Congresswoman Nancy Pelosi describes me as a free rider because I have no health insurance. Her words are intended to propagate a myth that the uninsured get all of their health care in hospital emergency departments and are a drain on the system.
My federal taxes help pay for health insurance for federal employees, retirees, members of the military, veterans, prisoners, those on Medicare, those on Medicaid, to say nothing of members of Congress, including Nancy Pelosi.
Health insurance for employees is a cost of doing business, passed on to consumers in the price of goods and services. As such, with every purchase I make at Walmart or Kroger, or if I buy gas, I help pay the cost of providing health insurance for the employees of those businesses.
Yet when I see a doctor, I pay with my credit card as I walk out the door. I alone pay the bills when they come in. I dont even get a tax deduction as, fortunately, the amounts do not warrant itemizing.
While some uninsured people undoubtedly use ERs, workers at walk-in clinics tell me that between 20 percent and 25 percent of their patients are self pay. I am not alone.
I lost my health insurance in June 2010 when the company I worked for lost its contract and ceased operating in the area and when my wifes employer went bankrupt.
When you lose your health insurance and you are a 60-year-old diabetic, you quickly learn that no health insurer wants to provide coverage. If you call a company about getting an individual policy, the polite ones put you on hold and let you listen to music until you finally tire and hang up. The others just laugh in your face.
The last resort was the N.C. Health Insurance Risk Pool operating as Inclusive Health, which had both a federal and state program. I qualified for both. The only option I could afford was a high-deductible plan under the federal program with a monthly premium of $276. The annual deductible was $4,500. This coverage came with a 51-page booklet summarizing benefit information.
The programs customer service department could never definitively answer whether a procedure was covered or what my out-of-pocket expense would be.
I did get a routine physical exam included with my premiums. I carefully asked my primary care physician and lab to make sure they coded my physical and tests properly so the insurer would pay for them. They assured me they would. Yet when the explanation of benefits arrived, the services were covered but the amount was applied toward my deductible. The insurer proposed to pay $0.
I made the usual phone call to Inclusive Health and was told the claim would be resubmitted for further processing. It must have paid the doctor and lab as they eventually stopped sending me bills.
My health is relatively good so I saw no prospect that I would meet the annual deductible. Id be paying for all services out-of-pocket with or without insurance. What really convinced me that Inclusive Health was a poor deal was when I discovered that many health care providers have special prices for uninsured patients that are often lower than the prices negotiated by my insurer.
I canceled the policy.
Few days go by that it does not come to my mind that I am one diagnosis or accident away from losing a lifetime of savings. I accept that as the price I pay to live in a country where Big Health Care appears to have its way with most of the decision-makers.
On top of it all, the former Speaker of the House has the nerve to brand me a free rider. Never mind that the president has just directed the Office of Personnel Management to give special subsidies for members of Congress and their staff toward the purchase of health insurance from exchanges.
Who is the free rider? Is it Marc Landry or Nancy Pelosi?
You tell me.
Contributing columnist Marc Landry can be reached at firstname.lastname@example.org.