The following is a series of stories I used for videos supporting the New York Health Act. While I have long supported healthcare for all, these stories made this call personal for me. If you’d rather watch the videos, visit my Facebook page: https://www.facebook.com/brian.lothridge.1238.
I nearly found myself in tens of thousands of dollars in debt in 2019. My wife had an emergency mental health issue and we took her to St. Joseph’s Hospital in Syracuse, one of the major hospitals in the region. I called my insurance company ahead of time and explained the situation. I was assured that we were going to a place that was in the network and the treatment was covered under my plan.
We went ahead with the treatment plan not knowing that the information from the insurance company was incorrect. The hospital was not in the network. This came as a shock: the insurance company said it was ok. Plus, other Syracuse hospitals – like Upstate and Crouse – were in network and St. Joseph’s is a major hospital. It was too late. We were involved in the treatment and couldn’t stop midway. The initial hospital stay alone was about $35,000 – never mind the various other costs that came from that stay and subsequent outpatient stays, which would have totaled nearly that same figure.
I spent a year and a half resolving this issue with my employer, the hospital, the doctors, and the insurance company. The issue was eventually resolved but it took hours and hours of persistence, careful note taking and record keeping, which not everyone has the time to do this work.
This stress had a very negative impact on my wife’s mental health and mine. We considered looking into bankruptcy. This would not have been an issue with the New York Health Act. We would have had the ability to choose where to get care and would not have been surprised by bad information that could have cost us dearly.
I will soon be without health insurance as my health insurance is tied to my employer. I am ending my employment before July, which means my health insurance will also end.
Now it’s time to wade through the various options on the New York Health Marketplace – weighing pros and cons against my family’s current health needs. It’s hours of research and planning all while hoping my next employer offers decent health insurance. This isn’t a guarantee. In fact, my current employer offers subpar health insurance.
There are many worse healthcare stories out there. Why does the richest country in the world have such poor health care? Why do people need to go in debt to stay healthy?
I will soon be without healthcare through my employer. I am leaving my job and I do not yet have another job.
Why is my healthcare tied to my employment? I know this is how the system is set up, but that still doesn’t answer the question. Linking health insurance and employment together makes no sense.
I have begun the process of finding health insurance through the NYS exchange. However, this process is so complicated that I solicited the help of a navigator. Some of the complexities of my situation were even tough for the navigator to navigate. If it is tough for a person who does this for a living what chance does a normal person have?
Changing insurance from employer to employer also brings the risk of my healthcare providers being considered out of network. I’ve had this happen a few times. Why is this so complicated?
The New York Health Act would solve the complications of our current system and allow people to retain health insurance no matter their employment status. This means, I wouldn’t have to worry about finding new insurance between jobs, waiting three months at a new employer before being eligible for employer-sponsored health insurance, and risking that my next employer would have worse coverage than my current employer.
Instead, all New Yorkers would automatically have their healthcare covered by a public statewide fund, regardless of age, employment, or financial means.
Visit www.nyhcampaign.org for more information. Also, ask your state representatives to support the NY Health Act.
My wife, Sherri, has been suffering from severe depression and anxiety for more than 20 years. We believe she’s virtually resistant to medication. She was seeing a counselor in Utica who encouraged us to look into more comprehensive treatment in the Syracuse area, claiming there wasn’t much hope in finding the care she needed locally.
We began looking at options in Syracuse and found a doctor who does electroconvulsive therapy. We discovered that this treatment would take months of outpatient visits to St. Joseph’s Hospital in Syracuse – an hour away. We also realized this doctor was the only doctor who was doing this treatment on an outpatient basis.
In the meantime, Sherri needed to go to a hospital for an emergency mental health issue. We took her to St. Joseph’s in hopes that she’d be able to begin receiving electroconvulsive therapy while she was there. I detail in another video how this process nearly cost us tens of thousands of dollars if it weren’t for my willingness to fight the insurance company for a year and a half.
One of the problems the insurance company had was the doctor performing the treatment was in network but the facility where he chose to do it – St. Joseph’s – was out of network. After being misled about St. Joe’s being in network we went ahead with the treatment and didn’t find out the hospital was out of network until midway through the series of treatments.
Even if we did know this ahead of time, how could we get our insurance company to pay for a treatment it covered, done by an in-network doctor, at an out-of-network hospital? It isn’t our fault the doctor chooses to do electroconvulsive therapy at a hospital that our insurance company considered out of network. If we knew this ahead of time we wouldn’t have gone forward with the treatment and Sherri would have not received this life-saving treatment.
This would not have been an issue with the New York Health Act. We would have had the ability to choose where to get care and would not have been surprised by bad information that almost cost us dearly. Sherri would have gotten the treatment she needed without all of the unnecessary worry about money.
Mental health care needs to be prioritized in our country and should be adequately covered by insurance. Did you know that behavioral health visits were ten times more likely to be out of network than primary care visits in New York state in 2017? This wouldn’t happen under the NY Health Act. Comprehensive mental health coverage would be available to every New Yorker.
Visit www.nyhcampaign.org for more information. Also, ask your state representatives to support the NY Health Act. As for me, I again call for Assemblywoman Buttenschon and Senator Joe Griffo for their support.
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