit history has kept interested employers from hiring me. I've tried for the past 3 months to find a less expensive provider of individual insurance but either I'm declined because of the hip surgery or the premiums are equally expensive with much higher deductibles and far fewer benefits. I may be able to afford "catastrophic" coverage but I'm still waiting to hear. In the meantime haven't used my insurance since 2007 for fear it'll be cancelled before I can find something affordable. There was a time when hospitals and health insurers were administered as "non profit" entities. That's the last time I recall health insurance being affordable and dependable. As soon as our collective health was made available to the "for profit" buzzards, we have all become its road kill. My mother died from ovarian cancer at age 57 because she had no health insurance and waited until she could no longer stand the pain to see a doctor. By then it was stage IV ovarian cancer and she was doomed. After her death in 1985, my father was left with nearly $100,000 in crushing medical bills. Imagine losing your wife of 35 years then being left to face financial ruin.
Mine isn't a rare or the worst insurance story out there. There are many far more life-denying stories from good folks who've had the bad luck to be laid off, or had their health insurance cancelled just when it's needed the most -- so I'm lucky. This sort of thing happens over and over every day in the world's richest country -- or are we?
Health insurance has become "wealth insurance" for the insurance company CEOs and their investors. There should be a bold red warning on all health insurance policies: "This insurance is provided by a 'for profit' corporation and may be hazardous to your health! Use at your own risk."