Health Care Rants

I need to rant about health care now.

Here is my personal story:

Back in September of last year I finally decided that you know, I should have health care. My parents were telling me, it's not safe to not have health care. You need to have this coverage. I buy it. I go online and buy personal health care coverage for myself. I have to pay $120 every month. Considering that I am a healthy, young female, this seems a bit outrageous. Everyone tells me - it's the only way to be safe, in case of a catastrophe. In my coverage it says that "preventative visits" are 100% covered. Not even a deductible! I decided to go and test that out. I made an appointment to see an OB/GYN. (I haven't had an annual exam in years because I didn't have insurance).

I go in, a bit apprehensive. But, I have a wonderful experience with my doctor and his assistant. I think - oh this is great. I'm paying all this money to my insurance company for this. It is paying off!

Then, I receive a Explanation of Benefits (EOB) from them. It says they will cover a procedure that my doctor billed them for. Good, this all seems right. The next day I receive three more EOB's. These state that they will not cover four different items billed to me by "Medical Diagno" and they will not cover two other items that my doctor's office billed them for. If I am charged the full price, which I could be, I would owe almost $700 for this visit, which was supposed to be completely covered by my insurance.

A few days later I received a bill from my doctor's office stating that I owe them $146. I have still not received a bill from this mysterious "medical diagno"

I must first state how terrible these documents are. They do not explain what my insurance is not covering. They are just items from "Medical Diagno" for $130. The column the title is printed in cuts off the full word. (The insurance repriced this mystery item at $19 - which basically means that if the insurance pays for it they would pay $19 but if I have to pay for it, I could pay $130). They also sent me a letter explaining that I have a right to appeal these. On the bottom of the page they list a number for the Texas Health and Consumer Protection Bureau. It states that they can help me with the appeal process. This letter looks like it could have been typed on a type writer from the 1950's.

Yesterday, I finally had time to follow up on all of this. I started with the Texas Health and Consumer Protection Bureau. They asked if I had already filed an appeal. I said no. They said I needed to talk to my insurance company first.

I called the insurance company. After being on hold for nearly 10 minutes, I spoke with a real, live person. I asked her about the denial of coverage. She said that they do not cover the visits. I said that my policy should have covered the visit, as it was preventative. (Now here's the real kicker, if I had gone to the doctor because I was actually sick - that is clearly NOT covered under my insurance). She said that my doctor's office had coded this visit as a visit related to an illness.

I then called my doctor's office. They're closed on Fridays. I have to call back on Monday to follow up on this.

Even if my doctor's office did make a mistake, this does not address the other four mysterious charges from "medical diagno". I asked the woman that I spoke with what they were for and she said that I would have to ask my doctor about that. She could not tell me.

I guess I'm still in the middle of figuring this out. I did cancel this insurance coverage shortly after my visit (before I got any EOB's) because I was picked up on employer's insurance coverage.

I've now given you the basics of my situation. I think insurance companies are some of the worst ideas ever sold to the American People.

Basically we are paying them lots of money so that they can pay for our health care if we ever get sick. However the plan that I was paying into specifically excluded paying for any doctor's visit because I was sick. Why am I buying something that I cannot use? I am buying it for the emergency scenario. God forbid, I get in a car accident or fall and break my leg or something else. They would cover a portion of that after I've met my $5,000 deductible. If I just have a cold or Bronchitis (which I actually did have recently but thankfully my new insurance actually covers me going to the doctor for a minor illness and all I had to pay was $25 plus a portion of my prescription). I was paying them every month, but if I ever had a minor illness I would have to pay for that on my own.

Medical providers are inflating the costs of their services. As shown in my EOB that I received from my insurance company the "cost" of the item was $130. My insurance company had negotiated a lower rate of $19. I have no idea of what the actual cost of this procedure is (I still don't even know what "it" is). Let's look at this from a purely financial standpoint. All companies have to make a profit. Let's imagine that they are charging the insurance companies at cost. Let's say they are not losing any money by charging my insurance company $19, but they are also not making a profit. Where does the profit for this company come from? It comes from all the people who either are denied coverage by their insurance companies and so have to pay the full value or they do not have coverage at all and so have the pay the full value. The "costs" are highly inflated, 684% by my basic estimation. If the real cost was charged to all customers would insurance even be necessary? The uninsured and those that the insurance refuses to cover are the ones that pay this price.

I'm very concerned that when the Supreme Court Rules on the Affordable Care Act this summer that they will side with the Government. I know that I'm progressive, but I don't believe that these corporations need the force of law to make us buy a product that should be a basic right. Access to affordable health care (and possibly free?) is something that the Government should provide. The government needs to provide the things that people cannot provide for themselves. Among these is affordable health care. We have a right to life, liberty and the pursuit of happiness. If people die because of a lack of health care (which happens every day in this country) than the Government is not holding up it's part of the bargain to ensure that we have these rights.

It is time for the American people to stand up and demand a single payer system for health care that removes the profit motive.

Thoughts?

On July 4, 1776 men gathered in Philadelphia and wrote these words: “But when a long train of abuses and usurpations, pursuing invariably the same Object evinces a design to reduce them under absolute Despotism, it is their right, it is their duty, to throw off such Government, and to provide new Guards for their future security.”

For the past 40 years our government has been invariably pursuing the interests of corporate greed over the interests of the people. This one Object has been their aim at the expense of the people that consent to be governed. We can and will create a full list of grievances, but that list would be much too long and incomplete. Instead, we can explain what it is that we would like to achieve and then begin that process.

