in december i have to chooooose. good grief. already?! the pressure.
we have had the good fortune of friends who have that-timed-it before us. and so, we are relying heavily on their medicare smarts. we even had an in-service up-north with our gang. handouts and everything.
so, when it comes time to actually signing up, we are hoping that it will be with ease.
because the fact-of-the-matter is that medicare – like most government programs – is not streamlined, not easy to understand, nothing less than dense, filled with loopholes and scary ramifications, rules and rules for rules.
and this is supposed to be a happy-happy social good-health-for-all program.
someone peeled carrots into the pond and then it froze over. shavings of those multicolored organic rainbow carrots on the ice surface, just below the surface…it made me laugh to see so many carrots in one place. only they weren’t carrots. they just looked like carrots. instead, it was bits of bark and dried grasses and small sticks – no nutritional value or nurture to bunnies and squirrels and chippies, deer and birds.
it brings to mind the children’s book “the carrot seed” – the little boy plants carrots despite the fact that practically everyone around him tells him – basically – that the bottom line is that they won’t come up, despite his care. the last frame of the book shows him – having persisted nurturing the seeds he had planted – pushing a wheelbarrow with the biggest carrot you’ve ever seen. the value – the power – of true nurture.
nurture: to care for and encourage the growth or development of someone or something.
at this moment, for me, it is a hop, skip and a jump from there to thoughts about healthcare and insurance, keeping wellness forefront.
insure: to secure or protect someone against (a possible contingency) this definition would lead one to believe that “to insure” is somewhat parallel – or at least supplementary – to “nurture” – seeking to keep someone safe, healthy, attempting to look out for someone’s best interests.
“insurance is a means of protection from financial loss in which, in exchange for a fee, a party agrees to compensate another party in the event of a certain loss, damage, or injury. it is a form of risk management, primarily used to hedge against the risk of a contingent or uncertain loss.” (wikipedia)
“insurance plans will help you pay for medical emergencies, hospitalization, contraction of any illnesses and treatment, and medical care required in the future.“(an insurance company)
our current (and unfortunately necessary) gap coverage insurance company states they are dedicated to a simple goal: “making health care easier for the people we serve.”
the insurance plan that will take effect in five days believes that “health connects us to each other” and that “what we all do impacts those around us”. and so, they say they are dedicated to “delivering better care to our members”.
nevertheless, the united states seems to have a grotesque insurance problem. the earnings pie – or say – the carrot cake only goes so far, particularly with major medical insurance. but then, there’s dental insurance, vision insurance, life insurance, home insurance, car insurance, major appliance insurance, small appliance warranty insurance, laptop and tablet insurance, recreational vehicle and boat insurance, travel insurance, personal, general, property damage liability insurances. americans are slicing away at their own cake…for most, never quite big enough to start with.
and then there’s business insurance…various insurance plans that companies, organizations, institutions purchase to cover costs associated with property damage or liability issues and to keep their employees safe and healthy – because companies and organizations and institutions care about their employees and want to look out for their best interests.
“your employees may be your business’ most valuable asset.” “… protect your employees …”(an insurance company)
yes.
ahh, but here’s the rest of that insurance company’s statement:
“your employees may be your business’ most valuable asset.” “… protect your employees – and your bottom line…”
hmmm.
though it may look like carrots, there are no carrots there. no nurturing. no nutritional value. just a bottom line.
yes. i know. it was auto-generated. the three mailings (first class mail stamps cost $1.74) and the three emails and the text were all auto-generated. and all of it? dehumanizing.
we are no longer on molina healthcare since during-the-year 2021, but for a company that literally charged $19,927 for the period of time we were, a balance due of 27 cents seems a bit inconsequential and the threat of policy termination and coverage loss – in the middle of a global pandemic – while they claim to be “caring about people and advocating on their behalf” and “helping those most in need” – well, it would seem that a bit of real-people-ness might need to shine through.
i know that we have grumbled before about healthcare in the united states; this will not be an out-and-out rant, for i’ve written that in previous posts and want to have a bye for future ones. but it is surely a tad bit humorous to think that a company with a january 2022 net worth of $16.24 billion – billion! – cares about 27 cents.
even funnier is that as soon as i knew we had an outstanding balance over and above our premiums – this 27 cents – i paid it online. yet the letters, emails and texts kept coming, even a month after we no longer had their services. auto-generated, aggressive, uncaring, impersonal.
molina – in their employee handbook, as part of how they describe their core values – states: “we focus on what is important. ‘it is a business of nickels.’ little things matter and the nickels add up.”
ahhh. yup. i’m guessin’ they must. focus on nickels, that is. “we are careful with scarce resources.”
this is a company that bases their existence on the early clinic of their founder, “where caring for people was more important than their ability to pay.”
yes. yes.
