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.

 

 

 

Real Healthcare NOW!

Hello dear reader(s)!

I hate health insurance companies.  So do my doctors.  So do most of the staff I have dealt with, even though I know that without the for-profit middle-men of the insurance companies interfering in health care, many of that staff would not be employed.

The simple fact of the matter, is that health insurance companies make everyone’s health care more expensive, and less effective.

Here is an example, from this morning.

I have a Medicare Advantage plan.   It usually picks up the other 20% Medicare won’t pay, (minus co-pays, deductibles, etc…) and also sets up yearly out-of-pocket maximums which makes it worth it.  It also has a decent drug plan.  However, that means you are subject to networks, and in my case (because it is HMO style), referrals.

So today, I went to an appointment with a PCP (Primary Care Physician, not the drug), in order to…wait for it…get referrals.

You see, for me, with my history, every damn thing I need requires specialists.  A Primary Care Physician simply can’t grasp all of the different pieces of the puzzle that is me.  There are a lot of people like me.

Yet insurance companies work off of what is good for the average patient they are fleecing and know that most people don’t usually need specialists and that they can save more money just be being seen by Primary Care Doctors.

But not me.  And not a lot of other people.  My Primary Care Doctor really has no business being involved in my care.  Yet here I am, taking up an appointment slot, causing a doctor to get paid asking me questions on why I need the specialists I seek when I know damn-well why and could call them myself for the appointments if my insurance would pay.

It is always a fight too.  Despite being part of the same health group of my most recent hospitalization, the initial hospitalization of my first chemotherapy post-diagnosis, and some follow-up care and other hospitalizations, they still have to waste time asking me questions to justify the need.  They finally pull up a bit of records and then they agree, knowing that they have neither the time nor the expertise to treat me.  They bill my insurance company who spreads the costs out in terms of premiums and my insurance company receives money from Medicare.  It was a completely unnecessary visit, but people must get paid.

In addition, my Primary Care Physician always seems to believe they will uncover some truth the specialists will miss or are unrelated to my vast history and will order labs.  (As if the specialists won’t duplicate the same tests when under their care.)  Now I have to go do labs that will then be billed to my insurance company and the government, increasing costs.

The labs will come out abnormal (because it’s me) and the people at the office of the Primary Care Physician will not understand that is my normal and that only a specialist can really properly interpret the numbers.  They will panic and either have me go the ER or come back in for another appointment rather than give me the numbers over the phone or just send them on to the multiple specialists I am already being referred to.  Everyone will get paid.


It’s fucking bullshit.

These fucking death profiteers need to get their grubby-ass hands out of the game altogether.  They are not legitimately insurance, as insurance indemnifies against loss and they just profit while sticking their nose in your treatment.  Their profit margins are so high, as is their overhead, that costs are ridiculous.

Additionally, every hospital and provider group need to hire additional staff in order to deal with these scum which makes the costs of everyone’s healthcare increase.

Then the GOP turns around and blames the sick for everyone’s high costs, not even mentioning the obscene profits of those with their dirty fingers in the pie.  Real insurance, would be able to cover everyone, with lower costs.  Insurance is a pool, everyone pays into.  The money is available for those who need, on the likely scenario that people paying in will not all need it, but it is there just in case.  When people dip into that pool for insane profits and lavish lifestyles, it makes it seem as though that pool is not big enough even though without the unchecked greed and extra costs, it absolutely would be.

Canada does healthcare great.  Is it perfect?  Nothing is.  But the biggest complaints I hear about Canadian healthcare is the wait for elective procedures.   Our wait is growing here too, and we aren’t covering everyone.

Add to that George W. Bush’s gift to big pharma that Medicare won’t even negotiate for drug prices as a block, and it is no wonder people (not just the poor) are losing everything when a health issue arises.

Despite popular belief, a lot of the catastrophic health issues that arise have nothing to do with lifestyle.


My Medicare Advantage plan is better than Medicare alone.  Am I glad I have it?  No.  Because in most places I wouldn’t need it.  It costs money for the premiums and my income is already severely limited.

