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 fornothing.

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.