Last month a sticky air mass slimed the east coast and dumped a gooey mess on my head that looked like a toasted marshmallow.
With my mind mired in goop, I became paralyzed from a crippling condition known as Constibraintion. When the creative cog gets stuck in a muddy rut of words because of too much input and zero output, writing slogs to a stop. Life has been overwhelming lately – doctors not doctoring, insurers not insuring and a blogger not blogging (me) because of technical crap. Nothing works anymore since Ludicrous fired Logic then stole her house in Malibu.
Seriously, when a basic logic theorem – all angels have wings, all birds have wings, therefore all angels are birds – can’t be applied to an insurance policy, sanity gets sucked into a wormhole, crashes into bizarro-world Earth and explodes upon impact, scattering DNA across the universe.
Sometimes on a clear night, you can see glutinous bits of brain cells light up the sky like the aurora borealis. I mean really.
My doctor is covered by my insurance when she’s at a hospital in the South Bronx but not when she’s at a clinic in White Plains. The reason my insurance company tells me – because hospital clinics aren’t covered even though the hospital that manages the clinic is. Confused yet? Let’s talk specifics.
Back in 2001, I was diagnosed with Multiple Sclerosis by a wonderful neurologist who was on my insurance plan at the time. She practiced at the MS Center in White Plains, New York, which provides outstanding services to MS patients.
I was one of those patients until two years ago when my husband’s insurance plan changed several times and the MS Center was not covered by either policy. I had to find a neurologist covered by our plan and then test drive him.
The doctor I found had a degree in neurology as well as veterinary medicine. I thought WTF, took him out for a spin anyway, then discovered he was a lemon.
He spent ten minutes with me, typed (or pretended to type) something on his rolling computer keyboard and then abruptly left the exam room. After collecting my records, I said, “Sayonara,” and hit the gas.
Sometime later, I landed in Mt Kisco with a new neurologist, Dr. Dunderhead, and a new insurance policy, Empire Blue Cross Blue Shield, where I received another quickie exam that lasted ten minutes, if that. Naturally,
I assumed at the time that the sub-par exam would be the worst part of the visit. But that was before Dr. Dunderhead Googled a question about Vitamin D3 and its relationship to gallstone development, of which my digestive system is in charge.
Since I was taking 3,000 ius of Vitamin D3 per day, this inquiring mind wanted to know if the dosage contributed to my digestive system’s decision to produce a gallstone without getting approval from the department head.
Meanwhile, my husband discovered that the wonderful neuro, Dr. Elkin, was on our insurance plan. But only when she practiced at Bronx Lebanon Hospital in the South Bronx, even though she still worked at the MS Center, a clinic managed by White Plains Hospital, which is on our insurance plan.
“Hospital clinics aren’t covered,” the insurance case manager said. “Dr. Elkin doesn’t practice in White Plains,” the hospital administrator said. “But White Plains Hospital is covered,” I replied.
“Yes,” said the administrator. “So all angels have wings, all birds have wings, BUT in this case, all angels are NOT birds.”
Click
So, I, and other MS patients like me, covered by Empire Blue Cross Blue Shield or a similar plan, cannot see Dr. Elkin at the more convenient, safer location without drug dealers and drive-by shootings, and have to schlep to the South Bronx wearing a bullet proof vest and helmet.
I never thought I could end up in a hospital after a trip to a hospital but in the South Bronx, where anything is possible, a logic theorem lies dead on a gurney from a gunshot wound.
Be afraid. Be very afraid. I am! My next appointment is in February. I’m hoping to get a stylish suit of body armor for Christmas.
What’s your healthcare horror story? (I should have posted this on Halloween.)
Thanks to Mike for the marshmallow prompt. Thanks to June for preventing my brain from melting. Thanks to Jayne for giving me a much needed, kick in the ass. Jim, thanks for being by my side during our trip through Oz.
I have an ongoing Healthcare nightmare too but, why worry, Obamacare is going to fix all of this. Yeah, Right!
I had terrible sinus pain and other stuff related to the flu. I went to the Minute Clinic where it was diagnosed as a Sinus Virus. Two week and it seemed to go away. 5 days of good health and it came back. That’s just not right!
When my head feels like a fishbowl, I cannot write either. Now I have characters screaming at each other inside my swollen head.
Where’s my Doctor? January, that’s where.
All of my Doctor’s other patients who are smarter than me, have booked him solid because they are scared to death that they will never see him again after Obamacare kicks in. Just today I read that United HC (my insurance) is kicking Doctors off they’re coverage programs.
Obamacare – I guess it’s not really paranoia if they really are out to get you.
It sucks when you can’t count on a doctor to do what he or she is supposed to do. And you realize halfway though the exam that they missed a semester of your malady. Geez!
