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What health reform means for the people of Illinois

A blog by IllinoisHealthMatters.org

Thursday, July 5, 2012

Scariest thing in the world

Wes Craven has certainly tried hard over the years to give us scary. Joss Whedon sprinkled it with humor. Edgar Allen Poe taught us all some lessons in horror.

Then there is real scary. The kind you don't find in books or movies. The slow fear that doesn't have a release in a moment involving some guy in a mask.

For two years, I was a diabetic without health insurance. Doesn't sound like the kind of thing John Carpenter would toss out there for 90 minutes, does it? But it is, without a doubt, the scariest thing on Earth.

I was laid off in 2008, one week precisely before Lehman Brothers crumbled and the global economy with it. While I was offered COBRA and searched desperately for some way to keep my insurance, there was nothing I could qualify for as a diabetic for less than $700 a month. Unemployment insurance only added up to about $1400 a month, so to pay for insurance, I'd have to skip rent or utilities or food.

Medicaid was no help either. Illinois is a great state, but our Medicaid system here is currently set up to help only the lowest of the low. I "made too much money" on unemployment, even as a diabetic, to qualify for the program.

Yet without insurance, insulin, the very thing I need to take multiple times a day just to live, would cost me insane amounts of money. I take two types of insulin. Each bottle of insulin lasts me about two to three weeks. Each bottle without insurance costs over $110-120. It would cost me over $450 a month just for my insulin. That doesn't begin to take into account the syringes, the other pills I take to help control aspects of my health as a diabetic, or any of the other conditions that I have related to my diabetes or not.

Taking care of my health looked impossible. I was lucky though. I had some amazing doctors and nurses that did everything they could to get me insulin, that helped me navigate the systems to eventually get set up for charity care where we could, and even cajoled a few pharmacy reps I think into making sure I survived. I would not be here but for their incredible hard work and help.

Despite all that hard work, it was still not always enough. I had to pay out of pocket once, early on when I still had a small emergency reserve of money, and visit the emergency room three times to get insulin when we couldn't get it fast enough from our various alternate sources. That's three ER visits that the state had to pay for, and therefore, in the end, you footed the bill through your tax dollars in the most inefficient way possible.

The Affordable Care Act changed all of that. I was one of the first to sign up for the "high-risk pool", IPXP here in Illinois, that was set up to help get those of us with pre-existing conditions in the individual market into plans that could help us until the health insurance exchanges start in 2014. I stood side-by-side with Governor Quinn as he announced the program to the public, and I defend it to this day as an important stop-gap measure.

Thanks to the subsidies made available through Obamacare, IPXP only costs me about $150 a month instead of the $700 I was quoted before. It'll be more now that I've celebrated my 35th birthday, going up to $200 a month, but that's still far better than not having insurance at all.

I got a job after three years of looking, one year after I got into the IPXP plan, but it was a contractor position that didn't offer benefits. I kept the IPXP plan through that year of employment, and I didn't have to worry about trying to wait until a job came along that offered health benefits. Now that I'm once again in the job market, I seamlessly have nothing to worry about from IPXP as it stays with me. This is what everyone can look forward to with the exchanges starting in January 2014.

One of the last fears I had left was washed away when the Supreme Court declared the ACA constitutional and upheld the law. (See my reaction to the ruling here) It's not the last hurdle, but it is one of the most important ones. There is no doubt now that Obamacare is the rightful law of the land and can help 32 million previously uninsured Americans just like me to ensure that health care is a right, not a privilege.

There are still challenges, and I hope you'll stand with me to ensure that I, and so many more just like me, never face that fear again. We will talk about many of those challenges in the days ahead, no doubt. Thank you for being interested in my story and for doing your part to ensure health care for all.

David Zoltan,
Guest Blogger for Illinois Health Matters

5 comments:

  1. I've known David and watched his struggles over the years, especially during those times in 2008 when he struggled with getting life critical medicines for his diabetes after getting laid off.

    In 2010, David gave some wonderful advice to my diabetic husband who was at that time also struggling to get insulin and its truly a scary, life or death scenario wherein PPACA can make a huge impact on not only filling the gap, but also saving lives and saving tax payers money.

    So that's to say that David is an advocate, person to person... not just writing to some online blog and making appearances next to politicians. He's my hero.

    The freedom of having affordable health care that is not tied to a job itself will become a revolution that offers Americans more choice in what they do for a living and how to best care for their families.

    There will be challenges along the way and things that couldn't be anticipated. Ours is a highly capitalized system of healthcare, but far from being a true free market. PPACA creates more transparency to insurance costs and pricing. This will trickle into pharma, medical facilities and devices and as soon as we as consumers can gain more visibility into these, we'll be that much closer to a true free market for selecting the care that we want to meet our healthcare needs.

    Supporting PPACA is supporting much more in the way of freedom than anyone would guess at a glance.

    And thank you David for your continued support, advocacy and for being a great friend who stepped in and helped my family when we were in the most dire need. <3

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  2. Thank you Jennifer for such a heartfelt and articulate response!

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