Sunday, January 18, 2009

WARNING: The Following is an Over Statement

Its been a long while. This Christmas shall go down as the sickest Christmas ever and I don't mean that in a 14-year-old-skater-kid kind of way.

The first news I received, after I took 2008 out back and beat the living shit out of it, was that my darling insurance company will be denying ALL of my claims associated with breast cancer.

Apparently having boobs is a pre-existing condition.

This is the part where I get angry.

I've been sort of alright with everything so far. Stage III? Well, that sucks....You tell me the drugs may make my heart explode? Hmmmm...well, I'm a team player. Yes, I'll quit smoking and drinking and I'll start running if you think it will help. I don't really need to eat so much red meat. Yes, I'll be there, two, three, four times a week and not be late, never ever....you all are keeping me alive right. I will never miss a treatment, dosage, appointment. Puking and complete exhaustion will be tolerated indefinitely...I understand. We'll just keep trying....some drug will make the tumors stop growing....whatever you say dude, you've got the degree...

All that I can handle...with relative grace, mind you, less a few episodes of utter desperation. (I think I'm allowed an episode...OR TWO..).

But what I absolutely will not tolerate is being FUCKED WITH BY THE INSURANCE COMPANY.

They have dragged me through a five year review which began in September and was just, as in a week or so ago, concluded. I'm assuming these people are completely inept at their jobs, otherwise there is no reason for it to have taken so long.

They have run me and the hospital and providers who have actually given me care around so many times all of us are not quite sure which way is up.

No one I speak to on the phone about my account concedes to calling what I have "breast cancer". It is a number, a code. It is "condition number 70836 as stated on your EOB". YOU FUCKERS!! Its cancer. What ails me is not some cold or chronic imaginary condition. It may kill me.

The burden is now on me to file an appeal. I must amass evidence and records and write an appeal on my own behalf trying to convince a giant corporate monolith to listen to me. This will be great fun.

I got insurance because I was tired of dealing with the healthcare system for the uninsured. I wanted to have the card that said I was tall enough to ride the ride. The card that would allow me, bleeding and broken, the luxury of prompt attention if I got hit by a bus.

What had spurred the initial getting of the health insurance was having to wait three weeks for a script for antibiotics last year. I'm not sure if anyone out there has had to deal with these places, the hospitals and healthcare providers that deal with the uninsured, but speed is not their strong suit. I cannot blame them however. They are dealing with the problem of the uninsured and under insured on a daily basis. They really truly are doing all they can.....slowly, but hell they're doing it.

The uninsured aren't lazy. They don't need better jobs. Most of them are denied full time hours by their employers so the employers don't have to pay for their coverage. 39.5 hours a week isn't lazy, but its not enough to be covered by most small companies group plans. ("Small business is the engine that keeps the economy moving"...blah, blah). That worker likely has another part time job that their first part time job keeps them away from so they can't get coverage at either place.

And who can blame business owners. Their primary reason for business is to make money. I get it. I wish the well-being of their employees was primary concern but I get that the world ain't a commune. I would like to change the way it all worked, created sustainable community pathways and all that....but the dudes in the suits really don't give a shit. They've got their own to worry about. The cost of coverage is often more than it takes to keep the motherscratching lights on. If the lights ain't on no one has a job. Its ugly the whole way round.

Declaring yourself "indigent" is a painful and awful thing. It hurts when you've worked your whole life and paid your bills on time and kept yourself above water and happy. To say that you are unable to take care of yourself and must have the taxpayers carry you is embarrassing, awful, heartbreaking. Many years ago I had to sign a paper in an emergency room in order to get treatment for a work accident that stated I couldn't take care of myself. That wasn't true....I couldn't afford a $5000-up-front emergency room visit but I certainly was taking care of myself. Some of us do think long and hard about the ramifications of what that really means. I come from a proud and self-sufficient people. Stories of how my great grandmother would never go "on the dole", even during the Depression, are legendary at the dinner table. The memory of basically being forced to ask for a handout has never left me.

I turned 30. My father died. It had taken me 3 weeks to get antibiotics. I was over it. I found a plan I could afford as an individual and bought it. I gave them my blood, literally. Three vials. I answered their questions. I paid my premium. I got their policy.

AND THEN I GOT HIT BY THE PROVERBIAL BUS!

I get it, insurance company. A thirty one year old woman with cancer IS weird!! Yes! I agree. No one thinks that is stranger THAN ME! I am not a sick bastard however and have not thought long and hard on how to defraud you as my cancer got worse and worse. Number 102-FT207 isn't that messed up in the head! Yes, dear insurance company, you've got me all figured out. I am the sort who would stand idly by, watching my own demise, for your awesome benefits (which, as it turns out, aren't that fucking great anyway). Did someone beat you all when you were young, you paranoid ass-hats? Christ.....

But the greatest crime really, the most aggravating, you've-got-to-be-shitting-me thing about this entire mess, is if I didn't have my wits about me the insurance company could just get away with it. They are intimidating as hell with all their paper and their numbers. What if there was a language barrier? Say I wasn't a primary English speaker? What if I had a type of cancer that was literally debilitating my mental function? What then? What if I was alone? What then? What if the treatments completely laid me out? What if I had no voice? No voice at all? Fuck me! What about all those other poor bastards in the world who won't fight because they are afraid or can't fight because they are too sick? What about them? They are all SICK people who tried to do the right thing and are hung out to dry for their efforts.

I work (quite a bit) but don't make a shit-ton of money. I qualify for financial assistance. That isn't the point. I don't want it for free. I want it for FAIR! I want to pay for what I owe. That's why I bought the plan to begin with. That's how you pay for healthcare in this country.

Seems strange that I now must begin a fight in the middle of another fight to be able to pay people. I could just say fuck it, let it lapse, and get it for free......but that safety net isn't for me! Its for the ones who can't fight. Damned either way, I suppose.

Apparently health insurance is for things like hangnails.

NUMBER 102-FT207 who has condition #70836 IS PISSED! I am not concerned with the quality of their sleep, but am confounded how anyone involved in the health insurance industry actually can sleep at night.

It reminds me of the people who slept so soundly in the towns surrounding the death camps.

An overstatement, you say?

The drug that is keeping me alive is $5000.00 a month. It is keeping me alive and my insurance company refuses to pay for a portion of the cost even though its covered in the policy I am paying for. I just shouldn't have gotten cancer. I should have gotten a better job. I should have gotten better health insurance. If I don't get the drug, I die. If the uninsured or underinsured don't get the drug they die too. But someone in an office in Kentucky or Minnesota or wherever gets to make these decisions, and their underlings carry it out, and someone somewhere gets a letter and throws up their hands and tries to hang on and finds they can't for very long......

And then they die.

They die.

They are overcome by a disease which they cannot afford to fight and they die.

Lots of them.

Tell me if that's an overstatement.

9 comments:

Ryan said...

This is an Understatement. The insanity of our healthcare system often rivals the madness of the government. I'm a Type 1 Diabetic who has frequently faced the complications of making too much money to get help (assistance) and too little money to afford medication. This is surely a microscopic version of your current undergoings. I would seriously like to do something to get involved. Write a letter, punch a face, whatever I can. Just tell me what. We're friends on Facebook, let me know.

Ryan Levon Swift

victoriaclaire said...

Abby,
I don't even have words for this. I'm sorry that these people have put another needless (and huge) obstacle in the way of your fight. Like Ryan said, if there's anything I can do, please, please let me know. We'll teach those fuckers that they should have thought twice before messing with our girl.

Charles Leverington said...

Hey there cuz

that is some truly some F*@ked up S%#t. it emphasizes the various aspects of life, in this our fair capitalistic country, that I have been analyzing for a bit of time now. you have always been a strong woman in my eyes and you have continued grow in strength. I would be more than willing to help start up a petition or to harass those corporate bastards as much as possible. You know your not alone. I love you chick and call me. the number I have for you has been disconnected but I'll keep tryin to find an updated one.
Peace & much love
Andrew

Ila & I said...

I havent cried at your other posts when I have read of you fighting tooth and nail for life but this doublespeak insurance company bullshit is too much for me. I wish I could smuggle you to Canada and give you my share of health care benefits that we rarely have to use but are always there. Stupid fucking privatized health care system. While I too would like the world to be more of a commune then a concentration camp a decent health care system is not much to ask for. I send you love and health and strength and praise for your voice. May the paper pushers never get the satisfaction of quieting it! I wish I could help. Shalom!

Komen KC Grantees said...

I see this every day and still cannot get over it. How can they do this? I want to line everyone up with a life-threatening disease who was denied coverage because of a "pre-existing condition" and march them to the front doors of these big healthcare companies and beat the ever loving crap out of all of them!! I am truly sorry you are having to go through this crap ON TOP OF the medication that just doesn't allow you to feel like yourself. UUGGHH!! You are in my thoughts and prayers. And you are NOT alone.

Kari Miller

Chis Burkhart said...

Abby,
Hope and prays. I've got a couple of friends in the insurance biz, and I am giving them a call with hopes they'll at least know what the right words are to use to fix this.
As always,
Chris 'Mongo' Burkhart

lilrant said...

Would Legal Aid be of any assistance to you? Perhaps it would be worth giving them a call. This just sounds fraudulent on the part of the insurance company. It is most definately BULLSHIT!

Gather all the helpers you can to acquire the documents the bastards require. Keep copies of everything you send them, and send it all "certified, return receipt requested". This shows them you mean business too!

I learned of your blog from a friend of a friend, I've been reading it for a couple of months now...you are a VERY gifted writer. I hope my suggestions do not insult your intelligence. I'm just a Mom, wishing I could help in some way.

Godspeed

Jason&Corin said...

Abby, or "Hope",

My name is Jason and I am a friend of Chris Burkhart. He called me today and sort of explained your situation to me. My Dad "Bob" is an actuary for an insurance company I never really even heard of, but he's been in the business for a long time and knows the in's and out's. I was going to forward this blog on to him, but I don't think he will appreciate the swearing, he's a bit conservative. So if you can send me some information and facts I can forward it to him and maybe he can help. I don't need any personal information just some basic stuff such as what HMO or PPO you are with. When your policy wen into effect. What policy you had. When you were diagnosed, etc. I can't make any promises but we can see what we can do. My email is rjo2393@hotmail.com. You can call Chris to verify my email and who I am. I would love to help.

-Jason

View from the Hilltop said...

{{{HUGS}}}