Friends With Benefits

Hello dear reader(s)!

This post is not about fuck buddies.  I am talking about the kind of benefits you might get from a job.  Benefits like good health insurance, 401K, a pension (if they still have those, and won’t sue to get out of them later), short and long-term disability benefits, a large coke, and a side of onion rings.

I remember when I didn’t have any benefits.  I had friends with benefits, that I was very jealous of.  Having no health insurance sucked.  I was always scared something catastrophic would happen if I were to get sick or injured.  I racked up a lot of medical debt during that time, from the non-catastrophic but still emergent things I needed done.

Eventually, I got a job with good benefits.  It came right in time as only about a year later I really started showing signs that I had cancer.  I was extremely fortunate to have had that job and those benefits when I did.  My company self-insured, but used a major insurance company to administer their plan.  It was a great plan, much better than any of the standard plans you see on the exchanges, or even with a good Medicare Advantage plan.

Now class, pay attention, because here is where I propose a plan for healthcare in this nation that might actually be feasible.  Ready?

Start by taking away the exchange and individual insurance markets from the health insurance companies, and give everyone not on a group plan Medicare.  We will not get a Medicare-for-all system as long as these companies are buying our politicians.  Even taking away the individual markets will require some strength on the part of those in power, but it will make those officials hugely popular with their constituents.  In exchange for losing the individual markets to Medicare, they can open their Medicare Supplemental and Medicare Advantage plans to those new Medicare recipients, provided those plans closed the donut-hole for prescriptions.  Some revenue for them would be better than none to them, which is the only other viable alternative.

In the meantime, the insurance companies can continue to insure and administer group plans, but all ACA requirements on plan quality must remain, and the plans must cover at least what Medicare does, for less cost to the employee, so that those plans are not seen as punishment for working.  Health coverage from a job should be an actual benefit.

Medicare should be allowed to then negotiate with pharmaceutical companies and other provider groups to lower healthcare costs.

My proposal would be paid for by lifting the payroll tax cap, a cut to the growth rate of our defense budget, and by folding the VA into the new Medicare system, and selling the facilities and assets to private hospital groups to be privately run, provided they agree to all of Medicare’s rules.  Our veterans will no longer have to wait and be neglected at some sub-standard facility.  Veteran’s Medicare would not have coinsurance but would be administered by Medicare rather than having a separate department and more overhead.

I would attempt to phase out the insurance companies from group plans as well, allowing those companies to reconfigure and find other ways to remain in business, but that would likely be a non-starter until automation has made employment obsolete and most of us are on a universal basic income.

Any representative who wishes to advance this or a similar proposal in order to fix the broken healthcare system in this country is more than welcome to do so, and can take all the credit for it.

The only thing I ask in return is that I have healthcare when I need it.

 

 

 

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My Letter Regarding United Healthcare

Hello Dear Reader(s)!

I have to apologize for once again being unavailable to post that much.  I have been dealing with my incompetent insurance company.  I have decided to share the message I sent to AARP regrading the issues I’ve been dealing with today for your entertainment, education, and enlightenment.  I am also sharing so you will know what others have in store when considering which health insurance company you will do business with.

Hello,
I am not a member of AARP as I am not 50 or older. But since I am disabled and on Medicare I was looking for Medicare Advantage Plans and chose one from United Healthcare partially based on the fact that it holds the AARP name.
I deeply regret that decision.
Their customer service is completely abhorrent. In January, I attempted to change my primary care provider to a specialist in their network and was told it would be done, only to find out in late March that not only wasn’t it done, but it could not be done due to the fact the provider is a specialist. I have been to that specialist and other specialists referred by that doctor, including a couple of procedures operating under the false information they gave me.
It was only for an unrelated glitch in their automated system that showed my plan terminated (it wasn’t), when a provider called for eligibility in late March that the error was discovered. At that time, the representative informed me that he would change it to the specialist. The call was disconnected on the representative’s end during an attempted transfer, so I called back and spoke with another representative who informed me there was no way to make a specialist my primary care physician. She would note the account of the misinformation in an attempt to stave off any denied claims due to improper referral and then would assign me a primary care physician for a blanket referral to my oncologist. She assigned me the primary care physician back to the one I technically was assigned to all along, but was supposed to have changed from in January. I informed her I had an upcoming procedure and she told me it would be fine until I could get into see him. I had the procedure and called today to make an appointment with that PCP for the explicit reason of getting a referral to my specialist and for any upcoming procedures necessary but when I did, he was not accepting new patients. I called UHC again to switch providers to someone who was. They assigned me to another doctor. I called that office to make an appointment, and they closed their clinic on March 31st. I called again to UHC and spoke with a supervisor. That supervisor then assigned me another doctor and called to make sure they were accepting new patients. They were. However their system had that doctor near me but in actuality they were far away in a completely different city. I am on the phone with them currently to get yet another primary care physician.
Beyond the obvious hassle involved and deficiency of United Health Care has demonstrated in even providing accurate information about the providers that contract with them, this also created a potential situation where they will deny claims based on me operating under the information they have told me.
Additionally, after the 3 provider changes today, I have found that there is a pattern for representatives including supervisors to try to get the customers off of the phone with changes that are not complete. My disability on some days does not prevent me from following up once I suspect that a company has not given me proper or complete information, but unfortunately, many of the vulnerable senior citizens you claim to represent may not be able to make 4 phone calls in a day to get something done. In addition, I trusted the company in January when they said they changed the provider the first time. I know better than to trust them now. How many senior citizens are being told misinformation and relying on it because of your endorsement? 
In short, I beg you to reconsider adding the AARP name to these plans. I beg you to look at more than the metrics provided by the company and look at actual member experiences. Having representatives available to answer the phones when a customer calls for service does not mean the service provided is competent.
Respectfully,
Joshua Wrenn

