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A Voice in the OT Wilderness

(Not) In the Mood

Published August 17, 2009 5:25 PM by OTCM
I have tried to stay away from writing in this blog about the political mess masquerading as “health reform” efforts; but the media din has given me writer’s block on any other topic.  Maybe I’m just intimidated by the spectacular capacity for fiction-writing coming out of the mouths of some members of Congress:  “Death Squads” coming to homes of the elderly to tell them their date and method of death? Doctors getting paid by Medicare to encourage euthanasia for the elderly as a way to save money? Give me a break! No matter how venal, stupid or inhumane I might think some politicians (and their followers) are, I can’t believe any Congressperson would go that far in writing actual legislation. But the fact that some elected officials are making these preposterous claims in front of microphones – and so many people believe them - makes me really pessimistic that anything will change for the better.

My personal concern is the cost of health insurance. I am one of the millions of people “on the precipice” of being without any health insurance. I was priced out of the private health insurance market (the only market available to me as a self-employed person) several years ago when regular premium increases reached 50% of my income. When I tried to change to a different policy with a lower premium, the insurer told me that because of a diagnosis (well- and inexpensively-managed so far: they were making really good profits off me) I acquired after they accepted me, they wouldn’t negotiate. They told me I could keep my current policy (which by state law they couldn’t cancel except for non-payment of premiums), or go elsewhere.  I searched everywhere for an alternative, but the only insurer that would even consider taking me wanted 80% of my income in premiums because of my “pre-existing” condition unless I was willing to have such a high deductible and low lifetime cap, I’d be better off just putting the premiums in the bank to earn interest until it was time to pay out of pocket for anything I might need.

In desperation, I went on my partner’s insurance through his employer, whose plan enrolled me, no questions asked.  I could’ve been on that plan for several years already (and saved a bundle of money), but knowing I was “untouchable”, I was afraid to be dependent on my partner’s continued employment by a company that has been down-sizing every 3-6 months for the past 15 years.  So far, my partner’s dodged the layoff ax, but I live in fear he’ll be next. He himself is afraid that his employer will cancel the coverage for retirees – who currently pay 100% of the premiums, but at the group rate – and that he’ll be thrown into the unaffordable private market.

I’m not impressed with any of the sketchy “plans” for any reform that have been trotted out so far. I have expressed my concerns – and ideas – to all of my state’s Senators and Representatives, not just the ones of my district; but have no confidence in the ability even of the ones I respect to be able to cut through the noxious clouds of conspiracy theories to achieve anything meaningful.

It’s all well and good for OTs to continue to speak up for the importance and value of our services; and I will continue to emphasize how OTs can and should be more directly involved in case management as a tool for cost-effectiveness. But the way things are going, fewer and fewer people will be able to access our referral sources, much less our services.
posted by OTCM

2 comments

Allie-

I agree totally with you. This reform has become a nightmare, and if it goes anything like PPS I don't want any part of it.

Tim Banish, LTC - COTA/L August 19, 2009 12:55 PM
Cincinnati OH

Thanks for mentionning the 'rant' on Facebook. I'm amazed at how long it has been since I checked the blog. Your essay on the R(ationing) word dovetails nicely with this. I've had a lot of questions from US colleagues about the horror stories re Canadian health care and yes there are situations where someone does not get everything that is theoretically available. I think we do a much better job of rationalising the rationing, though. What amazes me is that a lot of the scare mongering about Canadian health care is that statements such as not being able to choose your doctor are more likely to be true in the US given similar circumstances.

Joan ,, Geriatrics - OT(c), Alberta Health August 18, 2009 4:40 PM
High River

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