Since we are part of a movement that has no official leader and no official hierarchy each of us brings our own values to the movement. For me, I am passionate about alleviating poverty and homelessness. For others they are passionate about the way our government and society privileges people with lighter skin. For others they see the destruction of our environment as the paramount problem that we are facing today. Yet, the secret that no one in power wants to admit is that all of these issues are the same issue. They are rooted in our desire to control. People create a system of power over others so that they have a feeling of control. This system of power over people, plants or animals is a system of inequality that must be brought down. The Occupy movement is the last chance that this country, and this globe, has to fight against the powers that will destroy our world.

It is our right and our duty to throw off the Governments, around the world, that are invariably pursuing corporate profit over the health of our people and our planet. We are lucky enough to be alive in a time when we, as a global people, have become aware of the ways in which our governments are colluding with one another to frighten us into thinking that there is a scarcity and that we must fight each other over the crumbs that they give us. We must stand up and say that as The People we are united.

We are going to create the new world that we want to live in. We will no longer listen to your lies that tell us that we have to choose our issues to fight. We will no longer believe the lie that profit is more important that the life of the forests. We will no longer believe the lies that the only way to create prosperity for some is to build it on the backs of the poor. We will no longer believe your lies that only people who have money should have the best healthcare. We will no longer believe your lies that people in poverty are there because they do not work hard enough. We will no longer listen to the television that instills fear of those who practice a different religion or wear different clothes or speak a different language. We will embrace this diversity. This diversity is what makes us strong. We know that those of us standing up in Chicago and in New York and in Madrid and in Tahrir Square and in Tunisia and in Syria and here in Austin, TX are all brothers and sisters. We are fighting a united fight and we are winning.

The Poor will always be with you

There is this passage in Mark that has always bothered me. I've always been critical of this passage because I never understood it. I read it again this weekend in preparation for Children's Chapel on Sunday and I think I finally started to get it.

Here's a quick summary: Jesus and his disciples are eating dinner at Simon the Leper's home. A woman (in Luke she's identified as Mary Magdalene) comes and pours very expensive perfume on Jesus. The disciples rebuke her and say that the perfume should have been sold and given to the poor. Then Jesus rebukes the disciples and says that she did a good thing and that the disciples will "always have the poor with you."

In the past I've seen this passage as an excuse to neglect the poor; I've seen it as a way to say "the poor will always be with us" so we don't have to do anything for them. Instead lets spend tens of thousands of dollars on our new church. Jesus told us to right here that we don't have to spend money on the poor and instead we should spend money on him. Our church building is clearly what Jesus would have wanted.

When I read this on Sunday I noticed for the first time where the story was set. This story is set in the home of Simon the Leper. All we know about this man is that he has a home and that he has an incurable skin disease. (Any good Bible will have the footnote that the word for leprosy was used to refer to multiple skin diseases, not just leprosy). We also know that people with skin diseases were considered unclean and therefore were not allowed to participate in the religious life (or any communal) activities. The fact that Jesus and his disciples were in this man's house and sharing a meal with him is a radical act. That act, by itself, would be revolutionary. It would be as if the Pope decided to go and have dinner with an abortion doctor. This story just leaves the tidbit about where it is located as a small detail in the background. They move on to the real story, the woman pouring her perfume over Jesus.

This is a purely symbolic act. Jesus is preparing for his own death. At the end of this passage Jesus sends his disciples out to find a place for his final meal. He is clearly thinking about, and aware of, the fact the he will be leaving this earthly life in a few days time. He has brought the battle to Rome, so to speak. This woman, probably one of his disciples - although the male centric lens of the gospel does not name as one - pours this oil on his body in preparation for burial. She is probably giving him the most valuable item that she owns. Instead of waiting for him to die she is giving it to him in the here and now. She is saying that what we do right now is so much more important than what happens after we die. We don't need to wait until this life has gone to give our most valuable asset because the lives that we LIVE are our most valuable assets. By pouring her perfume on him she is saying - I am living my life for Jesus. I am not waiting until I die (or you die, Jesus) to have the Life that you offer.

The disciples reaction shows just how little they get it. They say that this is a waste. Her perfume could have been sold for a year's wages and the money given to the poor. What we forget is that all of this is taking place in the home of a poor person. Not just a poor person, an excluded person. Jesus does not talk about the poor in some abstract "over there" sort of way. No, Jesus goes to their homes for dinner as he is preparing to lose his life. Jesus is not concerned with the ability to throw money at the poor so that they are no longer poor. He is trying to create a new system where people are valued because of their humanity not because of their wealth. As long as we fall into the trap of believing that if we just give enough money to the poor then we will eventually eradicate poverty we will never overcome poverty. This is lie is tempting because it seems to address the basic cause. Why are the poor, poor? They do not have money. Yes, that is the definition of 'poor'. But that does not answer why. Why are they (we?) poor? We are poor because our society has been built to create a class of people that slaves away to serve those in power. We have been programmed to see poverty as something that we can fix as individuals. That is impossible. Poverty is a system of power that must be dismantled.

Jesus understood this. The disciples that followed him did not. They were probably uncomfortable because they were in the house of an unclean man just before one of the holiest holidays. They were probably thinking that Jesus had just ruined all their plans to celebrate Passover in Jerusalem. Now they see this opportunity to show how much they support the poor. Look at this waste of money on perfume that should be used after Jesus is dead! Why are you embalming him before he dies they cry. Why can't we just take that money and give it to the poor? They desperately want to try and prove that they get it. That they understand that we have to fight luxury and give money to the poor. That is not the solution.

The solution is a revolution that has no room for exploitation. A revolution that has no room for poverty. But also a revolution that is just as intolerant of greed.

I finally see what Jesus means when he says that the "poor will always be with you." He is really giving a command that we will always be with the poor. We will be among them. We will be poor so that we can combat a system that values people based on money. Finally this passage makes sense to me.