Health Care Horror Story

By Meagan Faller, staff writer

When Alyssa Williams*, devoted employee of a prominent retail company, heard her employers were changing their health care policy, she felt no reason to be worried. “They told us that, essentially, nothing would change,” she says. But when she got her hands on the pamphlet outlining her company\’s new health care plan, she was aghast.  The packet of information looks innocent enough: bright floral colors accompanied with flowery pink writing, vines spiraling up and down the pages, cartoon families holding hands. But the content is anything but innocuous.

Without dipping into legal and medical jargon, the pamphlet reads: dental and vision care is the same, as is the cost for regular check-ups. It\’s the emergency room and hospital costs that ensnare. Surgeries, specialist visits, emergency room visits, and urgent care have all gone ludicrously high, covering less while asking for a much higher copay; copay meaning the amount you pay simply to be admitted. Most of these procedures have a waived deductible, a deductible being the highest amount you can pay before your insurance jumps in, in other words a safety net. If your deductible is $5,000, that amount is the maximum amount of money you can pay for a certain service, before your health insurance steps in. This is waived, or eliminated, for physician visits, special office visits,  hospitalization, and emergency room visits—in short, there is no limit to the amount those procedures will cost you.

“It makes you think twice when  considering a situation where you would normally go to the hospital.”  Alyssa admits. “You consider every other option before the emergency room.” This may sound rather inapplicable- how many times do people have to go to the hospital?

A lot more often than you think. A caesarian section would be considered an operation, and the mandatory three-days a mother stays in the hospital after the birth is hospitalization.  A knee or hip replacement, the fourth and fifth most common surgeries in the nation, are essentially uncovered. Alyssa has to pay 10% of all procedures, but that could be anything from 10% of a $7,456 caesarian birth to a $2,400 hip replacement  to a $70,000 knee replacement. All of this, loss of coverage, while they take more out of her monthly paycheck. Alyssa would go with her husbands health insurance, but it costs $900 dollars a month, which is far more than her average-income family can afford to spend.

And this problem is not uncommon, unfortunately, as our economic crisis has forced companies to cut back on spending, and as a result are more prudent with their benefit policies. As Alyssa commented, “The only reason for this change is either that the health insurance company changed it\’s policy, or my company is trying to cut corners.” And who isn\’t trying to cut corners in this era of recession? And when the company puts the company\’s best interests foreword, they leave their employees in tight financial situations. When asked how she will tone down her spending to compensate for this new policy, Alyssa says bluntly, “We save coupons, we eat in, we never go shopping, we only take one vacation a year. There\’s not much else we can do.” This financial helplessness is the mindset of most people during this era of recession.

*named changed for privacy\’s sake