The hair, the single thread, holding us to this place is fraying. The primary care doctor I saw, one of the doctors Blue Cross Blue Shield asked to fill out one of the forms related to prescriptions that had been written, although she did not treat me for any illness or condition and did not see any of my medical records, wrote on that form that I had a history of ulcerative colitis and allergies. While she was at it, she should have written up that I was morbidly obese, psychotic, and had cancerous legions throughout my internal organs. If you’re going to shoot, aim for the heart! So… while I have not been denied health insurance, YET, I have a second round of forms to bring to said doctor so that she can fill in more damaging hearsay and destroy our chances of ever getting health insurance again.
Let this be evidence to any and all other Americans living and working in this United States: DO NOT EVER SEE A DOCTOR. A friend recently suggested using a fake name, traveling to another city, and paying out of pocket for any tests… literally, to periodically guess at what tests might you need to check in on your health, have them done out of pocket with a fake name, and then go about doing medicine on your own. I admit it sounded a bit too far-fetched at first glance. But actually? After what we have been through? It’s the best advice I’ve heard.
Is this really the future we face by choosing to live and work in this country?
Deep breath. Positive thinking. It will work out. But wait… even when we do finally manage to get some kind of coverage (our back-up option is to pay COBRA $1500/month for 18 months and then take all the agencies who denied us coverage to court) — what then? I am frankly too terrified to enter the system again.
Can we ask doctors to see us, but not make any diagnosis? Ever? Can they suggest medicines and then let you go buy them in some black market? Is it possible to have a relationship with a medical provider that is under the radar of the insurance industry?
I’m actually a bit afraid.
And you should be, too. Do you know that insurance agencies are now compiling a numbered system that can be sold to other agencies, similar to a credit score, for health insurance? Consider each time you see a doctor, chiropractor, mental health provider, emergency room, community clinic, or medical laboratory to be like missing a mortgage payment… it’s a hit to your score.
Ultimately, insurance is a bet. They are betting you won’t need it. You are betting you will. Each time you collect on their bet is a likelihood they aren’t going to want to play with you again. Win enough times and you get kicked out of the casino. At what point does it make sense to not play? How can anyone be compelled to buy insurance if it costs them a fortune to have it, another fortune to use it, and then precludes them from ever having it again?
Considering the tight wallets on working families who do not have employer benefits combined with what it really means to experience the medical insurance business system as a consumer… having health insurance doesn’t make a lot of sense. And add that in New Orleans, you get access to better physicians if you seek care in free clinics.
I would really love to stay here, to continue to advocate for working immigrants, the poor, and the disempowered. Our family has one heck of a lot to give to this community. But why should we bother, really? In the end, is there anything for us? I’m starting to doubt it. This really could be the last straw. Somehow, I have to go into this doctor’s office Monday — the one where the physician herself cannot be bothered to even speak with me unless I am paying for her time — and beg and plead for help in finishing these forms in a way that suggests all of her previous “history” notes were incorrect. Right.
Meanwhile, we continue to hope that any random problems the kids exhibit go away on their own. As for me? I feel so frustrated, angry, and desperate… now it’s MY fault that we are not insured. It shouldn’t be, but there it is. What if I were really, truly sick? What if I had a history of mental illness? Or a serious chronic illness? Or had a childhood cancer? What would be the options if anyone in our family had that kind of profile?
I think that by the end of this, both Paul and I will suffer from at least one from the list above.
Emmy | 09-Aug-08 at 7:43 pm | Permalink
This really sucks, and is very scary.
It seems like a cautionary tale: Never leave a job you hate, for fear of having to change providers.
This has us reconsidering our family employment options: Kevin was planning on seeking other work, but Elliot would clearly be seen as a “health liability” to any company.
What a crock–to only have health care available to you if you absolutely don’t need it.
shokufeh | 09-Aug-08 at 7:46 pm | Permalink
Ugh. I am so sorry. I know the stress of not being insured, and can’t imagine how it would be with other people involved – ones I’m supposed to be caring for, but the system is robbing me of my ability to do so. It truly is enough to make a person sick, even if you were okay to begin with.
admin | 09-Aug-08 at 9:30 pm | Permalink
If we were in a group plan, it wouldn’t be an issue. It makes me glad that we’ve made this jump to self-employment NOW… and not 10 years from now when we may have longer health histories. It’s amazing how the agencies can treat individuals and families looking for plans. They can do whatever they want, charge whatever they want, and just generally be like any other business. Privatized health care does not foster preventative medicine. (Nor does it foster a healthy population — particularly for those in vulnerable socio-economic positions.) The audacity of it is galling. How can physicians be expected to practice medicine? How can a patient approach their health in a confident manner?
Corporate profit at the expense of others is absolutely vile. That we, the wealthiest country on the planet, have not moved on from such an uninspired, unlighted model is an embarrassment.
But it feels better to have openly complained about it. Again. It helps me to figure out how to make the next step…
Violet | 10-Aug-08 at 4:50 pm | Permalink
I feel your pain. I was just turned down for long-term care insurance because I have bad knees and admitted that I was planning to undergo bilateral replacement in January. They never would have known this if I hadn’t disclosed it. This procedure (which has risks, yes, but fairly minimal) will actually ensure my ability to get around as I get older. I am only a few pounds overweight, I have a great heart an great vitals otherwise, but I can’t be covered.
Ridiculous. What is the point of having insurance if the policy holder must assume all of the risk?
Violet
Christoph | 10-Aug-08 at 7:32 pm | Permalink
Holly I am really worried about you. Really worried.
The problem with health insurance in America is that it’s run as if it’s a stock market. You have a history that health care brokers perceive a certain way, so those are selling you short, literally. Like brokers you pretty much have to game the system to win.
You do have a lot to give to a community. Doesn’t always mean that you should. We live in a Darwinistic society. Wishing that it were different doesn’t change that. It just makes you more vulnerable to being taken advantage of by systems and persons who have no such doubts. So take care of yourself right now, first and foremost. Then, when you have some measure of security, then help others.
Aunt Deb | 11-Aug-08 at 6:04 am | Permalink
Holly,
I hope that your problems get solved.
I am working on a problem with my records that got into another ladys records (We share the same name). They told me that I have never had the surgery and I have no rights to get my data from her file. I told the offending facility that I had had the surgery and they had mixed up the billing. Now they tell me that they don’t have such a person in their database. Wrong I say the computer monitor with 3 of us listed. I know the #2 person with the same name – my daughter-in-law. I just want to show up at the hospital and put my leg up on the counter and say “Look at the scar, do you think I’m imagining this?”
One of the interesting facts I have learned is the hospitals are only keeping the records for seven years. If you had anything that the insurance companies would deem negative longer than seven years ago- Do you have to list it on your application? You should be honest but??? What is the world coming to when you have to decide between honesty and health insurance?
admin | 11-Aug-08 at 6:57 am | Permalink
Thanks!
Violet: if YOU can’t get long term care as young as you are and as healthy and athletic as you are… I’m terrified!
Aunt Deb: I think you’re right… as consumers we have to decide what is best, honesty or coverage. I was wondering if I can abstain from filling out history forms in doctor’s offices in the future. I would rather do this and just be up front with the physician, face to face, then be dishonest on a form. (Of course, finding someone who would put in the extra time a form saves would be a challenge.)
Crisco: I’m okay. Really. I can introduce you to 100 other people who need a lot more worry than me. This will work out, I have to believe it will.
admin | 11-Aug-08 at 7:04 am | Permalink
Emmy… you got me wondering and web searching. Would any new employer be able to assess your family as a condition of employment? Or maybe this is small city syndrome, where everyone knows everyone else and anonymity in a job application is impossible?
After all the time looking over health plans available here through individual/family purchase, I have to say that I was underwhelmed. Not that they were all that radically different than other states, just that the range of benefits seemed more limited and exclusions were more than I had anticipated. Also, if I were pregnant or thinking of becoming pregnant, there is not a chance that we could do this now. I found ONE plan that included a pregnancy coverage… and it wasn’t a great plan. Scary!
Baggage Carousel 4 » Archivio » unsurprising, and unfortunate | 08-Sep-08 at 1:13 pm | Permalink
[…] outcome when the provision of health care services becomes a business venture. as my friend holly can attest, the result of this can be truly horrific. but even for those who are not trying to make the […]