reverse threading

the path back is the path forward


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open season. [kerri’s blog on saturday morning smack-dab.]

we’re getting all the mail – snail mail, email, texts, phone messages. tons of correspondence this holiday season. and all about … healthcare.

because forget about thanksgiving, forget about the gatherings of family and friends, forget about the holidays. we are now in healthcare open season. ok, they call it open enrollment….but it’s clearly one and the same….and the other day – when we saw a hunter, all geared up in camouflage, stride into the woods – it made me think of healthcare open season.

we – david and i and, in amusing moments, my former dear husband as well – are all receiving every manner of advertising for our healthcare. i must say – there is something vastly wrong about this – ads, brochures, glossy words schmoozing us about healthcare.

so we have until the 7th of december to lock in our medicare wishes, in addition to our chosen drug plan. we have until the 15th of december to sign up for whichever “affordable” care act (ACA) plan we wish. it’s all a bit like gambling and there really is no actuary on earth – sans a fortune teller – who can predict what we might really need, what we might really benefit from, what teeniest-tiny details in each plan might be relevant, what might not make us financially suffer.

but wait! there’s more! because now we are at the threshold of new stuff! there is a concept of a plan out there – floating in the universe somewhere – to change the lives of all americans who need healthcare which, ummm, is all of us.

maybe it will be like something we’ve never seen before! maybe something that might place the health and well-being of the populace highest on the priority list!! maybe something that won’t bankrupt people or place healthcare as the apex reason for being impossibly financially strapped. maybe it won’t be privatized in any way, won’t be so insanely priced that it necessitates government subsidies – which, incidentally, will likely disappear anyway in this regime. maybe something that will be like industrialized nations around the world! maybe – just maybe – universal healthcare!!

you are dreaming, i warn myself.

because magaland is not interested in what’s best for actual people. the bottom line, the bottom line, they scream! money, money, money, they insist! and so, instead, their concept is to go back to the days when pre–existing conditions were like leprosy to insurance companies. their concept is to severely cut medicaid, healthcare for the needy. their concept is to eliminate medicare supplemental plans – eliminating choice for people in their own healthcare, foisting privatized advantage plans upon unsuspecting purchasers who think that getting $80 in toothpaste is advantageous over the freedom of seeking out appropriate physicians and facilities and treatment plans for their own needs. their concept will keep regular americans poorer, all in their efforts to make the oligarchy richer. their concept is to be limiting, repressive, serving their own pockets and the pockets of their cronies in some kind of weird quest to make america unhealthier.

it’s all a sad story. and i’m wondering which maga-voters out there are now “learning” all this – suddenly knowledge (all available PRIOR to the election, i might add) is now more abundant. suddenly, some of the corrupt and cruel “policies” (and i use that term loosely) don’t seem like they are in your best interest. suddenly, it occurs to you that this looming autocracy wasn’t really a good idea.

oh well. que sera sera.

in the meanwhile, we’ve gotta don our camouflage and hunt down some healthcare.

*****

read DAVID’s thoughts this SATURDAY MORNING

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two broken wrists. and the saga continues. [k.s. friday]

and the saga continues

bananas.  they were $.49 lb.  we picked up a bunch and walked to the register.  a moment later, with no question or drama, we paid our $1.17 and left.

the next step in my two-broken-wrists saga is occupational therapy.  not because we do everything with our hands.  not because we write with them and open doors with them.  not because we use them for our personal hygiene or because we cook with them.  not because we drive with them or dress with them or shake hands with them.  but because using my hands IS what i do.  the therapist asked me how long i have played the piano.  53 years.  it’s what i DO.  so getting my wrists back to pre-snowboard-fall is imperative to me.  there are no other options.

before we went to this first appointment i, responsibly, called our healthcare insurance company – the one we pay $29,000 a year to – the one with the slogan ” for the care you need at a price you can afford” – to check in about the coverage of OT.  i was told, after much menu-choosing, that i am limited to 20 visits and that the cost will be $50 per visit.  with the OT’s recommendation that my getting-these-wrists-back-trajectory would involve appointments twice a week, that would add $400 to the already-$2400/month in healthcare costs.  bracing.  impossible.

the OT office checked in with me to remind me of my appointment, coincidentally, just after i hung up with the insurance company.  i told them what i had just learned and they insisted i was wrong.  “no,” i was told, “we have never heard of molina charging ANYthing for a copay.”  I asked them to please double-check for me and they assured me they would and that they would apprise me at my appointment.

when i arrived, the receptionist checking me in told me that they had their 23-year-insurance-veteran in the office check and that there would be no copay.  i asked them to provide a written document to that effect so that if and when i was billed i would have recourse.  they assured me that they would triple-check and to stop back after my appointment.

at the end of my appointment with the therapist, the receptionist told me that “no, you don’t have to pay $50 per visit.  it’s actually worse.  instead, you have to pay 100% of all fees until your thousands-of-dollars-deductible is met.”  what?!!!!  now this is the third story i am hearing about the same service with the same provider and the same insurance company.  who am i to believe?

i stood there and literally cried in front of the receptionist in the middle of the waiting area.  you mean to tell me that our $29,000 a year doesn’t really cover much of anything???  this is blatantly wrong, grossly outrageous.

bernie sanders, if you have listened to him speak, has given a example of the perverted and pathetic healthcare in this country.  he speaks about a family who makes $60,000 a year and that this family must pay $12,000 for healthcare.  “that’s 20% of their gross income,” he bellows.  what i wish he would add is this next example:  consider a couple who makes say $65,000 a year (this is the magic healthcare cliff for two people and only $5000 more than the previous example).  that couple will pay anywhere between $24,000 and $29,000 for a policy that will still have high deductibles and yet (clearly) not actually have good coverage.  i want to jump on the bernie-bellowing-band-wagon and yell, “that’s 45% of that couple’s income!!!  what is wrong with that???? EVERYTHING!”  how is it that we can live in this country, the richest country in the world, and have the worst healthcare for our populace?  how is it right to set the populace up for financial disaster when they have to deal with the eventual health scare, injury, illness??  (on a side note, i won’t even beGIN to start talking about Covid-19, for i have nothing good to say about the administration’s handling, lack of information or truth, and unpreparedness for this pandemic that will truly test the resiliency of our country.)

when i could take a breath at the receptionist’s desk i asked, “what do these appointments cost?”  how much is my professionalism worth to me, i am thinking.  i earn my living playing the piano, i am thinking.  i have fifteen albums of piano music, i am thinking.  i am a pianist, i am thinking.  i just need care for my wrists so that i can do what i do, i am thinking.  at what cost, i am thinking.

but healthcare is not like bananas.  i was told, “we can’t answer that.  we don’t know.”  i beg your pardon???  “billing handles that.  and it’s different depending upon insurance plans and whether or not you have appropriate insurance.”  i beg your pardon???? “what if i just wanted to pay cash right now?” i ask.  “you can’t,” she says.  “we don’t know what it costs.”

i wonder if it would be more if i paid cash – after all, i’m not an overstuffed insurance company that has the capacity to deny portions of the billing or disallow costs or base payment on the coding used to describe my treatment, while at the same time accepting ridiculously high premiums from clients with the knowledge that the insurance offered is incomprehensibly lacking.

no.  i’m just a person who needs her hands.

we left, went to the store and bought more bananas.

read DAVID’S thoughts this K.S. FRIDAY

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