It seems I get to tell my story a lot on Reddit these days…
3 minute video version here: https://app.berniesanders.com/r/hy8gzur
12/3 was the first anniversary of my open heart surgery. I had great insurance (Kaiser Permanente) at the time and my heart attack, trip through the ER, 8 days in the hospital, open heart surgery had an out of pocket expense of $250 plus another $100 for prescriptions.
While that was going on, my company was in the process of being sold to a large tech company. I can’t say who, but they’re in the next tier below Apple, Microsoft, Google, Facebook, Amazon, etc. You have heard of them.
On 1/1, the new owners took over, the insurance changed from Kaiser to Aetna and I lost ALL of my doctors 4 weeks in to a 6 week open heart surgery recovery.
On 1/3 I start having complications. I’m coughing all the time and if I lay down, I choke and gag like I’m drowning. We find out later it’s congestive heart failure, but we don’t know that yet.
I can’t see my old doctors because I’m not a Kaiser member anymore. But Aetna is an insurance provider, not a health care provider, so I don’t have new doctors to see yet.
Fortunately, the new company is large enough that they have their own concierge in the Aetna system and she sets me up with a hospital who tells me they’ll be happy to see me in 2-3 months.
When I relay that back to the concierge, her reaction is “Oh, nononono…” pulls some strings and gets an appointment in 2 weeks. Aetna won’t let me go direct to cardiology, I have to see a GP first.
So for two weeks, I sleep sitting up. I buy a neck pillow because if I lay down, I can’t breathe.
Appointment comes, they run a bunch of tests and I get the call, congestive heart failure. Go to the ER immediately.
So that’s another 7 days in the hospital where they drain 4 liters of fluid out of me per day. I developed an irregular heartbeat, that caused fluid to build up in my chest cavity and that fluid was crushing my heart and lungs. The reason it felt like I was drowning is because I was.
Under the new insurance, they only cover 80% of the costs until I hit an out of pocket maximum of $6,500. Naturally I hit that more or less immediately so I’ve been covered at 100% the rest of the year…
Oh, except this one time when my wife had her own issue, at the same hospital, and Aetna ruled her doctor was “out of network”, that was another $1,100.
It’s important to note that at no point during all this was I not covered. This is with employer provided coverage from one of the premier tech companies in the country.
This is why we so desperately need medicare for all.
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