Showing posts with label health insurance. Show all posts
Showing posts with label health insurance. Show all posts
Tuesday, March 29, 2011
Tuesday, February 8, 2011
It's Not that I'm Weird, I Just Know More Than You
HMO: We'd like to tell you about an exciting program that can help you manage your health.
ME: Is this the program where you have a nurse coach?
HMO: Yes it is.
ME: No offense or anything but I don't find that program helpful. I don't know if it's because I've taken the basic A&P classes or what, but I always seem to know more than the nurse*.
HMO: *silence, refers to script* Uh...what?
ME: I don't plan to participate. Thank you.
HMO: Okay. Thanks. *click*
They hung up before I could tell them what would really help me would be a good patient advocate. That would save us all money. But then the patient advocate would have to know something about adrenal glands and well...that's not gonna happen.
*It's not that nurses don't know anything, it's that I don't think they are allowed to deviate from their very narrow program scope. I did this type of program before and it is total fluff. Like kindergarten. "Asthma is a lung disease. You need to take your medication every day."
Really?
No sh*t. I thought it was the enlarged big toe of my unborn twin growing out of my rectum. (If that doesn't make sense to you, it's a sign that you need to watch more medical weirdness documentaries on TLC and Discovery Health).
Thank you HMO for using my premium dollars for this bullsh*t.
ME: Is this the program where you have a nurse coach?
HMO: Yes it is.
ME: No offense or anything but I don't find that program helpful. I don't know if it's because I've taken the basic A&P classes or what, but I always seem to know more than the nurse*.
HMO: *silence, refers to script* Uh...what?
ME: I don't plan to participate. Thank you.
HMO: Okay. Thanks. *click*
They hung up before I could tell them what would really help me would be a good patient advocate. That would save us all money. But then the patient advocate would have to know something about adrenal glands and well...that's not gonna happen.
*It's not that nurses don't know anything, it's that I don't think they are allowed to deviate from their very narrow program scope. I did this type of program before and it is total fluff. Like kindergarten. "Asthma is a lung disease. You need to take your medication every day."
Really?
No sh*t. I thought it was the enlarged big toe of my unborn twin growing out of my rectum. (If that doesn't make sense to you, it's a sign that you need to watch more medical weirdness documentaries on TLC and Discovery Health).
Thank you HMO for using my premium dollars for this bullsh*t.
Tuesday, November 2, 2010
Pay, Pay, and Pay Some More
That is the motto of our new health insurance.
Late last month, we finally got all the benefit information for 2011 from our employer.
Oh. My. Goodness.
Does anyone else spend hours on insurance stuff this time of year?
Or is it just us?
My head hurts.
Now we have exactly 5 days to figure out which end is up.
Yesterday we spent about an hour doing some virtually guided benefits adviser thing.
Trying to figure out the best plan for when you have a tumor in your lung that is probably NOT cancer but it COULD be cancer and what if you need a lung removed next year?
We picked this new plan, the one our employer is heavily pushing, where we open a flexible spending account with an investment company. We contribute and then pay out of that account for about $6000 annually until the insurance kicks in.
The idea is, if you don't have any major health issues, you can sock away money year after year and build a medical investment account. Like I told the hubby, it's really a 401k for your health.
But it only really works if you don't use it.
Hahahahahaha. That's a great punchline, isn't it? Here's health insurance that is only affordable if you don't use it.
Oh man, I'm going to hurt myself snorting in derision over here.
So the thing was, the employer sent us a brochure with all these 'real life' case studies where every. single. family. was better off with the new 401k-like health plan. There was not one example where a family should pick another plan. The brochure also stated that the health plan was ideal for healthy people.
Anyone here think I am a healthy person?
More like health impaired if you ask me.
So I wrote to the benefits department and was kind of snide because I was pissed that the brochure was a heavy sell marketing campaign not a tool to actually help people make a decision.
I wrote: It's great to see so many case studies and how every single time the best option is The Health Plan You Want Us To Buy. Are there case studies that show when other options are a better choice?
