Saturday, February 26, 2011

Health Care: From My Eyes...

Despite the last post (with my letter to the Governor,) it may surprise you to know that I am not very political.  Or maybe it won't...I haven't made it a secret that I try to avoid the news!  It seems to showcase a never ending battle between political parties that only increases during each election.  As the problems with health care continue, those arguments are on the tip of everyone's tongue.  So my plan to write about our country's health care system surprisingly does not come from having a political background, but rather from frustration about the ongoing arguments, and the things that have still not changed   And how do I know that our health care system is lousy?  I only need to step out into the world to know that!  I've come to this estimation the way I find out anything newsworthy...through word of mouth.  And the word is NOT GOOD.

I could make this post about finger pointing, bad mouthing, and constant arguing...who's at fault??  Republicans or Democrats?  Who caused all this nonsense??  Did he do it?  Was it her??  Yes, I could go down that road...and would end up in the same place we always end up, when the fighting never ends and the changes never come.  NOWHERE.  So I'm not going to waste my time, or yours.  Because, quite frankly, who CARES??  The fact of the matter is, our health care system is not doing its job.  It doesn't really matter who's essentially at fault or if it can be blamed on one person, or a political party...what matters is that we move forward and FIX IT.  And things do need to change.  Being a person with a disability you can imagine that I may have more physical needs than others.  I think I mentioned before how much my braces cost!  I'm not going to kid myself...there will be more costs in the future, and the thought SCARES me.  To the point where it keeps me up at night.  This is something that can't be helped, and yet...there's a certain level of guilt you are made to feel when a new cost comes up.  And a huge amount of frustration that is dumped on top of the guilt.  When I think of the issues I've had in the past and the struggle I faced in getting adaptive equipment covered, it makes me shudder...and I think I've been pretty lucky.  In the end I was able to get 40% back from my initial brace expense, and I am amazed I even got that much!  I hear other people's stories and realize that many are still fighting their medical/financial battles.  Stories such as the one my friend M (who has CMT) told me, where her insurance company assured her that "Yes...your leg braces will be covered!" and so she was fitted for them...I mean, what choice did she have?  And then she was mailed a denial of payment for ridiculous reasons such as "You didn't give us your middle name...DENIED!" and "You didn't give us your address...DENIED!"  (Is it just me, or did anyone else wonder how they managed to mail out her denial in the first place if they didn't have her address?)  And that's only the beginning...M followed the protocol, filled out all the forms and had her doctor send them proof of her need for braces...only to finally be told by the insurance company that she KNEW better--they were NEVER going to cover her braces and she shouldn't have asked in the first place!  Can you believe that?  And after all of those disappointments, she still hasn't seen any reimbursement for necessary medical equipment.  I see denials of payment such as this every week, as I work in a medical office.  And it's pathetic.  The hope seems to be that the person being denied will eventually give up, and GO AWAY.  And in most cases, that's exactly what happens.  The sad fact is that people with serious medical issues and serious physical needs, who truly need medical insurance coverage, are (in most cases) not going to have these medical problems go away anytime soon.  It can be difficult enough to face a life with these issues, and shell out incredible amounts of money to try and improve your quality of life, only to be denied assistance from the very insurance you count on.  And the fact of the matter is, I know if I didn't pay all that money to get my braces (an amount that makes my EYES cross) I wouldn't be able to walk.  Or drive.  Or ALL.  And neither would the people I talk to, who face the same challenges in life.  I could pretend that there were no options out there for me, and deny the fact that the braces make me a functioning member of society...but in the end, wouldn't that be worse, and cost the government even more money?

I have attempted to get more help, from agencies that are supposedly available to me...and you know what?  I did just what they were hoping...I gave up, and went away.  One experience comes to mind...the time when I accompanied my father to the County Offices to apply for food stamps.  I didn't want to go on food stamps, though according to the information we read on-line I qualified for about $126.00 a month.  Seeing as how I struggle to pay my monthly bills on what I get from disability and the small amount of hours I'm able to physically work, I decided to give it a shot.  Three hours later I was hoping I could be shot, as a quick and easy death would surely save me from the back pain, anger and frustration I was feeling!  As we sat and waited, I saw some things that made me question where our world is headed.  One was this woman not much older than myself, who bounced into the waiting room with a smile on her face...she greeted several people already there, yelling across the room about how she was doing, asking after their health.  Boy, she was lively!  Soon a social worker came out and called her name, and suddenly her whole attitude CHANGED...the pain (that was now) on her face radiated,  and her hand grabbed the small of her back as she limped her way to the woman's booth.  Hey...wait a minute... I thought to myself, and then spent the next 15 minutes listening to their exchange as she complained to the social worker about having to move because she was evicted, take her EX to court to get child support, and the fact that her cell phone died which is why she couldn't call about that job offer--I think I started to black out a little right about then.  All I know is that when I came to she was walking out, as brisk and bubbly as ever with a sly grin on her face.  And her back pain and limp were suddenly was a MIRACLE!!   I took that grin to mean that she had gotten whatever assistance she came for, whether it was food stamps or Medicaid...who knows?  It made me ANGRY, not because she was given assistance but because she lied about her physical issues to get it...but I had to let it go.  This is where they help people, right?  And that woman got assisted, even though she was so obviously faking when it came to her physical health...but who knew what her life was like outside the waiting room doors?  If she got help, I was in the clear...right?  RIGHT???   Finally, it was my turn.  I got to sit down with a very nice social worker, who went through all of my paperwork and told me the good news...that I qualified for $16 a month.  No, don't adjust your monitors--you read that right.  16 dollars!  WHOO-HOO!!!  Par-TAY!