I spoke with a doctor yesterday while picking up a prescription for my son. He told me that the healthcare bill was written by lobbyists, as all bills are these days, and that it benefits big business and will screw (not his words) the middle class.
When folks on the right and left stop fighting each other and realize that our government is being run by big business and not the people, maybe we’ll no longer be distracted by our anger and be able to take back our government by taking money out of politics.
Logic and insurance should not be used in the same sentence.
Let’s start a collection for your body armor.
The stories I hear about health care down here are policies being cancelled, insurance costs are increasing (always), the plans offered through the exchange aren’t all that “affordable”, and dependents have been dropped from policies (e.g. a spouse that has insurance available through his employer will no longer be covered on his wife’s insurance which was a better plan.) Oh, and employers requiring health exams and potentially charging “unhealthy” employees more for their health insurance along with a threat to drop them. Enough already!
Is it true that I will have to pay the fine for NOT having insurance because I’m on my wife’s insurance?
We both have United HC through AZ.
This seems incredibly unfair.
If you are on your wife’s insurance, then you have insurance. I don’t see why a penalty would be assessed. The case I’m referring to is that my friend has to either sign-up for an inferior plan through his employer or go to the exchange to see what he could find and then I would guess if he chose to not carry insurance, he would be fined. There may be more to it. It might be possible for him to justify why he needs to be covered on his wife’s plan. It all seems so complicated and crazy to me.
hah! Thank you! I wonder if I can shop online?
That’s seriously scary. My son and I are on my husband’s insurance plan. As I told Agent 54, a doctor told me the healthcare bill was written by lobbyists, not you, Agent 54, me or even our Congressmen. I can imagine the deal making that went on behind closed doors. “Let’s put lipstick on this pig, and they won’t know what it is until it’s close enough to stink.”
I know the healthcare run around can be very confusing and frustrating. My heart goes out to all (and their loved ones) who are dealing with ongoing healthcare issues.
My dad, who passed away in May, was definitely caught up in a healthcare nightmare. Each doctor he saw for the last year and a half of his life had their own diagnosis and treatment plans, none of which gave my dad the care he truly deserved. My sisters and I feel, had we been told the truth about our dad’s condition and prognosis to begin with, we would have handled things much differently. He would have received hospice care instead of ongoing hospital care. Hospice would have given the comfort our dad deserved and he would have died with dignity.
So sorry to hear that about your dad. His story is so awful and sad. I can’t imagine what you, your family and dad went through. Those doctors ought to be arrested for fraud. Your poor dad probably knew in his heart it was hopeless because of the way he felt and was confused by those charlatan doctors.
I was lucky enough to have had an excellent doctor before the other dumbasses that followed her. That’s why I knew I wasn’t getting the proper care.
My friend’s husband died from cancer earlier this year. She didn’t want to give up hope after the cancer returned. But her husband and his doctors knew better. He knew it was time to get his things in order and die with dignity. It was heart wrenching to see what my friend went through. But at one point, she realized she had to let go.
To not have the luxury of knowing the truth and be able to plan your life accordingly, is tragic and wrong. Sometimes it feels like we live in a third world country.
Thank you, Lauren. In my dad’s case, the doctors knew he was terminal when they hospitalized my dad for 4-5 weeks of radiation treatments. Finally, one of my sisters cornered the primary physician and got the truth out of him. Needless to say, it was physically and mentally agonizing for my dad as well as our entire family.
I can’t believe your sister had to corner the physician to force the truth out of him. I can’t believe he’s still practicing medicine.
I’m so sorry your dad’s illness was made worse by such incompetent doctors.
I’m afraid this all goes over my British (with a National Health System) head. I am constantly grateful for it too. Especially following my recent major op.
When you are sick, you don’t need added complications of who covers what and where. I feel for you.
You should be glad it goes over your British head! I’m happy to hear that a national health system works. Of course, the politicians here try to demonize your healthcare system. I don’t think you have the problem of money in politics to the extent that we have it here. Our government is run by big business and private donors. Whoever has the most money wins! So, we always lose.
Happy to kick your creative ass any time, girlfriend, but now I’m hungry for marshmallows. Sorry you’ve had such a time of it. I can’t speak for what’s going on anywhere else in the country, but here in California, where ACA has been fully implemented I’ll be saving $76/month for a much better policy than I had. I hope you’re unconstibrainted now. What a great word.
I’d love to learn more about why the California healthcare system appears to be working. I don’t know if the Republican run states are the ones having the biggest problems because they refused federal dollars. A neighbor of mine, here in Connecticut, said that he was kicked off his plan and has to get a more expensive one. Also, as I mentioned to Agent 54, my son’s doctor said that the bill was written by lobbyists. I totally agree with Phil about getting money out of politics. It’s the root of all our problems.
