Tuesday, March 16, 2010

Cubist Weeping

The Weeping Woman - Pablo Picasso

I cried today because:

1. I spent the better part of it on the phone with the insurance company and the mail order pharmacy trying to unwind the knots created by said insurance company to deny payment of a treatment for my daughter's refractory seizures. I was transferred probably four to five times and spoke to five different people, each of whom did not claim responsibility for knowing what to do and each of whom asked me my name, my daughter's ID number and date of birth, our address and the last four digits of my social security number. The whole episode is going to be called Birth Controlgate

2. I am burnt out at this whole spectacle of a medical system some of us call "the greatest in the world." I had listened earlier to some inane discussion on NPR between economic healthcare academics and some jokers at the conservative Heritage Foundation, both of whom spoke on and on in the driest of tones about healthcare costs, etc. etc. ad nauseum, suggesting that consumers want and need to "shop" for their healthcare plans to get the most competitive rates and that hospitals should make their fees more accessible and public so that one can SHOP for the best rate, etc. and it was all INCREDIBLY INSANE.(and I might add here that I know what they were talking about and I'm perfectly aware of the luxuries we do have here in the U.S. of A and the lack elsewhere and there is a very large part of me that even feels guilty complaining about this sort of thing but humor me, humor me, humor me). At one point, the conservative guy from the Heritage Foundation compared the shopping to food stamps and cheese and milk and the fabulous job grocery stores do or something or other and I actually wanted to stop the car and yell at the radio or at the very least call in and speak, but it wasn't a call-in show so instead I thought about how FUN that would be, to actually shop around for the best place for Sophie to get treatment -- to see what hospital outcomes were, what each individual doctor's results might be, and then figure out what plan covers what doctor. GREAT IDEA! is what I thought, maniacally. 

3. I now have to track down The New Neurologist (no small feat when these neurologists are overwhelmed with patients and are part of vast university systems) or her nurse to get her to write a letter of medical necessity stating that the hormones she prescribed for Sophie are not for birth control, technically (this despite the probably mile-high folder on my daughter that the insurance company possesses). I can't imagine how frustrating this must be for doctors...not to mention the cost, the cost, the cost of the inefficiencies. The only way I feel better about this is when I resort to utter, scathing sarcasm and with dripping condescension tell the poor soul on the phone that my daughter, who has seizures all day everyday and also has her period is NOT SEXUALLY ACTIVE that it's not something I'm particularly worried about right now which leads me to the inevitable

4. I lost my temper with the poor little Bartleby with the Indian accent on the phone who works for Anthem Blue Cross. I didn't use any curse words, except for bullshit, I think, but I did tell him that he works for an unethical industry and I didn't know how he could sleep at night. I was loudly weeping at that point, in full drama mode, and I spilled out that my daughter right that moment was suffering from hormonal issues and perhaps this medicine would help her and the fact that Anthem just raised her premium by double but wouldn't take a prescription from an eminent neurologist from one of the biggest epilepsy centers in the country without her having to do a song and dance to get through the insurance company's group medical review board and I took a few heaving breaths but I was dead serious, albeit emotional. I can't even imagine what the poor guy felt. This is what he said, though:

I understand your frustration, Miss Elizabeth. 

So I'm not even sure they have real people working at Anthem, anyway, and I'm probably just another asshole who thinks such tirades are going to not just change our abysmal situation but the system itself. It's weird how all my meditation and trying to be zen-like goes flying out the window and I realize simultaneously as it's happening that this is a test, sort of, and either I'm passing with flying colors or I'm being beaten to a humble pulp.

I feel better, now. I've put off til tomorrow what I can't do tonight. And that is call The New Neurologist's office, tell the answering machine that I really need some help. Then I'm going to take care of Sophie and ensure that she doesn't get into any trouble.



    or not. maybe that won't help but you rock. you rock. you are doing a great job in a fucked up world and system. i have and am there with the health care denials, SO THERE, like bankrupcy there.

    and NO WAY but my veri word is:

    um God? that's kind of fucked up.

  2. I don't understand the US health care system, I don't think it is the best in the world, and having people make those kind of comparisons is ridiculous anyway as the point is to make the system work the best it can and provide good service, not compare itself to other countries as a defense for it's failings.

    The grocery store comparison pisses me off, but if people want to use that, then to remain competitive there needs to be efficiency and quality of service, not endless bullshit.

  3. Oh good lord. If we had the greatest healthcare system in the world, the loving mother of a severely disabled girl who has seizures every day would not have to sob into a telephone. Ever. Never Ever. I hate, loathe & despise these people who know nothing of the trials you and others face daily.
    I wish you well in your efforts tomorrow.
    Damn them.
    And I believe there is a right-wing lot to make getting birth control pills covered by insurance very difficult.