In the end I didn't take wasn't worth it to me to deny someone else that small amount of money who may have needed it more, and didn't have a family to help them in times of need.  This feeling was confirmed as we were leaving that office, and an elderly couple came in supporting each other and stepping in line to begin their long wait.  It depressed me, knowing that they might face the same problems I had that day, and in the end be sent away with little or no assistance.  So does it matter to me who caused what, and who's to blame when I think about the lousy state of health care and other forms of assistance?  No...what matters is the fact that we live in a society that seems to reward the people who have the most excuses and put on the biggest act.  And when you speak the truth and feel no need to put on any acts, it often seems as if you are ignored, and made to feel guilty for asking for help in the first place.  I was always taught to work hard and do my best, no matter what I was capable of doing.  And though my physical abilities have changed dramatically over the years, I'm still trying.  It frustrates me to see others out there who are capable of SO much more, who are not even making the attempt!  But what matters the most?  The elderly couple.  We will all be there someday, struggling to get our medications covered on limited incomes, our bodies failing almost as fast as the cost of our meds increase.  We are in a crisis now!  These people are not being helped currently...things NEED to change for the better!  So please...stop the finger pointing and the arguing.  It's time to come in off the playground, and get back to basics.  EVERYONE deserves health care, and no one should be denied their medication from lack of ability to pay.  If that's the case?  Then the medication COSTS too much.  People with disabilities deserve health care that will cover the different equipment they need in order to function...they are improving their quality of life and becoming functioning members of society in the process.  And I guarantee you...most of the disabled people out there who require things like braces and wheelchairs are NOT trying to get them because they're fashionable.

The political arguments?  They need to stop as well.  Whether or not you agree with Obama's health care plan no longer matters...what we've had in the past hasn't worked for us, so let's make those changes now and stop yelling about who's at fault for the mere result of delaying change.  I personally don't agree with the House of Representative's vote to repeal the Obama health care law.  If that were to happen then people with pre-existing conditions would be denied necessary health care.  Instead I am putting my hope and faith in the President's plan...why wouldn't I?  I have a pre-existing condition, as many disabled Americans do.  Will his plan solve everything?  Probably not...I'm not sure we could ever develop a plan that fixed all our country's health care issues.  Should we take the risk?  Definitely, because change needs to happen.  And what should we do when things like acting and making excuses seem to be rewarded?  Well, that's a whole other post...and I may have to take a pill before I tackle that one.  Hopefully my medical insurance will cover it, when that time comes!


  1. As a friend , I guess I never realized just how much we have in common .
    A very ripe subject, so ripe in fact, that those who ponder on it in government , and haul us out during campains and filabusters on the floor , stink of the vile odor of the rotting system we now have in place . A system meant to over pay and bloat certain individuals , government officals , drug companies , and supplers ! Us .... why we are nothing but fodder for their cannons when they choose to pretend to make some noise on the issue . They drag us out , then toss us aside again , as they don't want to be reminded of their own guilt and shame !
    Also being disabled , and I thank the Lord every day that I'm able to deal with my problems , I feel and see the same pain , unjust treatment , and disparity in this system as you do . I wore a custom made brace on my right leg foe 16 years ....$1400.00 each starting in 1985 ...ending at $2100.00 in 2001. My Ins. Co. paid nothing ... said the treatment was experimental . In 2001 I had my entire right leg rebuilt , and have about 40% use.Now that Ins. Co. made a Quality of life decission ...who gave them that kind of power [ ? ] the Government ! Just a month ago MetLife sent me a letter stating that I was on one of my med's for my Protracted PTSD [ A DISABILITY ] for over 5 years , they felt it was too costly , and would no longer cover it !Instant panic ....had to see my doctor , start trying new pills , had a very difficult tame reajusting . This pill was one with helps hold back "Flash Backs " and "Night Terrors ". I have been medicated for this disability for over 40 years .... And they simply decide that to " SAVE MONEY " , WE WON'T COVER THAT PILL ANY LONGER.
    This will happen to each and every one of you if you allow this broken down , over bloated , corrupt system that we've had to remain .
    Yes , there may be many things in this plan we may not agree with ..... then we lean on our elected offical to correct them . I'm older , and in my 60's .....darn it , when we wanted something changed , we talked about it , then shouted about it , then acted like a community and made things happen !
    The time for change is now , don't let some Ins. Co. decide how you'll live your life . We allready have a much Higher Power looking after that for us ...........

  2. Christine I never fail to be moved by your passion for life and your articulation of so many things that go on in your life. God bless you and thank you for your voice, so rich and important. Thank you.

    I get very frustrated with the finger pointing blame game and who thinks that they are right and blah blah blah.

    It is sick and insane. The largest cost of bankruptcy is due to medical costs, not riotous living. *sigh*

    One problem is that we as a people tend to group others as "them," aka the evil enemy. It could be Democrats, Republicans, Liberals, Conservatives, Death Panels, etc etc etc. This gets us nowhere and it gets us there often and fast.

    The system is broken. I was just reading an article in America magazine and in describing issues between a Catholic hospital system and a union, the line that caught me was that neither was the enemy of the other... The enemy, if you will, was the healthcare system itself.

    I write this as I sit watching my dying sister-in-law in her hospital room. I consider my own medical bills, small in comparison to yours no doubt, but still a problem. Due to my under-insured situation, I decided to ride out some pain last year... That resulted in a 12 day hospital stay and bills that I will be paying for some time to come. So much for trying to avoid the expenses associated with my $2500 deductible; I have bigger bills to pay than that now. And would it not have been cheaper for my insurance company to have a lower deductible and not have to deal with their end of the huge costs?

    It all seems so very wrong.

    Be well and keep writing Christine!! You are a light!

  3. It is obvious that you strike a chord with a number of people, many of whom you'll never hear from. You speak from your heart and it makes me and your mother extremely proud of you. Keep going blogger victor!