Member since: Thu Jul 1, 2010, 08:10 AM
Number of posts: 4,143
Number of posts: 4,143
I am a soon to be former medical administrator. I am not retiring. I am dying. And I'm mad about it. Insurance companies are the devil.
What went wrong?
Posted by MedicalAdmin | Sat Jan 5, 2013, 01:58 PM (10 replies)
I thought everyone should know that my husband passed away a little more than a month ago. He had devoted the last part of his life to his family, but I know that he really appreciated Democratic Underground and often mentioned to me some particularly good argument he had, or some new information that he learned while posting here.
I would like to thank everyone on here for giving him such passion and fun. I appreciate it and I know he did. I only wish he hadn't been taken (and yes, I do mean taken) from us so early. He was truly a renaissance man. In his life he had worked as a social worker, teacher, oil worker, conductor, print and publishing sales, and an officer. His last career was as a medical administrator, a job that he was gravely passionate about.
I miss him more than words can explain. I feel it like a knife twisting in my heart. I wake up in the night and he isn't there. I look for him to come through the door and he doesn't. My phone rings and it isn't him. But my world is a little less empty every day. Maybe someday the scars on my heart will heal over. In the meantime God help the insurance exec that ends up in front of me when I'm driving anywhere.
I wish everyone here good luck. As for myself and the rest of our family, a cousin of his has sponsored us to move to another country where this insurance BS won't be able to happen again to us. And so we are leaving. I would stay and fight with you but I am so tired that I can't see past survival mode right now.
Thanks again for being my husbands online friends.
Posted by MedicalAdmin | Tue May 1, 2012, 02:57 PM (142 replies)
My story is not short and may take a few minutes to read. You will read it or you will ignore it and either way I am content. But if you should be so inclined I would appreciate your thoughts and comments especially as they pertain to solutions. That is what this board is supposed to be about, isnít it?
You may be asking yourself why, in the whole wild world of thoughts and worthy causes that you should give this one even a moment of your precious time and that is a good question. After all, there is the Republican primaries and the many laughs those are providing us with.
Let me present you with this reason, and if you feel it is worthy then read on and I will explain at the end why it should matter to us all and not just me, although I must admit to having more than a passing interest in the subject. Hereís the thing. I am dying and I shouldnít have to. It could have been avoided easily, but it wasnít and the reason is the crazy patchwork quilt of health care delivery that we call private insurance.
Hereís my story.
Six years ago I was healthy, employed, happy, and in good shape. I ran 10 miles a day (half of it on stairs), had a healthy diet, saw a doctor when appropriate, and contributed to my community through volunteer work. My wife and I loved each other and we were about to finally start a family. We had finally settled down after wandering the world and finishing our masters and doctors degrees (sheís the one with the brains). We had just bought our first house (an old fixer upper well within our budget) and had started fixing it up. In addition to trying for a kid of our own we were also looking at adoption because it was a need that we felt an obligation to fulfill both in ourselves and for children in need. Life was, in short, pretty good.
Then a company vehicle, driven by an unlicensed driver, ran a stop sign and plowed into me. I had a spinal injury and a lot of pain but surgery wasnít initially indicated contingent on PT (physical therapy) and other therapies to see if they would reduce the pain. And if it didnít work then I would have the surgery. I was making some progress, my boss was holding my job, and I almost recovered in about 6 months. It was hard painful daily work, but I felt that I was getting my life back one screaming session at a time. Hard work was paying off again.
And then it happened again. Ironically I was driving back from another PT session when someone in a big assed pick up truck ran a stop sign and T boned my ass. This time I couldnít feel my arms, back or legs, was in incredible pain, lost control of my bladder and bowels, and had to be hauled out of what was left of my car on a back board. I clearly remember people beeping their horns and yelling at me to ďmove my fucking car.Ē Oh, the humanity. Did I mention that I live in Michelle Bachmannís district? Anyone surprised? As a former certified First Responder, this stunned me as much as my physical injuries. I didnít know that such casual disregard existed.
The ambulance took me to an ER where I laid for 6 hours in my own cold urine before being seen by anyone on staff. Hmmmm. In my experience the much-ballyhooed great care in the US wasnít so good. I was in an ER in Canada about 10 years ago for a much less serious injury and I was seen in less than an hour.
I couldnít move. I thought I was going to die and it frightened me. And then I thought I might live and be paralyzed and that frightened me more. I think I aged about 10 years lying on that table.
