In July I started on a long medical journey to save my sight when I started to lose vision in my right eye and I called Kaiser Permanente on a Saturday for an eye appointment, which it gave me within the week, with an optometrist. By Monday I determined that I needed more immediate assistance and I called back and after describing my deteriorating eye condition, it gave me an appointment for the next morning. Kaiser called me back that evening and told me not to eat or drink anything after midnight, never a good indication for an upcoming appointment.
Thank God I have excellent insurance, a byproduct of working for a quarter century for the federal government, one of the few so blessed people in this great, rich country where lifetime beneficial health insurance is so niggardly given out. The next morning, after my $20 co-pay, I was seen by a surgeon ophthalmologist who scheduled me for eye surgery that very day because I had several tears in the superior region of my retina and was losing sight in that eye rapidly as the aqueous humor fluid got behind the retina through the tears and was shutting my eye sight down. I paid a $75 copay and was rolled into vision saving surgery.
That surgery didn't take and on my week-after visit, where it was determined that my retina was "rolling up," I was slapped back into surgery that very day after paying another $75 copay and they surgery filled my eye with oil (which would have to come out later in a third surgery, another $75 copay) to keep the retina in place during the healing process. That third surgery to remove the oil was last week, and I went to the doctor's office today for the week-after checkup full of trepidation that I would be slapped into a fourth surgery if my retina was still "rolling up." As I silently sat as the doctor examined the inside of my eye with his lighted magnification helmet, I heard him say, "Looks good, the retina is still adhering full."
Relief flooded over me, because eye surgery and its onerous recovery (google Face-Down Recovery) sucks bigly. The doctor cautioned me that I'm still "not out of the woods yet" as I face two months of sedate living without lifting anything over five pounds and then another two months of non-strenuous activity. But I am so encouraged that finally I might be on the road to recovery in trying to save my sight, at least in one eye, no matter how diminished the sight in my afflicted eye comes out to be (right now it's 2400/20).
Showing posts with label insurance. Show all posts
Showing posts with label insurance. Show all posts
Thursday, December 20, 2018
Friday, September 2, 2016
Numbers
Following my retirement at the end of May, I ran 100 miles in June and 135 miles in July. My mileage suffered a setback last month though, as I underwent surgery on August 12th and had to take two weeks off as I recovered. (My last run, at 4:30 am, on the morning I underwent surgery at 6:30 am.)
Since the surgery, I have run 19 miles, slowly, to finish out the month of August, giving me 90.2 miles for the month. Happily, my weight was under 180 on the last day of the month, the same as it was on the day of the procedure. (Coming home from Kaiser after my procedure, thanks to friends who took care of me that day.)
The conditions the surgery repaired, a return of an umbilical hernia (I had the same condition repaired in 2011) and an abdominal hernia, took six months to be scheduled after diagnosis (I was complaining of pain in my abdomen during long runs) by Kaiser Permanente, my insurance carrier. That lengthy delay is unacceptable, in my opinion. (A cut here, a cut there… .)
The cost was acceptable though. I spent out of pocket about $235 all told, including testing and medications, although I'm pretty sure that's at least double what I spent out of pocket to have a hernia repair five years ago. (I'm back to running, albeit slowly and for short distances for now.)
Since the surgery, I have run 19 miles, slowly, to finish out the month of August, giving me 90.2 miles for the month. Happily, my weight was under 180 on the last day of the month, the same as it was on the day of the procedure. (Coming home from Kaiser after my procedure, thanks to friends who took care of me that day.)
The conditions the surgery repaired, a return of an umbilical hernia (I had the same condition repaired in 2011) and an abdominal hernia, took six months to be scheduled after diagnosis (I was complaining of pain in my abdomen during long runs) by Kaiser Permanente, my insurance carrier. That lengthy delay is unacceptable, in my opinion. (A cut here, a cut there… .)
The cost was acceptable though. I spent out of pocket about $235 all told, including testing and medications, although I'm pretty sure that's at least double what I spent out of pocket to have a hernia repair five years ago. (I'm back to running, albeit slowly and for short distances for now.)
Saturday, July 9, 2016
How Health Care Insurance Divides Us
Donald Trump's health care "plan" would throw 18 million people out of their health care insurance coverage if implemented, and dumb down the coverage for many other people who didn't have their health care coverage through an employer sponsored plan. That would be a shocking step backward for this richest nation in the history of the world.
As a person who was thrown out of a plan (Blue Cross/Blue Shield) myself in 1990 when I was in law school, because I had two sickly babies at the time (one had infant asthma and the other had constant chronic ear infections), plus a wife who was using covered mental health care treatment, I can tell you from bitter personal experience how devastating it is to lose coverage when you most need it. To listen to one baby rasp and cough all night, and another cry and claw at his ears all night, because I couldn't afford costly medication for them, tore my heart up.
