Falling Through the Cracks: Stories of How Health Insurance Can Fail People with Diabetes

Health insurance companies are  a hot topic in the news today!  Healthcare reform, colloquially known as “Obamacare” especially looks at what the role of the Insurance companies is now? What their role should be? and How is the systematic structure contributing (either beneficially or detrimentally) to the overall afford-ability and availability of health insurance?

In class this past week we examined quite a few new terms and situations involved in Healthcare.  Sometimes I find that information seems vague until I either see or hear stories about how the current medical system is affecting individuals.  I came across this article and found it interesting because it not only breaks down the different levels of coverage offered at the moment, but it also offers personal stories about those individuals struggling financially to secure proper and just health insurance.

In particular, this article  examines only a small proportion of the population–those with Diabetes.  While Diabetes is just one chronic illness our neighbors suffer with in this country, the inability to get proper prescriptions, insulin, or testing strips, can prove detrimental on the health and finances of a family or individual.   To make matters worse, those individuals who have been recently laid off from work or anticipate being laid off from work must begin a transitioning process to look for new healthcare.  Often they are unable to find an affordable plan due to a pre-existing health condition.  In order to supplement these people, the government offers federal aid in the form of COBRA and HIPAA, which insure a recently unemployed individual for 18 to 36 months.  Unfortunately, in the case of Sylvia, a 52 year old diabetic patient, COBRA does not cover prescriptions or patient care.  In addition, some people like Walter of Kentucky, age 45, are recommended to test their blood glucose levels 3 times a day.  However, due to the expensive nature of his test strips (90$/box of 100 strips), he is only able to test once a day, leaving room for the potential of having too high of blood sugar the rest of the day.  Thus, while even those members who are federally covered by COBRA and HIPAA do receive some temporary healthcare benefits, the reality is that these benefits are insufficient and short-lived.  They are transitional aids, but they do not change the fact that the insurance companies can continue to simply deny these individuals based on pre-existing conditions, or minimal income, and thus high premiums.  Ultimately, many people in this article admit to forgoeing even minimal coverage because they fear the burden of having to pay extremely high prices for extra prescriptions (above the 3 allowed by some insurance companies/month) or unexpected doctors visits not covered by their plan.

In addition to the physical burden placed on the unemployed or poor when it comes to finding and maintaining good health insurance, often their is an emotional side.  When job loss occurs or unexpected hospitalization is required, patients and their families are put under pressure to choose to pay medical bills over their mortgage.  Some find themselves downsizing, or taking out more loans or even selling their house and moving in with other family members, thus extending their burden onto others.  Ultimately, there is no real simple answer, but stories like these truly hit home with us about what really is just or unjust when it comes to how insurance companies operate and extend coverage to individuals with chronic illnesses like diabetes.



1 Comment

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One response to “Falling Through the Cracks: Stories of How Health Insurance Can Fail People with Diabetes

  1. Leila Houshmand

    I agree that the lack of health insurance for those with pre-existing conditions in between transition times is a major problem. Not only do I think that it is detrimental to the health of these individuals if they are having to skimp on their care because it is not covered in their short-term health insurance plans, but I also think this can contribute to a larger bill having to be paid later by the federal government. As we have all learned in public health prevention is usually much more cost-effective than treatment. However, in this case diabetes can cause many problems and complicate other possible health risks. If these people end up needing emergent care, the government foots that bill, rather than providing adequate care to prevent such procedures. I do see a bit of a problem in the Affordable Care Act in that you have to have been uninsured for 6-months before you can qualify for the pre-existing condition insurance. While I think the idea of pre-existing condition insurance is a good one, maybe some other provisions should be made in this area.

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