A lot of people do not like the politicians in this country.  I am one of them.  Just because vast amounts of money are thrown at someone, doesn’t mean they need to take it and let it influence them.  But a lot of people seem to miss that there are people behind the politicians trying and succeeding at buying their influence.  They claim healthcare is so expensive but throw vast sums of money at people who are supposed to represent you in order to influence policy in a way that brings them the highest possible profits.


We need single-payer healthcare.  Genuine healthcare that isn’t tied to a company’s stock price.  Until we have it, do not expect anything to get better.


If the people ever rise up, I would hope they remember that it is not just the government who is the threat.

 

 

Invisible

Hello dear reader(s)!

I’m feeling kinda lousy today.  I have felt lousy most days since the end of my trip.  Yesterday, I went to the bank, and had to go inside.  The banker asked me what I did for a living when I asked about a direct deposit, and I told her I was disabled.  She looked at me in a way that I could tell she didn’t believe me, or thought I was “gaming the system”.

I was showered, I was smiling.  I spoke clearly and effectively.  My clothes were clean.  I felt terrible, but it didn’t show.  It was about the only thing I did yesterday.  I got there about four in the afternoon and it took me all day beforehand to work up the strength and energy to leave the house.  In that instant, she knew none of that.

The issues that make up my disability are invisible.  My kidney damage doesn’t cause a limp.  My cataracts only show up when a light is shined in them.  The memory issues that continue to plague me can’t be seen.  My gastrointestinal issues are on the inside.  The fatigue can’t be seen.  My poor immune system and lack of B cells do not show up on the skin.

Yes, on occasion, I can be a functioning human.  I can occasionally exist in the world, sometimes even days at time.  But when I do, I pay a heavy price.  A little activity leads to a lot of downtime.  Being around too many other people is risky.  A cross-country road trip makes me vulnerable to whatever little bugs most people can fight off may be out there.

I took the trash to the curb early this morning, and it just about killed me.  All of the sinus issues were aggravated by the cold early morning air, and I spent the next 15 minutes in a coughing fit gasping for air.  But all of this is rarely seen.

If you see me out in public, I look healthy.  Healthier than a lot of people, actually.  But looks are deceiving.  I am far from healthy.  People see that I have a bit of muscle mass, and that I am not carrying a ton of fat (plenty, but not a ton), and just assume that everything must be okay.  They have no idea what it took just to get through the shower and get dressed and ready to go out in public that day.  They have no idea what the next few days will be like for me because I dared to go to a friend’s house, or the grocery store, or the post office.

The disabled in this country are treated like shit.  Unless you are in a wheelchair with an American flag flying from it and a hat from whatever ship you were once stationed on, nobody even believes you are really disabled.  I paid into Social Security.  It is insurance.  The process is not at all easy and requires actual proof.  I am on Medicare now, and people think it is a damn entitlement.  It isn’t.  It is a fucking insurance policy that I paid into and had to take because I got fucking cancer and the treatment fucked me up.  That’s it.

Disability is looked down upon so much, that almost all Medicare Advantage and Medicare Supplement plans act as if only Senior Citizens should get Medicare.  Some of the Medicare Advantage plans in places I have lived even have Senior in their titles.  Almost all include some gym membership called something like Silver Sneakers or some other bullshit that totally ignores the disabled segment of people on their plans.  Then they sell your information to AARP so that they can send you their junk mail with all of the other pieces of unnecessary paper that never needs to be sent.  Yes, fuck you Humana, you inhumane profiteer, pieces of shit.

Then you have fucks like Paul Rand Ryan trying to pit the rest of the country against us.  Trying to privatize Medicare and Social Security because the money we paid in was raided by all of those career politicians to pay for their pet-projects.  They want to tell us what to eat, what medicines we should be taking over the advice of our doctors, and how we should spend our insurance money.

Listen here motherfuckers, if I scrimp and save all month-long, live with a roommate, and don’t buy a ton of other expensive shit in order to do it, if I go out to dinner and order a steak with my insurance money, that’s none of your fucking business.

I am not the reason your taxes are high.  Your taxes are high because you elect fuckers who give welfare to corporations.  Your taxes are high because the US has to have bases all over the motherfucking globe to protects its “interests”.  Your taxes are high because your gigantic military is basically a publicly subsided private security firm for international corporations.  Your taxes are high because payroll taxes are capped at $127,200.  Not because of my insurance.

