Tag Archives: health care

Second coffee

I no longer use my hulking desktop computer for anything but an archive repository. But the paleo-HP doesn’t know this about itself, and it accedes to every Windows 7 update that wakes it up. And, in fact, Windows awoke my HP at around 4:00 this morning as it, and I, stupidly slept. (My husband sleeps with fully engaged intelligence, and the Cat only sleeps in his dreams.)

As Windows prepared to dribble 28 must-have updates into my computer, the motor kicked on with the determined hum of a C-105 preparing for take-off, and the monitor shined into the hall like a supernova, illuminating the bedroom with a blue glow.

I have never been clever at falling asleep in airports, or in computer-simulated airport-like home environments (CSALHE), so I got up at 5:00 and made coffee. I tried to read, but my resentment toward the computer for its big-screen spectacular of light and sound left me with concentration sufficient only for planning a computer funeral. No death would be too ghastly for the HP.

I normally get up at 6:00, but somehow the difference between 5:00 and 6:00 in the morning is about four hours. I decided that as long as I was up, I might as well go to the hospital lab for a blood test I need for my doctor’s appointment later this month. The lab opened at 7:00, I hadn’t eaten anything (black coffee was permitted), and I could get the test over with.

I arrived at the lab at 7:20. There were four people waiting for blood draws ahead of me. There was one technician, then two, and within about half an hour, a third technician came on duty.

At 7:40 I called my husband to wish him a fine and fruitful day; I wasn’t going to make it home before he left for court at 8:00.

I was called for my draw at 8:19. I cannot explain why it took an hour for my turn. These are the things of government health and its radiant efficiency. The computerwork (formerly called “paperwork”) and blood draw took about 10 minutes.

Hospital parking lots usually confound me; but incredibly, I was still oriented enough to find the door I came through when I arrived, and I even sighted my car where I expected it to be. I ate my Cocoa Loco bar on my way home, and looked forward to my second coffee, the second coffee that I would need a tad early this morning.

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If I may be quotable on the subject of SSN divulgence

“If at some point you determine that it is necessary to visit a hospital or emergency health care provider, laboratory, or even your own doctor (except in the case of a VA provider), then, having conceded the necessity to have something unusual checked out, notwithstanding your staunch and well-founded belief that you will come away without any new information or help anyway, at least come away without surrendering your SSN to the prevaricating interrogators, no matter how heartfully and authoritatively they invoke federal mandates. You don’t have to. At least, not yet. Of course, the charitable presumption is that these professionals are well-intentioned and misinformed, and not merely lying; but we all know that sometimes weak ground is signed by strong insistence.”

I suppose that from this standpoint, and on this point alone, I could rate my recent ER excursion a victorious success.

Here’s another quotable axiom:

“Under the New Health Care, ‘privacy’ means everyone and their corporate affiliates gets to know what’s in your medical file except you.”

But you knew that. And this particular hill has yet to be taken.

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The health team meme

I just got off the phone — 51 minutes, 38 seconds isn’t very long — with our health insurance carrier, a Premera-owned company, trying to accomplish a matter that I was assured would be very routine. And it was routine: it was the same old routine of getting shuttled around the circuits of institutional cluelessness, between Customer Service representatives who assured me they had the last representative’s file notes, getting bounced to Care Management, and finally latching on to someone there with a triple-digit IQ — a rarity in these circles. She told me that my errand was actually the bailiwick of Customer Service, but she perceived my frustration and was willing to take up the mission.

This rare Care Management gem actually called me back within a few minutes instead of subjecting me to another 39-minute bout of evil hold music. She assured me that she was going to ride herd on this case until she saw correct results. She confided that Customer Service had been following its procedures, but that the procedures were incorrect. She promised to delve into the root of the problem and fix it. She asked me to call her back if I didn’t hear from her before the end of the week. I secured this incredible woman’s direct-line phone number; I figure it must have a fair street value to all Premera customers.

I saw this sort of thing coming when I was in grad school in public health, and by the time I was in law school and studying health law, it had arrived. Everything in this industry has to be done by teams. It takes a whole village to screw something up, and it takes a whole assemblage of villages to fix it. Teamwork benefits everybody, goes the meme. It guarantees full employment for drones who learn how to affect caring. And it overlooks the discomfiting reality that bright, competent people like to work alone. So the health care team powers the train, and the consumer, a nominal member of the team, gets to ride in the bumpy caboose. If you read Catch-22, it’s Milo Minderbinder’s dream come true. And everybody has a share.

