Health care for the truly sick: A real-life example
August 15, 2009Jon Brooks 2 Comments »So what’s wrong with health care, anyway? A recent CNN/Opinion Research poll measured 74% of Americans as satisfied with their insurance and 83% satisfied with the quality of care they receive. Pretty decent numbers that are nothing to sneeze at (pardon the thematic pun).
But let’s assume most respondents in this poll have never been seriously sick, with the kind of illness that is not only completely debilitating but life-threatening. How does the system work for those who have had their lives turned topsy-turvy in such a way?
Marc from New York City is a 46-year former Director of DVD Production for one of the major music companies. Seven years ago, he noticed a slight limp, which persisted and degenerated into paralysis of his limbs, one by one. Finally diagnosed with Primary Progressive Multiple Sclerosis in 2003, Marc can now move around only by way of wheelchair. From his blog, Wheelchair Kamikaze, where he documents his experience coping with the disease and posts kneeslappingly funny videos illustrating the triumphs and travails of navigating Manhattan streets on two wheels:
MS has stripped away the many trappings of life that had become central to my self identity. High profile job in a “glamour” industry? Gone with the wind… Sexy little sports car? Couldn’t even get into one these days… Fashionable clothes and fancy shoes? Ha! Putting on my socks is now a painful exercise in acrobatics, and I could just as easily use buttons and shoelaces as I could split the atom. All of those externals that once so dominated my definition of self are now mere memories, and in their place I’ve gradually come to know a different me, a me that resembles one that I knew a long time ago, back when I was a child unencumbered by the accouterments of adulthood.
So how has Marc, who had good insurance from a big corporation, and who now relies completely on the system to stave off total bankruptcy, fared? A post called “You’ve Got to Fight For Your Right (To Be Sick)”:
As if battling a disease that in the old days was called “Creeping Paralysis” isn’t enough, I’ve learned that the afflicted get the added bonus of having to fight a perpetual battle with the ungodly abominations known as insurance companies. Insurance companies rank right up there with the New York Yankees as the ultimate expressions of evil on earth. Their actions are enough to turn even the most rational person into the Unibomber.
A good friend of mine (another MS patient) was scheduled to have surgery this coming Monday, to try to fix her previously surgically “repaired” broken shoulder, which she injured in an MS related fall. The shoulder has been causing her unending misery for many months now, and my friend was hoping to finally find some relief from the constant pain. Unfortunately, that pain has now been compounded by the fiends employed by her insurance company, conniving ogres who have chosen not to authorize the surgery. Mind you, this is a surgery ordered by her orthopedic surgeon, not a cosmetic tummy tuck or facelift. They’re forcing her to go through an appeals process, which won’t be complete until sometime next week. So the surgery for Monday is off, hopefully to be rescheduled for the following week, if the insurance company’s annointed ultimately deem the procedure worthy.
My own experience with healthcare insurance companies has been maddeningly similar. I suppose, on balance, I really shouldn’t complain, as the company has paid for a myriad of expensive treatments and procedures. But I’ve also spent an insane amount of time on the phone with various insurance company goblins, desperately trying to convince them of the necessity of most of those procedures.
I’m generally very slow to anger, and not much of a screamer, but the insurance jackals on the other end of the line are possessed with an almost singular ability to turn me into the flesh and blood incarnation of Mount Vesuvius. I try hard to be a clear thinking individual, and strive to approach even the most emotional topics some Zen detachment, but put me on the phone with an insurance company rep and within five minutes I’m transformed into an eye bulging, mouth frothing crazy person, my senses of reason warped into the shape of a dyspeptic goat’s small intestines, and my language skills diminished to the point where I can only make Tasmanian Devil noises.
It took a full year to get my wheelchair approved and finally reimbursed; a year spent screaming into the phone at the demonic entities employed by Blue Cross Blue Shield. I swear, as I talked to them I could hear their leathery wings lazily flapping in the background as they sharpened their pointy tails. When I wasn’t busy trying to burst a blood vessel while holding a phone to my ear, I was scrambling to write scathing e-mails and letters documenting the fact that I was indeed partially paralyzed, and that the reason they call Progressive Multiple Sclerosis progressive is that it progresses, for God’s sake. Unless they could supply me with a magic wheelchair that could fly me to Lourdes, I wasn’t expecting to be going for a leisurely jog around the block any time soon.
Why they’ve given the name “Appeals Process” to the labyrinthine maze of bullshit they put me through is beyond me, because there’s nothing appealing about it. It should more accurately be called the “Appalling Process”. The situation only came to a resolution when an angelic RN, miraculously employed by the insurance company as my case manager (by mistake, I’m sure), interceded with her bean counting demonoid coworkers on my behalf. She has earned my undying gratitude and affection.
I’m a very nonviolent person, so mailing explosive devices to insurance executives is out, but I must admit to experiencing toe curling glee at the thought of a big box of ripe horse manure arriving on the desk of Blue Cross Blue Shield’s Vice President of Interminable Agony…
One man’s experience…
September 10th, 2009 at 9:43 pm
[...] friend the Wheelchair Kamikaze, who has written so eloquently about his experience with the insurance companies, objects to a study that finds that [...]
September 30th, 2009 at 1:37 pm
[...] Health care for the truly sick: A real-life example – the Wheelchair Kamikaze documents his experience coping with MS and discusses his awful experiences dealing with insurance companies [...]