Susan

Susan came in to meet with me to sign up for insurance. She had been identified during our screening process as someone who would not qualify for the Medicaid expansion, and needed to look at her options.

Susan has two part-time jobs, working for two local physicians. She was sent here because of headaches accompanied by nausea, vomiting and blurred vision. Her blood pressure was elevated at the clinic, but she had no history of high blood pressure.

She was sent for a CT Scan of her head. The CT showed a sinus cyst, so a referral was made to an ENT (ear, nose and throat doctor).

The headaches and nausea continued, so the decision was made to have an MRI and also a Magnetic Resonance Angiography (MRA), which is a group of techniques used to image blood vessels. MRA is used to generate images of arteries in order to evaluate them for stenosis (abnormal narrowing), occlusions, aneurysms  (vessel wall dilatations, at risk of rupture) or other abnormalities.

The MRI came back normal; but the MRA showed a “tiny outpouching… which may represent an aneurysm…”

Needless to say, she was devastated when she came in to see me. One of the physicians she works for had given her the results; the next test that needs to be done is not available locally, and the clinic has no ability to access the necessary testing for her.

The need for insurance was no longer a luxury, but a necessity.

So, we began the process. But as she answers the questions and we fill out the online form, it becomes clear to me that she will qualify for the Medicaid expansion – whenever it is finally available in Michigan. Red-tape, dumb legislators, and a system wrought with problems are keeping the expansion of Medicaid in Michigan from becoming a reality.

We talk about her options – she does qualify for tax subsidies because of her low income; but there are still some very real costs involved with insurance – deductibles, co-pays, out-of-pocket expenses. She looks at her reality: she needs access to healthcare NOW – not at some unknown point in the future. So, she makes the decision to purchase healthcare.

Please, please, please remember this: under the old healthcare system, she would not have been able to purchase healthcare for a number of reasons – cost being a major one. But, with a pre-existing condition such as this possible aneurysm, she would not have been able to purchase healthcare insurance. IF she had been able to purchase it at all – it would NOT have covered this condition – it would have been excluded because of being pre-existing.

The wicked, awful thing called “Obamacare” by many will possibly be what saves this young woman’s life. Did I mention she is 29 years old? She could be our daughter. She could be the daughter of any of us.

How can anyone believe that she doesn’t deserve access to healthcare? I don’t understand how mean spirited our country has become.

She will be able to purchase healthcare for a monthly premium of $0; she will have a deductible of $175 and will have co-pays to doctors and for medications. But, she will have real access to real healthcare.

She may still qualify for Medicaid at some point; but, for now she has healthcare beginning April 1 – and hopefully, that will be soon enough!

As it turns out, she shouldn’t have been referred to me. The clinic looks at household income for qualifying people for services; the government looks at who files taxes. So in this case, even though she lives in a household with more than one wage earner, she files income taxes on her own, so she qualifies for subsidies based on her income. I am glad a mistake was made in this case.

It might save her life.