Pointlessly Dicking People Around Is the Point

SIx months ago I was in a closet, at Chicago’s Navy Pier, yelling into my phone at my insurance company.

I’d spent most of the afternoon at the type of hospitality-networking event I rarely go to, because while free food and drinks are great I HATE gladhanding and would just as soon be getting some real work done. However, this one had been useful, and considering the day started with a doctor’s appointment I was happy to spend a few hours shoving free mimosas and scallops into my face.

Then my phone started going off and I ducked somewhere quiet to take it. It was my insurance, explaining that a prescription I needed that day for a procedure I was undergoing the next wasn’t going to be approved because I wasn’t enrolled in the proper supplemental plan for this type of treatment. I was enrolled in the plan, though. It involved having a stupid conversation with a nurse twice a year, but I had done it, so what was the deal?

They gave me a number to call. I called it. I explained that I’d been enrolled in the plan for three years. The plan people verified that, gave me my enrollment number, and I called the insurance company back and said yes I am enrolled in your stupid thing, and here is the set of digits (scrawled on the business card of the scallop-and-mimosa people) that prove that.

Cool, we’ll put your order through. I went back to the party. Free margarita? Why yes, why not? Someone was demonstrating a Segway and somebody else was trying to convince passers-by to rent a Ferrari for a day for like $1,500. Everybody at this thing had nicer shoes than me. It was a fun world to visit.

The phone rang again. Back into the closet. Your prescription can’t be approved, because it wasn’t pre-authorized. I was kind of tipsy and in a good mood so I didn’t immediately lose it: Who needs to call who here? I needed to call this other number and speak to these guys. Okay. I dialed and was immediately subjected to a quiz on dosages of various drugs contained in the prescription order and how many dispensations of each, things my doctor keeps track of so I don’t have to. Have your doctor call us, the lady on the other end of the phone said.

Called my doctor. Left a message. Received one back that said, “The insurance company will only speak to the patient about this. Here is the info to give them.” I played the message three times so I could write down the whole list of stuff on my arm. Called the insurance company back and gave them the info. Frustrated, but still not at the boiling point. I don’t usually drink tequila so it hits me like a brick when I do, and I think that helped me not explode.

Back into the Louboutin-shod fray. A piece of cake was offered. A fellow at a table was talking about the extensive history of craft cocktails. The phone rang again.

“You appear to have been prescribed this drug X times before, and we are required not to dispense another dose until X number of days has passed because of our concerns about oversupplying medication.”

I explained, as gently as I could, that no one on earth would hoard this medication for any reason. It does not get you high, it has no street value, it is not even addictive. My doctor knows how much she has prescribed to me, and she has nevertheless prescribed it again. There is a guy out there handing around cosmos made with hand-squeezed fruit juice, I said, and I am stuck in a closet with you people right now because nobody in seven different conversations has been able to solve THIS issue?

The poor woman on the phone, whose fault this emphatically was not, was at an utter loss. I hung up and went back to the party. I got the card of the cosmo guy and we agreed to meet to discuss how he could best provide those drinks at events that I work. Then I left, and while on the bus home found the Twitter handle of the insurance company with which I’d been dealing all day. The tequila was wearing off and I was going from slow burn to Johnny Storm.

Only by harrassing them repeatedly and publicly all goddamn afternoon/evening was I able to get a semblance of an answer and get someone to just conference all the various parts of the insurance company together in order to sort out who needed what. And even after I did, and had the scrip in my hot little hands, all I could think of was what on earth would happen to someone who DIDN’T have an afternoon to spend dealing with bullshit like this?

What happens to people who work jobs that don’t involve going to parties and who thus can’t just slip away to make seven phone calls about their drugs?

What happens to people who think an insurance company’s no really does mean no and just give up?

What happens to people who don’t know about or can’t access Twitter to bully a service provider into providing that service?

What happens to people who are seriously ill, physically or mentally, and just CANNOT with all this?

They drop out, which I suppose is the point:

When my wife and I were first married and living in Iowa we were also on Food Stamps. At the time I made $6.40 an hour at a cashier’s job which only gave my 38 hours a week. My wife had to quit her job at the same store when our baby was born, but she supplimented my income by providing day care for other parents.

Every month we were required to provide the State with records showing our income for that month. And every other month — like clockwork — the State would send us a letter saying that our Food Stamp allocation had been denied because we failed to do this.

Every time this happened, my wife would call the State Offices and tell them “No we didn’t; check again.” And they would check their records and say, “Never Mind.”

And two months later this would happen again.

My wife was convinced that this was a deliberate ploy to intimidate people to drop out of the program. She may well be right about that.

Every plan to “Reform Welfare” that comes down always seems to be focused not on “Raising People Out of Poverty”, but rather “Getting People Off Welfare”. If they’re still poor, that’s not important; if they’re not on the rolls, they don’t exist anymore. Problem solved.

And so they put up more hoops to jump through; ostensibly to winnow out the cheats, but really they don’t care who it winnows out just so long as it winnows out somebody.

That’s what happens. People who are old, or sick, or poor, or not in the best shape, or working hourly during the only times when the offices are open, or who don’t have the time to read the 40-page form, or who simply cannot because of mental illness or general lack of wherewithal wade through the endless layers of bullshit you have to wade through in order to get any kind of care in this goddamn country at all, they get winnowed out.

