KnitWit: Rantings of a Rabid Knitter

Comment by Angie

August 4, 2009 @ 4:41 pm

I’m a Canadian with extra medical coverage through my new job as a returning RN. WE have waiting lists and we have some serious blocks in the flow of care, but we’re working on it and no one is turned away.
http://www.hc-sc.gc.ca/hcs-sss/hhr-rhs/strateg/romanow-eng.php
When we have a problem, we start a Royal Commision and Roy Romanow know how to make a country better.

Comment by LizaKnitter

August 5, 2009 @ 9:27 pm

Keep up the great work and thank you for sharing your insights with us. Thank you so much for your wonderful podcast, Carry! You’ve summed up just what is wrong with our so-called “health care” system.” I listened to your great essay as I commuted to work this afternoon. Ironically, on the way home I had my own experience with the insanity and sheer depravity of the greed and profit driven insurance industry. Early this morning I’d called the pharmacy to refill my Warfarin (a.k.a. Coumadin) prescription because tomorrow, August 6, I plan to leave town, not to return until late Sunday night. Since the pharmacy is closed on Sunday, I needed to refill it today.

The insurance company refused the refill, claiming that according to their records I had enough Warfarin until August 15 and furthermore, could not have a refill until August 7. I was directed to the “Pharmacy Care Division” and told by a clerk I wasn’t even eligible for a “vacation exemption”. The person denying the refill assured me she was “only following the rules”. When asked, she admitted she isn’t a medical professional.
Here are the details:
Prescription dispensed 7/23/09:
Label on prescription states: TAKE FIVE TABLETS ONCE A DAY OR AS DIRECTED
The protocol is that patients have blood drawn periodically and the doctor adjusts the Warfarin dose according to the INR levels in the blood. My dosages: 5 mg for the first six days; on July 29, the doctor’s increased the dosage to 6 mgs/day.
By August 8 l will have taken 5 mgs for 6 days and 6mgs for 11 days for a total of 96 1 mg pills. On Sunday, August 9, before I will have only 4 mgs left. (Note, it is dangerous to change Warfarin levels abruptly)

Even if my dosage had remained at 5 mg/day, there would have been only enough Warfarin to last through August 11 although the insurance company claimed I had enough for 5 mgs/day through August 15! I charted this all out this evening and am appalled that they are making decisions using really bad math.

Why are some people being made to fear that clerks in the “government” will be making decisions when we are already subject to this corporate (and don’t leave out – FOR PROFIT)
nightmare system, enforced medically untrained clerks.

And, my rant doesn’t even touch on the fact that my new employer-provided insurance now has $2,000 in network deductible, plus $5000 out-of-network. Did I mention that I work for a wealthy not-for-profit organization and this was the best they could do? In addition I pay about $15/week for this very poor coverage.

We need to organize a real, powerful march on Washington with demonstrations all over the country. I’m willing to help.

Comment by heather

August 6, 2009 @ 5:46 am

You know, my first thought when you said $200/month for health insurance was that it was an amazing price; most decent health care would be 6-800, IMO. Then you explained; it wasn’t decent. Mom’s recent near-month hospital stay cost over $576,000, and even with insurance, I think they are supposed to pay $45,000. My dad has been underemployed for over a year, and my mom obviously hasn’t worked since May. She has kept her job rather than trying to go on disability because she and my dad have health issues, and therefore need health insurance, if they have any hope of avoiding bankruptcy. Yes, something definitely needs to be done.

Comment by LizaKnitter

August 11, 2009 @ 1:03 pm

Just an update — my health insurance costs at work amount to about $500 annually. And, I’ve started a blog to talk about this: Grumpy Granny on Health Care!
Thanks to Carry — you rock!

Comment by TJ France

August 12, 2009 @ 4:11 pm

Thank you for such insight into the problem of healthcare here in the US. I have been ‘unemployed’ now for 6 months (not working for +1 year due to taking care of my father). I totally agree that those who need insurance the most are probably the ones not getting it because of cost. And I’d say that most that do have insurance aren’t being given enough coverage. I could rant on about finer points, but just suffice it to say that your opinion is more popular than you realize.

But I do have one thing to say about your frustration with the insurance rep you spoke to. What she should have said is something along the lines of “It is under federal law (HIPAA) that I am not at liberty to disclose that information. You will need to speak with someone at your doctor’s office who can legally release the diagnosis to you.”

Even though I don’t blame her for not giving you the diagnosis since it law and all, I do think she could have handled the situation better…I can’t stand customer service people who glaze over and just repeat the same things over and over despite what you say to them.

Comment by Gramma Phyl

September 2, 2009 @ 8:50 am

Carry, I so agree with you about the state of health insurance in this country. I am dealing with
Social Security right now because they can’t seem to understand that at one point in time Federal Government employees did not pay into the SS system and therefore are not covered by Medicare/Medicaid. My mom, who is 96, worked for Uncle Sam for 30 years. When the Medicare system was established, she was just a few years from retirement and to her it did not make any sense to pay into it. Now almost 40 years later, I have spent almost a year and a half try to get her covered under the emergency program! This is because she is suffering from dementia and I cannot care for her at home. Her Federal Retirees Insurance does not cover nursing home care for an extended time.

As for my health insurance, I get to pay weekly, and in 40 weeks time pay the entire year’s coverage because I drive a school bus and thus don’t work during the summer. The company I work for pays a VERY small portion based on hours worked. On average, I pay about 1/3 of my weekly gross for the privilege (?) of seeing my primary care doctor twice a year (co-pay of $20) and this year I had minor surgery to remove a fatty cyst (various co-pays adding up to over $200). And the company says they need to raise their rates again!

Surely the government couldn’t do a worse job then both are already doing. Unless the follow the unwritten rule, and I quote my Mom, “If there are 2 ways of doing a job, one with 3 steps and one with 10, pick the 10 step way, add 2 more steps for which a new training program must be created. This of course will take at least 18 months, by which time the whole thing is obsolete. At this point you may use the obsolete program OR go back to square one and start over.” Sound familiar?

On a more personal note, Carry, I enjoy listening to your podcasts. I have a great deal of empathy for the things you share with us and am very happy that I have found your show to listen to. Keep up the good work and know that there are many of us lurkers out here listening and enjoying what you do

Comment by Cindy

September 6, 2009 @ 12:28 pm

I have taken a job I do not like just so I can get health insurance for my husband and I. It’s going to cost almost $800 a month. If we go the independent route, it will be well over $1300 a month! We lead healthy lifestyles but have both survived cancer which makes us technically “uninsurable” which is so unfair! The only people happy with their heath insurance in this country are healthy people with insurance through their employer.