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My parents paid for me to come into the world and to have my appendix and tonsils removed. I was in college for 5 years beginning in 1940. Tuition included a physical on entrance and possible physician visits, but I never needed any. From 1945 until I spent a year in Denmark (1950) I had no coverage. I paid for only two events as I recall: extracting two wisdom teeth and medication for a boil.
In Denmark I was in hospital twice--being a non-citizen I had to pay for food, which was as reasonable as on the outside. For the next 9 years it was catch-as-catch-can. I remember there was a time in New York City when I tried to find a clinic which would take me--to save on cost while building up a stake.
From 1955, I worked in offices of small businesses in Chicago. Finally in 1960, I was offered a hospitalization policy covering surgery--office visits and any medications were my expense. Except for the usual 3 months' wait time when changing jobs, I was well covered until retirement in 1977.
Then came the trauma of finding at least a major medical policy to protect attachment to our house. I waited 10 years for Medicare and my husband 4. We paid for good physicals and kept the rules of good health--while paying for insurance which we happily never had to use. Since 1987 I have Medicare. Following are a few observations of how the system worked, as I saw it.
I believe healthcare insurers, hospitals, doctors' groups, pharmaceutical manufacturers, and medicaid overlays onto original Medicare all make for a tangled situation.
To unravel a knot, start with the one which started the mess. In my view it is insurance as a general industry--be it for personal, property or financial coverage. To run a train the US government has layers of rules to instruct the railroad industry. Education used to be quite free of US regulations, but not any more. Food oversight has US intervention. But who tells the insurance companies what they can do?
Because we are talking about healthcare coverage, let's stick with it. Originally, after about 20 years of attempts, Medicare was enacted into law in 1965. In the beginning, doctors, hospitals and patients perhaps tried to game the system. After about 15 years those who were covered knew pretty well how they could interact with it.
Was it Reagan's administration where new rules were instituted? Covering persons under disability made it possible to provide them with Social Security (SSI) and what was, I suppose, called Medicaid. It was during the Clinton administration that HMOs became prominent. And by the time of the recent administraton, a prescription benefit was added. It was then that "duelies" had to be considered--those who were old enough for Medicare and poor enough for SSI. Those senior/disabled recipients interested in pills were quick to find some form of Medicare which is similar to HMOs. I guess that is called "Medicare Advantage."
The end result of all this seems to be taking the doctor out of the examining room, making hospitals align themselves with conglomerates even more corporate than the original HMOs. We all hear about the discontent of patient and professional medical providers. It is hard to determine how insurance companies call the shots. But it is evident that they, helped by patients who were anxious for cheap medical prescriptions, made for a cozy arrangement where big pharma and big insurance drive reform.
The first time I was aware of how legislation in the making could impact my reliance on Medicare was in 1993, when I became widowed. Our doctors were in Knoxville and I had a transportation problem. So I investigated the possibility of finding local help. No doctors would accept new Medicare patients, since it was the time of Hillary's proposals. I confronted my Knoxville doctor with a question of how old he was. He knew why I needed to know and said his personal policy would be to continue with the patients he had. After 16 years, I notice he seems close to retirement, but in the interim it was necessary for me to have a cardiologist, who definitely could outlast me. As far as I'm concerned those two men, who have kept me going until now, should be able to take care of me during the muddle of any new changes which will come in Medicare. At this point I just try to study what the new legislation is going to change.
Why can't everyone have healthcare coverage like mine?