I have to say though, that the government has the right idea. The only way you’re going to convince people to buy health insurance like this is to compel them to buy it. Health care is expensive because health insurance requirements drive up the costs, and health insurance is expensive because health care is expensive. It’s an ongoing con to get us finally to concede that the government should simply take care of all of it. Why would a health insurance carrier lower its prices if people are forced to buy its products? What kind of marketplace is that? But free-market health care and insurance are as dry bones, awaiting prophets who appear to be out of season.

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In sickness and in health, till insurance do us part…

“Why do you think I would join your community after you throw my wife off the bus?” my husband asked evenly. The underwriter only reaffirmed the fact of our two individual applications.

If health care reform isn’t making you sick, you are probably among those wise citizens who’s not paying attention.

My husband and I recently had the exhilarating experience of applying for health insurance through a different carrier. We wanted to change carriers only because my doctor is not a preferred network provider under our current plan, but he does have this coveted status with the intended new provider. It would mean a considerable difference in the cost of an office visit if my doctor were an in-network provider.

Once our COBRA coverage from my husband’s former employment lapsed, we had two choices for private coverage: Lifewise and Asuris. Regence, our former carrier, informed us that they did not provide coverage for individuals in Eastern Washington, but only in Western Washington and Idaho. Since we were moving from Western Washington to Eastern Washington, we were told, repeatedly, by several representatives, that we would not be in Regence country. None of the Regence representatives ever mentioned the fact that Asuris, which insures individuals in Eastern Washington, was owned by Regence. So, we selected Lifewise prior to moving.

I found a true keeper of a doctor. I had been told he accepted Lifewise, but it turned out that there was a semantic nuance: he was not in-network provider. There was a chance he would join the network this year, but then he opted not to. One thing I appreciate about my doctor is his entrepreneurial spirit, even though it likely was his entrepreneurial spirit that influenced him against going in-network with Lifewise.

Once we learned that my doctor was not going to be a Lifewise in-network provider, we decided to attempt to change to Asuris, which we only recently happened to learn was in fact owned by Regence. We knew it was a longshot, because my various chronic health issues would probably exceed the number of points that enables an insurer to reject an applicant, unless the applicant is just getting off COBRA coverage. We were no longer riding the COBRA’s tail, but we have had continuous coverage through Lifewise. Washington state grants insurers the privilege of rejecting applicants for health reasons based on a point system, but the option is open to insure applicants with high point scores. Notwithstanding my high point score, I thought Asuris would be impressed by the low cost of my maintenance, since most of my healthcare expenses are prescriptions, and they pay nothing toward prescriptions — prescriptions don’t even count toward the deductible. Still, we knew it was a longshot. We just didn’t know it would be such a gratuitously insulting longshot.

We waited a month for the results of our application. Finally, the big day came, and it was in the mail. I gleefully opened the chunky package, which was obviously full of new policy forms.

The letter’s salutation included only my husband, although we had applied as a couple. The rest of the letter consisted of an effusive welcome to the Asuris community. I turned the page, and there was my name, outlined in bold red marker, NOT INCL. written alongside of it.

It was Saturday, so there was no way to vent my sentiments to anyone at Asuris. I didn’t mind being rejected, but they should have rejected both of us, or at least rejected me in the same letter in which they gushed over my husband’s acceptance. We applied as a couple, and as a couple we stand. The letter was not signed, but ended with a simple typewritten signature, Medical Underwriting.

Monday morning at 8:01, my husband called Asuris, demanding Medical Underwriting, but first being stalled at Customer Service. After getting through to an underwriter, he got the news we already knew, with a twist. “Your wife received a letter too. Maybe it just hasn’t arrived yet.”

My husband asked whether it hadn’t occurred to anyone in Medical Underwriting that because we had applied as a unit, we expected to receive or be denied coverage as a unit. But no, of course not. If one applying “spouse/domestic partner” is accepted, and the other “spouse/domestic partner” is denied, the applicants are immediately sundered into two entities, the healthy one heartily welcomed, and the health pariah outlined in red, to receive a rejection letter when Medical Underwriting gets around to it.

My husband explained, very slowly, repeating himself many times as if he were talking to a very young or very stupid person, that if anyone from Regence had ever mentioned that Asuris was a Regence-owned company, we would have gone with them initially instead of Lifewise, and that perhaps there was some responsibility on Regence’s part to have disclosed this in the first place. At that point in time, Asuris would have had no choice but to insure us, coming directly from COBRA. But the point was utterly lost on the Medical Underwriting person.

