Wednesday, September 11, 2013

The Reality of Our Health Care System for Those Who Slip Through the Cracks

This is the reality of our health care system under the changes of "Obamacare".  I write this blog because I know that I am not the only person going through this. Please share this post to help me get the word out there about the forgotten ones.  The people in the grey area who make too much money for government assistance, yet not enough money to have health care for themselves and their families.  Please help me tell my story because it could just as easily be yours.

In August I received a notice from the New York State Department of Health and Human Services telling me that my family would no longer be covered by the Family Health Plus program.  Family Health Plus is a state run program designed for people who are working, who are not eligible for other government assistance such as food stamps, but cannot afford the high premiums of health insurance through their jobs.  In anticipation for President Obama's health care reform, Family Health Plus cut their income requirement in half.  Under their new guidelines a family of four must have an income of $2,458 dollars (before deductions) or less to qualify for this program.  What family of four lives on that kind of income without government assistance such as food stamps and medicaid?  I was informed that as of September 1st myself, my husband and my children would no longer have health insurance.
At about this same time, I developed a pinched nerve in my shoulder.  No big deal, right?  Happens all the time.  It hurts, but it heals and people move on.  Only, for me it did not heal.  Over the span of one week it got worse.  Much worse.  During the last days of having insurance I went to an urgent care clinic.  After 2 xrays they told me that it was not a bone issue, that it was muscular.  They gave me some pain medication and a mild muscle relaxer. Their advice was that if the situation did not improve in 5-7 days to see a doctor.  I laughed and told them that by then I will not have insurance so that is not an option.  They shrugged and sent me on my way. 
I returned home and took my medications.  I was on hydrocodone with ibuprofen for pain and it worked at first.  I was not able to sleep in my bed, so I slept on the recliner in my living room. One morning about 6 days after my my visit to the urgent care clinic I woke up in excruciating pain.  Over a 4 hour span of time I took 5 hydrocodone pills that did nothing to stop the pain.  All I could do was sit in my living room and cry.  My husband, at that point had enough of watching me suffer.  He called in to work and took me to the emergency room.  After over an hour of sitting there trying not to make a scene by writhing and crying in pain I saw a doctor.  She gave me a shot of morphine and prepared me for xrays.  The morphine did not even touch the pain.
After 7 xrays I went back to the waiting room and sat there for a while.  Eventually the emergency room doctor came out and spoke to me quietly among all the other people sitting there.  She told me that I have degenerative arthritis in my neck.  This was putting added pressure on the already pinched nerve and that it would not heal on it's own.  At the very least I would need physical therapy, but more likely I would need surgery.  I needed to see a neurologist, but she knew that I could not because I had no insurance.  It seemed as though she might just start crying with me as she told me there was nothing else she could do for me. 
The next day a nurse called me to check up after my emergency room visit.  We spoke about my situation and she became somewhat alarmed.  She exclaimed "Well, you have to do something!" To which I responded that I was aware of this and I asked her what she thought I should do.  She had no answers for me.  She gave me a phone number for a clinic that helped people with no insurance.  I called.  They told me they were so inundated with patients that they could not help me.  They transferred me to an outpatient clinic.  The woman on the other end of the phone had no idea why I was transferred to her because she could not help me either.  She transferred me to another person who was equally confused as to why I was calling her.  She transferred me to another person who was not in the office.  Her voice mail stated that she calls people back within 24 hours.  Here it is 6 days later and I have not heard anything from her, because she could not help me either.
So here I am with no options. I am still taking my muscle relaxers and ibuprofen, but I am still in pain.  And by tomorrow I will be out of medication.  If I return to the emergency room, I will not be able to receive any more pain medications.  This practice of denying people pain medication is to keep pill addicts from being able to feed their addictions.  The idea is that treatment is the only thing that will solve the problem and pain medication is not the answer.  I get that.  But what am I supposed to do?
To get health insurance through my husband's job would equal the cost of our car payment.  My family is stretched to our financial limits. To cover this cost, we would have to give up our car.  I was waiting until both of my kids started school on September 4th when I would be able to get a job to improve our situation.  Now I physically cannot get a job.  But since I cannot get to a doctor for an official diagnosis, I cannot go on disability.  I am left with this pain and absolutely no options.
In order to get health insurance I have a few choices.  My husband can quit his job and we can go on full welfare.  I can get a divorce.  Or I can have a "welfare baby". 
People tell me that once "Obamacare" takes effect that I will be able to get lower cost health insurance.  With Family Health Plus I had no copays and a minimal cost for prescriptions.  With how financially strapped my family is, we needed that.  Now the best I can look forward to is $250 dollars a month for health care, and this is only after January when the health care law goes into effect.  So what do we do from September until January? And once these changes are in place, if we don't find a way to pay that $250 a month, we get fined.  If we don't pay the fine, they take it out of our tax return. 
It's not like we're sitting here with a bunch of extras claiming poverty.  We don't have cell phones.  We can't afford them.  We don't eat dinner in restaurants.  We can't even afford to go to McDonald's.  With my husbands bi-weekly paychecks, we spend two weeks of every month unable to properly feed our children.  And there is no help for us.  None.  We get no help with food.  We get no help with school supplies for our kids, or clothing for them.  Each of my children have 3 school uniforms and that is it.  Not even enough to get through the week.  There are now three classes in American society.  Upper class, below the poverty line, and screwed.  My family has never done so badly in our existence than when we made the jump from below the poverty line to the "middle class", otherwise known as screwed.
This is the true story of our economy, and the changes our president is making.  This is the true story of the families that fall through the cracks.  This is the true story of what has happened to the so called "American Dream".  And I know we are not the only ones who suffer like this.
Please share my story. Please help me speak up for not only my story, but the stories of so many others who are dealing with the same troubles that I am.
Thank you.


