With our somewhat screwed up world, everything becomes a political football. (pun intended)
I am not going to try and figure out the answer for healthcare. Is it a right, privilege or commodity? I would say, (yes!) While we argue about socialism again with political Einsteins like Bernie, our hope seems somewhat lost. Healthcare is a commodity like food, water, electricity and so forth. You want it; you pay for it.
The rub comes when we have large parts of society who are somewhat irresponsible with their resources and misspend them. Working in the ER, we saw lots of accidents or gunshot victims with gold teeth or tattoos, beautiful clothing, packages of cigarettes and no insurance. On top of that when the toxicology reports came back many were full of drugs or “recreational chemistry.”
Folks, if you work two jobs, are dead tired on your feet, and still have the family to take care of, seeing this will piss you off! The people who live in ivory towers are removed from reality. Also, the people who cannot (or will not) find work, are also removed from reality. Their idea of reality is not mainstream.
Reality is working your ass off, watching your paycheck taken from you in fees and taxes, and then seeing the freeloaders calling you a racist for not wanting to pay their way too! That is tough stuff. It is hard not to become jaded. When gaming the system is an art, that we could write a dummies book about, something needs to change.
Here is why…
I have such a friend who worked two jobs and has taken care of families and been there to assist others when they down. “A good person!”
She recently was diagnosed with Cancer.
Cancer is a scary word, and if the body is not treated as a whole, the prognoses can get bleak. The doctors order test and procedures, and she pushes forward dutifully going to this doctor or that. The chemo makes her sick; the surgeries are painful. Her hair is all but gone, and then she sees yet another specialist.
This doctor wants to do XYZ . The insurance company declines it, and then the ballet ensues. Phone calls are left, and messages and e-mails from you to many who don’t care about their job are written. They sit in their chair for eight hours and talk on the phone when they have to. Communications go unanswered, and another form letter is pushed out the door, denying coverage.
While your phone call to them is critical to you, where they are concerned it is simply another task that they have to do. This can be put off until after lunch or Monday or whenever they just are forced to deal it with it. Your problem is not theirs and they don’t care.
The text from their friend or family or perhaps what is going on with facebook ranks higher than what you need.
Their hope is that you just give up.
Here is the issue. When someone is sick whether it be cancer or some other illness the entire body needs to be treated as a whole thing. Spirits need to be high and the person not only should be kept comforted but, comfortable. They do not need the frustration of dealing with auto adjudicated edicts from the damned insurance company.
Why are they auto? Becuase the people who have the job to assist you are more concerned with where they are going for lunch or who Jane is sleeping with, on some tv show.
I worked behind the scenes for too many years, trust me; this is life in corporate America.
Hate and anger feed cancer; I am convinced of it. Hate is a poison that you take in hopes that it will affect someone else. Foolish person, hate is killing you.
Frustration with a stuffed up system breeds anger which breeds hate.
Any time there is a decline in coverage an actual human should be required to look at the original request and see if the nurse or doctor forgot to check some box. Instead of looking for ways to deny coverage, they should be required to look for any way possible to pay for it. I realize that is counterproductive for the bottom line but folks, that is where the problem lies.
So here is another idea I am going to give away!
Someone who knows the healthcare industry and insurance industry should provide a service and sell it like insurance. The service would be the go-between, between your doctor and your insurance company and you. Like we have agents for car insurance we need an actual agent to deal with the insurance company.
You call your agent and tell them; I am going in for testing I may have something wrong.
Your agent then gets involved on your behalf and slogs through the red tape of bureaucracy and employees who don’t want to do their jobs, and is your advocate.
Instead of you fighting with a system that you are most probably ill-equipped to deal with, your advocate does it for you.
Usually, we call these lawyers, but I don’t think we need lawyers. With all of the layoffs in the insurance industry with the outsourcing and ravages left from the Obama Care debacle, there should be a plethora of folks who might want to tackle this and make a company out of it. Maybe the H&R Block folks who might not have work in the near future could take on the mantle of Health Advocate. HA for short.
Look, if you make millions of dollars with my idea, please keep me in mind, at least buy some of my books!
If you are a patient, who needs such a service tell me what you think.
Would something like this work?
I think having an advocate on your side to deal with the crap while you focused on getting better would assist many and possibly cut the cost of healthcare.
Many claims that are denied are simple coding errors, but since a computer looks for every dot to be filled correctly and adjudicates the petition based on human filled in dots, that is where the bulk of the problems arise. It is a simple truth table to the computer. IF A+B=C then everything is a go. One bit out of place, and it is denied.
Many just don’t bother to fight it and guess what, you are fighting for your life, so I get it.
Send this to @RealDonaldTrump about a million times, and maybe he will see it.
We need a little common sense in the industry and a little compassion for those who are dealing with illnesses like cancer. We need to keep the special interest and politicians out of it as they are responsible for the mess we have today. Many are paying thousands of dollars a month for insurance they will never use. If they do need it one has to wonder what it would cover.
Would it be better just to pay your way for the cheap stuff and then not have insurance and go to the ER anyway? That is the current system for many Americans and non-Americans alike. And that is one reason the cost of healthcare is so damned high!
You are indeed paying for the deadbeats and yes that is socialism. If you can afford to pay for it, you pay in spades.
If a senator has issues, do you think he or she worries about what will be paid for?
To quote Lilly Allen, “It’s not fair!”
Go check out some of my books. If you are a sci-fi person or a romantic kind of person I have it all. If you need a laugh, which we all do, go and check out some of my novels. Warm-hearted romance, to a nude romp through the galaxy in Saga of the Starduster.
Much Love – TW