WORKING THE PHONES

So this morning I had to call the insurance company. I went into it with the best, most positive attitude. Yesterday I'd sat down and read through my plan description for an hour, and was pleased to find that the latest round of denials (of all my prescription claims) was completely unfounded. My prescriptions are clearly covered. I was stoked up and ready to send in my appeal.

Before I can send in my official grievance, I am required to call Member Services because "usually concerns can be cleared up by just gathering more information."

That is, you call them and ask why your claim has been denied when clearly it should be covered, and some pitiable person with a lousy job tells you it's all perfectly reasonable for your claims to be denied and you are completely mistaken to think otherwise. Just one more step in the company's attempt to keep from reimbursing you.

It's all just part of the game, I've been through it many times before, and I know the poor person at the other end of phone is not out to get me, she just has a terrible job that she probably needs very badly, or she would have quit long ago.


INDIGNATION

Usually I pride myself on not losing it with this illness. Of course every now and then I do lose it-- I cry and scream and even throw things, but these occasions are rare, and getting rarer. Long ago I figured out that being angry about being sick is just a waste of energy. I'd rather enjoy all the things that are great in my life and deal with the myriad elements of sickness as best I can.

So why, two minutes into this phone call was I furious? I was shouting at this poor woman on the other end of the line, at a call center in Kansas, and I was close to tears. Tears of frustration, not just at the phone call, but for the ten years of my life lost to illness and the countless indignities I have to go through. Break out the violins!

Perhaps it was how nice and reasonable this woman sounded, like she really was a nice, nice person, the kind of person who would bring me raspberries from her garden if I lived nearby-- even while she was describing to me an entirely different set of rules and regulations that were nowhere to be found in my health care plan, and in this parallel universe where the prescription benefits administrators live none of the medicine that treats Lyme is covered, especially not the injectable kind, which of course is the kind I'm on like crazy and costs a fortune. She seemed puzzled that I didn't know about all these rules and regulations in her world, but ultimately she could do nothing. She couldn't even give me the address where I should send my appeal-- she told me to call a different number to find that. (Of course at the second number they told me to call the first again, but that's a different story.)


THE SYSTEM

In the whole discussion and debate about health care and the insurance industry, the thing that makes no sense to me is how people keep using the word "system" to describe the current state of health care in our country. I just would like to say, what system??? Perhaps Medicare and Medicaid have a system, but as for the rest of it, from what I can see and what I've experienced, there is no system. There is just a horse manure everywhere you go, with a few truly good people in the midst of it, such as Dr. Ross and Carolyn Humphreys, managing to help a few of their fellow humans.

When I hung up the phone I felt terrible for yelling at that poor woman. I'd already apologized to her several times before I hung up, having realized how badly I'd behaved. The worst part of it is I should be able to call up the executives running my insurance company and scream at them for an hour. I don't know if it would be productive, but at least my anger wouldn't be misdirected.

Instead I called my Congressman's office, and told the sweet woman who answered the phone that they should be sure they were working as hard as they could to make Meaningful Health Care Reform come true, because my insurance company was making me miserable. She asked my zip code so she could chalk up my call in the day's tally, and told me how sorry she was I was having a terrible time, and then we said goodbye.

I felt a little better.


DEMOCRACY AT WORK (THAT MEANS YOU!)

So here is my plea: Call your congressional representative.

If you are as miserable as I am with this or even if you aren't but you know me or you know someone else who goes through this stuff with the so-called system. Call and keep the pressure up so this legislature goes through.

It's not a big deal to call. They have people there whose job it is just to answer the phone when constituents call, and the best way to let them know you want change is by calling. Obama is the closest thing to a demi-god I have witnessed in my thirty-six years, but he can't do it all alone. We need to help.