Of course, if we elect Bernie Sanders, he will attempt to take these companies who profit off of the suffering of others out of the business altogether.

While the government may make errors too, wouldn’t it be nice if greed wasn’t a factor?  Additionally, I have had no trouble with Medicare itself, just the plans on top of it.

I will also be writing a letter regarding my situation to Medicare.  If any claims are denied based on the misinformation they gave me, I will also contact an attorney and the state’s insurance commissioner.

If any of you have had issues with this or any other health insurance company, I would love to hear about it in the comments.

War On Christianity

Hello dear reader(s)!

Have you heard about the war on Christianity?  I have a million and a half times, and yet, for some reason, I am still surrounded by and bombarded with institutional Christianity.  Somehow, despite this so-called “war”, every single community in the US I have ever been in allows Christians to practice their religions openly, and in some, they even encourage it.

The attacks on black churches were clearly attacks on the fact that they were black churches, as opposed to being battles in an invented war on Christianity.  Do Christians still get killed for being Christian?  Sure.  Just like Atheists get killed for being Atheist, Muslims get killed for being Muslim, Pagans get killed for being Pagan, and on, and on.  But make no mistake, there is no war on Christianity.  Not in the US, anyway.

What makes Christians think they are under attack when their religion dominates this nation like an opponent of the American football team I grew up watching?

I think I have an idea.  I’m just going to throw this out there, but I think a lot of so-called Christians aren’t actually Christians at all, but use it and hide behind it for their own agenda.  I also know people are very resistant to change, especially those indoctrinated with dogma and tradition.

I read an article after I got home this afternoon regarding a court case where a doctor is being sued for not wanting to perform a tubal ligation because it went against that doctor’s deeply held Catholic beliefs.  I really do not understand any of that.  #1.  Was there not an actual doctor, who believes in medicine and science capable of performing that operation?  #2.  Why would anyone want to be a doctor having such strict beliefs that are diametrically opposed to the field they are working in?  #3.  Does that doctor not treat people who eat meat on Fridays?  #4.  Why are people thinking they can pick and choose the passages in their texts to fit their own religion?

Nobody wants to take away this doctor’s right to believe what this doctor wants.  Any perceived war on Christianity is simply non-Christians and those Christians sympathetic to the plight of others who do not share their beliefs, desiring not to have someone elses beliefs forced upon them.

But, I have a compromise solution that I think will work out well.  Hear me out on this one, because it may just lead to more peace between sects as well as between secular and nonsecular people.

Here is the idea:  If your religious views are so deeply held that they prevent you from performing one of the regular functions of the job you want to pursue…find another fucking job.  How hard is that?  You are a pharmacist who does not want to sell contraceptives?  Fine.  Don’t be a fucking pharmacist.  This is the same reason I am not in the military.  This is why I don’t work in a slaughter-house.  This is why I am not a prostitute.  (Well, that and I don’t think the market is all that great.)  This is why I am not a preacher.  If my belief system (even as an Agnostic, we do have beliefs) goes against my job, I don’t do that job.  I’ll never work for a major bank.  I’ll never work in corrections.  I’ll never work for a tobacco company, oil company, or pesticide company.  (Although, I will likely unknowingly work for one of their affiliates.)  If your morals go against the job…don’t take on the fucking job.  Done.

