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Submitted By Diane L. Marolla, LICSW, MarollaConsulting@yahoo.com
“Although referred to as a health-care system, the United States actually delivers health care through a vast patchwork of public, for-profit and not-for-profit clinics; small community hospitals; large teaching and research institutions; health maintenance organizations; and thousands of doctors in private practice whose medical services are built around entrepreneurial enterprises.”(Delthia Ricks, Ms. Magazine, Spring 2009)
The topic of health care is broad, as it encompasses our overall wellbeing and the quality, delivery and affordability of our care. It includes our local providers and the facilities that take care of our health-care needs as well as the payment of services. No matter who we are, access to quality and affordable health care is critical. How often has it been said, that if we don’t have our health, we don’t have anything? In addition to the emotional side of losing our health or watching a loved one lose theirs, there’s also the practical side—in today’s world we can lose everything we’ve worked for. In some cases we can lose our jobs simply because of our own illness or having to take care of a loved one. Health-care costs are the number one reason why Americans are declaring bankruptcy, yet it seems that most Americans still pay more attention to the World Series, Tom Brady’s eventual retirement or what the Kardashians are posting on Instagram. We all need to be more involved in our health care—learning how to stay healthy, and knowing how the health care system works when we need to use it. The days of going to the doctor and only having a $10 co-pay are long gone. Today, people have watched their health care premiums increase year after year, and their coverage for services become less and less. When you do access health care services, you receive a confusing statement from your insurance company called an Explanation of Benefits (EOB) where you need a degree in nuclear engineering to understand what it says and if you owe anything. Many of us have gone to the pharmacy to pick up a prescription, only to hear the pharmacist say, “do you know your cost is $800 for this?” Health care has become a tangled web of confusion. As someone who has worked in the health-care industry for 30 years, I certainly understand why most individuals are not well versed in the American health-care system–how it works, and how it impacts one’s overall health and financial wellbeing. People only seem to know the sound bites they hear on the news or the stories they read in the newspaper. They either want to like Trump or hate him for his position on the Affordable Care Act. Democrats and Republicans both use the media to say that they are the ones fighting for health care. All of us as consumers need to get beyond the sound bites and understand that every man, woman and child in this country should and must have access to health-care as it is a basic need. Access to quality, affordable health care should not be considered some type of luxury. It should be a concern to everyone as we will all need to use the health-care system one day either for ourselves, a child, or a parent. Ultimately, the only way for all of us to ensure we have a functioning, affordable health-care system is to pay attention, get involved, and voice what we want. Professionally, I have “grown up” working in the health-care system in a variety of roles. I am passionate about this topic. I’ve witnessed the system become a complicated, inefficient, money-driven system that has consumers confused and health care facilities and providers spending most of their energies trying to get paid for services. I never set out to have a career in health care. I always say health care “picked me” versus me consciously making the decision. In any event, I am grateful that I know what I know, and have this opportunity each month to talk about topics that will hopefully interest you. My goal for this monthly article is to cover health care locally and nationally, including physical and mental health topics, legislation that you should be knowledgeable about, and my favorite topic, how to deal with your insurance company. I will use this platform to share information, and hopefully simplify topics that, at times, give me a headache. I also want to make this monthly article interactive, where you the readers either write to me with topics that you would like me to cover or perhaps send a question that I can discuss. If you have a health-care story that you would like to share with me, I want to hear that as well, since “sharing is caring.” I also learn from others teaching me and telling me their stories. Lastly, I accept criticism as well, so if you disagree with (or hate) something I say, tell me. I am a believer in direct, honest, authentic communication. Even though I have 30 years of experience, I still find navigating my own health care daunting and frustrating. I’ll share my personal experiences as well with a goal of letting you know that you are not alone in your frustrations. I look forward to taking this journey with you so that we can all make the system of care work for us.