The first year Obamacare was offered I didn’t have to pay for insurance because of my income at the time. As my practice has grown, I’ve had to adopt and pay a low monthly fee with a high deductible. Emergency coverage it’s called. Many of us who are practitioners have it. Is it ideal? What’s the alternative under our current health care system now undergoing massive change? Pay almost one-thousand dollars/month for a premium insurance carrier. How does a self-employed wellness practitioner making a low-middle class income year afford that?
I’ve wrestled with that issue long before Obamacare. I haven’t really had to use the emergency coverage. I’m basically a pretty healthy person with a pretty healthy lifestyle.
I work in the wellness profession and usually do monthly trades with other practitioners for services as needed: acupuncture, massage, cranio sacral, etc. I pay out-of-pocket for dental services, use Planned Parenthood for Ob-gyn, take vitamins and herbs, do lots of Reiki, etc.
And then I got the 2017 flu. It’s made me re-think my health care structure.
I’ve suffered major losses in my family and life over the last 3 months and combined with subsequent airplane trips out-of-state, I was probably setting my immunity up for some failure. Here’s my interpretation of this event and how someone with basic emergency medical coverage navigates such an ordeal:
Thursday 1/19 Ground Zero: Flu explodes in my body causing massive shaking and chills, fever, sweating and nausea throughout the day. Only by contacting 4 Reiki practitioners I know to send me distant Reiki combined with a crystal-infused heating pad and some aceitomyophen did the chills seize for some time. I was completely bed bound.
Friday 1/20 Calm before the storm: Awoke feeling strangely refreshed, like I had a whole body cleanse. Tired, but not sick like yesterday. Reiki is powerful, so I assumed I was well enough to go into work, listen to the inauguration and persevere. I was tired and rested that evening. I assumed perhaps this was a 24 hour flu.
Saturday-Sunday 1/21-22 Powering through weekend: The weekend I had two workshops scheduled that had been rescheduled before due to family crises. So I was going to complete them regardless of how tired I felt. I was able to manage my symptoms of cough and fatigue only because I knew Monday I had off to rest.
Monday 1/23-Almost complete rest day. Off cold medication for the whole day, so lots of coughing, but giving immunity chance to repair. Tired. Low appetite. Started to notice ear draining fluid. Some concern as have had a history of multiple prior ear infections resulting in compromised ear canals. Should I go to doctor? Not sure.
Tuesday 1/24-Compromised ear now unable to hear. Full congestion ear/nose/throat. Fatigue. Only a few clients to see later in day, but now getting concerned about hearing. By end of day both ears quite congested. Contemplate my options, go to ER or Urgent Care (only open in morning). Decide on Urgent Care because ER would just mean a longer wait.
Wednesday 1/25 5:30am Still exhausted but head to Urgent Care to get antibiotics for ear infection. Greeted by long-haired physician’s assistant in almost full Hazmat gear with mask/gloves. Intimidated. Realized in that moment that the healthcare structure I had created for myself was not adequate.
Found article online about a window of time during the flu for preventing hearing loss, especially in patients such as myself with compromised ear canals. My goal for the day becomes to find an otolaryngologist (ENT) who can prescribe me sterioids to reduce the swelling of my Eustachian tubes (ear canals) in order to prevent permanent hearing loss. I find this out through Google, not Urgent Care.
The Hippie in a Hazmat Suit prescribed antibiotics for my infected ear, so get that going while my friend and I attempt to find the lone gunman ENT Doctor in Seattle available that day. It’s a needle in a haystack. So many ENTs, are in partnership with hospitals or clinics, with their own insurance carriers and policies.
I offer cash for services and say I have no insurance to providers because I realize that: My emergency insurance is a barrier into getting adequate care that is needed immediately. This is the irony of the whole day
The lone gunman, or should I say lone gunwoman is found, has one appointment open later in the day all the way across town. She takes cash or check. The ENT has been doing her specialty for decades. Within seconds she can diagnose and see what is wrong with my ear canals and writes a prescription for the steroids. It is the perfect match of doctor and patient. I pay her $217 cash. The Urgent Care visit was $135. Approximately $375 with the prescriptions.
And I’m not out of the woods yet. Today, one week after this whole flu journey started, I have much more hearing back, but it’s only the first day on medication. I am cautiously optimistic that more hearing will return. Perhaps another follow-up visit to the ENT is needed. Hopefully not more than that.
And then lets assume once I am fully recovered, no other malady effects me for the rest of the year. My out-of-pocket expenditures might be less that $500.
I can afford that and the $250 monthly emergency medical coverage fees. But not much more. And that’s just me. Plenty of self-employed wellness practitioners I know do not even have the emergency medical coverage.
What this shows me is that in dismantling Obamacare, one way of thinking how we can rebuild the structure might involve the creation of a Health Savings Account (HSA), as the new administration has mentioned. Would they be able to put in half, and we come up with the other half? That’s an idea. Or, they provide us with $2-10K/year depending on our family size and we pay for the emergency medical coverage (EMC)? And then, they would need to dismantle all the other private insurance companies. EMC would just becomes the insurance carrier. We get to go to whom we want to because for our day-to-day we are paying out-of-pocket with the HSA.
These other private insurance carriers, many of whom I am actually a mental health provider for, are complex, broken, disingenuous systems. EMC does not work within them.
I am looking forward to a new way of health care developing in this country.
And I’m also looking forward to my hearing coming back!
Thoughts, comments welcome!
Copyright 2017 Eileen Dey Wurst