Okay, let’s pretend that you’re a pharmacist and for some reason you failed to notice that part of the job would be selling birth control.  1.  You’d be an idiot.  2.  Advertise it.  All people in any profession with religious beliefs that prevent them from performing the usual and customary duties associated with said profession need to advertise that fact, before anyone wastes their time in an attempt to support them.  All insurance companies should be required to provide coverage to other providers (at in-network rates) anytime one is faced with a situation where someone is obviously in the wrong line of work.

If you are the only doctor in a certain radius, then you have to do the things you don’t want to do, or else fucking quit so someone else can take your place.

Believe what you want.  Do not prevent me from obtaining legal services that are usual and customary for your profession based on those beliefs.  Why should that be too much to ask?

Fly your idiotic Confederate flags, just don’t do it where laws are being made on public property.  Read your idiotic texts, just keep them out of public schools and government facilities.  Hate other people, just don’t take any steps to hurt those people.  Practice your beliefs, just don’t bill yourself as a doctor or other science based professional while you do.  And if, for some odd reason, you are in that conflicting situation, and want to refuse to do your job…then kindly send me to someone who can and will.

Gone are the days of only one lunch counter in a town…for the most part.  If you don’t like me, I don’t fucking like you.  I don’t want your Indiana pizza, or Colorado wedding cakes, or whatever the fuck else you think is so special that you can refuse it to people you do not think are worthy.  We have this thing called the internet now, with delivery services that bring you whatever you need.  If your tiny piece of shit business wants to choose its customers, have at it, just let people know up front so they can avoid you.  And then don’t whine to me when your place goes under.

Can’t Complain

Hello dear reader(s)!

How are you this fine day?

Here is the thing…whether you like the ACA or not, (I prefer single-payer), when an extremely conservative court upholds the law, it does not mean they like it.  It means they can not find the law was unconstitutional.

The principle used that likely saved the law was the Chevron Deference principle, which, in 1984 upheld the Reagan Administration’s EPA guidelines for executing an act of Congress.  The EPA guidelines were upheld because the intent of the text of the law was ambiguous, and could be interpreted by the EPA the way they did, although it was not specifically outlined.  Chevron lost their case.

The principle has been used since by Chevron to win a suit against the government 18 years later.

Laws weren’t “rewritten” as conservatives would have you believe, the principle is a simple defining of the interpretation standards and legal precedent of the Supreme Court.  

The principle has upheld laws in favor of the right and the left.  In fact, Chevron itself has both won and lost using that principle.  

So…like it or not…the law is what it is, and the interpretation of the ACA by the Supreme Court is correct and consistent with legal precedent and the Supreme Court’s Constitutional authority.  

While many liberals are hailing this as a victory, and many conservatives are calling John Roberts a traitor…he may have just saved any chance for the Republicans to win in 2016.  Had the ACA been overturned, the millions of people receiving subsidies would have shown up to the polls after they lost affordable coverage.  By upholding the law, the court likely allowed for the conditions of voter apathy to outweigh the financial interest which permeates (unfortunately) the motives of US voters.  People are already assuming the law is invincible as evidenced by the #ACAHereToStay hashtag on Twitter.  

Healthcare????

More like HealthDON’Tcare, am I right?

Hello dear reader(s)!

Last week I had my oncologists appointment which went amazingly because of my counts, the fact that I really like my doctor, and that I was with it enough to remember to ask for a copy of the referral she sent to a psychiatrist for me back in April that I had not heard anything anything from.  My thought was that the psychiatrist was not taking new patients, but I would call to find out what happened, and then use that referral and the fact that psychiatrist was not taking new patients to try to get seen by another psychiatrist on my insurance company’s list.

So the next day, I call the number for the psychiatrist’s office and am greeted by an automated system where I can leave a voicemail for the patient coordinator.  So in my nicest customer voice, I mention that I was referred back in April and hadn’t heard anything back, that my doctor’s staff said they resent the referral a second time when I asked about it, and was wondering if they got it.  Then I left my call back number and ended politely with, “Thank you, and have a great day.”

While I was in the bathroom, the “patient coordinator” called and left the bitchiest sounding voicemail with no information asking me to call back.  So I call back and press the button thinking I will have to leave this patient coordinator another voicemail, but this time she answers the phone.  In the worst, most hurried tone I can imagine she says, “(her name)”…

Hello,” I begin, “My name is Joshua Wrenn and I was referred to Dr. (name) back on April 14th and have yet to hear anything back.  I was just wondering if-” (cut off)

“Dr. (name) isn’t accepting new patients.”