Thank goodness a whole generation later the nation took the step to pass the Affordable Care Act (ACA or Obamacare) to get millions more covered even if they don't have jobs or have pre-existing conditions. But there are bitter opposing points of view also, as pithily expressed by a relative of mine who finds me an appalling liberal. Here's his view, in his own words.
What about us people making 20k a year paying 300 bucks a month with 12k deductibles? Haven't been to the Dr in 4 years but yet I am forced by law to buy a plan that doesn't help me or my wife. I have a college degree and 4 years experience in my field and still am not offered insurance (nor have I ever) even though I work 50 hours + a week. This is the work of the "Affordable Care Act" that your liberal prince forced through.
My insurance used to be $120 a month with $1000 deductible. We are far from there, and my situation is much tougher than yours. Please save your tears and bleeding liberal heart rants especially since you voted for me to be placed in this situation.
I'm actually a supporter of single payor coverage for all, along the lines of what Bernie proposes. I feel for the young man who expressed his view so eloquently in the two paragraphs above; the ACA has its significant flaws and persons in his situation demonstrate them well, but I consider it a first step to universal coverage.
Another relative spoke up on the perniciousness of our current health care system. In her own words in the paragraph below, she expressed support for our opposing points of view but common problem--cost of provision of care. Why doesn't close to one hundred cents on the dollar go to providing care for the ailing?
I hear you both! Since we are finger pointing, I will point my finger at United Health. The conglomerate insurance company, which also controls many clinics in my area is a prime example of conflict of interest. their so called insurance, which is primarily catastrophic insurance as it has a $6,500 deducible in network or $13,000 out of network, and we are paying $1,200 a month for this. We are supposed to get one preventative care visit annually, but when you see the doctor, he will say, this is a treatment visit, so it isn't covered. The whole thing is a racket.
The real villains here aren't liberals or conservatives but the greedy, for profit rapacious health insurance industry, the very types that threw me out of my existing plan back when I was a student and had three babies (2 needing care) and a wife undergoing covered treatment. That isn't a bleeding heart sentiment, it happened to me and I watched my babies suffer for it as we bought the care we could at full price and did without for what we couldn't pay for. Blue Cross/Blue Shield turned in a list of the top 20% users of the plan the prior year to the group I was covered under (a Farmers Coop) and we were all discharged from the group and our coverage lapsed immediately (and we'd just met that year's deductibles!). Bastards. I'll never forget those months of desperation seeking treatment for my sickly babies before after graduation I caught on with the federal government, a single payor offering a multitude of excellent plans to its employees that dispensed with pre-existing conditions even back then.
The health insurance industry, which stands between us and our health care as it pursues profits, is what divides us all.
As a person who was thrown out of a plan (Blue Cross/Blue Shield) myself in 1990 when I was in law school, because I had two sickly babies at the time (one had infant asthma and the other had constant chronic ear infections), plus a wife who was using covered mental health care treatment, I can tell you from bitter personal experience how devastating it is to lose coverage when you most need it. To listen to one baby rasp and cough all night, and another cry and claw at his ears all night, because I couldn't afford costly medication for them, tore my heart up.
Thank goodness a whole generation later the nation took the step to pass the Affordable Care Act (ACA or Obamacare) to get millions more covered even if they don't have jobs or have pre-existing conditions. But there are bitter opposing points of view also, as pithily expressed by a relative of mine who finds me an appalling liberal. Here's his view, in his own words.
What about us people making 20k a year paying 300 bucks a month with 12k deductibles? Haven't been to the Dr in 4 years but yet I am forced by law to buy a plan that doesn't help me or my wife. I have a college degree and 4 years experience in my field and still am not offered insurance (nor have I ever) even though I work 50 hours + a week. This is the work of the "Affordable Care Act" that your liberal prince forced through.
My insurance used to be $120 a month with $1000 deductible. We are far from there, and my situation is much tougher than yours. Please save your tears and bleeding liberal heart rants especially since you voted for me to be placed in this situation.
I'm actually a supporter of single payor coverage for all, along the lines of what Bernie proposes. I feel for the young man who expressed his view so eloquently in the two paragraphs above; the ACA has its significant flaws and persons in his situation demonstrate them well, but I consider it a first step to universal coverage.
Another relative spoke up on the perniciousness of our current health care system. In her own words in the paragraph below, she expressed support for our opposing points of view but common problem--cost of provision of care. Why doesn't close to one hundred cents on the dollar go to providing care for the ailing?
I hear you both! Since we are finger pointing, I will point my finger at United Health. The conglomerate insurance company, which also controls many clinics in my area is a prime example of conflict of interest. their so called insurance, which is primarily catastrophic insurance as it has a $6,500 deducible in network or $13,000 out of network, and we are paying $1,200 a month for this. We are supposed to get one preventative care visit annually, but when you see the doctor, he will say, this is a treatment visit, so it isn't covered. The whole thing is a racket.