Another point utterly lost on the underwriter was that we were not upset that they determined me to be ineligible for coverage, but were upset with the way they handled it. “Why do you think I would join your community after you throw my wife off the bus?” my husband asked evenly. The underwriter only reaffirmed the fact of our two individual applications.

I have a very charitable friend who says she tries to treat unpleasantness she encounters with the attitude that the person being unpleasant has just received the worst possible news imaginable. So I tried to put the medical underwriter into some kind of perspective so that I would not resent the fact that she completely missed the idea that we might actually be insulted, not because I was not granted coverage, but because our joint application as a married couple was not acknowledged to be an all-or-nothing deal. Imagine your husband, but not you, receiving an invitation to a social event hosted by mutual friends. The medical underwriter offered no sort of apology whatsoever.

As far as I could advance toward being charitable was to resolve that I could admire this person for showing up at work, when she could probably receive SSI benefits for subnormal situational comprehension. But really, she’s just one of those rules jockeys who goes through life oblivious to the casualties of her unfeeling dutifulness.

Monday’s mail brought Asuris’s denial of coverage. There was no letter, no trace of human acknowledgment at all. There was a little chart that simply had a box for status, which contained the typewritten word “Denied.” The rest of the chunky package consisted of forms and prices for the state risk and pre-existing conditions pool.

End of rant. Life goes on. I have a doctor and we have insurance, so I suppose we’re still among those making it in America.

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Stay well, die young

It occurred to me this morning — and my cynical mind generates such thoughts fairly regularly — that the impossible mission of the new American healthcare system, if something so unsystematic may be called a system, encourages Americans to stay well because the alternative is unaffordable, while an underlying imperative suggests that if you live too long, you will live only to face abject penury, as well as inflict it on others who have also paid into the false security of Social Security. The rationale of health insurance and its exorbitant cost — unless you are a government employee — now matches that of the atomic bomb: we spend everything we have on what we hope to God we will never need to use.

Brought to you by the same sponsors is a ban on the words “Merry Christmas” in banks. I noticed a news clip about a little community bank in Perkins, Oklahoma that received a letter from the Fed, warning the small local institution that the Merry Christmas buttons worn by tellers and some — horrors — religious symbols could suggest the “appearance of discrimination,” and therefore were not permissible in a federally insured institution. Big hands, small brains. Presumably Sen. Inhofe will send the Fed a memo, alerting the awesome powers to the long stream of case law upholding the First Amendment in such things. What next? Someone says Merry Christmas to you, and you immediately suspect discrimination is forthcoming? “Merry Christmas” is more likely to portend discrimination than fraudulent letters of foreclosure being released “by accident” by TARP-funded banks? Okay, so the age of wisdom is behind us….

As I read through the book of Hebrews yesterday, I was reminded of the underlying cause of the criminal idiocy that dominates our news. In every age, men have opposed God, the author of truth, the source of wisdom. As the third chapter of Hebrews so clearly sets forth, opposition to truth is founded in unbelief, and unbelief is disobedience, and disobedience is unbelief. While unbelief prevails, truth is opposed, wisdom is subverted, and the unthinking thinking the unthinkable will dominate the landscape.

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Prevention

In case you’ve not heard,

“There is clear and incontrovertible evidence that family planning saves lives and improves health,” said obstetrician-gynecologist Dr. David Grimes, an international family planning expert who teaches medicine at the University of North Carolina. “Contraception rivals immunization in dollars saved for every dollar invested. Spacing out children allows for optimal pregnancies and optimal child rearing. Contraception is prototype of preventive medicine.” Source

Yes! Babies are right up there with measles: handily preventable. Contraception, vaccination: what’s the difference? It’s all good for our health. Contraception saves lives! And best of all, contraceptives are going to be free! Free, free, free! And, these spiffy new life-saving contraceptives come in snazzy designer compact cases. Why shouldn’t they — after all, the company’s marketing to the government, so why should they spare any expense in packaging?

I think the promoters of these things are the same people who call the cops at the grocery store when a parent raises his voice to his child, and reports the parent for thwarting the child’s self-esteem. They bellow things like, “every child has the right to be wanted,” but they never seem to get that every child has the right to be born. As for the authority of international expertise, I suppose they take great pride in aligning with Sweden, where marriage is virtually obsolete, and the rest of the developed nations with progressively negative birth rates.

If this causes a choking reflex in you, there is room for one more finger under your collar. If birth control is preventive medicine, isn’t abortion even more urgent preventive medicine? It is, after all, even closer to the onset of the dreaded disease. What health-minded citizen could conscionably oppose abortion under this thoughtful model?

I don’t know about spacing out children, but I know we have some seriously spaced out health policy.

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