Eventually I was released from the hospital with a strong recommendation for spinal surgery and either vertebral fusion and/ or disc replacement. Because of the location and complexity of this procedure, there was a 1 in 20 chance of death or total paralysis with a lesser chance of partial success. But between a choice of that or of having to live with the pain, diminished feeling and partial paralysis that I had (have) it was easy to say to the surgeon ďstart cutting baby. Iím feeling lucky. Daddy needs a new pair oí shoes. Winner, winner, chicken dinner.Ē
Here is where the story becomes relative to the rest of you.
As you know, Americaís health care is paid for by a worn out patchwork quilt of insurance companies (read: devils masquerading as thieving con men masquerading as middle men masquerading as efficiency experts). They are the ďDepartment of NoĒ that the mentally unhinged worry about when they moan, ďkeep the government out my Medicare.Ē
This is when the shit got bad. There were, at this point, 3 insurance companies involved in my care; two auto insurances and one health insurance (mine). The first accidentsí insurance company claimed that they werenít responsible because my problems were the second insurance companies responsibility. The second insurance company claimed that my injuries were the first insurance companies responsibility. My health insurance said that it was a car accident so they werenít paying either.
Understand that all of them admitted that I should be treated. They all said that I deserved treatment. But they all said it was the other companiesí problem.
My doctor wanted to help but the hospital wanted to be paid and they had 3 refusals of claim forms in hand, thus they asked for either cash or a credit card with a limit in the 6 figures. What had been ďthe other companies responsibilityĒ had become my problem.
I didnít have the money so I had to wait. 6 months later, my boss said she was very sorry to tell me that she HAD to replace me. That was pretty nice of her actually. She kept me on the books and my family covered with insurance for a full year. But I was replaced. There went my health insurance and my income and my disability insurance. I thought things were bad, but they were about to get worse.
After that I didnít have the money to ever see a doctor much more than every other month and then every 4 months and then every 6 months and then never. The income just wasnít there. With the loss of my income and the extra bills, my wife and I went from solidly middle class to poor. My car bloke down and I couldnít afford to fix it so I had to walk anywhere I needed to unless my wife was around and could drive me in her car. And she took a second job out of town to help cover the bills so I walked a lot. And in the winter, in Minnesota, let me tell you, walking everywhere sucks ass.
I hired a lawyer, a very good lawyer. In fact I hired the lawyer that none of the insurance companies wanted to see in court because he is very, very good. Of the top 10 payouts in our states personal injury history, he owns 3 of them. But the insurance companies are allowed by law to stall and not respond for up to 6 months to every request made and every question asked and they do. Why? Because they can. And it isnít their problem. Itís our problem.
Using procedural and other dodges all the insurance companies in question have pushed off any settlement now for almost 6 years. Just last week we got our first settlement offer from the first insurance company - $2000. This is an insult. Counting just lost income Iím out more than 300K. It is an invitation to sue which we are now doing. Finally the end is in sight. In about a year, we will likely get a court date.
Of course this is the part of the story where shit goes from worse to worst.
About 6 months ago I started to bleed out of my nose on a regular basis. This was accompanied by migraines. But I didnít think much about it because; I couldnít afford to do anything about it anyway, I already hurt, and what is one more symptom in the old shit sandwich. I figured it might just be another symptom connected to my spinal injury, or maybe just dry weather. I didnít know and I was worried about it, but I couldnít afford to see a doctor and I sure as shit couldnít afford any diagnostic tests, and even if I could afford those test, how in the hell could I afford any treatments? It was a dilemma and one I decided to ignore because, well, I couldnít do anything about it anyway.
This is the same dilemma that every man, woman and parent in this country makes if they lack coverage or have a crappy policy (that percentage is about 50% of the population and raising). This attitude may not make much sense to anyone with money in the bank or functioning insurance coverage, but remember that I had all of those things too and that coverage was denied to me. The insurance companies claim it is just a contract dispute, a minor administrative detail. To far too many of us, it is murder.
Hereís the rest of my story. The bleeding and headaches got worse. So my current boss at the clinic, where I work part time, offered to pay for an MRI. The MRI indicated a few more tests that my boss also paid for. Sheís a wonderful woman. And while Iíve earned my keep, some days I feel like a charity case. These days I feel like a complete one, because I am.
The tests came back. The news was bad. Real bad. Life ending bad. Which sucks.
