On being sick without insurance…. Lessons from 8 years. 

On September 1 Medicaire kicked in for me.   Tonight I finally got the final word that I had been accepted for a Medicare Advantage program.   Everything that was impossible for over 8 years is now possible. 

I write tonight sick.  I feel awful and have for about a week.   I have bronchitis which is a frequent occurrence for me.   I simply can’t stop coughing.  In the past,  without insurance,  bronchitis normally becomes pneumonia.   At least it did for me. There have been many close calls.   I  know when I would read stories of people who would go into the hospital and die from pneumonia I always knew “there but for the grace of God go I.”   It normally comes in January or February. This year it came early. 

This year it won’t be pneumonia.   It is still early in the cycle and tomorrow I am going to a doctor.   Unless you have been there you can never realize what that means.   280,000 people in Tennessee know.

The last really bad time was a couple of years ago.   I  had a full time job… ironically at a hospital,  but I had no full time benefits… no sick time,  no health insurance.  When it got really bad I was more concerned about missing work than anything.   If I didn’t work I didn’t get paid and not being able to pay the rent was a far worst thing than feeling bad. 

The lies you tell yourself are real predictable….. It’s just a cold…. Probably just bad allergies….. It will go away.   It won’t get bad again…. You can cope with it.   To much depending on you not being sick…. You can’t tell anybody how bad you feel.  Too risky… Toughen up.  Don’t be a wimp. 

When I finally had enough money to see a doctor she was furious and wanted to know what I used for sense.   I tried to tell her that things were not as bad as they sounded.   She told me,  “You’re right… It is worse..”  She told me if I had waited much longer it would have been disaster. 

You make deals with yourself when you don’t have insurance.   One of the first things I learned was it cost too much to stay well.   You learned to live with so much after a while it just seemed normal and common sense.   A doctor was only for after feeling real bad and not for preventing real bad.   Sometimes not even then.   You always figured in the end it would go away and your quietest and loudest fear was you knew eventually something was not going to go away. 

I remember when they told me I  needed a hernia operation.   I was in a lot of pain but I figured maybe it would get better.   I would have to take $4000 to the hospital just to get in the door.   That wasn’t happening and I told the doctor I  couldn’t get the operation.   I thought he was going to have a stroke.  I told him it couldn’t be that big a deal that many,  many men had hernias and they all survived.   It was one of the few times a doctor actually yelled at me. “It is not a big deal when people take care of it.  It can be a really big deal when they don’t.”   He then described in gruesome detail how I could die.  And what a bad death it might be. 

I  told him about the coverage gap and how the challenges facing me were minor compared to what many people I knew was facing.   He looked strangely at me when I said,  “You don’t understand.   I  am blessed compared to many I know.” 

There is so much I could talk about.   Sometimes you go to the ER but you learn quickly to hate that.   Even when you felt bad you really weren’t an emergency most of the time and some how they always made sure you knew that.  And despite what was assumed I hated owing huge sums of money I could never pay back.  It wasn’t what I needed,  I wasn’t what they needed.   You learned to hate it.  A friend after a bad experience put it this way,  “The ER is where poor people go to get referrals to doctors that can’t go to and get prescriptions they can’t afford to pick up.” 

This post is not what I hoped it would be.   I wanted to make an organized and compelling argument and this has not been much about being organized and I doubt that compelling.   I wanted to tell you that not having health insurance is a big deal that you will never understand unless you realize how big of a deal it is you have it.   Being in the Gap affects everything about you….the kind of person you are,  the way you make sense of the world,  and what seems realistic and common sense.   

I hope the day will come when closing the gap makes so much common sense it cannot be ignored or passed over.   I hope that day is this year. Much is ahead and I hope we will find ourselves determined and resolute in what is ahead. 

Tomorrow I am going to the doctor.   280,000 Tennesseans are still waiting for their day. 


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