To which they responded by directing us to the virtual benefits advisor.
We estimated our needs based on this past year, which is the worst medical year we've had in a while. 1 short hospital stay. 2 ER visits. 10 specialist appointments a year. About 5 primary care visits a year.
The virtual benefits advisor smarmily told us, based on all our information, The Health Plan They Want Us To Buy is the best choice for our situation.
So the big question is, am I in good health and just don't know it? Do healthy people commonly end up in the hospital and ER? Is that the definition of healthy? Please enlighten me.
Granted, this plan is likely the cheapest in terms of day-to-day costs. Most of my medications will be free, which saves about $1,000, but all doc visits and labs will be out-of-pocket. The big question mark is how that trade off works. Will I spend less or more on labs and doctor visits than medication? Can we actually save some of the money we contribute or will it all be spent on medical care?
We have not been given the information to calculate projected answers to these questions--just that heavy handed, rub our noses in it, marketing brochure. I have asked for price lists so I have some idea of how much the CT scans I'll need will cost. It seems unethical and almost criminal to burden people with such a large out-of-pocket deductible and not give them the price list.
I am sure the Benefits Dept. loooooooves me, but it galls me that I have to ask, even beg for this info. Makes ya really feel like a "valued employee" don't it?
The other thing that bothers me is that side by side financial comparisons do not tell the whole story. They also need to factor in when benefits kick in and how much. A lower deductible plan may have a higher total pay out, but barring a health disaster, it may provide more benefits for run-of-the-mill health stuff. This is the math that the employer is not doing or providing to its employees and I don't feel like I have enough information to run those numbers by myself.
I continue to be 'for' health care reform, but they need to work harder on not just access, but affordability. I do not have major health issues, just chronic ones, and it is killing us. How do people on dialysis or with diabetic complications or those in need of heart surgery survive?
There also ought to be a law on how large employers 'pitch' health care. Since,apparently, they aren't going to be ethical about it on their own.
*I say 'our employer' because I have my pension and what not there still even though I'm not currently employed there.
Late last month, we finally got all the benefit information for 2011 from our employer.
Oh. My. Goodness.
Does anyone else spend hours on insurance stuff this time of year?
Or is it just us?
My head hurts.
Now we have exactly 5 days to figure out which end is up.
Yesterday we spent about an hour doing some virtually guided benefits adviser thing.
Trying to figure out the best plan for when you have a tumor in your lung that is probably NOT cancer but it COULD be cancer and what if you need a lung removed next year?
We picked this new plan, the one our employer is heavily pushing, where we open a flexible spending account with an investment company. We contribute and then pay out of that account for about $6000 annually until the insurance kicks in.
The idea is, if you don't have any major health issues, you can sock away money year after year and build a medical investment account. Like I told the hubby, it's really a 401k for your health.
But it only really works if you don't use it.
Hahahahahaha. That's a great punchline, isn't it? Here's health insurance that is only affordable if you don't use it.
Oh man, I'm going to hurt myself snorting in derision over here.
So the thing was, the employer sent us a brochure with all these 'real life' case studies where every. single. family. was better off with the new 401k-like health plan. There was not one example where a family should pick another plan. The brochure also stated that the health plan was ideal for healthy people.
Anyone here think I am a healthy person?
More like health impaired if you ask me.
So I wrote to the benefits department and was kind of snide because I was pissed that the brochure was a heavy sell marketing campaign not a tool to actually help people make a decision.
I wrote: It's great to see so many case studies and how every single time the best option is The Health Plan You Want Us To Buy. Are there case studies that show when other options are a better choice?
To which they responded by directing us to the virtual benefits advisor.
We estimated our needs based on this past year, which is the worst medical year we've had in a while. 1 short hospital stay. 2 ER visits. 10 specialist appointments a year. About 5 primary care visits a year.
The virtual benefits advisor smarmily told us, based on all our information, The Health Plan They Want Us To Buy is the best choice for our situation.