Okay that it is what I figured, thanks for the information.

(Hang up)

“BITCH!”

Ugh, okay.  Now, I can understand that they are not able to accept new patients at this time.  They are probably over loaded as all hell because of all the cuts to mental health funding, the overflow of those who can get it to private mental health doctors and organizations, and the increased need for mental healthcare due to the issues experienced in modern society.  I get it.  What I don’t get is why they can’t take less than the time it took for me to make the call, her to call me back, and me to finally reach her for her to call my oncologist and advise they aren’t accepting new patients.  Or to call me and tell me.  No, they just decided to keep receiving and ignoring the referrals.  And they are probably doing that for every referral they get, and probably doing four times the work by addressing inquiries after people wait a month and a half with no response from them.  The other thing that really upsets me about this interaction was the “patient coordinator’s” attitude.  This is someone who has a job of dealing with the mentally ill.  As debilitating as my flash-backs, panic attacks, anxiety, and emotional outbursts out of nowhere can be…I am actually on the luckier side of those suffering.  I don’t want to self-harm, and I don’t get realistically violent.  The same can’t be said for everyone, and they aren’t in control of it.  And this bitch, this snotty bitch is talking to sick people and treating them that way?  Does her boss, the doctor know that?  If I can find an email address, he will.

But wait, there’s more!!!

I go onto my insurance plan’s website to look for area in-network psychiatrists and there is a good size list (I think it was 26).  Each one with the little green check mark beside “Accepting New Patients”.  Okay, easy, I thought.  Then I start calling.

First one, another bitchy receptionist.  I explain the situation.  The doctor is not accepting new patients.  “Maybe try back in July.”  Okay….guess the site needs to be updated.

Second.  A nicer sounding receptionist!  Hooray!!!!  I explain the situation.  “That doctor is no longer in the area.  Let me see if the other doctors in the group accept your insurance.”

Thank you!” I reply, just glad to be talking to someone who wasn’t evil.

“I’m sorry, they do not.  You could try (group), (group), and (group)?”

Well okay, thank you very much, have a great day!

“You too, good luck!” she says.

Feeling good, I look for the groups on my in network provider list.  Nope.  Not one of them.

So on to the next one on the list.  Another bitchy receptionist.  Another doctor moved out of the area.

The next.  Number is not a working number.

Next.  Nice but clueless receptionist.  “The doctor is not in, but I will have someone get back to you about that.”  Seriously, she didn’t even know if he is accepting new patients?  Okay…

Next.  Jerk receptionist.  He was as rude as the first lady.  Not accepting new patients.

On and on that went.  Finally, as a last-ditch I called the one place I had been avoiding, a doctor who works at the state mental health hospital.

Now, I want to make clear…it is not that I think that I am above the patients who need the state mental health system.  This is not a stigma thing.  What this is, is being pissed off that I have health insurance, so I don’t need the state’s assistance on this.  BUT TOO MANY PEOPLE DO.  And by going there, I am using resources designed for people who can’t see a doctor in a private group.  They take payment based on a sliding scale, some people will obviously be seen for free.  I have insurance.  If I go there, it will take longer for someone who has no options to be seen.  Plus, they are likely extremely overworked and so I don’t know about the frequency or intensity of care available when they are just trying to keep people alive.

However, thanks to insurance, and the providers in this area, and the general stigma surrounding mental health that is pushing people out of the profession…it appears as that I have no other choice but do drive down to the hospital, go to the financial building of the complex, where I simply show them my insurance card because the sliding scale wouldn’t apply…and try to get an appointment to see someone (which probably won’t be until July).

Healthcare indeed.

Weebles Wobble

But if they are high up on a ledge and get knocked off of it, they will fall down.  A Weeble‘s terminal velocity is actually higher than a penny, so a falling Weeble from a height where it could reach its terminal velocity, (such as the Empire State building) could actually seriously harm someone.  We believe that Hasbro should be liable for any injuries associated with falling Weebles due to their commercials claiming that they don’t fall down.  If you have ever been injured by a Weeble falling from a tall structure, consult the Law Offices of Bob and Steve for a free, personal consultation.

Hello dear reader(s)!

This post is not about Weebles.  It is a random post about a few random things because um like, I’m like totally random all the time.  Like totally.  But speaking of Weebles, do you remember Weebles?  Did you own any Weebles as a child?  Do your children have Weebles, or just iPads?  I remember Weebles.  I loved Weebles (though not in the romantic sense, although there was that one time…) sorry, I digress.

