Hi. Just in case any of your staffers are roaming the web looking to see what we the people think about healthcare, I thought I’d let you know what’s going on in the head of this one particular voter/taxpayer.
I don’t have a healthcare horror story to relate--I just have the sort of story that millions of us have. When I opted for self-employment I discovered in real terms what it means to no longer have the leverage provided by small-group coverage: I had no negotiating power whatsoever, and was entirely at the whim of the insurance companies. I’ve written here already about what ensued, but suffice it to say that the merest hint of a possible malady on some sort of red-flag list they keep (an MRI that proved I didn’t have rheumatoid arthritis or any other kind of arthritis, just a shoulder problem that eventually resolved itself) was enough for various insurers to refuse to take me on. I spent weeks trying to arrange coverage until I finally went to the specialist, obtained copies of my medical records, and faxed them in to prove that dammit all, I wasn’t sick. At that point, sure, they were happy to see me and I got coverage.
Two months later they nearly doubled the premium price.
And, of course, after assuring me that I would be able to stay with my current doctor, who is fantastic (and thus my first priority in arranging coverage was to stay with this guy), I called said doctor’s office to make an appointment and was told “Oh no, he doesn’t take that coverage. Hasn’t for ten years now.”
So after being harassed, lied to and conned by the insurance companies, I find myself firmly believing that a public-option healthcare plan is essential. The insurance companies have created a cartel with monopoly powers, and if the government can come in and compete with them, well hell, seems to me that’s good old capitalism at work, and I can’t imagine why all those free-market Republicans would be against it.
Oh wait a second, yes I can imagine why. It’s the tale told by Wendell Potter, former head of corporate communications at CIGNA, who related to Congress and then again on Bill Moyers’s invaluable program, exactly how and why the insurance companies would rather see me die than lose an extra dollar in profit.
And so, Mr. or Ms. Congressperson, Mr. or Madame Senator, I’m putting you on notice. Specifically, Rep. Waxman, Senators Boxer and Feinstein, I’m putting you all on notice: I’m one of your voters, and I’ve decided that in the next election, I’m going to be a single-issue voter. If any of you vote against a healthcare option that includes a competitive public plan, I will in turn vote against you. I don’t care about the rest of your record or how effective you’ve been on this committee or that, I don’t care. Healthcare reform is essential for the long-term growth of the nation, and I firmly believe that a public option must be part of that reform. Give me this, or I’ll go find someone who will.
Thank you for your time. Or I should say, your staffer’s time.
Showing posts with label Health Care Shenanigans. Show all posts
Showing posts with label Health Care Shenanigans. Show all posts
Monday, August 03, 2009
Thursday, December 04, 2008
MRSy!
Several weeks ago I lamented the difficulties of getting new health care coverage, even though I was perfectly healthy. "Can't Get Coverage" was the title of my little screed.
Okay, I got coverage. But wait, it gets better.
My appeal to the underwriters was successful, coverage was instated, all that remained was to set up the HSA side of the equation. (HSA = Health Savings Account. Handy little things whereby you put money into an account, accruing both interest and tax advantages, then pay for treatment with a debit card that draws on that account. In other words, you own a good portion of your own health-care money rather than just paying it to the insurance company where it disappears into pockets that aren't your own.) I patiently waited a couple weeks for the insurance company to send me info on their HSA program.
Nothing arrived. I called, got their info, comparison-shopped with a couple other programs, decided which one I wanted, sent in my application. Picked the 20th of each month for money to be auto-debited from my checking account and put into the HSA's coffers. So it would only be a couple more weeks, till November 20th, when the process would finally be complete. Full coverage, money at hand, all right with the world and the sleep of the untroubled once again.
In the meantime...
... a rash appeared. A pesky, itchy thing that slowly spread itself all over the place. It appeared during exactly that period when my HSA was not yet in place, and I didn't want to spend unbudgeted, non-tax-advantaged money when all I had to do was wait a few more (itchy) days.
The 20th came. The 21st came. No money in the HSA. I called, and was told "Oh yes, that first debit takes about thirty days, so if you'll just please wait till December 20th, that would be nifty for us."