We have created a series of systems at every level designed to discourage people from getting well and getting by. We have made it very, very, very hard, in order that the weak can die off and the rest of us can be comforted that there are “fewer people in poverty” or “fewer uninsured people’ when what that really means is more dead people, more sick people, who have just stopped fighting the fight you have to fight every day just to fucking survive.

I always say that my scenario is the absolute best case scenario in American health care: I have employer-provided insurance from a well-known company and I live in a state that requires said insurance to not treat me like a leper just because I have a reproductive system. I’m not making use of any state program right now to supplement or otherwise pay for my insurance, and I have, really, a minimum of forms to fill out and hoops to jump through. My illnesses are not acute or life-threatening. I am very lucky, and that state of unbelievable luck still requires me to deal on a regular basis with nonsense that makes me want to tear my own head off and eat it.

Right now Republicans are shutting down the federal government in order to protect people from a system in which that best case scenario will not change one whit. In which those of us who on a regular basis eat scallops and wear nice shoes and rent Ferraris can continue to do so unencumbered by any new rules whatsoever. In which those of us who see doctors we like can continue to do so, and continue to be able to bitch about all the ways in which insurance companies make things a pain in the balls all the time. They are fighting for nothing.

Nothing but the right to harrass people who are already at a disadvantage right out of the very systems designed to help them, when said systems do the job just fine on their own.

A week after I got that scrip I had to get another one filled. My doctor called it in, and an hour later my phone rang.

“We don’t have any record of your enrollment in our supplemental program …”

A.

4 thoughts on “Pointlessly Dicking People Around Is the Point

  1. Hobbes says:

    I got an IUD installed this summer (they probably shouldn’t have done a procedure that causes you to scream bloody murder in the room next to the one where the rosy-cheeked mother-to-be is getting her first ultrasound, but I digress). This involved three doctor visits: a consultation to make sure I knew exactly how this could possibly kill me and to make sure I really wanted the IUD that made your periods go away rather than the one that makes them worse, the actual installation, and then a five-minute followup to make sure everything was hunky-dory.
    Here’s how the billing went down:
    Appointment 1: Doc billed something like $150; $130 of it was “approved” (whatever that means), and the insurance covered $115. I got the remaining $15. Whatever, I can do that.
    Appointment 2: I never received a bill, nor a statement that it was even covered by insurance. I presume, however, because of what I know about ACA, that the entirety of this procedure was covered, which is good, because those little fuckers cost $843.60 without insurance.
    Appointment 3: Here’s the bitch. I got a bill for the entirety of this five minute “everything is where it should be” office visit, which came out to about $150 again. A note on the bill said my insurance claim had been denied, because “client could not be ide…” which I assumed (correctly) meant “identified”. Next business day, I called up the insurance company. No record of anything being claimed for a visit on that date; I should call my doc. Called doc; they had no idea, but the billing company should have followed up with that; I should call them. Called billing company, and after about ten minutes of waiting for their computers to boot (it was, admittedly, 8:30a) discovered that during an internal migration to a new computer system, they’d fucked up my group number. Corrected that, resubmitted the claim, and went about my merry way.
    WHY THE FUCK DID I HAVE TO DO THAT. It was entirely an internal error, not even on the part of my insurance company. What was I supposed to do if I didn’t have the time or resources to play phone tag with a bunch of customer service agents? What was I supposed to do if I couldn’t figure out what “ide…” meant? Despite doing nothing wrong, being completely 100% covered by a great insurance plan (thanks UW), I’d have been out $150 for a five minute doctor visit, which is TEN PERCENT OF MY MONTHLY INCOME.
    (Unrelated: My but the spammers are busy today.)

  2. MichaelF says:

    For about a decade my credit rating was virtually subterranean because my then-insurance company denied a claim…then retroactively denied every claim I’d made previously for various things ranging from checkups to minor surgery.
    Of course, I’d changed jobs, insurance companies, and had moved out-of-state by the time I got word of this wonderful set of decisions. And after about two weeks of the sort of phone tag that must be reserved for at least Dante’s eighth circle, I…gave up.
    I found out several years later — I think from an NPR report — that this sort of thing is pretty routine for insurance companies. Deny the claim, make it nearly impossible to appeal, and hope the person pays out of pocket…or accepts the black mark on their credit report.
    Nice, eh?

  3. greennotGreen says:

    I have great insurance that paid a *huge* proportion of my medical bills this last year – bills that started with $114,000 for surgery. But there were some weirdnesses , too. I had to inject myself with enoxaparin every day, and the insurance company would only pay for 17 days worth at a time. Like there’s some great black market for enoxaparin! I think they were just hoping I’d die quickly, and they wouldn’t have paid for many unused doses. When you’re very sick, getting to the pharmacy every 17 days can be a hardship.

  4. MapleStreeet says:

    You’re on the verge of getting a long sermon from me on how a single-payer , government insurance system (Medicaid for Everybody)would save hospitals, doctors, and patients by dealing with a single group of rules rather than a separate set of tomes for each insurance company.
    Not to mention, as a corporation, the Insurance Companies are required to make a profit. So anything they can do to deter you is added to the bottom line. The Governement isn’t supposed to be for profit and therefore much likely to be reasonable when compared with a insurance company (Of course I realize that many R-TX et al. seem to think that govt should privatize and make a profit from the people).

Comments are closed.

%d bloggers like this: