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02 Sep 2015

Community Voices: If It Weren't for Obamacare, I'd Be Blind in One Eye

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Many Republicans predicted that the Affordable Care Act, aka “Obamacare,” would send this country into utter chaos.

Of course, this didn’t happen. Nonetheless, there is murmuring among a few 2016 Republican presidential candidates that repealing the ACA would be one of the first things they’d do if elected. But in reality, the plan is working so well that it would be political suicide to try to repeal it at this point—and I am one of the millions of Americans who have benefited from the plan.

On July 3, 2014, I was diagnosed with a detached retina. A blow to the back of the head a week earlier and two subsequent airplane rides caused the injury. I was in South Bend, Ind., meeting my partner’s family for the first time, when I got the news. I was given a choice: I could have surgery in Indiana, and be forbidden to fly for six weeks (not an option), or fly home to Palm Springs as soon as possible and have surgery there. A detached retina is a serious situation, and time is of the essence, but since my retina was already completely detached, the doctor said a few days would not make much of a difference.

I was barely absorbing this information, since I was pretty much hysterical. Thank God for my partner, Eric, who calmly took control of the situation. It was after 5 p.m. on Thursday, July 3, the day before a major holiday. The office was closing up, and the janitor was vacuuming the carpet. Luckily, the ophthalmologist I had seen was kind enough to stay until we could make the arrangements. I will never forget the sight of Eric sitting on the floor, urgently trying to get through to someone in the Inland Empire Health Plan office in Palm Springs to set up an appointment ASAP. Fortunately, he got through.

We flew back to the desert on Saturday night, saw the IEHP folks on Sunday, and met with the surgeon on Monday; I had the surgery on Thursday, July 10. A series of miracles, to be sure.

My surgery—a vitrectomy—involved removing the liquid from the eye and inserting a gas bubble in the eyeball, which then pressed the retina back into place. The rehab is ghastly—six weeks of sleeping face-down on a special cut-out pillow—and keeping your head down at all times. Yes, at all times. That includes sitting, standing, walking, showering—everything, so that gravity can do its work.

I was a dutiful patient, and followed directions to the letter. Thankfully, the outcome was good: The vision in my left eye is at 99.9 percent, and will likely keep improving. Another miracle.

None of this would have happened if Eric and I had not received health insurance coverage from the Affordable Care Act, just two months before all this occurred. Eric and I are both professional performers, but we also have “job jobs” to pay the bills. He had just been hired to sell Steinways for SoCal Pianos in San Marcos, and I work part-time as the activities assistant at a local senior health care facility. Neither of us could afford health insurance before the advent of “Obamacare.”

In addition to my surgery, I had to fill five or six different prescriptions for eye drops (some of which I am still using more than a year later); go through cataract surgery the following January; and endure many, many follow-up appointments. My total out-of-pocket expense has been $30—to rush some lab work. Had I not had “Obamacare,” there is no question I would now be blind in my left eye. A friend of mine has a cousin who suffered a detached retina and did not have insurance. He lost his sight.

Of course, there are thousands of people like me who made it through catastrophic injury or illness because of the Affordable Care Act. Like 58-year-old Kathy Bentzoni of Slatington, Pa., who got a life-saving transfusion after being diagnosed with a rare blood disorder. Her previous insurance company called it a pre-existing condition and denied her coverage. Or 41-year-old Mike O’Dell of Kansas, who received a new heart after his heart developed an infection. His old health plan would not cover the $4,000 a month for anti-rejection medicine following the transplant.

Those who still disparage the ACA are ignoring the facts. According to a 2014 article in the Los Angeles Times, nearly 10 million previously uninsured people now have health care coverage because of the ACA. The nonprofit Rand Corp. indicates that fewer than a million people who had health plans in 2013 are now uninsured—and that’s because their plans were canceled for not meeting new standards set by the law. Fox News personality Juan Williams says half of those people can get better coverage for a lower price, and some will even get subsidies to help them pay for it. What the ACA basically did was put in place consumer protection so that health insurance companies could no longer take advantage of people by giving them crappy coverage.

It’s important to remember what insurance companies can no longer do because of the ACA: They can no longer cancel your policy if you get sick, deny you coverage or charge you more for a pre-existing condition, or impose lifelong caps on your health coverage. The ACA also mandates that your insurance company must pay for the ambulance ride if you are rushed to the hospital. Those are long-overdue, positive changes—so what’s all the fuss about?

So the next time you hear someone railing against “Obamacare,” think about the millions of people who now have access to healthcare who once did not. Think about Kathy Bentzoni and Mike O’Dell.

I will. And I will be filled with gratitude that I can today see a beautiful desert sunrise—with both eyes.

1 comment

  • Comment Link Star Thursday, 03 September 2015 12:08 posted by Star

    I lost my sight in my right eye despite having insurance and four surgeries. You were lucky. What is your deductible and premium? You need to be a little careful of extrapolating from your individual experience to the whole universe of insurance holders and non-holders. Many people--incl my adult daughter--are not basking in the warmth of this scheme. But that isn't to say it did not work out for you.

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