More Targeted Ranting

You know that one of my favorite topics is healthcare. This time it's a doozie, if we can ever begin to define doozie.

For those of you following at home, my new insurance has a $5,000 deductible, plus over $500 per month in premiums. I shopped Obamacare and found that my choices were very similar, so I went with a work plan.

I had to pick up a prescription the other day. This was at the only pharmacy chain I was permitted to use. The lovely lady behind the counter, flush with cleavage (moreso than most customer service people) rang the medicine up and hesitated, backing away from the register. This was a subtle sign that I chose to file away in the almost not-noticed category.

She asked if I knew I had a copay. Of course I had a copay, this was Obamacare. This is when I made my second mistake: "Hit me," I said.

Thirteen hundred and forty seven dollars.

I forgot all about her cleavage, which is something I cannot normally avoid and asked her to repeat it, in case I had stuck an icepick in my ear or had a lapse in my ability to comprehend numbers.

Thirteen hundred and forty seven dollars.

Thirteen hundred and forty seven dollars?

Thirteen hundred and forty seven dollars.

For medicine?

Thirteen hundred and forty seven dollars.

For an old, generic medicine I have to refill monthly.

Thirteen hundred and forty seven dollars.

Jesus tap-dancing Christ, to quote South Park. What have we come to? This is a negotiated preferred price. I cannot afford that now, no less monthly.

What exactly were the criminal Obama and criminal Congress thinking? Oh yeah, gifts for the insurers and Big Pharma<tm>. How are (semi-)normal people supposed to afford healthcare? I have bloodwork scheduled and I'm wondering if I should mortgage the house in preparation. HOW IS THIS INSURANCE?

My doctor recommended a few online sites. Friends recommended Canada. I wound up at goodrx.com. This is a coupon-based site that negotiates deals. It even works with insurance. You can only go to certain places but they are chains, like Walmart. According to the website, my thirteen hundred and forty seven dollar prescription would cost me thirty seven dollars. Really - thirty seven dollars. Gee, that's a bit of a discount.

Off to Walmart. The medicine was six hundred dollars cash. With the coupon, it was only about three hundred and fifty dollars. Even the most math-impaired among us will recognize that the discount price was about ten times the advertised price. The kind gentleman behind the counter, completely without cleavage, informed me that the 'discount' price from the website was usually incorrect, even to the ten times figure.

A call to the site yielded the fact that although there were seven options, none of them led to a human (even after yelling the F-word, which sometimes gets you what passes for a human). Each option recommended performing that action online. Emailing would take twenty four hours, which I did not wish to spend wandering around Walmart, even considering this was a twenty four hour Walmart.

My very patient doctor prescribed something else, which was ready in ten minutes, at about sixty bucks with coupon from goodrx. When I suggested strangling the people who voted for Obamacare, the doc said it was actually Big Pharma<tm>. That's a lot of strangling. The situation is so bad that the doctor didn't have health insurance. Digest that for a moment.

Contact your Congressperson and demand a workable solution. This can mean torture and/or starving for people who need healthcare. You think gun-related violence is bad now? Wait til people can't get their psych meds.


With concern and respect,
-lefty

You Call That Insurance?

They say to never blog while pissed off but I don't care. I don't even know who They are anyway.

I got a letter from my pharmacy insurer last week. Note that this used to be covered under insurance. The letter stated that I have to use a certain pharmacy or mail order or pay for it myself. My 'insurance' went into effect on the first of the year, so why wait thirty days to send me notice?

My benefits admin was very pleasant and called the pharmacy insurer with me. They kindly told me exactly what the letter said. I told them I support a local pharmacy, as I have for the past twenty years. Tough shit - you use THIS pharmacy or we don't pay.  Ooh, I forgot to mention that the pharmacy insurer has a two part name, the second part being the pharmacy I must use. Nothing fishy there.

I've flippin HAD IT.
(don't blog when pissed off)

My first effort against this travesty called insurance was to contact my congressman. He greatly sympathized with my plight and promised to vote to repeal Obamacare as soon as possible. For some reason, I did not feel helped.


