Gasp! An uninsured Nurse (rant)

[optimist]

I visited a Dermatologist today to check out a painful spot that had developed on my lip. It came up in conversation with his assisstant that I was a nurse. She glanced at my chart and remarked "I see you dont have insurance, and you're a nurse? How can that be? Surely you realize how important insurance is." My response "I dont buy into the insurance business and Im prepared to take the finacial risks that that may entail". She rolled her eyes and went on about her business. This is not the first time Ive caught flack for being a nurse and not having medical insurance, as if my involvement in the healthcare field should somehow guarantee that I be excluded from the millions of Americans living without health insurance.

The truth is, my employer does not offer coverage for part-time employees (which I choose to be due to family obligations). I could be added on to my husbands work policy on which he carries himself and our daughter but at a price of over $700 a month (heck he would practically be working for just insurance!). I could get my own policy to the tune of $150 a month and pay outrageous copays for every visit and Rx. But Ive found that barring any major emergency/Dx that Im coming out much better NOT having insurance. The dermatologist gave me a discount for paying cash so my bill was only $60 (an insurance copay would have been $70). When I get sick I go to urgent care where they also give cash discounts, I pay $86 whereas hubby and baby have an urgent care copay of $200. I go to the health dept for my yearly GYN visit and BC pills to the tune of $90 (as based on my income) whereas when I had insurance I paid $35 per visit plus $25 a month for Rx. Im saving a ton of money not being insured. Now I know that if anything major comes up Ill have a ton of bills to pay out of pocket, but thats why they make payment plans. I just cant justify paying $1800 a year for a healthcare discount program (i.e. Insurance)

And just because Im a nurse does not mean I should have to have insurance!

[nursel56]

Maybe. But those of us who actually have been unfortunate enough to be sidelined with a catastrophic illness know up close and personal how medical costs can spiral out of control. That's why it's unfathomable to someone like me to see someone seem so cavalier about dealing with something "if it happens." Heck, I just got a lab bill, for which I will be entirely responsible, for $3,340. I already hit my out-of-pocket max. for the year (which means I have shelled out beaucoup bucks), but insurance isn't covering this charge.

I don't know too many nurses who can afford to pay tens, even hundreds of thousands of dollars for medical care OOP.

I'm not talking about whether or not the OP is cavalier. I believe her main question was -- should nurses be held to a different standard than everyone else based on their personal financial situation that has nothing to do with her job as nurse.

I'm not talking about indigent people using the ER(D) as a walk-in Free Clinic. I'm not talking about people who choose a trip to Puerto Vallarta instead of getting health insurance.

I'm talking about the rather superior and scolding tone some people here have adopted and the innuendo that uninsured people need to just figure out a way to get covered!! Discussing how much you pay at age 25 living in Iowa and your medical history is you fell off your bike when you were 10 is meaningless. And how does anyone know the OP would default and become just another burden on the taxpayers? I'm going to guess that there will we an uptick in student loan defaults for new grad nurses who can't find jobs, but I wouldn't presume any individual person would be that person.

Should we need to bring copy of our bank statement to interviews so they can just run through that real quick to make sure you aren't eating take-out too often and can afford the >$50,000 you'll owe for your portion of a standard 80/20 policy should you or a family member have a cancer diagnosis? Does having a mother and brother with cancer count as personal experience with the insane cost of cancer treatment?

I'm really not upset with anyone here. I'm upset that we're reduced to having arguments like this when the big fat elephant in the room is the entire system with it's many life-altering ramifications. I'm upset that every job I've had until recently had kick *** insurance, and now I have to know people I care about are having their assets stripped away in a matter of months -- and that the premium for my healthy self-employed 59 yearold friend is that ridiculous sum of $700 a month that was mentioned.

[rn/writer, RN]

To the OP: Sounds like you have half of a good plan.

Your reasoning makes sense with the day-to-day medical expenses. But I would encourage you to look into getting a catastrophic illness/injury policy that would cover the disastrous situations many of the other posters in this thread are talking about. The premiums are usually much lower than those for a policy that covers minor and medium expenses because the deductible is so high. But then you know that if your expenses exceed a certain dollar amount, they will be covered.

For example, if the deductible is $12,000, just to pick a number out of a hat, you know that's what you'll be stuck with. It's a doozy of a bill, but a lot less than, say, the $72,000 if you should be in a car accident and need three surgeries and months of therapy.

The high deductible is a scary number, but one that you can eventually pay down. But without a catastrophic policy, the sky's the limit.

The system you're employing now (pay cash for a reduced rate, take advantage of low-cost medical services, etc.) can still work for you, but you'll have some kind of protection if the roof falls in.

If you look into this, I'd be interested in hearing what you find out.

[Laurie52]

The reason insurance works is because a large pool of people have insurance for many years. When I had a trip to the ED and emergency surgery with bills of $50,000, the insurance paid for it even though my premiums for the year were not any way near that amount. So that year I lucked out.

All the years before that, that I had insurance and didn't use it, well someone else lucked out.

That is why insurance is important. To share the risk--and not just when you need it

[Pepper The Cat, BSN, RN]

I have to admit that as a Canadian I am both shocked and fasinated by this discussion. I can't even imagine being faced with the bills that some people here have mentioned.

I have often said that one thing I like about being Canadian is that if I get hit by a bus tomorrow at least I don't have to worry about losing my home to medical bills.

To the OP - I think you are gambling that you and your family will always be healthy. Perhaps payment plans are available but do you really want to spend the next 20 years paying off medical expenses?

