Healthcare Worries

A Condition. A Diagnosis. A Pre-existing Condition.

We all have a pre-existing condition, most just do not know it yet. This point was made in a recent article I read, in regards to the current political healthcare battle.

The last week has been consumed with Brayden’s waiver and insurance.

I have been collecting charts, data, letters, forms, notes from phone calls and meetings.

Trying to understand the waiver/insurance deciding to cut Brayden’s nursing AND attendant hours. Saying that he did not meet their requirements.

It has been the SAME forms completed, his care coordinator, the nursing agency and his doctor sign off on, for many years. The form gives points for medical conditions, tally those points to show how many hours he qualifies for…he has always qualified for 16+ per day. Somehow a doctor and review (does anyone really read all of Brayden’s paperwork) says he only gets 10.

Here is the BIG problem.

Brayden costs too much. Brayden is a liability. No one wants to take responsibility for Brayden and those like him.

We are seeing this with insurance/waiver, the school system, programs that work with special needs kids and basically everything else. To all of these, Brayden costs too much, he is a liability and no one wants responsibility for such a high cost, medically fragile child. 

In Brayden’s lifetime, it has not seen great improvements, it is worse.

What is someone’s contribution to society? Are they are drain/stress on society? What is a person’s value? Who gets to decide this?

And this is not just about medically complex children. Healthcare has an impact on everyone. I am going to get a bit political here. And I will put it out there, I consider myself on the conservative side of things, and certainly do NOT vote that way all the time. I try to do my research and assess. Healthcare has been a deciding factor for me, I do not think any party has a great plan for Healthcare.

As many know, the Republican and Democrats on the Federal and on the State level have been arguing Healthcare reform for many years. Obamacare, ACA, was doomed to fail because there was no real way to pay for it (the medical community and insurance companies found it to be too costly). But I will tell you a lot of it had good intentions. It required coverage for pre-existing conditions, removed lifetime caps, included treatment for mental health and chronic diseases. It also expanded Medicaid, which is Brayden’s secondary insurance. Yes, there were many troubles with Obamacare. But I really do not see the Republicans plan, as much better, some trying to leave decisions in the hands of the insurance companies or the state to decide. Insurance companies could charge more for pre-existing conditions or possibly be denied. States could decide if insurance companies could have that power. Also the potential Republican plan is looking to make large cuts to Medicaid programs, this is a hot button issue. I think many see Medicaid as supporting those is poverty or unemployed or leaches to the system. Medicaid is so much more than that and includes those in every walk of life.  Brayden’s waiver/Medicaid program has been a vital part of his care and health. He is on a program through Virginia that gives him access to Medicaid as a secondary insurance.

With all of the current troubles we are having with Brayden’s insurance and waiver, I am fearful.  Fearful that the world is quantifying what some is worth; laws and insurance get to make that decision. Who qualifies for treatment, medical attention, etc.?

Would people hesitate to get preventative care or screening? Would they get dropped for testing positive for the BRCA gene? Or have large insurance payments (that most could not afford) for family history of cardiac problems? Prenatal testing that could show defects or medical issues. Would people not get testing? Would people consider aborting because they could not get or afford insurance for a child that is yet to be born? Would insurance companies require DNA testing, family medical history, health screening to qualify for a plan?

Perhaps I am a little burned by all of this.  Even in our home owner’s insurance. We had a house fire. It cost the insurance company. They covered everything with no real problem. BUT we were dropped from that insurance the moment our renewal time came. Now we are considered “undesirable” candidates. We have few options (expensive) and have to wait a period of 5 years, without incident, to return to being a good candidate.

And guess what? Health insurance is heading that direction.

Brayden and our family is undesirable to health insurance companies and programs.

As I said in the beginning of this blog: We all have a pre-existing condition, most just do not know it yet.

***Disclaimer, I gave a VERY basic outline and my personal highlights/thoughts of ACA and the Republican plans that have been in the works. They are still working on all of it, so wording gets changed. There is a lot of push and pull from both sides of the isle. It is happening on your state level, how they will use funds. And happening on the federal level. I want everyone to understand how important Healthcare is, something can and will happen to your family.  Looks at both sides of the Healthcare arguments, through the lens of what if this happened to me, to my loved ones.

And side note, if you have watched Man in the High Castle - discussions around Healthcare worry me to the level of Thomas Smith, Obergruppenfuhrer Smith's son, with a pre-existing condition.