I PROMISE YOU CAN KEEP YOUR DOCTOR

I am trying my best to state facts and not call people names; it's juvenile and counterproductive. (Even though I feel juvenile and want to release a fusillade of epithets in their general direction.) The fact is that the President and every Congressman who voted for this travesty should be thrown out on their asses. Better yet, they should have to USE Obamacare. A special version of Obamacare that involves $500 per week premiums and a $20,000 deductible. Let them live like the proles.

This alleged insurance is a scam, benefiting lower income folks, insurance companies and of course, Big Pharma<tm>. It is not my intention to offend any of you who fall into these categories - there are better ways to do this. We were lied to from the beginning. It's not insurance if it doesn't start paying until you meet your yearly $5,000 deductible. Any idea what it would take to do that? Perhaps being run over by a bus, if you manage to live. This would create its own unique set of issues because after you've met your deductible, the copays start, not to mention the emergency room fee, the doctor fee, the diagnostic fee(s), and $40 copay per gourmet hospital meal (featuring fruit from a can, vegetables from a can, mashed potatoes from a can, and chicken from a can). We will simply pay for every medical expense, all year long, unless, heaven forbid, we reach our deductible. And all this is mandatory. I don't care what the Supreme Court says; they have no right to compel us to purchase something.

I was out of my mind with rage over insurance years back, with premiums that rose up to fifteen percent per year. That seems like Disneyland by comparison.

Was it over when the Germans bombed Pearl Harbor? (Animal House)
It's time for ACTION. Yes, action. Let's get ready for it.
The only problem is what kind of action.
To start, we need to lobby Congresspeople. Write letters and emails. Call and visit their office to talk to their staff (they have staff to help people with insurance and other things).
We're fighting Insurers. We're fighting entrenched government and Big Dollar Lobbies.
We need to take a stand and the time to do this is now. The republicans promise to repeal Obamacare but I believe some of them voted for it. It's all a show regardless. Neither party will help us.



Don't even get me started on dentists; which your plan may or may not cover.

Hold Onto Your Ankles, it's Healthcare Time

I started my job a while back but just became eligible for benefits. This is stupid, as employers can grant benefits at any point. I have been delaying signing up because I didn't want to look at the coverage and costs.
It was worse than I thought.

WHAT?

The recruiter who got me hired gave me a benefits package, indicating that the least expensive insurance came with a two thousand dollar deductible.  Yes, you read that right - a two thousand dollar deductible! Sheer lunacy.  And this was the least expensive plan.

After further research, I realized that the recruiter gave me old information: the deductible was fifty five hundred dollars.  This is, quite frankly, not insurance.  It's catastrophic coverage for the price of very expensive health insurance. To back up a bit, health insurance used to cover hospitalization; you paid cash for doctors. When insurance expanded to cover doctors, rates went through the roof. As rates continued to skyrocket, HMOs were introduced. These promised to lower the cost of healthcare. They failed miserably.

Healthcare, to be truthful, is broken beyond repair.

WHO?

Some of our politicians decided to 'help' fix healthcare. This is never a good idea, yet the current occupant of the White House shoved his plan through. And he touted himself a hero.

And he IS a hero, to the two groups that benefit: the poor and the insurance industry, who won big on this gamble with our money. The poor get insurance, with a financial assist.  Who does the assist come from? Healthier people, who need less services, and people who make more than the poor, whose premiums are jacked up through the ceiling and have outrageous deductibles. The insurers benefit because everyone is required to purchase insurance (thank you Supreme Court) and the government is now the enforcement arm of the insurance industry.

Government has no place in healthcare, especially if it involves fixing things. I only have to point to Medicare, Social Security and Medicaid to make my point. Do you want these people involved with your healthcare? Look at socialized medicine in England and Canada - it's a mess there too. We shouldn't have to choose between messes.

In the end, Obama et al have not fixed the system: they've tacked premiums onto the mess. If he were truly interested in a fix, he'd have fixed the system, not created a new mess. But we know where his interests were. We also know that the insurance companies drafted the law.

I have a decent job, thankfully.  Unfortunately, a huge percentage of my income goes to healthcare already, for my wife. This is also due to the insurance nightmare, plus the same group of thieves who messed with insurance earlier and raised rates and screwed Medicare recipients via their Donut Hole, wherein insurance doesn't have to cover much medicine after a certain amount, no matter how sick the insured.  So we can add my wife's premiums and payments and non-covered items to my healthcare coverage, which turns out to be four hundred dollars per month, plus the aforementioned fifty five hundred dollar deductible.

