Moving from NYC to San Diego - Part 3: What about healthcare? Conflicted over GOVT ASSISTANCE (cue scary music)
It's been awhile since I've felt inspired to write, but yesterday's events got me started on this post last night. It got pretty long though, so thank you in advance for sticking with me!
(view of NYC from the Brooklyn Promenade at sunset)
I've come to the conclusion that one of the harshest realities I've had to face being an entrepreneur is that there is no large company to back a fancy PPO insurance plan. For the first time since I graduated college, I was without insurance. I never thought I would be in a position to apply for Medicare, but I guess my perceptions of the program were all wrong. What other choice do I have when I am starting out my own business venture with barely enough profit to keep me out of the red? I figured it couldn't be that bad - most insurance companies are scams anyways, and as long as I can see a doctor, who cares?
Right? Or is this privileged ignorance?
In the interest of keeping this just under novel length (lol) I'll skip to saying I have medicare healthcare now. It was a bit of a process, quite different than enrolling from my desk right after signing up for the company matched 401k plan. I had to go in person to submit paperwork proving that I can care for myself and that I am not homeless. Wait. What? Honestly, I thought I would be rejected when they saw how much I had saved up for this opportunity to be a starving artist. On the contrary, if I could not prove that I have more than enough money for rent and other expenses for awhile (like, A WHILE guys, not just a week or two), then I was sure to be denied. So now I'm confused as to what government assistance programs are for. Surely a homeless person is in more need than I am? And in their situation more prone to illness, disease....so right off the bat, I feel uneasy about using my brand new, state issued medical card. Who am I taking from in my time of need if they're so picky as to who they want to help? I don't think I want to be in debt to these types of people, and surely free medical insurance comes with strings attached. Somehow.
My feelings didn't matter yet anyways, because I still had a few more hoops to jump through before I was actually enrolled. Because, you know, being accepted to medicare is NOT the same thing as having health insurance. With me so far? Yes, I consider myself to be pretty smart, educated and all that but this system is impossible! So, I picked a provider, called the number they gave me and stated what I wanted to do when I finally navigated the hell of automated answering services. Of course I would pick the one with the most hoops. They needed a letter of recommendation first. I don't know what this has to do with anything, but I'm told any location of this provider can give me a letter. After a drive around North County and hitting up three different places, I finally realized this was just a stupid (smart) tactic to get people to not choose them. Literally nobody knew what I was talking about. Ahh, nice. Ok. The "best" rated provider doesn't want my free insurance. Message read loud and clear. I found out after the fact that I was to wait in a room full of people and closed, unmarked doors for an unspecified time until someone returned and opened a door. No receptionist, only a touch screen pad to sign in for an appointment (which I didn't have because I'm not enrolled yet, haha) and no option to speak with a person. This someone would give me a generic print out with my name filled in and that was the go-ahead. I think I'm glad I ended up not going with those assholes, because what the fuck is that shit. Go get a piece of paper so then you can have insurance? I'm like Indiana Jones trying to get the to the holy water to save his dad, only I don't have the diary telling me to kneel so my head doesn't get chopped off.
So back at home, I call the number again and just say give me the one insurance I can sign up for with you, right now, no stupid tasks to complete like this is a treasure hunt or something. Got it. So now I can see a doctor, right? Wrong. First, you must pick one out of a telephone sized book and designate them as YOUR doctor. I'm confused again because why would I pick one to be my primary care doctor if I've never met them before? Ok, fine. I'll play by the rules. Random doctor picked, let's move on.