So the big question is, am I in good health and just don't know it? Do healthy people commonly end up in the hospital and ER? Is that the definition of healthy? Please enlighten me.
Granted, this plan is likely the cheapest in terms of day-to-day costs. Most of my medications will be free, which saves about $1,000, but all doc visits and labs will be out-of-pocket. The big question mark is how that trade off works. Will I spend less or more on labs and doctor visits than medication? Can we actually save some of the money we contribute or will it all be spent on medical care?
We have not been given the information to calculate projected answers to these questions--just that heavy handed, rub our noses in it, marketing brochure. I have asked for price lists so I have some idea of how much the CT scans I'll need will cost. It seems unethical and almost criminal to burden people with such a large out-of-pocket deductible and not give them the price list.
I am sure the Benefits Dept. loooooooves me, but it galls me that I have to ask, even beg for this info. Makes ya really feel like a "valued employee" don't it?
The other thing that bothers me is that side by side financial comparisons do not tell the whole story. They also need to factor in when benefits kick in and how much. A lower deductible plan may have a higher total pay out, but barring a health disaster, it may provide more benefits for run-of-the-mill health stuff. This is the math that the employer is not doing or providing to its employees and I don't feel like I have enough information to run those numbers by myself.
I continue to be 'for' health care reform, but they need to work harder on not just access, but affordability. I do not have major health issues, just chronic ones, and it is killing us. How do people on dialysis or with diabetic complications or those in need of heart surgery survive?
There also ought to be a law on how large employers 'pitch' health care. Since,apparently, they aren't going to be ethical about it on their own.
*I say 'our employer' because I have my pension and what not there still even though I'm not currently employed there.
Friday, November 20, 2009
...and now Pap smears...
["Curiouser and curiouser."]
Holy Toledo! Now we don't need Pap smears as often. Have we been (the equivalent) of navel-gazing in the past, getting ourselves checked out too often? Our society is paranoid about cancer. Screenings make us feel like we're doing something, like we're being (that horrible corporate word) pro-active. As Sen. Arlen Spector told the New York Times, That is curious.
The past recommendation had been for young women to have Pap smears three years after becoming sexually active. Now the guidelines are to wait until age 21, no matter when a girl started having sex. The numbers bear this out: only two new cases per million teens (15 to 19 years old) per year in the U.S. What if you are one of the two girls? Everything makes sense, statistically, but not if you're one of the statistics.
The old tension between the individual vs. the community.
Cervical cancer is slow-growing, and pre-cancerous conditions often don't turn into cancer. Surgery for the pre-cancerous conditions could lead to premature births, says the Times.
This is the same thinking that went into the decision to recommend mammograms less often. The mammograms picked up non-cancerous tumors, which led to biopsies and more tests, for nothing, I guess you could say. And anxiety. Everyone is worried about our anxiety. I think most women would vote for a little surgery and anxiety so that their anxiety about cancer would be lessened. At least most women who have the choice.
A student of mine this fall thinks she has mono but can't afford health insurance or a visit to a doctor. She assured me last night she was no longer contagious. But she wasn't absolutely sure about the diagnosis, which had been delivered by a guess-timating nurse.
We all need the health insurance coverage that our federal elected officials get. Don't we deserve that?
Thursday, October 8, 2009
The Need for Health Insurance
At present the United States has the unenviable distinction of being the only great industrial nation without universal health insurance.
Health insurance is like elementary education. To function properly, it must be universal and to be universal, it must be obligatory.
Certain interests which think they would be adversely affected by health insurance have made the specious plea that it is an un-American interference with liberty. According to the logic of those now shedding crocodile tears, we ought, in order to remain truly American and truly free, retain the precious liberties of our people to be illiterate, to suffer accidents without indemnification, as well as to be sick without indemnification.
It is by the compelling hand of the law that society secures liberation from the evils of crime, vice, ignorance, accidents, unemployment, invalidity, and disease.
--by Irving Fisher, The Progressive, Jan. 1917