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Ethics, health insurance, prematurity

When your oxygen benefits run out

My boys were 8 months old when their oxygen benefits ran out.

It’s a bit dystopian in that Total Recall kind of way (the first film where they turn the oxygen off, not the second one). I mean run out of oxygen benefits? What kind of demon dreams this shit up? It’s one thing to say you must have a generic medication, but it’s another to say, “Sorry ma’am, your kids are simply out of air. Better luck next go round.”

And holy crap, what if you actually needed more oxygen than the 1/4 liter per hour my kids needed? Many adults need 1-2 liters/hour. So what does that translate into? A couple of weeks and then, “Hey buddy, you’re on your own!”

I went from stunned to a, “It figures”. I mean the medical insurance provided to the faculty at the University of Colorado in 2004 was shitty. I am told it was a self-funded plan, which of course is a sneaky little loophole that employers can use to bypass a variety of regulations. Another stellar example of its shitatude was the reimbursement for psychiatric visits, so bad that the Psychiatry department at the University of Colorado didn’t even accept their own insurance (how’s that for a mind bender?). They accepted Medicaid, but not their own insurance plan!

But then panic set in. The fear that makes you desperate in that uncomfortable, feral kind of way. My kids needed supplemental oxygen 24 hours a day and they would continue to need it for months. I counted the stockpiled oxygen canisters that I had on hand for an emergency (our living room looked like a scuba shack) and assembled a plan. I was pretty sure I could work the system to get the benefits covered, knowing the inner workings of insurance is very helpful, but before I called and started what would be several days of negotiations I ran a budget to see how we would pay for the oxygen.

And now you scoff. You say, a doctor, how could you not pay for oxygen? Well, medical tragedies are expensive and unpredictable. We planned on dropping from a 2 income to a 1 income family for 4 months, not 5 years. In addition, there were many therapies and medications not covered by our insurance that we were already paying for.

In the end we managed, but what happens to those whose medical expenses become so great that they just don’t have the resources? What do they do?

Some go without and some resort to that down the rabbit hole version of a lemonade stand: the medical fundraiser. You see posters for them on the weekends: kids with leukemia, a teenager paralyzed in an accident, an adult who suffered a stroke. Tragedies that seem handpicked by the devil himself. Many of these people are insured, but just don’t have enough coverage to get all the care they need. Often the sheer volume of co-payments for office visits, admissions, and medications that just become financially overwhelming. Many of these families, like my own, need a full-time care giver at home and so the strain is accentuated by going from two incomes to one.

If you think we have a safety net, I challenge you to peruse youcaring.com, an online fundraising site. The number of people asking for money for medical reasons is shocking.

In what other first world country do people need to do this?

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Discussion

8 thoughts on “When your oxygen benefits run out

  1. People do this type of fundraising in Russia. Yes, we are at the level of the post communist country where male life expectancy is around 55.

    Posted by Gulia Koroleva | October 9, 2012, 7:31 am
  2. Reblogged this on The Ethical Villain.

    Posted by Beth Ivy | October 9, 2012, 10:49 am
  3. That’s shocking. Did the Affordable Care Act change this situation?

    Posted by Janet | October 11, 2012, 5:26 am
  4. Reblogged this on A Freehold of My Own and commented:
    Reposting since it involves SAHM’s.

    Posted by themorningstar3 | October 13, 2012, 10:27 pm
  5. Hope those flow rates were per minute and not per hour!

    Posted by Lancelot Gobbo | October 18, 2012, 5:18 pm

Trackbacks/Pingbacks

  1. Pingback: Divorced From American Reality « herlander-walking - October 12, 2012

  2. Pingback: Divorced From American Reality « herlander-walking - October 12, 2012

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