Food For Thought

This morning I was on Facebook and made a comment regarding the health care system. My friend Willma has a granddaughter who has had multiple surgeries the last few weeks. She is waiting for another one on Friday. This surgery had been scheduled previously but had to be delayed due to insurance approval or something. There were several comments about the workings of our health care system. I wrote that I felt like it is often a matter of "crossing our fingers and saying our prayers". Really, I should have added that "sometimes it's a matter of bending over and kissing our asses goodbye".

I have been very lucky. I was lucky to have health insurance when I needed it this time. That first year I was covered I had a pre-existing conditions clause. I was lucky that the first two appointments I made with my doctor for my annual checkup had to be cancelled due to not being able to get off work. When I finally got in it was a week after the year was up. Of course it took another 6 weeks before they actually diagnosed me. If I had gotten in six months earlier it may not have changed the diagnosis but I wouldn't have been covered.

Of course having coverage isn't the only issue. You still have to come up with co-pays and annual deductibles and all that stuff. All of this applies to in-patient, out-patient and prescription coverage and in network and out of network. It can take a heavy toll mentally and financially. If you're sick enough to not be able to work, whether it is temporary or permanent, you better be ready for those monthly Cobra Insurance payments. God forbid you can't make that payment each month. Sure, you may have no income coming in or maybe you're getting a percentage of your income and now you have the same bills as before and the full cost of your health insurance. You bought the extra disability insurance not realizing it isn't on top of Social Security. It works in conjunction with...the good thing though is they might help you get on Social Security sooner. At first you think it's because they are looking out for your best interest and then you are informed it's because they will deduct the amount of your Social Security check from the amount of your benefit from them. It's all good though. You have to be positive and realize you could be getting 60% of your previous income instead of 65%.

God forbid you are too sick to administer your own benefits. You need to be at least familiar with your benefits and coverage. Be on your toes so deadlines are met. You will need to make a lot of decisions. Thank God I was able to do all this and no issues came up when I was so sick I couldn't deal with them. Thank God also for Tonya who gave me suggestions on checking things out and who to call. We all know that Cobra offers 18 months of coverage if you lose your job for any reason. God must have been watching over me the day I was speaking to Cobra and for some reason mentioned I was on disability. They had no record of that from my employer and thank goodness the rep on the phone informed me that I would be eligible for additional months of coverage. I had worried endlessly about what I would do when the 18 months was up and I would be uninsurable. Thank goodness Cobra had never sent me the election letter so the time limit didn't apply. Mostly, thank goodness the young lady on the phone was honest and didn't try to tell me they sent this document which I knew I had never seen. I had to fight for it but I finally qualified. Thank goodness my former employer was cooperative. There was only one benefit I was denied and after several appeals they finally approved it (well, they approved after I made a third appeal directly to the labor board).

I just had a thought about why of all the places I have been for treatment, my favorite place to go is the St. Francis Oncology Center in Grand Island, Nebraska. I thought it was because the treatment rooms are larger and more private and the nursing staff is so pleasant. I think the actual reason is because it is the only place I go where the first thing they don't do is make sure they have that co-pay up front. What if I didn't have my $40.00 that day and I needed to wait for my monthly check. They always bill me. At the other places you're pretty sure they might not see you if they don't get that money upfront. Just the way they say "I need your co-pay now" makes me feel like they think I'm a deadbeat. Hell, I just signed in, give me enough time to pull out my checkbook. I know I have to give it to you. I should just start having the check in my hand when I walk in the door and hand it over before I sign in. If you didn't have the money you would have to discuss it with a receptionist in front of a waiting room full of people. As if your privacy hasn't already been invaded enough.

My main thought about health care is what it covers. Isn't it strange that they will pay someone to fry you with radiation and pay someone to poison you with chemo but they won't pay for all the other stuff that you may need to help you get better or even to live more comfortably with your disease. Massage therapy for neuropathy, nutrition training for eating healthier (or handling your chemo treatments better), hydro colon therapy for digestive health etc. etc. So my insurance has no problem paying over $5000.00 per chemo treatment but won't pay for my $75.00 massage. Oh hell. They probably think I'm sitting at a spa living the high life.

Life is all about perspective. You know is the glass half empty or half full. I may have cancer but how lucky have I been? I know that I could still lose my house if I were to require long term nursing home care etc. but I am counting my blessings every day. As usual, this blog is all about me...me...me but my heart goes out to all those people without health care and the means to pay for health services and those people with health insurance who can still stand to lose everything they have worked their whole lives for. I have been there and it's a very scary "black hole" to be in. I am not advocating universal health care or handouts from the government. I have made it my rule in life to never argue about politics or religion. I just feel that people deserve the basic necessities in life. I am no "bleeding heart" liberal but I would like to think that I have compassion for my fellow man. I don't know what the answers are for reform but, isn't that what the "experts" get paid for, to know the answers or to find the answers? Even if reform isn't the answer maybe some accountability from insurance companies and pharmaceutical companies would make a big difference in cost to the consumer. The health care industry had unbelievable profits this year but rates keep going up because of the "cost" of health care. Oh, or was that because of the "cost" to produce those profits. Have we all forgotten the $5.00 a gallon gas prices that were supposedly due to the cost of obtaining the fuel then the gas companies reported record profits? Do these people think all Americans are ignorant or just too passive to speak up? Okay, I'm off the soap box. Obviously, that was one of those "don't get me started" things! Blessings to everyone (regardless of your health insurance coverage status or position).