The number one cause of bankruptcy is medical expenses. Fix THAT, Obama (and puppetmasters).


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There is simply no way to top that, so I'll just throw in a few Mental Health Musings:

• I’m depressed and dyslexic: it takes me forever to get out of deb.
• I long for the good old days, when bipolar disorder was manic depression.
• My wife has multiple personalities: they all hate me.
• My brother is a healthy depressed schizophrenic: the voices are too tired to speak to him.
• My other brother is a drunk schizophrenic: his voices just slur and tell him they love him, man.

MUSIC MAN SAYS...

My first guitar idol was the Ultimate Lefty: Jimi Hendrix. Jimi occupies a special place in my heart. He died in 1970, way too soon and way too early for me to have seen him live. The man practically invented rock guitar, no small feat. He also put Marshall amplifiers on the map (oh, is that why you named your dog Marshall?). We still have not caught up to Jimi.

There is no way to pick one great Jimi song, so I'll give you one of my favorites: Manic Depression. This song never fails to get me going - it should do the same to you, with it's catchy hook, great rhythm and a drumbeat that tends to confuse drummers.

There are precious few songs that reach down into me and make the hair on my neck stand at attention. This is one - Jimi's version of the Star Spangled Banner at Woodstock. No one had ever made those noises with a guitar before. Or since (I can do a poor impersonation).

Health Insurance or Let's Make Your Head Explode

Now that I'm sorta almost nearly employed, it's time to deal with the Evil Empire (no, not Comcast) - health insurance. For those of you who think Obama did wonders for the uninsured, it's time to crawl back under whatever rock from which you emerged.

I objected to government-run healthcare and I caught a ton of crap for it. I objected because nothing run by the government is a good idea or works correctly: look at Medicare and Social Security. The objection from the other side was that at least people would be insured.

The long and short of it, dear readers/plodders, is that Obamacare is a gift to insurance companies. You must have an Obama-approved plan or pay a fine. After some research, a fine would actually be better in some cases.

If you have an employer-sponsored plan, do the research. You'll probably find that it's cheaper with your employer. You will also avoid the dreaded Donut Hole [more later].

My previous employer (where the yellow brick road meets the duck pond) had good coverage at ridiculous rates. My new employer offers so-so coverage at ridiculous Obamacare rates. It makes my head spin.

So off I went, to healthcare.gov, to do my own research. Now I know insurance, from being in the field, being a consumer and being married to a Frequent Flyer. With all of my cumulative years of insurance dealings, after doing the research and going over the numbers, my head exploded. There are bits of cranium, red stuff and something that looks vaguely like cauliflour all over the ceiling. Have you ever tried to clean this stuff off a ceiling? With or without a ladder? In the dead of winter? Without so much as a pole?

The people who champion Obamacare will tell you that millions more people now have healthcare than before.  What they don't tell you is that in most cases, this is subsidized by everyone else. And they can have up to six thousand dollar deductibles. For all of you playing along at home, this means that the insured have to pay up to six thousand dollars before their insurance kicks in (twelve thousand for couples). People who have never had insurance before are getting the shock of their lives because they don't know what a deductible is. Yes, they are technically covered but most won't even make their deductible (unless they have a hospital trip in their future). So that's a monthly premium plus a deductible. You are paying for the right to pay your deductible (or pay a fine).

To be fair, one of my loyal readers is overjoyed with their plan. I must admit that it's a great deal and really helps my reader out.  There may also be a difference between states that have their own plans and states that default to the federal plan (mine).

Are you ready?  [drum roll]

I did some ridiculously complex spreadsheet projections to see what plan benefits us most. This was rather a shame, as I am completely incapable of ridiculously complex spreadsheet projections. One has to take into account the premium, deductible, copay for office visits (primary and specialist) and drug copay. Add a headache to your already-spinning head.

For a single guy about my age, the cheapest plan is about four hundred dollars per month, with a sixteen hundred dollar deductible. In the end, I will have put out an additional thirty eight hundred dollars on top of the premium and deductible (plus donut hole). I am by no means a large user of medical services. This kind of plan is good for younger, healthy folks or me.

But wait...