By the time I got my card and what not in the mail, they'd already sent a letter yelling at me for not making an appointment yet. But I don't need a doctor. I need a dentist. Earlier this week, a very large chunk of a filling in my back molar fell out. Pretty sure it's not related to the ladder falling on my head, but you never know. It's one of those old, silver ones. Looks like I spat out a bullet. Anyways. I need a dentist, right? The ones who fix your teeth. So I go to my heath care provider website, pick a dentist, call for an appointment....and they tell me no, sorry, we have to be assigned as your dentist first. Fuck. I forgot about this assigning thing. My spoiled ass has always had a PPO so whoever I wanted to see was fair game. Ok, back to the phone number and I'm told oh no, health care isn't dental care. I'll spare you the next few transfers since it makes me angry just thinking about it but just know it ended with my boyfriend reading me the literature sent from the provider basically saying dental is not covered at the same exact time the woman on the phone tells me I can go to whatever dentist I want since medicare doesn't really have a dental plan. OH yeah, that cannot be true. I don't work there, but that's absolutely not true. I just tried, remember?
So now I am back to making a doctor's appointment I do not need. Why? To "establish a relationship". I wonder what code that gets billed under. Regardless, I have to be social with the doctor before he will assign me a dentist. LOL. This is crazy. I'm glad I'm laughing as I type this because I sure was not laughing at the lady on the phone.
Once she set my doctor's appointment for JUNE 19, I totally snapped. I said look, I don't need the doctor, I need a dentist. That is what this whole rigamarole is about. I explained my situation and she said OK, we make exceptions for this type of thing, but please be aware we can only address the issue you just told me about. The dentist is not allowed to look at anything else or do any other work. Guys, seriously. Am I being a snob or does this not sound right? What do you mean they're NOT ALLOWED. Shouldn't the dentist clean my teeth before he does a filling, or is that a separate service all together? Since when does a doctor or dentist not complete any work he sees necessary at the moment? OH RIGHT. FREE SERVICE. This really sucks. Just because I can't afford insurance or do not work at a fancy corporation that means this is what I am entitled to now? This seems all types of wrong to me.
Except then I think about the doctors and the dentists. If I went to school for all those extra years, you're damn right I'd be setting my own prices that I bet the government is not willing to subsidize. And if I'm the government then why should I pay for fancy doctors? This is America, if you want something, go out and get it yourself! Work hard for it!
But isn't that what I'm doing? It doesn't happen overnight. Ugh.
I never thought insurance would be such an issue and make me feel so uneasy about my position in life right now. I have never been asked if I was homeless before moving to California, and now it seems like a regular occurrence. That has to play with your psyche at least a little bit, no? I love what I'm doing and where I'm at, but taking assistance just doesn't feel good. Now, don't get me wrong - most of the customer service members I spoke to were lovely and as helpful as they could be. But what have I got myself into when I'm sent a booklet telling me if I need a gyno or family planning doctor there is no need to see a primary for a referral but when I try to make the appointment, I'm told to go be social with a general practitioner first. I don't know about any of you, but as a woman with a functioning uterus, I should go to the gyno once a year. I don't feel the need to see a general practitioner, ever. Knock on wood, but I usually don't get sick. If I have a problem, I'd like to see the guy who specializes in that problem. Again - spoiled? Or just realizing the price of time and unnecessary prodding by someone who will tell me to go see the specialist anyways. When I had a migraine for a month, I needed a neurologist, not someone sticking a tongue depressor down my throat. I know I need to have a test every 6 months for something only the gyno can do. Not the general practitioner. So why waste both of our times?
If you've made it this far and are still with me - let me know. Anyone in the medical field out there that can weigh in on your side of things? Does this keep people from booking unnecessary appointments? Does it actually save any money in the long run, or is it just a way to bill multiple office visits for the same problem? You can probably guess that I'm assuming its the latter.
I truly apologize if this post has come off snooty or extra privileged in some way. But I like to think I'm sharing my views of both what I had and gave up...and what it's like now. Not having the best healthcare at my fingertips is definitely a huge drawback to this whole journey but I'm still not ready to go back to a desk job. I feel really conflicted at what government assistance is and what it means to be taking it. Does it mean anything? Does it reflect who I am or how hard I've worked to get here? Am I being judged....wait, yes, that's a stupid question. Of course I am. It's easy to ask yourself why people don't take the proper care to be healthy, or go to the doctor when they're sick. Just get in your car and go, right? I was one of those people - if others don't care to put effort into preventative health care, then why should my taxes be responsible for making them feel better after the fact?
