In my 20s I worked for Hawaii Medical Service Association, the Blue Cross-Blue Shield in that state. I was a customer service rep for a few years, helping insured members understand the hows and whys of their reimbursements or nonpayments. It was a tricky path to maneuver, defending the insurance giant’s decisions.
Looking back…it was a lot of mumbo-jumbo, smoke and screens. Granted, it makes more sense when one is ensconced in the jargon on a daily basis. However the reality of it is insurance companies want to give back as little of the money as possible in benefits, that they garner in premiums from its members. At the time I couldn’t help but feel uncomfortable that the big-wigs were giving themselves great salaries and nice perks. I heard this from a friend who was married to a rising star in management.
Granted, huge compensation packages are part and parcel of capitalism. Companies use them to attract and keep excellent executives. However in dealing with life and death, making money is not like buying and selling merchandise. Unlike any other enterprise, health insurance coverage deals in morality. Dismissing this fundamental fact in favor of believing that disbursement of health dollars should be strictly measured according to some committee’s valuation is disturbing…at least to me.
I don’t profess to be an expert on Obamacare. Just as there are some good points, I’m certain there are some that don’t bode well for certain groups. I can only speak to those that hold value for me.
Among those items I support…family plans to allow coverage for children until age 26, drug help for seniors, premiums for women the same as for men, no disallowance for pre-existing conditions, and no maxing out of coverage.
Having to explain to insured members that they aren’t covered for treatment of diabetes or heart disease or pregnancies because they’re pre-existing conditions was like walking on hot rocks. Not fun. Not easy. But I made it to the other side of the argument. And if I didn’t, I turned the customer over to my supervisor. He was better at walking on hot rocks. I guess it helped that he made more money than me. That helps when you’ve got to take on a nearly-impossible task.
Then there were the times when I had to tackle the conundrum of insured members maxing out their medical benefits. “Oh, sorry. We’re no longer covering your chemotherapy treatment because you’ve run out of coverage. Sorry. Sorry.”
Ever since I left the insurance business, I’ve been extremely reluctant to deal with my own or my family’s medical claim problems. I know the rigamarole, the yada-yada-yada, the run-around. I’m resigned to the fact that customer service reps are regurgitating what they’ve learned to say by rote. Thinking outside the box is not generally allowed.
Rather than succumb to stress which would ultimately undermine my own health, I try to “think outside the box” to help myself. Not everyone has the means or wherewithall to do the same. So I commend President Obama for sticking his own political neck out, and Chief Justice Roberts for alienating his conservative cronies. They have given a hand up to those unable to take on the big conglomerates by themselves.
Having been to the emergency room on several occasions, I can attest to the astronomical costs those visits incur. After my last trip when I was sure something was terribly wrong when nausea and sharp abdominal pain came on suddenly, I firmly resolved never to return when I saw the $8,000 bill. And I have insurance! So I’m not obligating my fellow taxpayers to foot my expenses. Without health care reform, we’re all paying emergency room visits for the uninsured.
Those with the most to lose, don’t like it when the status quo is disrupted.
Change is inevitable. History overflows with examples. Mankind has always adjusted, sometimes kicking and screaming all the way. Life moves forward, regardless.
My advice? Live long. Live happy. Even if you can’t embrace it, get use to change…
…especially when it’s…for the better of all human beings…not just some…