my jaundiced eye

the absurdities of life

Category: health insurance companies

oh no! bama care

oh-no-bama-care

MJE is going to take a quick commercial break from politics and tackle another topic just this once. Obama care.

This program is in the headlines right now because it has been announced that premiums may go up as much as twenty five percent in the coming year…. AAAAGGGGHHH….zombies are on the front porch, help me! They’re eating my dog and tromping on my landscaping!

I’m not sure where people get their health insurance but from a lifetime of paying premiums to BC/BS I can state without fear of contradiction that my premiums rose about 20% on average every year. And hello, did I hear anyone screaming about it, no I didn’t because the fact of the matter is that insurance companies of every stripe have you by the short hairs. What are you going to do, say screw you and get insurance somewhere else…oops, then you get into the whole pre-existing condition fun house, or the you’re pretty old to be shopping around septic tank, or whatever other excuse they can haul out to either deny you coverage or to charge you ten times what your current provider does. Better the devil you know than the one you don’t. And when they get tired of you because you actually filed a claim, you’re dropped like one of the conald’s wives…I was lucky enough to get sick when I was 64, maxed out my annual and lifetime deductions and finally got a portion of my pound of flesh out of my long and costly association with BC/BS…and the best part of it was that as of 1/1/16 I was on medicare and they couldn’t drop me…and people don’t believe in karma?

But BTW, medicare ain’t no picnic either, lower premiums, really? Single payer!!!! Woo hoo!!!! By the time I pay the regular (income adjusted) premium, add the extra part Z to cover the dreaded “donut hole” and the prescription add-on I am at about 140% of what I was paying BC/BS. Which unbeknownst to me is not even available to those of us who have survived long enough to enjoy our golden years unless we are covered by a major corporate insurance plan. You’re in, like it or not. Wanna contest a claim denial, opt for an IRS audit instead, it’s far less labor intensive and stressful.

So the conald (commercial break is over kids) is touting (or trouting in the vernacular) the tired repeal and replace trope. Part of his plan is to offer health savings accounts. Yo, dono! head’s up, HSA’s have been around for decades…and they are great. You sign up for a high deductible health insurance plan and you sock away $5K or so a year into an account that is untaxed as long as you pay medical bills with the funds. But, just so you know, that $5K doesn’t arrive on your doorstep like a publisher’s clearinghouse sweepstakes check, you actually have to have the money to put in there. So say you’re living on $50K a year before taxes, does it seem likely that you might have a spare 10% of your gross income to put in an HSA? Thanks for the thoughtful and incisive input conald.

Then there is the “erasing of state lines” thing…not sure about other providers but BC/BS seems to cover medical expenses incurred over state lines without a problem as long as your doctor is within the BC/BS network. Admittedly, coverage expenses can vary greatly from state to state so MJE is going to give the conald a passing grade for that, although he get’s an f for originality.

I can’t actually remember what the other parts of his plan were because when he reads from the teleprompter it’s like watching a hostage video, and I have to turn it off and lie down.

But the upshot of the conald’s plan is that everyone is going to have great, really great medical care for a low, really low price and we’re all going to beat the house at black jack. Speaking of which, how does a casino lose money…seriously, how does that happen? Maybe we’ll find out if the conald gets his hands on the us treasury’s checkbook…

well done

well done

Okay, so after eleven months, the medical industrial complex has finally wrung MJE dry and kicked me to the curb…my right hooter has been mammogrammed, programmed, pajamagrammed, MRI’d, FYI’d, DIY’d, x-rayed, blue rayed, inspected, bisected, dissected, irrigated, oxygenated and irradiated. Every doc, nurse, orderly, lab tech and passerby in several states has felt it, held it, fracked it, hacked it and packed it. I’ve been cooked to medium-well and am sporting a Boehner tan headlamp with a permanent smirk. Oh, that and a head of holocaust hair.

So, what did MJE learn from this experience? First off and a tad bit late for me, that the kind of cancer with which I was diagnosed is a form that many in the forefront of oncology now believe may be best left alone and monitored closely. No rush to surgery. Treated more like a polyp in your bottom than a bombshell in your bosom. Also that a surgeon never met a piece of meat he didn’t want to carve up and will never admit when he doesn’t know what he doesn’t know. I also realized that many doctors are as resistant to change as the most stagnant civil servants and that a patient needs to do her homework, sharply question a treatment plan, or lack thereof, and to over ride it without feeling guilty about changing docs or getting another opinion. My health and yours are more important than some doc’s inflated ego. I also think that being a tattle-tale is a good thing for the general betterment of the afflicted. I’m not talking about going to the medical board, but if a specialist has been referred by your primary doc and you have valid complaints, you should let the referring doc know before he sends another hapless victim over.

I also discovered that nurses and technicians can literally be your best friends and are entirely under-appreciated in the medical universe. I found that getting their take on what’s really going on is invaluable. They are in the trenches all day every day while most docs pop in when required, having read the notes (or as is sometimes the case not even that) give you a cursory once over and waft out the door without so much as a by your leave. That said, MJE was treated by a couple of exemplary docs who were more than willing to put away their stop watches and take whatever time was necessary, so all is not lost, yet.

Finally MJE was extremely gratified to find that it is actually possible to get your money’s worth out of the godless health insurance companies if you: meet your horrendous deductible, then get some really crappy diagnosis, have months of complications, endless (often unnecessary) tests and a tediously lengthy treatment plan. MJE totally ate BC/BS’s lunch in 2015! Admittedly it was an extremely long and unappetizing meal , but in the end the dessert was delicious. And for once it was on the house.