What pisses me off is that if I had had access to even a basic physical exam with some basic lab exams a year ago, it might likely have been diagnosed early and I wouldnít be facing my death soon. The type of cancer I have is so treatable that it is considered non fatal if caught early enough. But it is too extensive, too pervasive to deal with now. Itís mutated. Itís spread. Itís now highly malignant.
And understand. Even if it wasnít it doesnít matter. Because I canít afford treatment. If anyone want to claim that medical care is free at an ER I will just be more polite than you deserve and say ďyou are a low life, low information, immoral, pig ignorant, hateful suckass motherless asshat.Ē You can and do get basic ER care in an ER. The law is specific. Public hospitals are required to treat you just enough that you are stabilized and then they release you and bill you and then sue you if you canít pay. And they will do NOTHING for any long term, chronic, and deadly disease like cancer. That is NOT what they are set up to do. They are called EMERGENCY ROOMS because that is all that they deal with. How fucking stupid does someone have to be not to understand that? (OK Ė Iíll stop ranting now, but seriously, WTF?)
In other words it didnít have to happen and wouldnít have if I had coverage and could have seen a doctor occasionally. In fact the original surgery would have been done and none of this story would have happened. I would be working on my house. My wife wouldnít be working herself into an early grave. My car would work. I would be employed. And I would be a father. And I would have a future. And my family and I would grow old together.
I will die soon and the ONLY REASON is that I donít live in a civilized country. Let that sink in for a moment.
Now let this sink in: Iím not alone. There are 100,000 Americans who face the same thing every year. This is an honest to god slaughter of innocents.
People dying of preventable disease in the USA every day because insurance companies decide they deserve to die. A clerical snit between my insurance companies has killed me.
In answer to some of you who may suggest that I check with the hospitals and charities and programs, and I have. The problem is that both my wife and I are self-employed so we make too much gross income (on paper) to qualify for any aid or any programs. However the net income is too little to afford much beyond the basics. And so here I sit, close to the end. My wife of 20 years will be alone. This make me so sad.
It feels strange to be so accepting of my own fate. Iím dying and Iíve spent the last few weeks calling old friends and family and reconnecting. Iíve been thinking about what I have done and accomplished in my life and except for the fact that I never had kids, I am content.
Iíve lived in Canada, the USA, and Venezuela. I have traveled to Mexico, Guatemala, Costa Rica, Columbia, Panama, Brazil, England, France, Germany, Australia, and New Zealand. I have friends all over the world. I have experienced some really cool shit in my life. Iíve worked as a rig pig, corrections officer, teacher, conductor, musician, private chef, and medical administrator. Iíve hiked glaciers and mountains, shot white water rapids, played with jazz, rock and symphonic bands, explored the Amazon, and eaten way too much ice cream.
Iíve helped set up a food co-op and a school in Guatemala, taught English as a second language to immigrants, taught composition and elocution to Chinese diplomats, worked with the sick, developed curriculum for developmentally delayed students, helped find housing and education for homeless people, donated to charities, conducted an orchestra, worked to get progressives elected (Iím a graduate of camp Wellstone Ė a highly worthy cause) and I make one mean roast leg of lamb.
Iíve been diving, mountain climbing, mountain biking, camping, hiking, skiing, and so many other things. Iíve had great friends and Iíve had an impact on my world. My life, although shorter than I wanted it to be and missing a few adventures, has been good. I am content except for my worry about my wife.
Someone once said that we all live the same amount of time. We are born and then we die. What happens in the middle is what counts. My life has been full. My life counted. I just wish it could have counted for a little while longer.
But that isnít what I wanted to talk about. What I want to talk about it is why we tolerate this.
It has been estimated that about 100,000 people die in the USA a year from lack of proper care. That is more people every 2 weeks than died on 9-11. We spent about a trillion in response to that event. So why arenít we responding to this with the same passion and strength?
More importantly, what are we going to do about it? Well, not we, but you. I wonít be around for the rest of this fight. So itís up to all of you.
I want to ask that question to every politician, media person, lobbyist and advocate in the country; ďwhat are we going to do about this?Ē But Iím out of time.
Farewell DU. This will be my last post and with the exception of answering questions on this post for the next day or so, Iím done. I probably have about another month or 2 and Iíd rather spend them not worrying about the state of things. I plan on spending as much time with family and friends as possible. There are still a few books I havenít gotten to and a few songs still un-played.
