The Knotty Dogwalker

Hey guys, in today’s installment of healthcare posts, we’ve got The Knotty Dogwalker, a petcare specialist in northern Maryland.

I have lived with depression, ranging from manageable to suicidal, since I was a teenager. In 2008, at the age of 27, I was 5’4″ and 175 pounds, self medicating with food. I was working a high stress job in the nonprofit sector, commuting over an hour each way to the city often 6 days a week. The one good thing about my job was that I had health insurance, which paid for me to go to an ob/gyn who prescribed me a baby dose (5 mg) of lexapro to keep me at a functioning level. Without lexapro, I could not get out of bed in the morning.
I was so miserable with my job and my life that I made the dramatic leap to become a dog walker. I still had a commute, but found someone to employ me as an independent contractor with no benefits. I continued to work a part-time, lower stress job at the nonprofit, but found that if I wanted to keep my health care, my entire paycheck would go to health insurance. I applied for private insurance through United Health Care and was declined. Apparently, my history of depression and weight gain was a pre-exisiting condition. I could have one or the other, but not both. Sudden weight gain and loss is a major symptom of depression, and yet it counted as an extra strike against me. I decided to risk it and go completely off of health insurance.
I went to my ob/gyn and she was immensely supportive of my decision to leave my non-profit nightmare. “Thank goodness!” she exclaimed.”I didn’t want to tell you this because you wouldn’t have been able to handle it. You were well on your way to an early heart attack.” Without health insurance, I had to pay full price out-of-pocket to see her, but she functioned as a therapist, psychiatrist, primary/urgent care provider and ob/gyn. She knew I took a dramatic pay cut and slipped me free samples of lexapro and birth control (the last thing this situation needed was a baby).
Over the next four years a lot of things happened. I got a roommate to help make ends meet. My employer couldn’t find enough work for me so I started my own business. My parents bailed me out with zero interest loans. My mortgage company worked with me so I got a lower interest rate. And the Affordable Care Act was passed.
My “Obamacare” choices were underwhelming. I could pay a few hundred dollars a month for stellar coverage (did I need this at the age of 30?) or under $100 a month for the bare minimum. I figured out a way to make the ACA work for me, though. I signed up for a silver plan, which helped me to afford a psychiatrist, therapist, ob/gyn, and primary care provider. I got the Essure permanent birth control procedure done, eliminating the need for The Pill and improving my overall mood and health.
As a self-employed small-business owner who doesn’t want children (seriously, never.) the Essure procedure was life-changing. It only cost me a few hundred dollars and I never have to worry about becoming pregnant. A pregnancy or a serious accident could spiral me into poverty. Although my situation has improved greatly, thanks in part to the ACA, I still live paycheck to paycheck. An accident (I’m clumsy, folks) would mean weeks off of work. If I don’t show up to work, I don’t get money. If I don’t show up for weeks, my clients will likely find another professional and move on. The debt from the medical care would stack on top of the lack of income and I could be on the street in a matter of months. But for right now, that’s not going to happen.
My business (and I!) are thriving because I am doing what I love. I lost 30 pounds, went vegan, ran my first 5k, and hired two independent contractors to take overflow clients. I continue to use my silver health care plan, which is far from perfect, but still provides essential coverage that I can now afford. This year at my physical, my doctor said I am possibly the healthiest patient he saw all month. And yet, without the ACA, I might not be eligible for health insurance.
So which do I choose? A job that makes me sick but provides care for the symptoms or a job that helps me thrive with no safety net? How about a third option: let me keep my ACA benefits.

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