When Do We Want It? NOW! Unread! Not Understood! But WITH FEELING. TODAY.

Many of you whom, you must admit, do not work in the patient care industry have been plying me with “it’s not fair” questions lately regarding pre-existing conditions. “But the Pelosi Plan is sound, as it forces insurers to cover pre-existing conditions! Therefore, it’s good! Good, good, good! And you’re a big meanie for not trusting it immediately even though not one person in this country could possibly have had the time to read all 1,900 pages of it. Meanie!”

Newsflash: I HAVE FOUR PRE-EXISTING CONDITIONS AND I STILL DON’T THINK THE PELOSI TOME HAS THE ANSWER. Why? Because I actually work in health care. I have worked in health care for 19 years, mostly in billing, and I can tell you several other ideas just off the top of my head today, during a really fruitful discussion I had with a reasonable person, that have nothing to do with universal health care.

I was going to post a giant rant, citing a number of postings I’ve made on this subject over the past three weeks, but instead I figured, for now, since I am tired, it would be easier to post just my half of today’s conversation. If you have questions or comments, I am happy to elaborate in coming days, but I warn you, I can go on about this for weeks. And have.

The challenge was basically to defend the GOP health plan since it doesn’t touch pre-existing conditions. My response is below, but I’ve modified it a little for clarity to a wider audience:

I’ve been thinking about this since I actually have pre-exes. It makes sense to me instead that these either be covered by specific insurance groups willing to offset the risk with other ventures, charity, self pay clinics that specialize in certain chronic conditions at low cost (like my “special” doctor), HSAs (which are saving my arse right now) or a combo. 

The argument for not forcing insurance companies to cover pre-ex is because it would drive costs up for everybody, including regular old healthy folks unlike me, across the board (I’m healthy, but I have to take measures other people don’t to stay that way). 

If companies are allowed to come up with innovative ways to serve the pre-ex community, the market can better serve them, more cost effectively, than the government, without imposing on everybody. I know I have fibromyalgia and am perfectly willing to pay into an insurance group willing to offer fibromyalgia coverage. However, if you take for example your employer’s insurance (ours just got crappier with the rising costs), you are having to pay for the gal who can’t say no to a doughnut even though she has diabetes & heart disease. You are taking on her risk (which is why I think we should scrap employer insurance altogether and be allowed to purchase our own plans, just like car insurance). 

I have other friends in health care with chronic pain conditions or other illnesses who are also opposed to the Pelosi Plan. They want to pay for their illness, not a drunk driver who got in an accident and now has chronic back pain (or several hundred thousand of them). 

Even if something is not a lifestyle choice, there’re better ways to handle it than letting the government step in to control it. For example, my condition is just something that happens to you. I wouldn’t feel comfortable going on government care, because what is currently approved by the FDA (the government) to treat my condition is not only the most expensive drug to treat my condition, it’s also NOT the best! 

Now I pay cash to see a no-insurance doctor who treats a lot of people with FMS. He’s had me change my diet & take supplements to deal with my condition, and it’s improved dramatically. I take a third of the FDA approved rx than I used to, and I can exercise, think more clearly, and lift more than I was able to on the full dose of the meds. 

My neurologist, who is beholden to insurance rules as she bills my plan (which, like all private plans, is now influenced almost entirely by CMS guidelines), can’t go off label with my rx. She has a limited amount of time to see me since she contracts with Medicare & HMOs, & needs to get a certain amount of people in per day to make up her overhead. 

My cash pay doctor does not. In addition to this, although my out of pocket for him is way over my co-pay for my neuro, I spend anywhere from 1 hour to 3 hours with him. With my neuro, maybe 30 minutes if we get gossiping. Because he spends more time with me, he notices things I can tweak to make my life easier & more pain free. 

With my HSA, my cash pay doctor becomes 30% less expensive. 

So there are lots of alternatives to a big, expensive government health plan, even more than I’ve mentioned this evening. But keep throwing situations at me; I will try to think of ideas where a private solution could be better.

In addition to this conversation, I have to throw something else out there. Many of you might not realize that the Pelosi Tome also pays for abortions under a variety of conditions that you might not feel terribly comfortable with, and in fact, you might not feel comfortable paying for other people’s abortions at all. I do not; it goes quite vehemently against my religious beliefs. So the health plan is going to violate my first amendment rights because someone who was not raped or not in danger of losing their life didn’t use birth control? Really?

No, I can’t do that. You can make that choice. You can’t force me to pay for it. That’s not American.

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One thought on “When Do We Want It? NOW! Unread! Not Understood! But WITH FEELING. TODAY.

  1. Maeko says:

    Damn, you really did make me at least really start to question the whole Pelosi option. I was all for government option… but I think it should be just that, just another option in a sea of choices. Having insurance on an individual level, required like car insurance does make more sense. Everyone walking around who has health should have it, and if they get caught without it, then they should pay the consequence. That makes more sense economically for everyone.Of course, I haven’t worked in healthcare anywhere near as long as you, and I work on the insurance brokerage side, so I don’t even know anything at all…But you definitely got me thinking!Oh and the whole “Asia/California” thing sucks even harder when it comes from a fellow Californian. “Wow, you have great skin.””thanks.””Do all the people where you come from have great skin?””What do you mean?””Where you’re from, your nationality?””You mean, Canada?””No… where you’re from!””San Diego…?””Where’re your people from?””Canada… California…!””No, you don’t get it…””Uh, no, YOU don’t get it.”Assholes.

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