The real villains here aren't liberals or conservatives but the greedy, for profit rapacious health insurance industry, the very types that threw me out of my existing plan back when I was a student and had three babies (2 needing care) and a wife undergoing covered treatment. That isn't a bleeding heart sentiment, it happened to me and I watched my babies suffer for it as we bought the care we could at full price and did without for what we couldn't pay for. Blue Cross/Blue Shield turned in a list of the top 20% users of the plan the prior year to the group I was covered under (a Farmers Coop) and we were all discharged from the group and our coverage lapsed immediately (and we'd just met that year's deductibles!). Bastards. I'll never forget those months of desperation seeking treatment for my sickly babies before after graduation I caught on with the federal government, a single payor offering a multitude of excellent plans to its employees that dispensed with pre-existing conditions even back then.
The health insurance industry, which stands between us and our health care as it pursues profits, is what divides us all.
Tuesday, April 15, 2014
Happy Happy
Today is THE day, the day I started working towards when I graduated from law school 24 years ago in my late 30s and went into government service. Being able to get my family of five, with two of three children with pre-existing conditions and a wife with expensive utilization of mental health provisions (we were kicked out of our Blue Cross/Blue Shield plan for using covered services), into the government's gold-standard health care plan (basically its single-payor, and it works mostly great), had everything to do with my mid-life career choice.
Only in America would the health-care industry boot an asthmatic two-year old toddler, a sickly one-year old baby and a panic-attack stricken adult out of their existing, fully-being-paid-for plan into Virginia's catastrophic individual family policy which I quickly found was an expensive (ruinous) joke akin to a pay-fully-for-everything-as-well-as-triple-the-former-premiums "plan." I'll meet those health care plan industry executives in hell, along with all divorce lawyers except my own, when I'm done with this life.
I hear the gentle patter of rain falling outside. It rained on my wedding day too, 37 years ago.
My three children, the ones I struggled to get proper health insurance for, for whom I purchased tuition plans for with them as beneficiaries that paid 100% of their college tuition and fees using money given to me by my mother, haven't spoken to me in over half a decade nor any member of my family in over a decade. Only in America.
In 2010 I took a retirement seminar just to see what the possibilities were despite knowing that I would have to work till I died after the five-year divorce litigation destroyed me financially pursuant to her nefarious and sick-minded plan. I discovered that the maximum enhancement for my retirement formula, insignificant as it might be, accrued on 4/15/14.
Any time worked past that date gilded the edges slowly for sure as the years droned on, but that date became emblazoned in my mind. It's here.
Almost all my college friends have retired or are retiring this year. But I can't afford to retire, yet.
After living through a life-altering modern western divorce, and the calamitous (in so many ways!) Dubya presidency, perhaps next decade, or next year. Or perhaps next month, or tomorrow.
But I'll go in to work today and keep at it, working under the supervision of my thirty-something managers. After almost four decades of work at jobs ranging from dishwasher to bartender, cop to lawyer, I know one thing foremost among many things--that managers are in it primarily for themselves.
My few friends who really know the workings of my mind say that I don't have a plan, I have a date. But it has arrived, hasn't it.
Only in America would the health-care industry boot an asthmatic two-year old toddler, a sickly one-year old baby and a panic-attack stricken adult out of their existing, fully-being-paid-for plan into Virginia's catastrophic individual family policy which I quickly found was an expensive (ruinous) joke akin to a pay-fully-for-everything-as-well-as-triple-the-former-premiums "plan." I'll meet those health care plan industry executives in hell, along with all divorce lawyers except my own, when I'm done with this life.
I hear the gentle patter of rain falling outside. It rained on my wedding day too, 37 years ago.
My three children, the ones I struggled to get proper health insurance for, for whom I purchased tuition plans for with them as beneficiaries that paid 100% of their college tuition and fees using money given to me by my mother, haven't spoken to me in over half a decade nor any member of my family in over a decade. Only in America.
In 2010 I took a retirement seminar just to see what the possibilities were despite knowing that I would have to work till I died after the five-year divorce litigation destroyed me financially pursuant to her nefarious and sick-minded plan. I discovered that the maximum enhancement for my retirement formula, insignificant as it might be, accrued on 4/15/14.
Any time worked past that date gilded the edges slowly for sure as the years droned on, but that date became emblazoned in my mind. It's here.
Almost all my college friends have retired or are retiring this year. But I can't afford to retire, yet.
After living through a life-altering modern western divorce, and the calamitous (in so many ways!) Dubya presidency, perhaps next decade, or next year. Or perhaps next month, or tomorrow.
But I'll go in to work today and keep at it, working under the supervision of my thirty-something managers. After almost four decades of work at jobs ranging from dishwasher to bartender, cop to lawyer, I know one thing foremost among many things--that managers are in it primarily for themselves.
My few friends who really know the workings of my mind say that I don't have a plan, I have a date. But it has arrived, hasn't it.
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