I’m Dreaming of an HMO

The health care debate is probably the HOTTEST topic since former President Clinton got his cigar wet with Monica Lewinsky. Admit it. We ALL are talking about it. We ALL have a stance on it. We ALL want something done about health care in this country.

But let me ask you this…..who here has health care and is BITCHING about the plan Obama is suggesting? Just give me a quick raise of hands. OH, over 250 million of you. How many of you read my blog? How many of you think the health care plan Obama and Congress, who are insured by the way, are proposing is flawed?

Now how many don’t think the plan is flawed?

**ME, Waving my hand wildly!!**

Before you go and hit the unfollow with Google and Blogger here my political rant for just a moment. There are roughly over 300 million people in this country based on the 2008 U.S. census bureau, of that number only 47 million are uninsured. I AM ONE OF THEM.

You got it. I have no health insurance. NONE. Nada. Zippo. Zilch, Zero, Nine, nothing to cover my family for basic office visits, vaccinations, check ups and gasp accidents in the event one of my kids needs to go to the ER for anything major. So the proposal of ANY health care for ALL people is fantastic, awesome, superb, fucking great, fabulous, sign me up. You see the hubs and I had our policy cancelled by his employer back in May. We were told they would no longer supply group coverage to the employees. Okay. Not good news, but the great news was that the coverage sucked a goats tail so we were eager to shop for our own private, self-pay policy. We found one too. One that was roughly the same payment each month but better coverage. But that was clearly a pipe dream. Let me explain why.

Yesterday while checking my mail, like any other suburban, desperate housewife day, I saw a few letters from our “proposed” insurance company. I was eager to open these envelopes like Christmas Day was upon me. I truly wish I had not been so eager. Here are the contents of the first letter. Ladies please enjoy my limited coverage reasons….(click to enlarge so you can see)

Do you see it? Do you see the exclusions for my coverage? That’s right my tata’s. Everything that outwardly shows I am female, my bosom, that which nursed each of my three children. You got it, they will not cover me tata’s. But what I find funny in that, is had I not upgraded the girls to 2.0 I would be covered. So if I got breast cancer and a double mastectomy that would be covered, as well as the implants to replace the ones I lost, but did you know they won’t cover you again if you get breast cancer again in the event any traces of breast tissue are left? You got it. A double edged sword. Now DH, well he was declined altogether.

Want to know why?

Well in 2005 when he was stressed to the hilt with a new job, excruciating back pain, and other environmental factors, he was told he has high blood pressure. Sure most people, most NORMAL people have elevated blood pressure when in pain. A body’s normal reaction to pain, excitement, fear, we do not ALWAYS have perfect blood pressure. So when figuring out what was going on with him for pain, and getting a normal check up he saw a nurse practitioner. Let me repeat: A. NURSE. PRACTITIONER. Did you get that? A NURSE. Not a physician. Okay, so he sees her, she does a work up, does blood work, orders results, blah blah, takes said blood pressure. His blood pressure is ELEVATED. He explains his pain and environmental factors such as work stress, blah blah. She ignores this. She does not issue him to come back to see the DOCTOR to take his blood pressure again. She does not tell him, okay lets treat the pain (which we did ALL ON OUR OWN) and see what the pain management does for your blood pressure. Nope. She does what ALL health care practitioners do: ISSUE DRUGS.


Well this royally fucks your medical records, AND, AND they get their cut from the insurance companies, from the drug companies, they get bonuses, kickbacks, perks. The whole thing is a circle jerk of greedy bastards. You don’t believe me? Go see a shrink. In a 10 minute session you will be diagnosed with depression or anxiety and put on meds just because of normal stress and everyday conditions in your life that talk therapy could help ease. Go, see for yourself. I did. Ruined my life for TWO years. But that’s a whole OTHER blog post.

Said NURSE PRACTITIONER tells DH “Well, you are showing “SIGNS” of high blood pressure which may suggest you have a problem. Let’s write you a prescription and see how that goes.”