Do you know what else I remember?  Mother-fucking Big Wheels!  I rode my Big Wheel all over the place because that is what kids my age did before we had motorized everything to do the work for us.  I remember when Power Wheels came out and we couldn’t afford them but some of my friends could and they all had heart attacks in their teen years.  Okay, not really, but who needs those motorized toys when we have good old-fashioned pedal-power?!?!  And I’m not just saying these things because I am jealous of the kids who had parents that loved them could afford to buy those for them.  But do you know what I saw today?

The inside of a doctor’s office.  For way too long.  Because my insurance sucks.  But do you know what I saw on the way home?

The pet food store that charges an ungodly amount for my cat’s food.  Yeah, we’ll be ordering it online from now on.  You may close now.  But do you know what I saw on my way home from there?

Kids, playing outside.  The girl sitting down and pushing a big skateboard, and her older brother riding a Big Wheel.  A real, honest-to-goodness Big Wheel.  Yes, I have seen these children before today, and yes, they have come by in their Power Wheels, or have been walking with their dad? grandpa? older gentleman who watches them but doesn’t seem to be creepy about it?  Anyway no, today one of the kids was riding a Big Wheel.

“Big deal Josh, so you saw kids outside and one was riding a Big Wheel,” you spit through your sense of indignation.

Well, it IS a big deal.  Beyond the fact that this proves not every child is spending all day everyday playing video games or hacking the NSA, that kid riding his Big Wheel was leaving plastic wheel marks on the exact same places I left mine roughly 32 years ago.  That is pretty damn awesome, whether you ask me or not.  So that made me happy, which is necessary because…

Have I ever mentioned how much I hate health insurance companies?  Well, in case I haven’t, (and I honestly can’t remember any post I ever might have written blasting a health or prescription insurance company), I will let you know that I mother-fucking hate mother-fucking health insurance companies.  More than I love to use “mother-fucking”.  Today I went back to my doctor’s office for a couple of things they determined I would need yesterday.  The first was a shot of Neupogen to boost my neutrophils because I am slightly neutropenic.  (Not a big worry, sometimes the marrow just kind of hiccups and I need to have the shot for a boost.  It used to be all the time, and now it is every couple of months or less.)  I also had to get a 1/2 pint of blood taken from me to help lower my iron content.  (This is actually very good because it means my hematocrit and hemoglobin were well within the normal range so it could be done.)  Oh, and my platelets are doing better too, but now I’m just bragging about my counts.  Anyway, the blood draining took about 15 minutes.  The shot?  Maybe 3 with prep.  How long do you think I was at the doctor’s office?

2 mother-fucking hours.  Why?  Well, it wasn’t the doctor’s staff, or the nurses, or the doctors themselves.  No, it was the mother-fucking insurance company.  My group plan which is COBRA, is having a hard time letting go of the fact that they haven’t been primary since the beginning of the year when I became eligible for Medicare.  I’ve called, I’ve e-mailed, but they insist on trying to pay primary.  Medicare (who makes the rules) knows that the rules say they are primary.  So I was held up for an hour and 40 minutes not due to questions about what is and isn’t covered, not about co-pays, co-insurance, or deductibles, no, I was held up that long because they were trying to OVERpay.  I told the nurse, “Fuck ’em.  Take their money then.”  Unfortunately for me, they are honest there or something silly like that.

So as if the draining isn’t exhausting enough, I spent a lot longer than I was supposed to waiting, which is exhausting by itself.  Especially when you’re in the room 3 doors down from where you were first diagnosed with cancer.  Or I was actually, hopefully you weren’t diagnosed with cancer.  Anyway, like a Weeble, I’m wobbling.  Unlike a Weeble however, I am about to fall down.

Weeble and Hasbro are likely registered trademarks of the Hasbro corporation and I bet they reserve all rights but since I’m not trading on their brand, I think I’m safe.  Also, I do not know the terminal velocity of a Weeble or whether or not, in fact, they might be dangerous.  What I do know is that you should look up when walking beneath the empire state building because (while a penny or dime can’t injure you), a dropped bolt or possibly even a Weeble could.  You also might get shit on by a bird.  I also should say that there likely is no lawsuit against Hasbro for injuries sustained due to falling Weebles nor probably should their be.  Finally, I would also like to say that mother-fucking is likely a registered trademark of Samuel L. Jackson, and if not, it probably should be.