Tuesday, November 09, 2010

Dysfunctional Health Care System Hits Home

I need to vent. I just found out this afternoon that United Health One has again denied my application for coverage. This is personally frustrating and expensive but also significant in that my case demonstrates just how pathetic the system has become. Why? Because, by all measures, I am in ideal health.

I am 46 year-old woman, have zero medical history, take zero medications and have excellent vitals and BMI. I've never smoked and work out at least 4 times a week. Nonetheless, United Health One denied my initial application for coverage because I take vitamin B-12. That's right, the need to take a vitamin constitutes a pre-existing condition worthy of denial.

Over the summer, my doctor here in the District noticed my B-12 levels were low based on a routine blood test. She explained that a low B-12 count is a common condition, especially for people like me who eat little or no meat, suggested that I take a B-12 vitamin everyday and we'd recheck the values in two months. United Health One (a.k.a., “Golden Rule,” how ironic is that?) decided this was sufficient to deny coverage and, after an appeal that included a strongly worded letter from this same doctor, denied the appeal.

I'm one of the healthiest people I know. But as an independent contractor, unaffiliated with a larger insurance buyer, I am being denied coverage for a brutal profit calculation. I'm not saying that the system would be okay as long as I and people like me can get coverage. Rather, my case demonstrates just how ridiculous the situation has become for all of us. Though Health Care Reform legislation may be flawed in some ways, it's also true that, come 2014, what happened to me today would be illegal. If the Republicans in Congress come through on their campaign promises to repeal reform, the system will continue to attend to the wallets of shareholders and CEO's, leaving our health and the health of our families in the dust.


At 6:02 AM, Anonymous Anonymous said...

It's so ridiculous!! I'm not sure why their calculations even show you to be a risk. You would think that a person with your good health would actually BOOST their profit margin, so I am at a complete loss here. If you can't get insurance, who can? Arghghgh. - Sarah

At 8:51 AM, Blogger Joyce Patterson said...

Many those who oppose the current administration's health reform do so because they think it is just a handout to "those deadbeats." They don't see how many are in your position - working, self-reliant and yet unable to get coverage - and they aren't thinking how a devastating health problem could financially bankrupt a person and remove them from productive contribution to society. We need a system that keeps people working and productive. It's so backwards to force people out of the system because we think it is too expensive.

At 4:43 AM, Blogger jonwilson said...

You should just keep your options open, Kristin. With so many insurance companies out there, you're bound to find one that can give you coverage.

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