Now here is what I got out of that conversation “suggest” and “signs” which both tell me NO CLEAR DIAGNOSIS. No physician made any determination. No physician saw him. NO follow up to this appointment to suggest they look at him again. So here are the results:

You see there? Because he FAILED TO COMPLY with taking medication he is denied health coverage. FAILED TO COMPLY with something that was illegitimate. That was “suggested” not diagnosed, by. a. NURSE. Not a PHYSICIAN, A. NURSE. And so the health care saga continues where we now have to fight. Yes, we have to contact said DOCTOR’s office to COMPLAIN and FIGHT that a NURSE “suggested “a diagnosis based on a single visit. Not multiple visits, not multiple blood pressure readings, not after the pain management of his ruptured discs, nope, just a flat diagnosis. Which the health insurance company took for gospel. Can you see it? At the bottom? Sorry DH, no health insurance for you. So we have to visit said doctor WITH NO HEALTH INSURANCE, to get a clear diagnosis. Where we have to PAY the whole kit and caboodle. Sure we cannot pay like many others and let it screw our credit when they send us to collections….but that’s not how we roll.
Oh did I mention….this is the letter they provided to show you why they declined, or the reason for limiting coverage. You tell me…..where is my explanation? Oh, that’s right…if I want a legitimate explanation I have to request it IN WRITING. And, if I am lucky in 30 days they will comply and send me a fancy letter written on behalf of their legal department that is so cryptic that I need a VCR manual as my dictionary to help me decipher.
Thanks for playing Let’s Make a Health Care Deal.

I ask you….all of you…..ANY of you….the offering of a NATIONAL health care plan, which would be funded by tax dollars, is it really so bad? I mean you fork out thousands a year anyway in taxes AND health insurance premiums through your employer, why not lump it into one. Why not have the government regulate these greedy fucks who keep us healthy. Regulate the greedy corporate heads that run these insurance companies who determine whether or not we get coverage. Regulate care based on TRUE patient care and not quotas, bonuses, and kick backs! Hell give the docs a bonus for not seeing as many patients a year because we as a nation are choosing a healthier lifestyle, healthier living, healthier CHOICES! Give them a kickback for not writing as many scripts, for promoting wellness through healthier life choices such as diet, exercise, sleep, massages, fresh air, the REAL luxuries we want in life. We as a country were so busy regulating and deregulating banking that the silent thief that was fleecing all of us was HEALTHCARE. Health insurance companies, doctors, pharmaceutical companies. Did you know that they all still make and made profits despite our “recession”? Of course, health is big business, so why not bend us all over and not treat us to happy hour before hand, or at least a little foreplay.

What is even more funny is people talk about the costs of raising children. Some people are choosing not to have additional children because of the recession. What people are not telling you, is what the initial investment is to have those children. Not the lifetime commitment we as parents or future parents have agreed to, no, I mean the thousands of dollars we spend for OB/GYN care, delivery fees, physician’s costs, hospital fees. Holy cow I spent less to close my house than I did to close up my c-section for my twins!!

The debate about death panels (EFF YOU Sarah Palin…you have insurane right? Kthx, thanks for playing!), undocumented immigrants, semantics, rhetorics, who is and who is not a liar is complete MINUTIAE!! You want to know my death panel? Not having ANY health care coverage on my bread winner, DH, not having health coverage on the loves of my life, DH and my three priceless children. That is my death panel. But the best part about insurance, life insurance! Yup, my insurance agent is trying to SHOVE life insurace down my throat. I can see why. 1. He gets a large cut for commissions, and 2. Might as well get paid out on my dying family who cannot afford to go to the doctor right? Amazing! I am sure there will be a kicker there though, the life insurance will fail to pay for the fact that we were negligent with our health because we could not afford the $200 fee just to walk in the door to see the doctor to care for our illness.

