We want to let you know about a very important program offered through your Blue Cross and Blue Shield of North Carolina (BCBSNC) health plan. A representative will contact you shortly to let you know about our personalized nursing support services that are available to you at no additional cost.
Wow! Sounds amazing! Tell me more!
The health care staff at BCBSNC includes nurse case managers, social workers, and a registered, licensed dietitian.
OMG, that’s awesome! That sounds just like my dialysis provider! I’m so lucky to have them looking out for me, because my health is their #1 concern. I’m sure it’s yours, too, BCBSNC, and that’s why you do this!
Blah blah blah…help you better manage and improve your health….blah blah blah
Dear BCBSNC:
My employer and I pay you a monthly premium. You cut checks. Repeat until we tell you otherwise. That’s all you need to do. Now leave me alone.
I’ll ignore the ugly stuff out there for a minute and savor the fact that the most important legislation in my lifetime has passed. It should be crystal-clear to everyone that the two political parties aren’t quite the same. Elections do matter. If you voted for Obama, and you believe that healthcare should be more of a right than a privilege, you can feel like your vote mattered. And if you’re a Republican, and you believe that government shouldn’t play a role in ensuring access to healthcare, you can be quite confident that your vote counted, too, since every Republican in the House of Representatives voted against the reform bill. Fortunately for Democrats, they have a sizable majority, because they did well in two straight elections. Elections do matter. And Barack Obama, for all of the blame he deserves for ceding the debate for the better part of year, deserves enormous credit for rallying his diverse party to pass a flawed, but monumental piece of legislation.
For:
(President Barack Obama Addresses Democratic Members of Congress, 2010.03.20)
I have the great pleasure of having a really nice library at the White House. And I was tooling through some of the writings of some previous Presidents and I came upon this quote by Abraham Lincoln: “I am not bound to win, but I’m bound to be true. I’m not bound to succeed, but I’m bound to live up to what light I have.”
This debate has been a difficult debate. This process has been a difficult process. And this year has been a difficult year for the American people. When I was sworn in, we were in the midst of the worst recession since the Great Depression. Eight hundred thousand people per month were losing their jobs. Millions of people were losing their health insurance. And the financial system was on the verge of collapse.
And this body has taken on some of the toughest votes and some of the toughest decisions in the history of Congress. Not because you were bound to win, but because you were bound to be true. Because each and every one of you made a decision that at a moment of such urgency, it was less important to measure what the polls said than to measure what was right.
A year later, we’re in different circumstances. Because of the actions that you’ve taken, the financial system has stabilized. The stock market has stabilized. Businesses are starting to invest again. The economy, instead of contracting, is now growing again. There are signs that people are going to start hiring again. There’s still tremendous hardship all across the country, but there is a sense that we are making progress — because of you.
But even before this crisis, each and every one of us knew that there were millions of people across America who were living their own quiet crises. Maybe because they had a child who had a preexisting condition and no matter how desperate they were, no matter what insurance company they called, they couldn’t get coverage for that child. Maybe it was somebody who had been forced into early retirement, in their 50s not yet eligible for Medicare, and they couldn’t find a job and they couldn’t find health insurance, despite the fact that they had some sort of chronic condition that had to be tended to. (more…)
Roger Ebert takes on that 911-fee I mentioned a few days ago and goes much further, reflecting on the state of the United States that we find ourselves in today. I feel compelled to label Ebert’s journal as a must-read once again.
I forgot. Before Al Franken was seated, which wasn’t until JULY, the Democrats only had 59 votes. Before Arlen Specter switched parties back in April, the Democrats only had 58 votes. Do you mean to tell me that they had no plan to pass meaningful health reform back when they ONLY had a 16-seat edge in the Senate?
What the hell?
And as for the liberal House members who now say they will refuse to rubber-stamp the Senate bill…good for them. Last night, I felt like the Dems ought to salvage something, like a healthcare reform bill. Right now, I feel like the progressives need to salvage their principles, and that means rejecting a bill that fattens the pockets of the insurance companies and does not bring down costs. Or just pass the friggin bill. I don’t friggin know…
The person in HR who could switch my insurance over is not in today and won’t be in until January 4. A particularly unhelpful person in HR left a message for the helpful-but-unavailable person, who had been pretty clear that I could switch insurance, but only before January 1. So am I screwed? I won’t know until Monday.
I abruptly discovered last week that my health insurance plan does not cover the expenses of an unrelated donor.
The Duke transplant program tells donors that they are not responsible for the costs of the surgery. They say the recipients’ insurance is responsible. Except when it’s not, apparently (and ironically).
Duke Transplant:
The tests, the surgery, the hospital stay, and your return visit will not cost you directly. They are charged to the recipient’s insurance or Medicare.
My insurance:
The Plan does not cover any expenses related to the donation of organs, tissues, bone marrow or peripheral stem cells by live donors unless the donor is a living relative and the donor expenses were not covered under the donor’s health plan.
And the reason all of this is all suddenly acutely relevant…I’ve had a relative, who doesn’t fit the insurance policy’s definition of a relative, who has expressed interest in being a donor and may very well be a compatible donor.
Technicalities aside, it would seem that if the transplant team deems a donor’s kidney to be a likely match, that is all that should matter.
My nephrologist says that my insurance’s policy’s clause is “unconscionable”. For me, the discovery was a wicked punch to the gut. I allowed myself to think that perhaps my dialysis experience would be relatively brief, perhaps just a few months rather than 6-7 years. Following this policy, I’d need to not only find a willing and compatible donor, but I’d have to raise money for the surgery. When I was originally signed up for the transplant program, no one told me of relatives-only restriction. No one told my relative before my relative embarked on tests that weren’t covered.
—
The loophole…
My employer offers another plan that does not seem to have the relative-only restriction for transplants. I am told that the insurance will cover the donor’s surgery. But I cannot get a 100% guarantee because I have to be a policyholder first.
Normally, one is allowed to change plans only during open enrollment in October or due to a qualifying event (starting job, marriage, new baby). An HR benefits specialist has told me I can make the switch as long as I do so before January 1.
Now, I got the semi-definitive word from the transplant financial specialist around 4PM today. (Again, I can’t be 100% certain that this will really work until I’m a policyholder of the other policy). By the time I called the HR specialist, she was gone for the day…and possibly until January 4, as that’s what her voicemail indicated.
So, I have to hope that, either the HR benefits specialist is in tomorrow, or that someone else in HR can perform the same magic.
And all of this anxiety because of some fine-print on my insurance policy that I hadn’t noticed.
Call this Exhibit #84923827 of an insurance company playing doctor to the detriment of the patient. Not sure current health reform efforts would even do anything about this. It’s not like I am entitled to an almost-free kidney transplant. Folks on Medicare are. Geez…thank goodness we’re not getting Medicare for all…that would be horrible…
Alright. I’m not in the mindset to write about this healthcare debate that’s turning into a debacle. I’ll leave it to two of my favorite political figures, Howard Dean and Al Franken.
This bill is no longer reform.
- Howard Dean (link to video)
We’re entitled to our own opinions. We’re not entitled to our own facts.
- Al Franken (link to video)
Dear Toastie:
I’ll ignore 