The issues that make up my disability are invisible.  I, however, am not.  The other disabled people, are not.  As much as you might like them to be, we are not going to be.  We will fight for the respect and treatment that we deserve, whenever we are able.

 

Let’s Talk About Cancer…Again

Hello dear reader(s)!

It is October, and you all know what that means!

If you guessed Halloween, or Fall fun, you probably didn’t read the title.

It is Breast Cancer Awareness Month, because, apparently, people only need to be aware that people get breast cancer in October.  So…you know…don’t go doing anything crazy like scheduling those mammograms any other month now.

It is also Domestic Violence Awareness, which is very convenient for the NFL so they can hide their lack of standards on domestic violence behind pink Susan G. Komen merchandise and ribbons for cancer merchandise marketing.

Now, unlike many cancer survivors, I do not have a problem with Breast Cancer having a whole month.  The marketing and profits off of it bother me, but not the concept.  Just because it wasn’t my particular type of cancer, does not mean I am offended mine doesn’t have a whole month.  You can screen for breast cancer, so be aware of that, and do it.  Just don’t pay $35 for a pink ribbon, of which very little goes to any actual curative efforts.

Anyway, this isn’t an anti-Komen post.  This is a post to, once again, educate all of you who have never had cancer about the realities of cancer that you may not understand.

  • Cancer is not a cold  Not everyone just gets over it once it is no longer in their body.  For me, my true battle didn’t even begin until there was no evidence of disease.  The damage done to the rest of my body from the treatment of this otherwise fatal disease did permanent damage to my body that I will never fully recover from.  I hear in one ear only, I have kidney damage, I have immunity issues that can be severe, I have periods of complete fatigue where just keeping my head upright can be a struggle, I have peripheral neuropathy which is constantly painful to very painful nerve damage, I have cataracts that have made night driving virtually impossible, I have low nutritional absorption and hormone production, I have a couple of related psychological disorders.  Just because some days I can walk, and lift, and look healthy, does not mean I am.  To paraphrase one of my former oncologists, I look a lot better in person than on paper.
  • Cannabis has not been shown to cure cancer  But make no mistake, I believe it was imperative in my survival.  I am very much pro-legalization and would still be using it today were it not very illegal here.  My ability not to, has also proven it isn’t addictive the way people claim, for all you anti-legalization advocates.   It’s a great medicine, but if you think you can not do any of the treatment your doctor recommends and only do cannabis instead, you’re gonna have a bad time.
  • It can still happen, no matter how clean you live  Vegans get cancer.  Vegetarians get cancer.  Nonsmokers get cancer, teetotalers get cancer, paleo diet enthusiasts get cancer, gluten-free people get cancer, anyone can get cancer.  I was super clean prior to cancer.  I don’t smoke, and I didn’t then.  I rarely drink.  It didn’t matter.  A cell division error happened, and I had cancer.  That doesn’t mean living healthy will not help to put the odds in your favor, it just means you should not assume that anyone with cancer had a lifestyle issue.
  • All the miraculous treatments you read about on the internet will not be available to most people for years, if ever, and probably won’t be so miraculous by the time they are  Immunotherapy may be the big exception to this one.  I really wish I could have been a trial subject on that one back when I was first diagnosed.  I’d probably have a lot more of my function, and would not have had the kind of insane fight and many near-death experiences that I had if that had been available to me.
  • You have no advice to give  Whatever you just read on the internet has already been researched by either the patient, their doctor, or their family.  Whatever methods you use to get through the things that you have to do does not apply to them.  No matter how much you think your tips for making sure you can get things done works for you when you are having lazy days, it isn’t going to be effective for someone having trouble keeping their eyes open that day.  That doesn’t mean you can’t help.

If you want to help someone with cancer, or with the sometimes very damaging and life-altering after affects, here is what you can do.

  • Ask, “Is there something I can help you with?”
  • Be understanding when someone is down  

If I need something, and someone offers, I will let them know.  Otherwise, not only do I need it, but chances are that I am going to get offended by the person offering things unsolicited.

This isn’t one size fits all.  Neither is cancer.  But with those two last bullet points, you are probably not going to go wrong with anyone.

May you never need to know any of this one day.

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.