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Is Health Care Just a Privilege for the Wealthy?

By Aracelia M., Miami-Dade County


I am 58 years old and suffer from various chronic diseases. I have type 2 diabetes, high blood pressure, psoriasis, and allergy issues. Many years ago I was also diagnosed with atrial fibrillation, a problem with the pumping of the heart. Shortly after moving to the United States from Cuba 19 years ago, I had to undergo emergency surgery for this condition. My health history in this country started in a very complicated way due to my heart problems.


Before immigrating to the United States, I didn't know why I was experiencing tachycardia or why I felt short of breath after walking short distances. I thought that it might have something to do with the fact that I was moving to a new country. Shortly after arriving, my symptoms worsened and there came a point when I felt like I couldn’t breathe after walking a few steps. During this time, it was very difficult for me to go to the doctor or the hospital because I did not have health insurance. A friend who lived in Orlando and used to be a nurse in Cuba came to stay with me for a few days to help me figure out what was happening to me. I felt very bad and she found my pulse to be extremely high when taking my vital signs. We called a cardiologist friend of hers, who said that I urgently needed to go to the hospital. My friend took me to the University of Miami hospital and I was apparently in very bad shape because doctors and nurses seemed to be extremely concerned about my condition while they stabilized me. I started crying because I thought that I wouldn’t make it out of the hospital and that I would never see my daughter again. Although they prepared me for a procedure called cardiac ablation, that same day they informed me that they could not operate on me. So they sent me home with a medicine that I had to take because I was at risk of having a stroke. I spent a year and a half to two years taking this medication and going to consultations to monitor my progress. Meanwhile, I spent a lot of time on the internet researching everything I could about the procedure that could possibly be done on me eventually. It seemed that everything with my treatment was going just fine.

When I went to one of my follow-up visits, a medical student who saw me that day informed me that the medicine I was taking was no longer working with the desired effect and that I had to undergo surgery. I explained that I had no money for this procedure. However, he left the room and came back with a doctor who was visiting the hospital and teaching there temporarily. That doctor gave me the incredible news that he was going to cover the cost of my operation and that he would be performing it as well. Amazingly, I only had to pay $200 for my hospital stay. I will always feel grateful to that doctor and to God because they saved my life through that operation. That doctor was like an angel to me. This is how my health journey in this country began.


I have worked providing cleaning services for the majority of the 19 years I’ve been in this country, and I have reported taxes every year. However, I have not worked for more than a year because in March 2020, the woman for whom I was working told me that I could not go anymore due to the beginning of the pandemic. A month later, the most unexpected thing happened to me: I accidentally fell down the stairs of my house, and unfortunately I broke my inner ankle, tibia, and fibula of my left leg. I live alone because my daughter lives in Europe, so I ended up calling a friend who took me to the hospital. There they put me in a cast and sent me to see a specialist. The following week the specialist saw me and told me that I had to have surgery. When everything was ready for the operation, they informed me that my insurance had a deductible of $2000. Imagine! Physically compromised and unable to work, how was I going to pay the $2000? Since I had no way to pay, I did not have the operation that week. Then someone involved with my case spoke with the director of the hospital and told me that I could pay the $2000 plus the cost of the MRI in installments after the operation. After the procedure, the doctor told me that I could not work for a year in order for my leg to heal well. Being diabetic and obese complicated my recovery, so the doctor wanted to ensure that I could have the most thorough recovery possible.


Six months after the surgery, my medical bills began to arrive. I explained to the person who called me about them that I was not working and that I had no way to pay these bills yet. I do not receive unemployment benefits because I do not qualify for them, but I do receive temporary assistance for being unemployed during the pandemic. The $125 a week I receive in assistance helps me survive, but it is not enough to meet my medical payments. I had applied for Medicaid due to not being able to work after my injury, but was denied. I also applied for temporary disability benefits and was also denied because I am not a U.S. citizen. A few years ago I had to pause the process to become a citizen because I could not present a legal document about my divorce that occurred in Cuba a long time ago. So as you can see, I have been very limited physically and financially for over a year.


One year after my fall, I had to go to the hospital due to a hemorrhage caused by necrotic polyps in my uterus. They were not going to operate on me without paying what was due for the procedure upfront, so I had to pay immediately. At the last follow-up visit I had with the doctor about my leg injury, he told me that I have to have another operation to remove the metal plate and screws from my leg. It is practically the same procedure as the first time, so they will charge me the same. If I have not finished paying for the first operation, how am I going to add another medical bill? At the moment, I cannot undergo this surgery because of that.