Oh, hell no. But there was another option: fill out this form, fax it in, and make a one-time transfer into the HSA. I filled it out and faxed it immediately, then called my doctor's office to set an appointment.
"Oh, Dr. F__________ doesn't accept PPO insurance."
Now bear in mind: when arranging for coverage, the one thing I insisted on, over and over again, was that my first priority was keeping Dr. F______________. He's a fantastic doctor, and I was very clear that any plan I adopted must have him on its rolls. "No problem," they said, as they helped me arrange coverage that would absolutely not include Dr. F_____________ in its rolls. (He hasn't accepted PPO coverage for a decade, so it's not like it's a new thing.)
Dr. F__________'s office, rather than setting up an appointment for a general checkup, simply referred me to a dermatologist, one who most definitely does accept my PPO insurance, and I decided that for the time being, I'd simply have to deal with the immediate (itchy) problem and worry about the General Practitioner problem later. I made an appointment for Monday the 24th.
Money finally hit my HSA. And of course, it was both deductions: the regularly scheduled one that I'd been told wouldn't happen till December, plus the one-time deduction I'd made to cover the immediate need. Which of course wrecks my budget for December, thanks a bunch.
Doctor visits followed. Cultures were taken. Dr. B______________, the dermatologist (a former Bulwer-Lytton contest winner, no fooling, with the annoying habit of dropping word-puzzles in front of me and, when I don't come up with immediate solutions, saying "You're embarrassing yourself"), prescribed this and that, and the rash immediately responded.
But didn't completely go away. It seems to be stubbornly hanging on. Very annoying.
Results of the cultures finally came in today. Group B strep, plus MRSA, the evil antibiotic-resistant staph infection. A bacteria cocktail.
Eighteen months. I had wonderful coverage through COBRA for eighteen months with no medical issues whatsoever. During that exact period when I was working and waiting, arranging for new coverage, what happens? A bacteria cocktail. And how many days did those bacteria have to flourish while I waited and waited for bad bureaucracy to do its job badly?
On the other hand--the bacteria are delighted. At least some organism is happy.
Okay, I got coverage. But wait, it gets better.
My appeal to the underwriters was successful, coverage was instated, all that remained was to set up the HSA side of the equation. (HSA = Health Savings Account. Handy little things whereby you put money into an account, accruing both interest and tax advantages, then pay for treatment with a debit card that draws on that account. In other words, you own a good portion of your own health-care money rather than just paying it to the insurance company where it disappears into pockets that aren't your own.) I patiently waited a couple weeks for the insurance company to send me info on their HSA program.
Nothing arrived. I called, got their info, comparison-shopped with a couple other programs, decided which one I wanted, sent in my application. Picked the 20th of each month for money to be auto-debited from my checking account and put into the HSA's coffers. So it would only be a couple more weeks, till November 20th, when the process would finally be complete. Full coverage, money at hand, all right with the world and the sleep of the untroubled once again.
In the meantime...
... a rash appeared. A pesky, itchy thing that slowly spread itself all over the place. It appeared during exactly that period when my HSA was not yet in place, and I didn't want to spend unbudgeted, non-tax-advantaged money when all I had to do was wait a few more (itchy) days.
The 20th came. The 21st came. No money in the HSA. I called, and was told "Oh yes, that first debit takes about thirty days, so if you'll just please wait till December 20th, that would be nifty for us."
Oh, hell no. But there was another option: fill out this form, fax it in, and make a one-time transfer into the HSA. I filled it out and faxed it immediately, then called my doctor's office to set an appointment.
"Oh, Dr. F__________ doesn't accept PPO insurance."
Now bear in mind: when arranging for coverage, the one thing I insisted on, over and over again, was that my first priority was keeping Dr. F______________. He's a fantastic doctor, and I was very clear that any plan I adopted must have him on its rolls. "No problem," they said, as they helped me arrange coverage that would absolutely not include Dr. F_____________ in its rolls. (He hasn't accepted PPO coverage for a decade, so it's not like it's a new thing.)