  4. I feel your pain and upset. It's always been beyond my understanding why such a rich country like the US doesn't want to provide free healthcare for all its citizens. It beggars belief.

    I hope your situation changes.

    Greetings from London.

  5. It's the best health care system in the world for share holders who make a fortune on other people's misery. For those who go bankrupt as a result of one single illness, or who are denied coverage or who cannot afford the astronomical premiums, the US healthcare system is more like a failure.

    It's hard to shop around when they don't let you in the store.

    I'm really really sorry that you have to deal with this BS. The injustice of it burns me up inside.

  6. All right- this is a complete and utterly ridiculous suggestion but is there a health department where women can go to obtain free birth control in your area? Or would the logistics of that be too weird and too crazy?
    Elizabeth, I just don't have any idea of how crazy-making the dealing with your daughter's myriad of problems must be and the suffocating layer of this, this INDUSTRY on top of it all must make you feel as if you cannot breathe, cannot move.
    I have so much to say and this isn't the place to say it but I will say this- I think Obama gets it and that he truly wants to do something about the insanity. And look where it's gotten him.
    I love you.

  7. I suddenly had a vision of you calling your local media and seeing you on CNN with shots of people in bars raising glasses of green beer to your courage.

    because it's all so insane. Too real and absurd .

    love to you

  8. How can the "best health care system in the world" not be dedicated to treating all citizens and strongly promote preventive health care and patient education?

    You, Elizabeth, have the ability to advocate for Sophie in the system. Admittedly, it is soooo frustrating to get out of them what she needs and deserves. What about those who don't have the wherewithall to advocate for themselves? Our system, in supposedly the greatest society on earth, is archaic!

    As I believe I have indicated before, we have the same federal health care that congress has. So, why am I so up in arms? Because I believe in health care for all and easy access to that health care. As it is now, doctors are very frustrated with the "hoops" they have to jump through which leaves them with less time to spend with their patients.

    If something isn't done, it can only get worse. And with our elected officials only looking toward re-election, it seems hopeless. Maybe we should be lobbying for eight year terms for all without possibility of re-election!

    Ah, thank you for an outlet!!!!!


  9. I swear those people we talk to after we push 1 and 4 and sit on hold...those people who I am not sure really hear you...and the best they can say is "I understand your frustration..." Really? How would they unless they walk in your shoes everyday...crazy. What happened to when you called a number and a real live human answered? That they even knew who you were when you said your name...

    My sister my marriage seems to do this little trick when she wants to bypass voicemails and such...she asks the Dr. for their email address or how best to reach them quickly or as needed because going through the normal channels doesn't work. And she gets that and never has a problem ...because what Dr. would say no...put in that position they just give it. Maybe ask for their direct phone line...cell number......all they could do is say no...but they will understand more about your needs and be more attuned to what you are going through when it comes to contacting them.

    I hope today is a more successful day and less stressful...

  10. ACK! I'm so sorry for all the time and frustration this insanity causes you (and so many others) ALL THE TIME. I like what Maggie May said though I'd never have the guts. I hope today is a better day and that you get this resolved and get a moment of peace. sending love!

  11. Sitting here, trying not to GRIND MY TEETH about this. When I read your posts about the abuses that your family suffers at the hands of the insurance system, I feel helpless anger and frustration for you. I wish I knew what to do or say! PPffthfttht!

    Elizabeth, if I lived closer, I would drop by your house with sweet treats from our Norwegian bakery and the best coffee in the USA (also nearby), and we would do whatever brought comfort to you. I would listen, or just drop the treats off and leave, or we would sit with Sophie so I could gaze at her beautiful face, and yours.
    I am so sorry about this injustice, and am sending bunches of love, like spring lilacs, to you.

  12. It is unbelievable how inefficient the whole system is and that every single person with whom you speak needs the same information--isn't that why we created computers.

    You are doing an amazing job--one question is if Anthem has any nurse case managers? I was assigned to one a few years ago for our son with multiple disabilities and it was helpful to have a name and number in the system but I fear that program may have ended

  13. Unfortunately, what you write here is so common. Urgghh. My mother currently has an outstanding medical bill from a physician who saw her for one minute (my aunt was in the room and observed this) while she was hospitalized. She didn't ask to see this particular doctor, and didn't medically need to have this doctor see her. I think it was one of those "cover our butts just in case" situations. So anyway, neither medicare nor her supplemental insurance will pay. But she has too. She is retired and widowed. We will have to help her out. And we are "in" the system - my husband is a physician and I'm a nurse-midwife. Every part of this system is about to crash, I fear. Maybe then we will have universal coverage. In the meantime, I hope you will be able to navigate this with some semblance of sanity. I like the script Maggie May wrote.



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