I've certainly learned a thing or two about myself in this whole process. Up until yesterday, I was Team ME. Privatized social security accounts sounded like the perfect solution, and I always assumed health care would be a top priority spend for anyone who cares about life, no questions asked. I still think that if you can afford the best doctors, then yay you. I don't agree with a free health care system where you can't pay for better/faster/experimental services but what we've got going on here now needs an uplift in my opinion. It's sad that the conflict hasn't arisen for me until now, but letting some administrator dictate the type of care and from whom I get it from should not be the way. Sure, exclude me from going to see a Beverly Hills plastic surgeon that bills $1200/hour. But don't limit my basic needs, like a dentist and women's wellness. And for fucks sake, make it easy for people to see a doctor! No wonder people are uneducated on how to keep their health in check - if I didn't actually need a few tests then I would have given up trying to get insurance a long time ago and just crossed my fingers.
(SoCal sunset from my back yard)
So no, some (most?) of us just cannot "get up and go" to the doctor of their choosing on the same day they feel ill.
I'm not trusted enough to know my own body, I need to have a social call first.
What do you think? Be honest, I don't care if you offend me. This is a hard topic I can't seem to pin down my feelings on. Everyone should have access to awesome healthcare but still be able to buy extra privileges based on their income? That sounds like an oxymoron. But I do believe everyone should have the best healthcare available at anytime to them. But I just don't want to let go of that idea that I CAN buy my health back, if it comes to it and there in lies the unfairness. I can't have it both ways, can I. At the very least, my takeaway today is that it's not as easy as I thought it was to see a doctor and that's no fault of the patients so we shouldn't be judging, we should be educating.
Let's just hope I don't need a specialist anytime soon, lol.
Ah yes, the wonderful world of the self-employed. If you don't have a bank account, it's almost impossible to get one. Also impossible to get accounts such as a cell phone contract, unless you have a prior credit history. Total pain in the ass. We don't have state medical insurance here. So if you don't have health insurance, you go to state hospitals. The ones where the homeless people go. And you will die waiting in the queue.
So much for encouraging entrepeneurship.
Isn't it ass backwards? You need to have good credit to be able to do things, but in order to build your credit report you need a credit card. And you can't have a credit card without having credit history. Thank god my mom saw the value in teaching me finances at an early age and co-signed a "credit card" for me when I was 13. It was a $200 limit and fully funded by her account if I failed to pay, but it taught me a lot at a young age and started building my credit so that I was able to have a good credit score by the time I was an adult.
So I guess I should be thankful the state does offer at least something here. Is there an option to pay for health insurance out of pocket if it doesn't come through your job? Can I go to the state hospital and pay to cut the line? I remember being offered a severance package from a prior job that gave me three months of health insurance. After the three months was up, it was $970 a month. That seems like such a ridiculous amount to pay monthly unless you're already sick and know you need multiple doctor visits.
The whole system is insane. Especially the day I was told, 20+ years after I opened my bank account, "we don't give bank accounts to self-employed people anymore". Not that I had ever had a zero balance, quite the opposite in fact. A few years later, I was told by a consultant, looking at my savings balance "oh, you qualify for a credit card, don't you want one?" I said no politely although I really wanted to tell her to shove it.
Wait, what? So, if you're self employed you've got to keep your money stashed under the mattress? No wonder there's so much crime there - there's tons of cash just floating around! That is ridiculous! They didn't try to take the account away from you because you were self employed, right? The trick with banks here is that if you have a low balance, they'll charge you a fee for their services. But if I keep just the right amount of money in there, it's free. Since leaving the work force, I dont think Ive been hitting that amount because I move money around a lot now. UGH I just realized this. I better go check!