Seven years ago I was diagnosed with diabetes. My blood sugar is out of control and I haven’t been able to regulate it because I have so many worries. The stress also causes psoriasis to flare up on my elbows. The doctor tells me that I need to calm down and handle stress better, but the stressful thoughts come to my head on their own. The stress about the pandemic, my fear of not being able to pay my house and the housing association bill, having to request extensions for the electricity bill, the copayment that I have to pay for medications, and the rest of my medical bills all contribute to my inability to calm down. To add to the stress, I am afraid that I will not qualify for Obamacare insurance when it comes time to renew it because I have not worked in over a year. Without an income, it is difficult to qualify for an insurance plan through the Marketplace. Besides that, without an income I have had to make choices regarding what bills I pay. I end up paying for one thing without being able to pay another. For that reason, I keep getting called when I am late in my payments and am told that they are going to send me to the Credit Bureau. I explain to them that I want to pay but that I don't have the money to do so at this time.

I wish I could work in order to pay my bills and take care of my debt. I like to be useful. I have applied for jobs in several stores, but they have not offered me anything. I think they end up not offering these jobs to me because of my age or my illnesses. I cannot carry more than 10 pounds. I cannot stand for many hours because of my leg problem. I also cannot be exposed to high temperatures for a long time because of my heart problem. Recently, I had to have an MRI done due to a round growth that has surfaced in my cheek. I have yet to find out the results, but I am so afraid that it will be something that will need to be resolved through surgery. I did not choose to be sick or to fall. However, I am limited at the moment. My medical problems keep piling up, and the bills seem to go on forever.


One aspect of my health that has also become extremely complicated for me is my oral health. Diabetes has caused my teeth to loosen at their roots, so the dentist has had to remove them one by one. I still have three teeth and one molar to remove, but they charge me $180 for each tooth they remove. I do not have the money to continue paying for these dental procedures at this time. My oral health problems have even caused me to have digestive issues because I can't chew my food. I have to practically swallow food whole. If I had the money, I would go to the dentist to finish removing the rest of my loose teeth. The saddest thing is that all of the teeth that have been extracted so far were good teeth-- They were not even chipped! But they had to be removed because the fact that they are loose causes me terrible pain when I bite into anything.


When it was possible for me to travel to Cuba in the past, I used to receive dental services with my brother's wife because she is a dentist. In comparison, dental services in the United States cost an immense amount. I used to have dental insurance, which I paid alongside my health insurance through the Marketplace. However, I had to pay about $80 for each dental visit, and that was more than I could afford. When I lost my job, I could no longer pay for my dental insurance because my health insurance and medical copays were already too much for me. I even went to a dentist that I saw through an advertisement on television to get an estimate. They wanted to charge me a total of $26,000 for the dental procedures I need. Obviously, I left because I don't have the money for that.


I would really like to have dental insurance to fix my teeth. I wish I could get dental implants, but that is not possible for me right now. I have dentures because I can't undergo any procedures to fix my teeth at the moment. In other words, I am completely stuck without a solution in sight for my oral health issues, and this situation has caused me a lot of sadness. I get frustrated, I cry, and I get nervous because nobody wants to be without teeth. One’s teeth are so important. In addition to the pain I feel in my mouth, the digestive problems I’ve developed, and the stress this has caused me, these issues have affected me aesthetically and I do not like to look like this. Luckily now it is normal to put on a mask or a face covering. At least others are not able to see the state of my mouth while I’m wearing one.

If the state of Florida expanded the Medicaid program and I were to qualify, it would benefit me immensely. I have a friend with Medicaid coverage who is also diabetic and has been through many of the oral health problems that I am going through. With Medicaid coverage, she has been able to get her physical and oral health issues under control. Having Medicaid has given her access to so many of the health services that I am in need of due to the limitations and difficulties that I am going through. It is very difficult to grow old in this country. I always say that getting sick in this country is for people who have money. Those of us who are poor have to go through so much when we get sick. Having Medicaid would greatly alleviate many of the difficulties that I am going through. If I had Medicaid, it would change my life. I wouldn't be going through so much. It would change my life completely.

 

Many Floridians face serious obstacles when trying to access health care. Common barriers include cost, limited local providers, local hospital and clinic closures, lack of coverage, and insurance not accepted. If you've struggled to access health care in Florida, your story can be a powerful catalyst for change. We amplify these experiences to help our legislators and voters understand the health care challenges being faced by everyday Floridians. Complete the form below to share your story.



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