In my opinion, progressives are the last, best hope for America. Donít give up the fight. Too many lives depend on what you do and the opinions you influence. Donít stop taking the fight to the enemies of democracy. Donít just stay on DU. This place is a store-house of knowledge and help and vision. Use that. Then go out into the world and make a difference. And then get up tomorrow and do it again. Be the difference you want to see in the world.
In closing I would like to apologize for every mean word, turn of phrase, misunderstanding, or slight that I have delivered to anyone here. I wanted to be a better person and I failed in that, so I hope you will forgive me. My mom used to say that those who were the hardest to love probably needed love the most. Be good to each other and respect and honor our differences, as they are our greatest strength. Thank you, DU, for giving me a home these past few years.
Good luck everyone. May your road home be filled with sunshine, gentle slopes, green grass and many a glass of fine beer on warm summer nights.
on edit - the title of the essay does NOT refer to me. I could be called many things, but innocent isnt one of them.
Posted by MedicalAdmin | Wed Feb 1, 2012, 03:24 PM (210 replies)
My story in short. 6 years ago I was hit by a driver who blew through a stop sign. 1 year after that I was driving back from PT from the 1st accident and it happened again. My insurance companies (company health insurance, auto1 and auto 2) get into an argument over who isn't going to pay. Long story short, no one takes responsibility by blaming the other companies. Doctor will not perform spinal surgery without cash at this point. I am in chronic pain and lost my job. I am also partially paralyzed and have bad balance. Oh and I have migraines.
I got another job with a smaller and nicer clinic working administrative tasks. IT's a switch but I like it a learn lots all the time.
This year I started to get spontaneous nose bleeds and cough up some blood. It becomes a daily ritual. I start to make sure that I ALWAYS have tissue at hand, just in case. Migraines get worse and balance is even more off, but I don't think too much about it because, well, I hurt all the time anyway so what is another log on the old shit sandwich?
I post about the downsides of having health problems, make too much to qualify for aid (I'm lucky that way) but too little to afford insurance with a pre-existing and about the bleeding on DU and I get some really good advice to seek more help and get an MRI. I take this advice and the results are really not good. Really not good. I really don't want to think about it, but reality can't be denied unless you are republican.
I haven't given up but my options are basically nil. My clinic is primary care and not set up to deal with this, and while my boss has been supportive (she is basically paying for my MRI), there is little she can do.
So what I want to write about it the dilemma that a growing percentage of American's are facing. We are stuck in a catch 22; we can't afford treatment and we need it. Our choices are either rolling the dice and impoverishing our families (perhaps leading to them being homeless) or rolling the dice and perhaps dying. And a growing number of us are saying that we would rather not leave the legacy of generational poverty to our spouses and families.
I would like your input on your thoughts on this. If you don't have insurance, what are you doing about it? Would you want to know the results of a test if you knew that you couldn't afford treatment (keeping in mind that a lot of this is NOT what ERs do so that is a ridiculous suggestion anyway), or would you not want to know? What would you choose to do? Would you say your goodbyes and then get on an ice flow and drift off? Would you fight for your life? Would you feel, perhaps with justification, that it wasn't worth the fight?
Is this even a topic that should be written about?
Thanks in advance for any feedback.
Posted by MedicalAdmin | Sun Dec 18, 2011, 02:35 PM (10 replies)
I'm not sure where to post this. Do you think I should move it?
My boss very nicely offered to help me pay for an MRI (basically she is paying for it) in order to screen out the reason why I have been experiencing bad migraines and bleeding.... in addition to my spinal injury issues (which also are not being seen to due to finances).
Now I wish I didn't know.
I am stuck on the horns of the dilemma that all too many American's face. I don't make enough to afford care, but I make too much to get any kind of assistance. So like many others I would rather die hard and swift by my own hand than cripple my family financially after I shrug off these mortal coils.
I guess on the whole it is good to know, but I can't afford the kind of aggressive therapy it would take to take this on. And now that there is an official diagnosis, I couldn't get insurance even if I could afford it.
I'm really not sure how to feel about this. I'm numb mostly.
Fuck. Now I get to go home and tell my family. That'll be fun.
Maybe while I'm still OK, it is time to put on a backpack and see what I haven't seen yet. ... I need a drink or 7.
Posted by MedicalAdmin | Thu Dec 15, 2011, 06:51 PM (4 replies)
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