Pondering the Healthcare/Insurance Mess

I can think of many creative adjectives to describe the current health care debacle, but I will try to keep this as clean and respectful as possible. My family has what the government is considering a "Cadillac" plan. My husband works VERY hard for these benefits. We earn a decent living, even though our income has literally been cut in half due to the state of our current economy. I LOVE my insurance company. I am starting to question some of the doctors I have seen.

Here's my beef (be patient, I have several steaks to fry!). I have had chronic sinus infections for years, which have lead to some really nasty bronchial infections including pneumonia. I was told that my problems were rooted in allergies. Mind you, I have been told this by many family doctors. I can't even begin to tell you how many times I was in the doctor's office from November - May of last year. Every time, I paid my copay, and walked out with over $100 in rx. I rotated Levequin, Cipro, Augmentin, and the ZPak. I took prednisone, inhaled steroids and shot them up my nose, only to return 5 days after the antibiotics ran out to get a different one. Finally, in May I was so sick again, I decided to go to an ENT (Ear, Nose and Throat Specialist). I figured, if I had allergies, I needed to find what I was allergic to. One look up my nose, and he asked how many times I had broken my nose. In amazement, I replied "Several". Long story short- He fixed my nose surgically and I haven't been sick since. My insurance company had me in surgery within 3 days. After hundreds of dollars spent by me and my insurance company, this would have been avoided YEARS ago if I would have gone to a specialist first, or the Family Doctors that had been treating me knew what they were looking at when they looked up my nose. I had the power through my insurance company to seek out a specialist without a referral from a family doctor, some are not that fortunate. Other than the hundreds of dollars I have spent treating this problem, I have some serious Achilles tendinitis from the antibiotics I have taken. Lesson learned. See a specialist.

Last summer, my husband was doing what we call- "drive by docking" with our boat. I jumped from the boat to the dock and felt my knee pop. It didn't hurt at the time, but as time went on, it started killing me. Since this had the potential to be a 3rd surgery on that knee, I waited as long as possible to see my Ortho. When I went to see him, he said I had torn my meniscus and required surgery sooner than later. I asked him if I needed a MRI, he said he would do one if it made me feel better, but it wasn't necessary. I had the surgery, my knee was fixed. BAM. This is how it should be. My insurance company didn't require a MRI or a second opinion. I love them both. Lesson learned. See a specialist.

When I spoke with my Orthopedic Surgeon just before my surgery, I told him how grateful I was to have him. I really love this guy! He humbly said he was just a mechanic and that what he does is pretty easy. Pretty cool coming from a guy that fixes the knees of famous athletes all over the world. That made me think- if my car was broken, would I keep taking it to the same place that couldn't fix the problem? Hmm.

We are very fortunate to have the insurance plan we have. I don't want anything to change. My insurance company is easy to work with, they pay claims quickly and I can always get a live person on the phone. We are not able to qualify for insurance unless we are covered under a group plan at this time. I don't know what we would do without this great benefit we receive from my husband's company. On the flip side, if the small business I work for was required to enroll all of their employee's in a plan, like many other small businesses it would be financially devastating for the business. I don't know what the answers are for everyone. I just know what works for my family. I don't want the government running my health, my bank or my car company. I think they have bigger fish to fix first- how 'bout unemployment??