There have been so many heists on cash vans, there was a big push towards getting everyone to use cards, with the banks making a killing on transaction fees. Luckily I got my account long before that. Now, if your account is empty, it's closed. You'll pay fewer fees if you have a fat balance. Card fraud is huge here and it's a huge rip-off all round. I'm always amazed to see foreign tourists hand over cards that aren't PIN-protected. That was phased out years ago here
That is a scary system! If your account is closed, then you have no choice but to get a credit card or use cash all the time? Sounds like they give you no leeway to fuck up in life there, otherwise itll be even harder to get back on top.
You'd never get a credit card. It's true how being between the cracks is such a long way up. Banks have been pressured to make fee-free accounts for the "unbankeable" though. Although of course you have to prove that you qualify for that too. Such a rip off. One of the many reasons why Africans have been at the forefront of developing non-traditional money transfer services
I mean, how do you expect anyone to get ahead in life if you dont give them a chance or teach them how to be "bankable"? Now that you say it, it makes a lot of sense why I see a lot of successful steemers coming from your continent.
That sounds like such a nightmare. Whenever I think about the possibility of moving back to the States, I always wonder about health care. If I couldn’t find a job with health care benefits, how would I ever be able to afford insurance for my wife and I and two kids? I can’t even imagine. In Japan, I pay roughly $140 a month for myself and two kids. And we can see any doctor we want.
Unless you are independently wealthy, the cost for a family of four wouldn't make sense. I see now why people go without it and get into debt over medical bills. Is the $140 subsidized though a company? When I was at the investment bank I think I was only paying around that.
And what happens when you're old and retire? Medicare. Same system. So my grandfather is a miracle, was supposed to die about 4 times already and I have rushed home more than once for him to make a ridiculous recovery in less than 24 hours. Strokes, skin cancer, chrones disease, mersa, the list goes on. He's the most sickly out of anyone in the family but we joke he will outlast us all. Anyways, the guy has a colostamy bag, and that coupled with the chrones means he doesn't get enough nutrients to keep his body functioning. He needs IV nutrients every day. Medicare decided he didn't need it because it costs $1000/day and he wound up in the hospital for two weeks, too weak to be functioning. Only now do they realize the importance of the $1000/day which is nothing to them, compared to what a two week hospital stay costs! So in order to try to save a few bucks, they experiment with people's health. THAT is why I'm afraid to use this program.
It is a huge racket! I have a nurse friend who wants to advocate for patients but that os being self employed, too. Sigh. I am very thankful for Matt's employer offering us Kaiser. One stop medical campus. Very expensive still.
Ridiculous. Turns out I need a crown. But in order to get that, I need to go see the primary doctor first, and then get a wellness check up from the dentist and then on the third visit back, I get to pay out of pocket for the crown and visit. I'm like, so if I'm paying out of pocket anyways, can't I skip the first two appointments?
When we had to get major orthodontics for Ivan, we discovered that a payment plan with the dentist office itself was cheaper and better than any dental insurance out there. 6K spread over 4 years for surgery, braces, xrays, cleaning, and partial denture for the teeth that never grew in.... I couldn't agree more that dentistry is a major part of overall healthcare! He still had baby teeth embedded in his jaw, which would have dissolved and caused heart damage or ??? It is unfathomable. Hope you get your crown and all care needed reasonably! A lot of Californians go to Mexico for dental care, saving thousands.
Oh yeah! I cant believe I didnt remember everyone telling me Mexico is the place to go to the dentist, LOL.
@dennisauburn also recommended his friend who is a dentist in Fallbrook. I drive by the office every day, and never realized it! If worse comes to worst and I cant deal with the politics of the appointment making, then I'm just gonna throw the whole bill on my Care Credit card and hope they offer 0% financing for at least 6 months. My dentist back in Brooklyn understood the bullshit that is insurance for dental so they let me put everything on that card and gave me years at 0% to pay it off. Even if the bill was $100, they still gave me at least 6 months.
My thoughts are with you. Dental issues are a serious bitch. Hugs