Tuesday May 30, 2023

Health insurance

When I had a car accident 10+ years ago, I had to sue my insurance company to make them pay my hospital bills. After they settled and paid, they threatend to sue me for the full amount at any point they felt like over the next 30 years. They offered to accept 1/3 paid back to them immediately to settle. My attorney said that was a good deal. They stalled paying anything for 6 months. In the mean time, the hospital put debt collections out on me for $30k. I needed an attorney working several weeks to stop it.

I’ve changed insurance companies at least once a year, every year, since 1997. It was great while I was a government contractor, and my first year at a very nice software company. It always gets more expensive. It always covers less. My accident was more than 10 years ago.

While I’m looking for work, most jobs I’m offered (usually contractors) no longer offer health insurance plans, or charge me several hundred dollars per paycheck for basic coverage.

My healthcare for ADHD and related mental healthcare is even worse. Mental health coverage is not covered by the same insurance company, it is always outsourced to a third party not even mentioned in employee briefings. I pay several hundred dollars / month for that even with insurance, because therapy (considered mandatory by most doctors) has been covered for one year out of the past 20.

Same insurance for prescriptions, however. Under my wife’s insurance, I drive more than 20 miles one-way to get prescriptions because only one pharmacy at one location is covered. Almost always, the price of individual medications after insurance is higher than the price for the same medications in countries without health insurance (everywhere). My employers (who ultimately foots the bill for insurance) are charged several thousand dollars / month. That’s what I would pay without insurance. But I’m sure that’s never been relevant to me being picked during a layoff.

I usually go several days every 1-3 months without prescriptions because an insurance company demands that the medication be pre-authorized before the prescription is filled, without warning. For medications I’ve been taking for a decade. They’ll randomly decide that I need to switch to a generic (which usually works differently, for mental healthcare prescriptions), or decide whatever I’ve found that works is no longer covered at all. I’ve heard both that medications I were on were outdated and no longer the preference as well as too new / experimental simultaneously, 3 times. Whenever I switch insurance, I need to pre-auth nearly every prescription. That means going with prescriptions for several days. If you’ve never gone without ADHD medication and antidepressants it’s like this: stop smoking, stop being an alcoholic, cut out caffeine, and go to work with absolutely no sleep on the same day. There is also a risk of seizure, when suddenly stopping any psychiatric medication. No employer is ever sympathetic. No insurance company representative has ever been the least bit knowledgeable of any of those healthcare issues.

All of that is tied to an employer. So they try to get the cheapest plan, get a new plan every year, and there’s no continuation of coverage when I change jobs. If I’m out of work, I’m not getting any insurance for myself. I’m relying entirely on my spouse’s insurance. There is no competitive market, for the consumer of health insurance.

Health insurance is the worst possible way to pay for healthcare in the industrialized world. There are good reasons to make the way insurance companies scam customers illegal.


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