Tuesday, September 25, 2007

I Hate Insurance Companies

You know, it seems such a fair and equitable deal at first: You (0r preferably, your employer) pay something like $4000 a year into a pot of money, with the knowledge that at some point you're going to get sick and use that money to pay for your medical expenses. Most years, you only use a teensy bit of that to get some Keflex for that nasty sinus infection you insist on catching from your wheezing co-worker each November. One of these days, he'll learn to cover his mouth when he coughs.

Some years, the Wheel of Fortune is not so kind and you get really sick, or you fall off the ladder while trying to retrieve your daughter's screaming rocket balloon that got lodged in the maple tree out front, or you get knocked up and have a baby. So those years, maybe you take a bit more than you put in. I think it cost me about $12,000 to produce my current offspring, including all the pre-natal, the c-section, and the realization that I'd totally effed up my life and the resulting trip to the funny farm.

So that's what? Three years' worth? And it was seven years ago?

My point is that when you are young, you pour a ton of money into this system, and I'll venture to guess that most of us are polite enough to kick the can or go on Medicare before we use it all up. I'd say the insurance companies, between what we don't withdraw from the kitty and the investments they make with our money while they're holding it, make a pretty penny on the vast majority of us.

So why the hell do they insist on this nickel and dime, we-ain't-gonna-pay-last-year's-rent attitude toward paying out what we pay in???

First, you can't stay in a hospital to recuperate from major surgery anymore. Nope. You say your children are not trained Physical Therapists with stay-at-home lifestyles? Oh, too bad. You have to go to a skilled care facility (a/k/a a nursing home) to actualy heal. Strike one.

Then, they restrict the places you can go for said nursing care. Is there a skilled care facility adjacent to your hospital? Sorry; they're not on the list. but there's a great place in this shack 15 miles away. Don't mind the roaches. They don't eat much. Strike two.

So your child, as a responsible family member, visits several of the places on the approved list, and deems one of them to be populated by caring humans and not too ill-equipped for your needs. You think you're out of the woods? Guess again. Now you have to convince the insurance company that you actually NEED this care and that your well-meaning children really AREN'T PT specialists. You say it's just a broken leg? Why can't you go home with a broken leg? What are you, some kinda WIMP?

Strike three.

After 12 hours of fights with the insurance company and extensive tours of 4 skilled care facilities (don't use the "N-H" word, please), Mom is finally installed in the least objectionable of them for the next week or so until she's strong enough to go to the bathroom and make a sandwich unassisted.

I'm exhausted, I'm frustrated, and I'm on the guilt trip of the century that she's not here already.

5 comments:

Michelle said...

I'm so sorry, Beth! *hug*

They (insurance companies) have the ability to kick us when we're down and worried about those we love and we are helpless in their clutches.

I know that many of those people are just doing a job to make a living for their own families but there also seems to be a certain percentage of sadistic @$$wipes who actually enjoy making people suffer.

There must be a special level of hell for them.

My thoughts are with you and your mom.

Alison said...

*hug*

bhd said...

Which is why insurance companies should be privately-held non-profits and not beholden to shareholders. Factor profit in there and the customer is going to get screwed every time.

But ease up on the guilt. This isn't an option. She needs what she's getting now.

And don't forget about getting help at your house when she moves in.

Beanie said...

Thanks everyone. I hate to kvetch, but this is all so new and something I didn't think we were going to face for another 10 years or so...

BHD: I think the insurance pays for a home health aide for a couple days a week...which, really, is all we will need if the PT ladies do a good job. We only have a few hours a day when no one is home, and I've already set up a couple friends and neighbors to look in. I talked to her boss about her working from my house part-time while she recuperates.


I went back this morning before work, to visit. They were falling all over her and she seemed somewhat content and even a little ornery. This is a good thing.

The PT director told me her goal is to have Mom in better shape when she checks out than she was before she hurt her leg. At least they're going to basically force her to quit smoking, exercise daily and eat something balanced. That's progress right there!

Melanie said...

but how is your voice? is it still there? I tend to raise my voice at those drones. I over react sometimes. :doh:

You are a capable and wonderful woman. You deserve lots and lots of hugs. ask for some. :hugs: