My Own Insurance Dilemma Versus Others


My father was fond of asking: ‘Vat, you think money grows on trees?’  Sometimes we’d answer ‘yes’ just to hear him laugh.  Of course, this was also the same man who invited us along to “go crazy” after hopping into the truck cab.  Then we’d all pile in the bed of the truck, no helmets, no seatbelts – bouncing around freely, yelling into the wind.  Not worrying about a thing.

In mid-May each department of our hospital met to hear a message from our CEO, Joe.  The money tree’s growth spurt was over and, now,   the jist was everyone, every one of us, would take a 5% decrease in wages. There were three options on how to do that.   Regardless of the option chosen, it came out to a 5% decrease in wages.  Since our department is one of those considered ‘critical’ only two options were open for us.  At least in our dept, there wasn’t much grumbling or muttering as business was clearly ‘off.’  I’m fairly certain most folks knew the frank extent.  According to Joe, this will all lift next June 1st (2010).

Sooo – in light of that the beginning of June brought out yet another mandatory meeting. This time for all those insured via the hospital regarding upcoming “important changes” effective July 1st.  Now at that meeting, there was considerable grumbling.  This is part of ‘why.’

  • Deductible: $750 individual; $1500 family.  As it is, we have no decision in what deductible to take; it’s been made for us.
  • New:  Differences in rates for non-tobacco versus tobacco users: cigs, pipes, chewing.  We had to sign an affidavit in front of a notary, conveniently provided by an HR employee, that stated we haven’t used any tobacco products for one year.
  • New: Doctor Visits:
  • a) Co-Pay:   Regardless of the number of visits, the office co-payment had been $30 per visit.  Now only 4 visits are to be covered by the $30 co-pay, then it’s completely out-of-pocket until the deductible is met.  When the deductible is met, then we’re required to pay 20% of the office visit cost.
  • b) Physicians:  Primary care physician:  $30/co-pay.  Specialty Care physician: $45 co-payment.  Also as above under (a) regarding number of visits.
  • Medication:  Big push to get meds via mail-order.
  • Diagnostics:  Lab & radiology: anything from plain x-rays to MRI, routine blood work, etc.   Meet the deductible, then you pay 20% if at St. Luke’s.  (In or out of network = we pay 40%).  We’re partnered with St. Luke’s with therapy clinics around the Treasure Valley, including Ontario, so this is supposedly some good deal.

Now in the three years I’ve been working there outside of an annual visit to make sure my doctor is still a doctor and arcm4aupdate on medication I take daily, the medication co-pay, I haven’t utilized much involving my insurance.   In fact, in all years employed elsewhere, I didn’t utilize my insurance except for annual visits, mammograms and medication.   I’ve never come close to meeting my deductible.

Now that’s me.  As an adult, I’ve rarely been without insurance.  Neither had my sister, who has been without insurance for over a year.  She was employed by the Meridian School District in special education.   Due to some merging of schools and transferring of those with seniority, she became unemployed.  She just got hired by the Boise School District – this week in fact – and she has insurance again.  She is sooo freakin’ relieved. tiny-div2

Even given the restrictions on my insurance, it is workable.  However if something happens, an accident or traumatic injury, any kind of syndrome or disease lurking – I wonder, but I must say I don’t worry about it.

On most Saturdays I listen to the radio, KBSU. It’s been part of my Saturdays since 1980 or so and begins with Linda Laz early, early in the morning to beyond Janie Harris’s jazz show  – sometimes listening into Blues Before Sunrise overnight.  A few weeks ago I heard of a benefit being held for Janie Harris – widow of jazz musician, Gene Harris, and hostess of the KBSU Saturday evening jazz show – who “is facing hundreds of thousands of dollars of debt after battling cancer.”  That concert was on Saturday, the 22nd.

It was “organized by pianist Paul Tillotson, who headlines the concert with his trio, including Jim Kassis on drums and Rod Wray on bass. Other musicians on the bill include Cherie Buckner-Webb, Billy Mitchell, Harris Lawless, Phil Batt, John Jones, The New Trio and Frim Fram Fellas, among others.  A cash-donation auction will be held midway through the concert led by auctioneer Larry Flynn. All proceeds from the auction and concert ticket sales will go to Harris.  In addition, donations can be made directly to her and sent to Janie Harris, 5699 Fortress Ct., Boise, ID 83703.”

Why was it organized?  Why did I ‘find’ $40.00 of not so disposable income to go?

Janie Harris is one of many.  Finding a lump in her breast was terrifying enough I’m sure, however  she had insurance and therefore she was covered.  Apparently her struggles with breast cancer, surgery, and other medical issues directly or indirectly related to her cancer resulted in the assignment of her having “a preexisting condition” wherein Janie  lost her insurance.  According to Bill Cope at the Boise Weekly, Janie “has been hit with an avalanche of medical bills and no possible way to pay them.

Bill Cope:

But I have to ask: Is this any way to run a country? Whether it’s the naked immorality of insurance companies or the shameful absence of any health insurance at all for millions, the financial ruination of Americans–not to mention the actual deaths–has become as common as weeds in foreclosed lawns.  It is impossible for most thoughtful citizens to imagine how it could get much worse, yet battalions of insurance lobby shock goons are invading town hall meetings across the country–ignorant savages, spitting their venom on those who would improve our lives, trying their best to make sure this travesty we call a health-care system continues on as it is.

The naked immorality of insurance companies . . . . and yet we hear about ‘death panels’ knowing full well who stocks those ‘death panels.’  The insurance companies.  It’s not your doctor or Janie’s doctor putting the skids on certain procedures.  It’s the insurance companies.

If Janie Harris’ story isn’t troubling enough, remember the LA Fitness shooting in Pittsburgh?   Heather Sherba, one of the victims of that death and shooting spree, has wonderful friends.  They got together and had a benefit to raise money for her as well – a car wash.  Rachel Maddow spotlighted it on her show last night.  $500 – that’s what was raised.  $500 was from a car wash because Heather who recently graduated with a nursing degree has no insurance, has student loan debt with a mother who is very emphatic, however just as financially strapped as Heather.

As Rachel said: God help the richest nation on earth for making this the excuse we have for a healthcare system.


3 Responses

  1. […] View original here:  My Own Insurance Dilemma Versus Others […]

  2. I’m not usually stunned by something said on the news. Irritated, yes. Inspired, sometimes. But when Rachel said that about the richest nation, I was completely stunned. Why is it we have this mess of a health care system? Oh, right, it’s all those politicians who turn a deaf ear while opening their pockets to the health industry interests. Pisses me off!

  3. A fucking car wash, Tara! My nephew – who has Williams Syndrome – they have car washes & sell baked goods to raise money for their “road trips” so everyone can go even those who cannot afford it.

    Pisses me off – doesn’t even begin to describe it. The disconnect between the few brain cells of these people who are out there fighting so others CANNOT have some form of health coverage. They are the personification of evil posing as God-fearing, country-loving folks. They are no such thing.

Comments are closed.

%d bloggers like this: