Wednesday, January 20, 2010

8/5/2010

We are expecting Baby Hayden #2 somewhere near August 5, 2010. The new addition to the family was a surprise to Shey and I (to say the least!), and we are getting more excited, but for a while we've just been overwhelmed. In light of recent events in Massachusetts, and the ongoing discussions about health care in our country, I thought I might add a personal story to the mix.

After Shey's difficult and complicated pregnancy, delivery, and Rowan's early troubles, we had a difficult time getting insurance for both Shey and Rowan. Rowan was added to my policy at the church after an initial appeal, but Shey was denied twice. They advised us to reapply after six months to a year, and thought that without any other complications she would be fine to get coverage. During the next year, we kept coverage for Shey through COBRA which is anything but cheap, stretching our budget a good bit, but we worked things out. We reapplied this past summer and Shey was denied coverage again on the plan with Rowan and me.

So we pursued an individual policy for Shey through Anthem Blue Cross and Blue Shield (the same company I was on with Rowan, and the same company that Shey was on through her school) and she got coverage. Weird isn't it? As part of the policy, we had to pick up a maternity rider, the rules being that Shey could not become pregnant within the first six months of coverage or they would not cover the pregnancy costs. We made it 4 1/2 months. We weren't trying to get pregnant, but apparently being careful doesn't always work!

So, not only were we faced with the prospect of a major change in our family, which is surprising, but we could certainly grow more excited...but we then had to face what seemed like overwhelming obstacles of trying to figure out how we are going to cover the costs of all of the medical expenses. Pre-natal visits, labor, delivery, hospital costs, estimated between $10-15,000. Add to this that Shey must also be on a prescription of Lovenox shots, twice/day, with an estimated cost of $3,000/month. And oh yeah, we are in the middle of buying a house! And while we've saved some money by renting and living in people's basements, we don't have that much money...I'm a youth pastor and my wife was a teacher for four years before Rowan. Basically the conservative estimated medical costs (shots for 10 months, pre-natal, labor/delivery, and then a normal hospital stay) would be my entire salary for one year.

So most of December was spent trying to finish up teaching, finish my book, and then figure out how to cover some of the upcoming medical expenses. We found out that I make too much to qualify for Medicaid, but not enough to pay for all the expenses outright, so as you can imagine we were freaking out a bit.

Thankfully, the folks over at the company who make Lovenox (Sanofi Aventis) have a program for those who are underinsured or uninsured, and they have given us a 3-month supply of shots for free, and as long as I don't get a raise, and we should continue to be able to qualify for the program. Next, there is a Baptist Minister's Relief Fund of Virginia that is in the process of helping us figure out some things. I just got an email yesterday, and am going to talk with someone about negotiating with the price of the hospital stay for Shey.

We've played by the rules, we've been decent people, we've paid taxes, we've never lost coverage for health insurance, and we've done of good job of staying pretty healthy, but at the time when we needed solid coverage and health insurance, it hasn't worked. We are certainly thankful for the other organizations and even for the drug company (even though it is the steep prices that caused much of the problem in the first place), and of course our families will never let us starve or foreclose on our new house...but the healthcare system didn't work for us. And we aren't poor, and are educated, and have access to information that many other folks don't have, to at least explore other means of help.

I'm not going to say that Obama's plan is the only viable option, or that I know all the answers; because I don't. But I thought that our story is one that helps highlight the need for change and reform. If we can't get reasonable coverage or coverage when we need it the most, and we are in the middle class or even wealthy compared to many families who are without jobs or whose lives have been devastated by lack of coverage earlier, it seems like change might be a good thing.

We knew that the system was messed up after the last pregnancy and birth of Rowan, and their hospital bills without insurance would have been about $90,000/person respectively (and that's nothing compared to some of our other friends who have had more serious problems or Shey's sister who suffered through a car accident and was hospitalized for nearly a year).

I guess I wanted to add my voice to the discussion, because it is easy to think about healthcare as a political issue (which it certainly is), but it is also really easy to demonize people who disagree with you on the issue. I simply wanted to share our story about how the current healthcare system is not working for us. Thankfully, the community of faith, and our family are supporting us and helping us figure some things out, but many people are not so lucky.

So as you discuss healthcare reform or change, or talk about how the "Dem's" are trying to make us all socialists, or how the "Rep's" need to stop having tea parties and start offering other solutions, I hope that we can try to help others see beyond the political spin machine and remember that there are real people whose lives are being dramatically altered and changed, and perhaps forever changed depending on the results of the healthcare discussion. We know ours is.

2 comments:

april said...

Thanks for sharing this, Josh. Post it to facebook! :)

Brendan O'Connor said...

From the cost for my brother for a broken leg, to the shower of bills my cousin received after an almost-deadly fall last year, to the $300 or so i had to pay to see a specialist out of network, to this, i can't help but blame some good ol' American individualism for the lack of solutions, among other things. Hope this eggs people on to get involved in some way--write your member of Congress, your local paper, get involved with a group like RESULTS.org, something.

Sorry for it Josh, thinking about you guys and hope to connect soon