“if we don’t receive your payment, your policy will be terminated and you’ll lose your coverage.”
we paid our 27 cents. molina healthcare lost at least $1.47 in that exchange.
in the category of vices-to-get-us-through-the-winter, you will find the occasional french fry binge. these are not the side dish. instead, they are front and center at happy hour…shoestring happiness. there is something about carbs and sea salt combined that will – yes, i know it’s temporary – raise our spirits to the point of giddy. much like the sheer joy my best friend susan and i would experience on giant bike hikes back on long island when we’d pull into the mcdonald’s parking lot and head inside to order large fries and a chocolate shake, d and i wait for the oven timer to go off and do the french-fry-happy-dance when it does. it’s the same. i am back at 14. sea-salty fries and a beverage-of-choice – in this case a red – give us moments to ride up the carb-escalator-of-glee and we have no remorse.
i needed fries on friday. comfort food for a complex day.
somehow i have hurt my foot and, after researching hand-in-hand with google numerous times, icing, resting and advil-ing over the past not-quite-two-weeks, decided it was time to see a real-live doctor.
i made an appointment at a medical clinic i’ve been going to for the last fifteen years or so. my former doctor, a woman, is no longer practicing there but there is a male physician i’ve seen and i figured that since he had an interest in sports medicine he would be a fine person to evaluate my foot, start the process of proper care. the receptionist told me they were “coding” me as a “new patient”, even though i wasn’t. so i asked what implications that had – on my insurance, on this specific visit, on me as a patient. i am a big question-asker. she informed me that there were no implications whatsoever.
cue up debacle.
i’ll skip to the part where i was in the examining room explaining to the nurse about my foot and two other concerns i had wanted to address.
she asked me if i had fasted.
“fasted?” i repeated back. “no…why would i have fasted?”
“for the bloodwork,” she replied.
“bloodwork??? what bloodwork???” i inquired.
“the bloodwork for your physical,” she stated flatly, staring at me.
i stared back, likely with a blank look on my face. “i’m not having a physical. i’m just here for my foot,” i calmly explained, a nagging sensation beginning in the pit of my stomach.
“you’re a new patient. you have to have a physical,” was her retort, followed by “you’re running out of your appointment. what do you wanna do?”
continuing to have eye contact i asked, “why wasn’t i told there would be a physical? why, when i specifically asked questions about the implications of the terminology ‘new patient’ wasn’t i told a physical would be necessary and that i should fast for bloodwork?”
she then threw the front end folks under the bus saying, “they’re receptionists. they don’t know anything.”
evenly, but with a growing nagging sensation now at the nape of my neck, i asked, “if THEY don’t know anything, how would i?”
“look, this isn’t urgent care. what do you wanna do?”
a few moments and a few queries later and it was obvious that this appointment – for which i hadn’t been instructed to fast and for which i hadn’t prepared the laundry list of questions and concerns one should bring to a once-a-year physical – would be the only one health insurance would cover for this year.
i hadn’t been properly informed. i didn’t find that acceptable. this health care system’s “safe care promise” states “see what to expect at your visit” and “clear previsit instructions” will be provided. hmm. not.
i left.
after d picked me up at the curb outside the center we sat in the parking lot for a few minutes, processing.
“your health and safety is our highest priority” reads the front page of their website. it would seem that patient-centered care would be their ‘thing’. yet, these were moments when (and i grant you that the entire medical community has been and is in overwhelm – as are all of us living through this pandemic) a nurse in this circumstance could have responded in a hundred different ways.
responding to me, as a patient trusting the information i have been given (or not given, for that matter), she could have apologized for the lack of clarity represented to me. she could have not thrown her colleagues, regardless of the pecking order, under the bus. she could have suggested that they waive the physical for this particular appointment since i had actually seen this doctor before and since they had at least fifteen years of records on me at that location, offering a chance to return for a physical at a later date. she could have given the doctor the choice. she could have ensured that the patient’s pressing need – the reason for being there – pain and an obvious concern that made me limp slowly down the hall apologizing for not being able to keep up – was addressed.
she could have.
but she didn’t.
“you are at the heart of everything we do. we treat each person as a person, not as a patient, an illness or an appointment. anything is possible when we apply our imaginations and knowledge toward our purpose of helping people live well. at advocate aurora health, we’re embracing bold, innovative ways to connect our consumers, team members and communities to their health. where we’re going is for the daring. advocate aurora’s goal is to have zero events of serious patient harm by 2025. this is advocate aurora’s “true north goal”. we also call this our “moonshot goal” since its just like putting a man on the moon.” (directly from the website)
and so, french fries were clearly on the happy hour docket longgg before happy hour.
they didn’t help my foot but they sure helped my spirit.
reverse threading 