Sometime the price of insurance is worth it in the long run/

Of course, like I say, as a Canadian I really don't fully grasp the American medical system. I only know that I was born with a disease that has required me to have 8 operations so far, and am gearing up for #9 - if I were American, I'd hate to think of what my family and now I would be paying for this. As a

Canadian my only out of pocket expenses has been my pain meds and, when I was young, the travel costs to get me to the specialize hosptial I needed at the time.

[brandy1017, ASN, RN]

Well, I wouldn't take the chance of being uninsured, especially if I had a family and a home. We of all people see how many health problems can come up and how incredibly expensive they can be. Will you just file for bankruptcy if the worst happens? I've heard in some states they can take your house if you have medical bills so I guess you would need the house to be in your husband's name only.

It is scary that nurses can be without health insurance and that jobs wouldn't offer it, because even if you are part-time your pay would probably be too high to qualify for any govt health insurance programs and health care can easily cost more than a house if the worse happens! Unless you are in absolute perfect health without blemish you can forget about getting private insurance and would have to pay for high risk state pool insurance if you could get it.

[Twinmom06, ASN, APN]

also - if something chronic does happen (ie diabetes or hypertension) that is treatable and manageable you'll have to wait a year before any insurance you purchase will cover any side effects of it (diabetic foot care for example) if you can't show proof of 12 months of insurance prior...

[cherrybreeze, ADN, RN]

Thank you. There are certainly a lot of people here wagging their fingers about this without knowing jack about the person's life, their assets, their health, their judgement, their probable insurance premiums based on age and previous health history, their zip code and their moral fiber. I think we know a catastrophic illness can wipe us out financially.

What matters is that we meet those obligations like responsible adults. Otherwise it's none of their business. I don't know any nurse who can't afford insurance spending her extra bucks on cell phones, manicures, and designer handbags.

Well, by posting it here, it's sharing said business?

I'm talking about the rather superior and scolding tone some people here have adopted and the innuendo that uninsured people need to just figure out a way to get covered!! Discussing how much you pay at age 25 living in Iowa and your medical history is you fell off your bike when you were 10 is meaningless. And how does anyone know the OP would default and become just another burden on the taxpayers? I'm going to guess that there will we an uptick in student loan defaults for new grad nurses who can't find jobs, but I wouldn't presume any individual person would be that person.

Obviously, no one knows for sure what the OP would do in the potential face of hundreds of thousands of dollars in medical debt (heaven forbid, I might add). She DID say that she doesn't want to pay $1800 per year for an insurance plan....so the inference is there. The vast majority of people could not afford (and therefore default on) that type of catastrophic debt, so it's just a game of odds. That's all. Maybe it shouldn't be, but it reads that way. I think some people are pointing out that a monthly payment plan may be harder than the OP thinks; it does sound good and easy in theory, but the reality is different.

In a way, it IS kind of like, "uninsured people need to just figure out a way to get covered"....I know I had to. Having to deal with that bill per month is better than facing one umpteen times higher than that, should something unforeseen happen to me. I didn't so much get the superior/scolding tone from the thread, though....I think it was just surprise (it was for me at least). The fact that OP is a nurse only matters to me in that, we see more of what COULD happen, and we see it on a daily basis. I WOULD expect a nurse to have a different opinion/attitude towards it.

I'm not saying that makes it EASY, though, don't get me wrong there. I know it's tough, I'm living it too!

[DookieMeisterRN]

I've always worked FT just to make sure I have health insurance as my dh has a plan comparable to what the OP dh has. Working those extra hours gives me peace of mind. While I've been relatively healthy without any hospitalizations I sure wouldn't want to fork over the $2k for the MRI I just had. I personally wouldn't want to be responsible for my family's bankruptcy for an unforeseen illness. I also have a sizable life insurance for myself if something were to happen to me, my family wouldn't suffer financially.

I can see where the OP is coming from. I thought that way too.... in my 20's. And than I realized I'm an adult and need to take financial responsibility for myself/family.

[~Mi Vida Loca~RN, ASN, RN]

I won't comment on the Ins. part because I get it. But it was completely unprofessional for the lady at the docs office to treat you the way she did, I would have had to call her on it for rolling her eyes.

[~Mi Vida Loca~RN, ASN, RN]

Ok I was going to try and not comment. LOL When you are talking about Ins. rates in 500+ dollar amount and that doesn't account for all the co-pays you sometimes have to sacrifice on not having it. While it's good to be protected in the LONG run, that makes sense, but when you have live on a very tight budget and need to feed your kids or get gas to go to work or need a home to live in and so on, things you need NOW you kinda have to go with what you can do.

It would be nicer if Ins. rates weren't so ridiculously insane. But if it comes down to my children eating, or me being insured. I assure you, my kids are going to eat.

If you aren't faced with decisions like that then that's great. But some people just don't have the 500 bucks a month to spare.

[chevyv, BSN, RN]

I can only add that right now you've been lucky and that's great! I'm sure many of us have seen some serious illness come on suddenly enough to know that it's not really a matter of if but when. I went without and so did my youngest for many years. I was so grateful to find a job with insurance. I could care less about the pay, I only prayed for a job with decent health insurance.

[kids]

My concern would be that you are not taking the financial risk alone. If you should develop a serious condition at any point (injury or illness) not only would you be affected by the financial burden so would your husband and your child. Would you really want to see your child living in poverty because of your lack of insurance?

Her child wont live in poverty, if something catastrophic happens they can just file bankruptcy and all share the costs.