Our healthcare system is broken. This isn’t news to anyone but I’ve experienced that personally over the last couple of weeks. I recently left my job. My family had healthcare through my employment and we were switching to the healthcare provided by my wife’s employment. We knew this would be a mess. Nothing with healthcare goes smoothly. I’d been with my old firm for 19 years and we had the same insurance provider for at least three years if not longer. It was phenomenal. At least that’s what I’ve always been told. I don’t really know. Money comes out of my paycheck and I go to the doctor when I need to. I get medication when I need to. I’ve been privileged. I remember a conversation with a peer four years ago very distinctly. He’d recently moved to my firm from a competitor. He said that one of the benefits that those at his old company always talked about was our healthcare coverage. I thought to myself, “Wow, our health benefits are so good that employees at other firms are talking about it!?” This was one of the many reasons that quitting was scary.
When my wife called her benefits center they said they needed an official notice from my company that we no longer had coverage there. I contacted my firm. I hadn’t been officially terminated yet. I texted my old boss. He hadn’t processed it yet. By the time he processed it and I was able to get a letter from HR it had been almost two weeks. The new coverage could be backdated so this wasn’t a big issue from an emergency standpoint. It was a bigger issue in the procurement of regular medication for my daughter. She takes three prescription medicines each day and one of those is incredibly expensive even with insurance. We were running out. Two weeks after my last day of work, we were supposedly in the system for healthcare coverage under my wife.
She immediately went to the drugstore. When the pharmacist tried to run things through the system, he said that my wife was covered but that my daughter wasn’t. My wife needed to contact HR again to try and identify what was going on. My wife asked the pharmacist what we could get without insurance assuming that things would be too expensive and we would need to wait. The pharmacist said that there’s a non-insured generic form of the drug that we could get for less than the price we were paying in the past through my coverage. What? This doesn’t make sense. Apparently some health insurance doesn’t allow for generic forms of some medications.
I’m not a doctor. I’m not a pharmacist. I’m not involved in the healthcare field, so I don’t know the details of what’s behind this structure, but I can’t find the logic. As a consumer, now that I was uninsured I could get medication at a lower price. I know that isn’t typical and being uninsured is an incredibly bad idea that one should avoid at all costs but in this case we actually benefited from it. We are lucky and we are insured again so maybe we’ll pay more for our drugs again. I don’t know. All I can do is what all Americans do, pay for insurance and pray that when things are needed we don’t go bankrupt trying to get the care we need. The reality is we have no idea how any of it works, but it doesn’t seem to work well.
There are so many stories more shocking and more terrifying than the results in what I shared above, but it's one additional example of the flaws in the system.