Now stop waiting. You can select plans with escalating monthly premiums. For a premium of four hundred thirty eight dollars and a four thousand dollar deductible, I would put out two thousand one hundred fifty six additional dollars. Plus donut hole.

There are a few other plans with cheaper monthly premiums and deductible so high that insurance would never kick in.

And if you think this is bad, try adding your spouse to the plan. It comes out over double the premium for a single person.  And if you think this is bad, I won't even mention the family plan.

And now your head has exploded, like mine, and your relatives/cohabitants/roommates are left to try to remove the stains from the ceiling.


WHO REALLY WANTS TO DO THIS?

I have a thing about being interrupted - it agitates me. The more interruptions, the more agitated I get.
So I'm starting my Grand Analysis and my wife jumps up to have a cigarette. I continue then ask for the cost of her meds. She leaps from the couch and starts watering a plant.

At this point, I'm getting the idea that she does not want to deal with this. I asked. She asked why I asked. I told her that it's important we do this and the fact that she keeps leaving the general area seems to indicate that she wants no part of this process.

Attempting to listen to my point, she sits down and her leg starts jumping around of its own accord. In her family, leg jumping indicates agitation and anger. When Dad's leg was moving, she needed to make herself scarce. I pointed at her leg, which she hadn't noticed. Even when she noticed it, it would not stop moving. I have to admit it was pretty funny watching her trying to stop it (and failing).

Further into calculating numbers, my darling picks up her phone and starts reviewing the calls. At this point, I'm quite agitated due to the constant interruptions (although neither of my legs is moving about on its own). Finally I had to pull out the Big Guns and ask if playing with the phone was more important than deciding on healthcare.  She finally admitted that she didn't want to do this.

Funny, neither did I.  And I pity folks who have little knowledge of healthcare and insurance.


DONUT HOLES

Far from being a tasty treat, donut holes are poisonous entities, otherwise known as gifts to insurance companies, installed by Congress as a Screw You to the populace.  And don't forget - Congress does not have to use this wreck they created; they have their own special plan that covers what ours doesn't.

Donut holes come with drug plans that aren't from an employer, for instance, all Obamacare plans. Your drugs are covered up to a certain dollar amount, then you fall into the donut hole, when the plan pays a paltry percentage for your meds. Another few thousand dollars later, you are again covered under the catastrophic portion of the plan.  If you are prescribed a lot of medicines, especially expensive ones, you are beyond screwed. It's cat food for you (which would be just fine with my dog but not me).

My parents hit their donut hole in October. My wife hit her donut hole in forty five days. And this magic carpet ride starts all over again in January.


OLD FOLKS

The Medicare set, along with the Disability set, gets Medicare insurance. This is a good insurance but it does not cover the entire medical expense. It also does not cover drugs.  For example, let's say the doctor charges you one hundred dollars for your visit. In the Olde Days<tm>, Medicare would pay eighty dollars (after deductible) and your additional Medigap policy would cover the extra twenty. But since this is most definitely not the Olde Days<tm>, it no longer works that way. Out of one hundred dollars, Medicate pays eighty (after a larger deductible) and Medigap, depending on plan, might pay ten, with the extra ten to come directly from your pocket.  So you need Medicare hospital and doctor (Plans A+B), supplemental/Medigap (Plan C) and meds (Plan D, after deductible, with possible pre-existing conditions).  There are also Medicare replacements, which encompass Plans A,B,C and D and have exclusions and weird HMO regulations.

There is also a late filing fee for people who don't get their insurance during Normal Signup Time. Normal Signup Time is a few days in December, between the hours of ten and eleven, at the Normal Registration Place, around the corner, in the sub-basement, in the secret room you must go on a trek to locate the key for.  Hint: beware of the anteaters; they're out to get you.

By the time my wife has navigated this mess, her plans cost two hundred dollars per month with a five hundred dollar deductible and an additional six thousand dollars out of pocket. This estimate does not include some meds, hidden deductibles, hidden costs, late fees, and a one thousand dollar mandatory tribute to the President and architects of this Insurance Wonder.

If you're wondering why I was unemployed so long, let me do the math for you.... I need to make approximately two hundred thousand dollars per year to pay for all of this. And this is before anyone runs into my car (with its five hundred dollar deductible).

I have to go now. My insurance only covers one cranial explosion per year, plus the ceiling cleanup is not covered by anybody but me.