I am a postdoctoral fellow who is currently working on pain/drug abuse research.
I was once a hopeful person and enthusiastic about working on the cutting edge of medical innovation. However, my enthusiasm has been moderated by the new health care law and its lack of honesty. It has also been moderated by the fact that I was forced to sign up for an exchange plan, and that there were several lies about what these plans were supposed to cover. Far worse is the fact that my new insurance company, Aetna, has been given unlimited abilities to refuse to pay for any medical expenses, even though taxpayers are giving them $580 a month.
That’s correct; universities don’t provide postdoctoral fellows (the people who do research at the universities) with health insurance. I knew that going into it and had no issues with getting private health insurance. The issue here is that this new entitlement program will most certainly continue the flat funding of National Institutes of Health (NIH), indefinitely. Not only is money needlessly being siphoned away to pay for my worthless health insurance, the failed federal/state websites for the exchanges cost around 2 billion dollars to produce. NIH, recently, was able to get an extra 1 billion dollars to fund medical research. I wonder if 3 billion would have been better.
My situation also reinforces the controversy over how insurance companies would act with their new found power over the consumer; since citizens are forced to either pay a fine and go without health insurance or buy health insurance. Insurance companies are already secretive about which drugs are covered under exchange plans, which leads me to believe that they will not cover any new medications, or fight tooth and nail to not have to cover them. This fact alone will destroy the incentive for life saving medications. Further, my insurance company denied paying for my daughter’s immunizations, which is only going to increase measles outbreaks. People who are denied these “preventive services” will likely refuse to finish the immunization schedules. I would not have imagined that with the government controlling health insurance that companies would actually use that leverage to hurt health care coverage further. The current administration said that they were eliminating these egregious practices, whereas they are only making them worse. My insurance also does not cover dental visits for my children, even though they are supposed to cover dental insurance. I was not allowed to get a dental rider for my children through the exchange because, again, I was told that my exchange plan was supposed to cover dental visits.
Getting to the thrust of my story, my 6 month daughter went to get her 6 month immunizations. Under the healthcare law,immunizations are covered free of charge, as long as they are “in-network.” Well, I chose our exchange plan because it included our pediatrician. After the visit, I got a bill for $440. My insurance company denied the claim because our pediatrician is out of network. It turns out that they terminated my pediatrician after our visit. To further confound things, my pediatrician is still included as a provider.
This is going to be the future of health care. My biggest issue is that medical innovation is going to be influenced even more by the government as insurance companies continue to refuse payment of procedures.
Because the government has given unprecedented powers to health insurance companies, it will only be a matter of time before medical innovation becomes unprofitable.
The United States is still the greatest engine of medical innovation, which is why wealthy individuals from single payer countries come to the United States for medical procedures. Once the new health care law ruins our advantage, where will sick people go? Normal 0 false false false EN-US X-NONE X-NONE
Date: June 4, 2014