Wednesday, August 29, 2012

Denial Because...

I couldn't make this letter up if I wanted to. Therefore, I decided to post it for you.

If you read the letter you will see that the insurance company will not pay for the prior authorized visit to a doctor I went to "because"

Claims Department

That's right, they didn't say why, they just said "because."

It's okay to laugh. I did after I got over the shock of getting a denial letter for a prior authorized appointment.

The company is based in Florida and if this was my first rodeo with an insurance company in Florida I might think "oops, someone sent this by mistake." However, attached to this notice of denial is also my EOB (explanation of benefits) reiterating the fact that my insurance company (that I faithfully pay every month) will indeed not cover this appointment they authorized me to go to.

The truth of the matter is Florida has lax regulations on insurance companies. They're not the only state with these lax regulations, but you have to question why so many of these companies avoiding their obligations are based in certain states and not in others.

In general American's don't like "regulations"--- there is a fear that "regulations" will lead to a communist system. I think that's a bit of extreme thinking and there is no way our country would move briskly to a non-capitalist society based on regulations for companies who are clearly not working for the best interest of their consumers.

All regulation means (in this case) is the loopholes, games, and tricks these companies play to gain the most profits based on denying coverage would be accountable to review. I personally think that would only improve our health care system.

Or maybe we will all begin to accept letters without question that say "We will not cover your care, because."

Wednesday, August 22, 2012

Political Platform to Prevent Coverage

I don't know if you all saw the story of Jackie Curtiss, the 22 year old Republican who voiced her concern over the new party platform on abortion.


Here's what that article says:

"Curtiss made waves in the committee when she objected to an amendment to the platform banning medication "that terminates human life after conception." The amendment was aimed at RU-486 and other so-called “abortion pills," but Curtiss warned that it could potentially include the “morning after pill.”

"Nevertheless, the amendment passed and found its way into the party’s 2012 manifesto."

That is one slippery slope folks...

The reason I'm raising concern is not because I'm anti-Republican or because I'm voicing judgement on abortion at all-- but rather because I am pro- life for people who have cancer, RA, and other major illness.

Most chemotherapy medications have warnings that state women may experience spontaneous abortion while taking the medication.

This platform doesn't differentiate between drugs, it just bans all medication that "terminates human life after conception."

I understand what the Republican Party is trying to get at, but if we aren't incredibly clear when we document our ideas unintentional problems can and will arise.

Monday, August 20, 2012

Health Care or Political Football?

When you're getting ready to buy a car, it happens. When you're trying to have a baby, it happens. And apparently when a presidential election is about to occur, it happens.

You see what you want EVERYWHERE.

Perhaps you decide on a Honda. Guaranteed you will see more Civics on the road than ever before. Want to have a child? Your office will flood with pregnant women. Want health care? Every political discussion will taper back to your topic.

While I knew health care was going to be one of the political footballs used for punting in this election, I still find myself frustrated.

For the kick off -the political ad about the man who lost his job and then his wife passed away from cancer. The return- if that patient had lived in Massachusetts she wouldn't have died. The tackle- the person who put the Massachusetts law in place wants to repeal the federal equivalent. New line of scrimmage-- the little girl's father whose company let him go because his daughter needed a transplant.

These stories are hard to hear, and they seem to fire up both political parties. However, they are not new, they're not even unique. They happen every day, in every state.

Why is it that we are only interested in hearing about these horror stories when an election is on the horizon? We should be outraged and concerned even when political ads are not invading our favorite evening television program.

Did you hear the one about the 90 year old in the nursing home? How her coverage ran out? Probably not. It's not as powerful when we're talking about Grandma.

These political teams pick and choose the most effective stories to "expose" and while it is supposed to serve as an example of what is going on in our country, it seems like we as viewers get tunnel vision.

"This is the story I heard about, it's a fluke."

The "fluke" is that we are only hearing about a very small number of people struggling daily and until we decide health care is not a political football and make sure everyone in this country is adequately cared for, we just keep playing a game.

Friday, August 10, 2012

November, 2012!!! Vote for--- Medicare?

Tonight Mitt Romney chose a running mate. (drum roll please)...Paul Ryan, of Wisconsin. I'm not surprised he chose Mr. Ryan whose plans to phase out Medicare and Medicaid were widely publicized recently.

In order to distance himself from "Romneycare" it only makes political sense to find a running mate who has put significant time and focus into plotting out ways to rid our country of safety net health care, for the elderly, the sick and the poor.

Perhaps this decision will boost the health care dialogue for November. In that sense, I'm thrilled with Mr. Romney's choice. My concern is the PR "spin" this new campaign will put on the topic of health care. They will talk about all the money wasted on caring for those who have no other health support.

It is important we listen to the message behind the words that will be spoken regarding Medicare and Medicaid. We must remember these are not "programs" to be cut, these are "people" to be cut.

Thursday, August 9, 2012

Passion for Purpose

As many of you know, last year I connected with a group of people on a mission. The mission was to discover our passions and how they could translate into purpose.

I have many passions. I am passionate about music, I am passionate about my family, I am passionate about making a difference. Before this journey I would not say I was "passionate" about health care. I was just struggling to work through a system that was not easy. The best way to describe my relationship with health care was persistence, but not passion.

However, I had a fire in my stomach for social justice and this system stoked that fire more and more. I believe we are given recurring themes in our lives that build and shape us to become warriors for good, if we're willing to accept the challenge.

Over this last year I have accepted my desire to help others so they may not have to struggle the way I did. I have recognized how that ties into health care, and how ultimately that really is the clearest passion for purpose path I've been given.

I am educating myself daily to try and build my understanding of this passion. I am recognizing there is no "one right answer." I am learning from people I agree with and those I disagree with.

Passion for purpose is not an easy road--- but so far it is rewarding.

What unexpected passions do you have? How can you use them for a greater purpose?