I want to know…what is the fight really about? The ones who are fighting and arguing are the ones WITH health care coverage. You know who they are….all 50 members of each party of the Senate,(100total) all some 500 members of the House of Representatives (if I can recall 8th grade civics correctly), all 250 plus million of you, including senior citizens who are already on national health care…yes that’s right…Medicare is not private…government. Oh and the VA, the one that covers our soldiers, well that is government health care too…good enough for all of them right? The military, yeah they are government health care too, good enough to care for them and treat them and their families? Why not me?

Next time you go to argue about the health care debate, think about me, DH, Big G, Seth-en-stein, and my Little Bitty, who DO NOT HAVE healthcare coverage. Who cannot afford the exorbitant premiums of the private, self-pay health care, where the employer DOES NOT offer group health coverage. Next time you visit your doctor and pay your $20 copay, you think of me. How we are fighting to get coverage, the keep coverage, to afford coverage. Tell me….what is wrong with this picture!

9 Replies to “I’m Dreaming of an HMO”

  1. I'm with you 100% on this. I have no health insurance on myself of any kind. My daughter is at least covered by Medicaid due to a disability but if something happened to me who would take care of her?

    I understand that people get upset when the "status quo" is threatened but where would we be if things hadn't changed in the past? Do we really want to live like we did "back in the day"?

    Glad you voiced your opinions so that I had the opportunity to state my opinion also.

  2. TOML – I understand how people are afraid of change, we all are. I think that instilling fear and stalemating progress and equality and care to those who are our kin and brethren is ignorant! Why is it OK for them to all be covered but not my family?

    Amy – LMAO!! I hope the bill passes or some bill, something for the rest of us who will risk the loss of our homes, credit ratings, credit cards being maxed, and in debt to the hilt just so we can care for our children with the basics! THE BASICS! Eyeglasses in my opinion are a basic, so are well checks, vaccinations, paps, mamos, I wish our state senators and representatives were doing more to speak for us…the people and not worrying about their lobbyist partnerships and corporate backings.

  3. I love me tatas too! Those insurance guys can shove it…I'm more afraid of the food I get making me sick than my boobs. Hell that will be the only thing on me healthy and not as aged are my boobs!

  4. You should post a link to this on one of the conservative blogs. When I read the anti-healthcare reform posts on some of them I just want to puke. And I'm a Canadian!! Meaning I shouldn't care, right? Well, I do. I really want to see this bill pass for you guys. You deserve it.

  5. Oh yeah…one more thing….My DOG…yes MY DOG has health insurance. In fact, better health insurance than I had since if she passes, they pay for her cremation!! How about that for HORSE SHIT!

  6. Oh wow!
    I COMPLETELY agree with you on this.
    I too, am Canadian and our basic health care is *free*.
    We have to get insurance to cover glasses, prescriptions etc (which is only a couple hundred dollars per month for the entire family) – but at least we can walk into a doctors' office and see one when we want to!

    You need a better health care system and a proper maternity leave!!!
    We get 1 year paid leave here, and your few weeks sucks ASS!
    Wee babies need their mommas!!!
    Who's brilliant idea was it to rip them away from their Mom's at such an early stage in life??
    Poor Mom's has to work to pay for health insurance, right??

    {I'm praying for a better system for you, even more posh than the dogs' insurance!!!}

    You said it right, and if anyone unsubscribes – may their own insurance be declined too!!

  7. Over here we dont pay if we go to the national hospital or a poly clinic. We can get certain medicines free if say you are on high blood prssure pills for life. With the taxes we pay national insurance and it covers all…wether we go to the ER to have a baby or anything else. Doctors thanwe pay for them if we go to their private office, but we can get an appt same day and we have their home and mobile number for 24 hrs help if need be or free advice 🙂

  8. Personally I think that it is unconscionable that we have so many uninsured people in this country. And as someone who has insurance and someone who administers insurance, I think a public option to cover the basics and private insurance to cover some other stuff (like braces, fancy drugs, etc) would be the way to go.

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