  1. the complete network of agencies, facilities, and all providers of health care in a specified geographic area. Nursing services are integral to all levels and patterns of care, and nurses form the largest number of providers in a health care system.

    1. Thank you for your comment. However, my post was not in any way intended to diminish the role of nurses in our health care system.

    2. Are you seriously that inept that you responding with this? are you kidding? OBVIOUSLY its integral. The number of healthcare workers wasn't the issue, half-wit. Pemna, do everyone a favor, and learn what "critical thinking" is....or maybe in your case, just the thinking part.

  2. I said this was going to happen years ago, a lot of my friends supported this president but now have taken another look at things. Unfortunately it's too late they voted twice for this mess.

  3. Don't blame Obama, blame the Republicans. Obama wanted Universal Single Payer like Canada has. Republicans said NO, we go with our plan.

    Aside from that you should review your options and don't forget about the 'federal subsidies' available to you and others in your position...

    While premiums in the law’s soon-to-be opened health care exchanges have varied throughout the country, New Yorkers will experience savings of at least 50 percent as a result of Obamacare

    “An individual with annual income of $17,000 will pay about $55 a month for a silver plan, state regulators said. A person with a $20,000 income will pay about $85 a month for a silver plan, while someone earning $25,000 will pay about $145 a month for a silver plan.”

    Now that I've done my commentary you need to go to the link below....

    The premium you pay for health plans purchased through the Marketplace may be further reduced if your household income is below 400 percent of the federal poverty level ($45,960 for individuals and $94,200 for a family of four).

    The Tax Credit and Premium Estimator estimates the amount you would pay toward a health plan when you are eligible for tax credits. Your estimated advanced tax credit is paid directly to your health plan by the federal government. You only pay your portion of the premium.

    Click on the Tax Credit and Premium Estimator below, to estimate the amount of tax credit you may be eligible for and the amount you will have to pay toward coverage each month

    1. Thank you for the information. When my husband researched this the best we found was a $250 a month premium. It is very difficult to get straight answers because it's different everywhere you look. But a huge part of my issue is that I am in pain NOW. I can't imagine living through this pain until January when these options are open to us. I have tried several alternatives in my area, however all of them are inundated with the uninsured and cannot help me, especially since my situation requires a specialist and surgery. It's not like I have the flu or something. No one wants to touch this one. But don't think I'm sitting here throwing my hands up (or the one I can use anyway) and resigning myself to having no options. My days are spent making phone calls and contacting anyone who might be able to help me. However, I get the proverbial door shut in my face every time.