You have reached your limit of free articles this month.

Enjoy unlimited access to myStatesman.com

Starting at just 99¢ for 8 weeks.

GREAT REASONS TO SUBSCRIBE TODAY!

  • IN-DEPTH REPORTING
  • INTERACTIVE STORYTELLING
  • NEW TOPICS & COVERAGE
  • ePAPER
X

You have read of premium articles.

Get unlimited access to all of our breaking news, in-depth coverage and bonus content- exclusively for subscribers. Starting at just 99¢ for 8 weeks

X

Welcome to myStatesman.com

This subscriber-only site gives you exclusive access to breaking news, in-depth coverage, exclusive interactives and bonus content.

You can read free articles of your choice a month that are only available on myStatesman.com.

Commentary: Why affordable insurance alone won’t keep Americans healthy


As business owners, when our broker recommended four years ago that my husband and I get off the group PPO and switch to marketplace PPO insurance — which saved our company $400 a month due to our age — it seemed like a good idea.

At Year One, there was no difference in the quality of insurance. At Year Two, our premiums escalated equal to the cost of our company’s group plan — but otherwise the insurance was satisfactory.

In 2016, following a horse-related back injury, finding anyone new who would take my insurance was a nightmare. First, I had to switch to a family physician who was taking the revised marketplace plans. Thus began the HMO-required referral process, resulting in a six-week delay and three failed referrals because all three specialists had recently quit accepting my brand of insurance. How could I blame them?

Page 2 of the referral form stated — and I paraphrase — “if you are a beneficiary of the ACA, be advised that you have 90 days to keep your premiums current. At the end of 90 days, if your account is not current, we will be forced to retrieve any monies paid to your physician on your behalf.”

As former President Barack Obama had promised, I did get to see my doctors if I paid cash, as they no longer accepted my insurance. However, cash couldn’t get me in the door to a back specialist. I got off Obamacare and back in my group midyear. I had a new doctor a week later.

Though I believe health care should be made available to all, it comes with responsibilities on the part of the recipients. The first is to keep our premiums paid. Secondly, we are stewards of our own health.

My husband and I believe staying active is key to staying healthy. We are both avid horse people. He opened his engineering firm in 1990. I retired from a career as a veterinary technician five years ago.

My passion is competitive trail riding. For that reason alone, I have to keep this body in shape — and at times I need to get in to see a doctor for a tuneup. Though access to basic insurance — a marketplace — is now seen as a right, based on my experience, I’ve learned that access to broader availability of care — group coverage — is a privilege not available to everyone.

I’m also aware that if I suffer another accident, I can be seen immediately at an emergency room. I will pay dearly for that visit, though someone in the next bed may pay little or nothing, as most hospitals can’t turn away patients for inability to pay. I don’t mind sharing the load via higher premiums, but I need to know that I can be seen when I have a need — through proper channels and in a timely fashion.

I readily acknowledge this is a very complex issue. I feel that there were indeed some positives to the original ACA, such as our daughter being able to stay on our insurance plan after college, until she was gainfully employed. The bottom line is this: What good is insurance at any price level if no one accepts it?



Reader Comments ...


Next Up in Opinion

Commentary: Legislature must do more about surprise medical bills
Commentary: Legislature must do more about surprise medical bills

Is there anything more emblematic of our troubled health care system than a patient receiving a “surprise bill” in the mail after receiving emergency care? The most egregious form of surprise medical bills, also known as balance bills, happen when an out-of-network provider bills a patient despite having delivered care at an in-network...
Two Views: Abbott’s pick-up sticks play politics with a special session
Two Views: Abbott’s pick-up sticks play politics with a special session

With apologies to Joyce Kilmer, the American poet and hero killed in World War I, we might begin a look at the upcoming special session of the Texas Legislature by rudely rewriting a bit of Kilmer’s most famous poem: Laws are made by fools like thee But only God can make a tree. Only the governor can set agenda items for a special session &mdash...
Two Views: Special session offers opportunity for conservative reforms
Two Views: Special session offers opportunity for conservative reforms

There’s a scene in the 1984 film, “Romancing the Stone,” when Kathleen Turner’s character, whose sister has been kidnapped and held for ransom until she delivers a treasure map, says to her hero, “That map is my sister’s life.” Jack T. Colton, played by Michael Douglas, replies, “Like hell it is. Whatever&rsquo...
Letters to the editor: June 26, 2017
Letters to the editor: June 26, 2017

Re: June 20 article, “Already pinched, Texas parks not getting promised state money.” Why am I not surprised! Texas lawmakers have once again siphoned off these state park funds for other purposes, including balancing the state budget. Enough already! The state parks have millions of dollars of backlogged maintenance of parks, facilities...
Commentary: On school bonds, it’s time to go in for all of Austin
Commentary: On school bonds, it’s time to go in for all of Austin

When your school district includes 130 buildings with an average age of 46 years, major renovations will be in order. It is time for Austin to go all in for a school bond that declares our commitment to education across the whole city. The current proposed bond package serves some areas well, neglects others, and doesn’t do enough to address...
More Stories