The Gap Between Reality and Congress

I’d like to ask you to imagine a scenario:

You are an adult, married with kids and a mortgage, employed full-time in a high stress job that involves a significant amount of travel, and you have been struggling with Depression for a protracted period of time.  Eventually your Depression symptoms cause you to seek professional help, as both your personal and professional lives are suffering. You enter a hospital for treatment and are diagnosed with Bipolar Disorder Type II, and begin treatment including therapy and medication, away from both your family and your job.

After about 75 days inpatient you return to your home for outpatient treatment. You are still unable to return to your high stress job. After about 21 days in outpatient treatment, you and your doctors determine you should return to inpatient treatment in order to stabilize your condition. You do go back inpatient and, to date, you’ve been back there about 2 weeks with, very likely, several more to go.

Now, let’s assume your job comes with average benefits of 2 weeks vacation, average HMO-type healthcare benefits and FMLA.

You’ve been off work for 15 weeks.  Your FMLA benefits kicked in week two, which required you to exhaust your vacation for those first two weeks, so you haven’t gotten a paycheck in 13 weeks. You still have to pay your healthcare premiums, though, so you’re out of pocket somewhere in the neighborhood of $1,500 for the employee portion of those 12 weeks, plus deductibles for medication, hospitalization, and outpatient treatment. Now that the 12 weeks your job is guaranteed by FMLA have passed, your employer has just informed you that you have lost your job, and now your medical insurance is COBRA, and you owe $2,800 a month for your insurance premium from here on out.

You can’t afford the COBRA without a job, and you can’t qualify for Medicaid because you still have your house – for now. So the medical bills for your second inpatient stay are piling up, and you will be behind on your mortgage in a month or two. Your doctors feel that it will take very likely the rest of the year to get your condition stabilized to the point where you can return to work, but he strongly suggests you take a much lower stress job.

By the time you are discharged, you are three months behind on your mortgage, you have over $20,000 in medical bills piled up, and you’re unemployed.  It’s Christmas, but you can’t afford anything for your children. Your spouse has had to cut back  hours on his/her job because someone has had to be there for the children while you have been inpatient for over 5 months this year. You’re facing homelessness and  bankruptcy in the new year. At least you’ll soon qualify for Medicaid, but since the doctor who has been treating you doesn’t accept Medicaid, you’ll have to start over with a new psychiatrist.

Now imagine you have great health insurance with no premium that covers the best doctors and hospitals in America. You not only still have your job, but you have been told you will keep it for at least another 2 years. You’ve been paid 100% of your salary for the 15 weeks you haven’t worked.

If you are Congressman Jesse Jackson, Jr, this is no hypothetical.  It’s your reality. And this is the great mental health care divide in this country.  

I hope, when Congressman Jackson finally returns to Congress, he fights for the rest of us that live the first scenario.

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  • Marian Wiseman October 26, 2012 at 4:12 pm

    What I hope is that he appreciates the help and support he has enough to wish to see it extended to all of the Parents Like Us. Nobody can understand the true strain until they have been in the position. Compassion is often a strong catalyst for change.

  • Chrisa Hickey October 26, 2012 at 4:12 pm

    Amen, Marian.

  • Anonymous October 29, 2012 at 10:25 am

    What a great post! It really puts into words how insufficient our safety nets and health care system is. Sadly the first scenario is way too common for people suffering from both physical and mental illness. Most of us are only an illness away from homelessness and there is no help to be found. It's a disgrace that in a country as wealthy as ours there are no safety nets at all when we fall on hard times. FMLA and COBRA are just the crumbs they throw us to shut us up.

  • Lewiston November 23, 2012 at 3:07 am

    Well folks have no idea the struggles of neighbors with psychiatric illnesses. MI is a nightmare on many levels.

  • Lewiston November 23, 2012 at 3:07 am

    When COBRA was begun I had to use it for a few months. 25 years ago it was an affordable bridge. Now few can afford it. What a shame.

  • Anonymous November 30, 2012 at 11:46 am

    I am struggling to imagine is how anyone with "normal" health insurance managed to get 75 days inpatient treatment prior to diagnosis? Based on my experience trying to help my son find approriate treatment that scenario is just pure fantasy….

  • Anonymous November 30, 2012 at 11:46 am

    The "take care of yourself first" mantra is hard to hear sometimes and financially can be just an extra burden; have you checked into the Family Leave Act, maybe that would help?

  • Chrisa Hickey November 30, 2012 at 11:48 am

    It's hard, because FMLA provides up to 12 weeks to care for yourself or a loved one, but it's unpaid. Many people just can't afford it.

  • Anonymous December 4, 2012 at 7:56 am

    I am here right now. Both my supervisor, and the director at my place of work have recommended I take some time off. I got a call today strongly suggesting I take all next week off. NOT because of my mental illness, but because I'm hanging by a thread after dealing with my child's for almost two years now. While what they are doing is thoughtful and in my best interest.. it is also adding stress. I worry…. what do I do when the next crisis hits and I have no vacation time left because I took time to "take care of myself?" How can I afford to "take care of myself"? Does sitting at home help? Going to work is sometimes just the respite I need. Very stressful stuff for sure.