The people in the states that did not sign onto the ACA and set up their exchanges are the ones that have to use the federal site. Not coincidentally, those states have Republican governors. California began working on our website as soon as the bill was signed into law. Also, reports are starting to surface that right-wing hacker have been messing with the Obamacare website. Who knows what’s true anymore? But the states that signed on early and got everything ready in advance seem to be doing fine.
Lauren, first, I LOVE the way you weaved your story into the marshmallow prompt. Faaaaaaaaabulous! What a wonderful writer you are!
And I’m so sorry to hear you’re having a rough time right now. My mother went through this same thing with her healthcare. It was a nightmare!
Hey, I don’t think I knew you lived in White Plains. I visited there many times when I lived in NYC and thought it was such a beautiful area.
And you’re not going to believe this but I don’t have health insurance. I pay for everything out of my pocket. And thank god, I’m a pretty healthy person, outside of having some issues with old fillings and bridges in my mouth last year, which I had to pay for on a credit card. But it looks like I’m going to HAVE to get health insurance soon with this new Obamacare.
Thank you so much, Ron. I had posted on FB about having difficulty in writing and Mike gave me the marshmallow prompt.
I’m sorry your mom went through the same thing. It’s just absolutely disgusting that this country’s healthcare system is so dysfunctional. But dysfunction trickles down from Congress.
We actually live in Ridgefield, CT now but we lived in White Plains for about 13 years. Yes, it’s a great city. I miss it. Do you live in Philadelphia or near there?
I will knock wood for you about your health. It’s nice to know that you can get health insurance now if you need it. I hope Obamacare doesn’t destroy lives. The Republicans are doing everything they can to sabotage that parts that haven’t sabotaged themselves.
Yes, I live in Center City, Philadelphia, but I am SUCH a New Yorker at heart. I lived in Manhattan for five years. And hopefully one of these days I’ll be moving back. I miss it and visit often.
Like Babs, I am completely baffled by your healthcare nightmares Our national healthcare system is not perfect, but at least I don’t have to drive all over my province to see an approved doctor. And, when my son had pneumonia and was hospitalised for two weeks, I didn’t have to declare bankruptcy or sell my home to pay his bills. On top of it all, we do have insurance companies for the things that aren’t covered by our national system – chiropractors, podiatry, physical therapy, prescriptions, short- and long-term sick leave… So our insurance companies still make money.
I just don’t get that the US, with a larger population, can’t pull off something similar.
I’m completely baffled by our healthcare system, too, Nicky.
Canada and Britain seem to be doing things right despite what the fear-mongering politicians have told us about the horrors of a national healthcare system. It all comes down to dirty money in politics. But they should never launder it.
I hope your son is doing better. That is scary.
Good grief. The more I hear about America’s health insurance stuff the more I’m disgusted by it. I can’t believe that they are doing this to you and many others. Maybe the insurers should take the time out of their busy schedule to go to the South Bronx with you a few times, and maybe they might change their minds. So why not send them an invite which includes a nice dinner at the local cafe over there at S/B?
I’ve heard about the South Bronx, and I know they don’t mess over there.
I’m just so sorry that this is happening to you right now.
It is absolutely disgusting! I think I will invite the insurance nurse manager to take a trip with me to the South Bronx and kick her out of the car along the way. Great idea!
Give me back my gooey mess, please.
Hah! But that marshmallow doesn’t have any eye or nose holes.
Oh, Lauren.
I am so sorry you’re dealing with this nightmare. Really. It’s enough just being sick – but not being able to see your doctor unless she is in a specific location is totally ludicrous.
And, believe me, I completely relate to the Constibraintion.
xoxox
Thanks!!!! It’s absolutely ludicrous. I think I’ll contact one of the MS organizations and see if they can do something about it.
I’m glad you’re no longer suffering from Constibraintion. : )
That’s a good idea. Definitely contact one of the MS organizations to see if they can do anything about this.
So sorry to hear that you are going through this with your haelth Lauren. Hope you can get proper care and well soon.
The problem is that the healthcare system in this country is broken, and has been for a long time. No matter who is in charge on Capitol Hill as long as the drug companies and lobbyists are in the politicians pockets nothing will change.
We are the richest country in the world and everyone should have some sort of health care. It’s just amazing how screwed up it all is.
Thanks. I’m still going to the doctor in the Bronx. My husband drives there with me. I forgot to mention that if I were to see the doctor out of network at the MS Center, it would cost about $350 dollar.
You said it, Phil. The healthcare system is broken and Congress is broken. The only way to fix Congress is to take the money out of politics. It’s destroying our country.
I agree with you there Lauren, I think the moment we stop paying Congressmen so much is the day we might be able to move forward as a country. A lot of our current politicians are not motivated by helping the country/their constituents when it comes down to it. They enjoy the political game, and the money they can get from it. Hopefully something will be figured out soon to really get back to helping people, and not taking advantage of them.
There is a grassroots organization – https://represent.us/