Dr. F__________'s office, rather than setting up an appointment for a general checkup, simply referred me to a dermatologist, one who most definitely does accept my PPO insurance, and I decided that for the time being, I'd simply have to deal with the immediate (itchy) problem and worry about the General Practitioner problem later. I made an appointment for Monday the 24th.
Money finally hit my HSA. And of course, it was both deductions: the regularly scheduled one that I'd been told wouldn't happen till December, plus the one-time deduction I'd made to cover the immediate need. Which of course wrecks my budget for December, thanks a bunch.
Doctor visits followed. Cultures were taken. Dr. B______________, the dermatologist (a former Bulwer-Lytton contest winner, no fooling, with the annoying habit of dropping word-puzzles in front of me and, when I don't come up with immediate solutions, saying "You're embarrassing yourself"), prescribed this and that, and the rash immediately responded.
But didn't completely go away. It seems to be stubbornly hanging on. Very annoying.
Results of the cultures finally came in today. Group B strep, plus MRSA, the evil antibiotic-resistant staph infection. A bacteria cocktail.
Eighteen months. I had wonderful coverage through COBRA for eighteen months with no medical issues whatsoever. During that exact period when I was working and waiting, arranging for new coverage, what happens? A bacteria cocktail. And how many days did those bacteria have to flourish while I waited and waited for bad bureaucracy to do its job badly?
On the other hand--the bacteria are delighted. At least some organism is happy.
Thursday, October 09, 2008
Can't Get Coverage
Some background: when I left the dayjob last year (o happy day!), I decided to stay on their small-group health coverage through COBRA. But COBRA has an 18-month limit, and I hit the end of that period on September 30th. So in mid-September I started looking for new coverage, knowing full well that as an individual, not a member of any kind of organization, I wouldn't be able to get the same level of excellent coverage.
Some further background: a couple years ago I was having trouble with my right shoulder. Turned out to be a little tendonitis and a wee bone spur. Couldn't raise my arm above my shoulder without a lot of, you know, screaming. So I went to my doctor, who sent me to a specialist, who sent me for an MRI. The MRI revealed that I didn't need surgery, and that the problem would most likely find a way to resolve itself. (Sloooowly.) The specialist gave me some specialized exercises, I did them, and the problem did in fact resolve itself. (Sloooooooooooooowly.) It's quite gone now, and I can raise my arm above my shoulder, all the way to the ceiling, easily. Yay, me.
I first applied for a health-care plan tailored to young people. They saw the MRI, laughed in my face, and turned me down. So I started over again, and ended up applying for a plan linked to an HSA, thus allowing me to actually own a substantial portion of my own health-care money rather than simply send it to the Aetnas of the world and maybe never see it again. The application was just about the meanest, nastiest application I've ever completed, and it took a good ninety minutes to complete it and get it submitted.
There was, obviously, a great deal more detail requested. And when I filled out the section about that MRI, since I don't have the actual medical records, only the claim forms, I tried very hard to remember what specifically happened then, and when the application essentially defaulted to a choice of "Rheumatoid Arthritis," I figured that was probably pretty close to what had happened, and selected that.
Ninety minutes to complete the form. Ninety seconds to get turned down again.
Bear in mind, there's a section in the application where you can write an explanation of whatever you wish, so I described exactly what happened with the MRI, how it successfully ruled out a costly operation, and how I am now entirely trouble-free. But of course the computer making the decisions doesn't bother with that, it was "Rheumatoid Arthritis" and that was it, end of story.
I had to visit the specialist's office, get copies of the medical records, and send them in with a letter requesting a review. That was ten days ago, and still no word on a decision. In the meantime, I haven't had health-care coverage all month, and am rightfully worried about what would happen if something should happen to me. Because you know--if something should happen while they're still reviewing my file, it's an ironclad guarantee that they'll find some other reason to turn me down.
All this while I am, in fact, completely healthy. Nothing wrong with me. Look at that shoulder, what a terrific shoulder.
This has, of course, given me some perspective on the health-care debate going on between the candidates. There are two proposals, and boiled down (thanks to an analysis by some guys at Bank of America), they are:
Okay. So McCain would provide me with a $2,500 tax credit to spend on health care however I wish. (The plan I applied for would cost around $4,000, including money put into the HSA.) But here's what caught my attention: if I were still employed at the law firm, the incentive for that law firm to provide health insurance, namely the tax deduction, would disappear. That means it's pretty much a sure thing that the firm would discontinue the program, and everyone would have to obtain coverage as individuals rather than members of a group.
Having gone through exactly that process, I can tell you: plenty of people would be declined, particularly people with any kind of preexisting condition, and everyone would end up spending more, more, more on their coverage, no matter how big the tax allowance provided for by Mr. McCain.
The real winners? The insurance companies. If they get to charge everyone individual rates for the same (or worse) coverage those folks were getting as employees at group rates, the insurers will rake in the cash.
Ask me if I'm surprised.
Some further background: a couple years ago I was having trouble with my right shoulder. Turned out to be a little tendonitis and a wee bone spur. Couldn't raise my arm above my shoulder without a lot of, you know, screaming. So I went to my doctor, who sent me to a specialist, who sent me for an MRI. The MRI revealed that I didn't need surgery, and that the problem would most likely find a way to resolve itself. (Sloooowly.) The specialist gave me some specialized exercises, I did them, and the problem did in fact resolve itself. (Sloooooooooooooowly.) It's quite gone now, and I can raise my arm above my shoulder, all the way to the ceiling, easily. Yay, me.
I first applied for a health-care plan tailored to young people. They saw the MRI, laughed in my face, and turned me down. So I started over again, and ended up applying for a plan linked to an HSA, thus allowing me to actually own a substantial portion of my own health-care money rather than simply send it to the Aetnas of the world and maybe never see it again. The application was just about the meanest, nastiest application I've ever completed, and it took a good ninety minutes to complete it and get it submitted.
There was, obviously, a great deal more detail requested. And when I filled out the section about that MRI, since I don't have the actual medical records, only the claim forms, I tried very hard to remember what specifically happened then, and when the application essentially defaulted to a choice of "Rheumatoid Arthritis," I figured that was probably pretty close to what had happened, and selected that.
Ninety minutes to complete the form. Ninety seconds to get turned down again.
Bear in mind, there's a section in the application where you can write an explanation of whatever you wish, so I described exactly what happened with the MRI, how it successfully ruled out a costly operation, and how I am now entirely trouble-free. But of course the computer making the decisions doesn't bother with that, it was "Rheumatoid Arthritis" and that was it, end of story.
I had to visit the specialist's office, get copies of the medical records, and send them in with a letter requesting a review. That was ten days ago, and still no word on a decision. In the meantime, I haven't had health-care coverage all month, and am rightfully worried about what would happen if something should happen to me. Because you know--if something should happen while they're still reviewing my file, it's an ironclad guarantee that they'll find some other reason to turn me down.
All this while I am, in fact, completely healthy. Nothing wrong with me. Look at that shoulder, what a terrific shoulder.
This has, of course, given me some perspective on the health-care debate going on between the candidates. There are two proposals, and boiled down (thanks to an analysis by some guys at Bank of America), they are:
McCAIN: Eliminate deductibility of employer-sponsored insurance and replace with refundable credit of $2500 for individuals and $5000 for families.
OBAMA: Universal health care with affordable health coverage and benefits similar to those available to Members of Congress ... Creation of National Health Insurance Exchange for people without access to employer insurance or public programs...
Okay. So McCain would provide me with a $2,500 tax credit to spend on health care however I wish. (The plan I applied for would cost around $4,000, including money put into the HSA.) But here's what caught my attention: if I were still employed at the law firm, the incentive for that law firm to provide health insurance, namely the tax deduction, would disappear. That means it's pretty much a sure thing that the firm would discontinue the program, and everyone would have to obtain coverage as individuals rather than members of a group.
Having gone through exactly that process, I can tell you: plenty of people would be declined, particularly people with any kind of preexisting condition, and everyone would end up spending more, more, more on their coverage, no matter how big the tax allowance provided for by Mr. McCain.
The real winners? The insurance companies. If they get to charge everyone individual rates for the same (or worse) coverage those folks were getting as employees at group rates, the insurers will rake in the cash.
Ask me if I'm surprised.
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