Lets ride the Obamacare merry-go-round again!

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I swear, A LOT!

Especially when I’m having to deal with the complete and utter Bullshit that Obamacare is causing in average folks lives.

But I really start swearing when I’m having to clean up the mess Obamacare has introduced into my nice neat life. For the second time in less than a month it appears that my insurance is in an indeterminate state.

The primary hitch seems to be in the prescription coverage.

I spoke to a nice young lady a few weeks ago and she gave me the proper string of numbers and letters to have a prescription filled. I found out today that string of letters and numbers doesn’t work anymore.

Which loops me back to the problem that I was trying to solve several weeks ago that required me being on hold for 5 hours or so.

At the time I asked the nice young lady if there was a problem with my policy. She said nope, you’re paid up until March.

Uhh, it’s Feb 3rd and apparently there is something wrong with my insurance.

I’ve now been on hold for another hour and aside from the same repeating loop of music and a female voice saying,

“All agents are still assisting other callers please continue to hold and your call will be answered as soon as possible.  Thank you for your patience.”

Nothing much has changed.

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As I sit here on hold I realized that if someone was trying to sort out this problem from their place of employment, they’d have to take a day off from work.

Think about the people in retail or the waiters and waitresses. Do you think their employers would accept the fact that they need to be on hold for hours on end just to sort out getting a prescription for their sick child?

Why should I as an independent business person have to ignore my clients and not get any work done because I’m dealing with Obamacare or the ramifications of Obamacare?

Does all this lost time get factored into the cost equations of implementing Obamacare? It should!

The boondoggle of Obamacare is not only canceling insurance for people that were previously insured, it’s creating a backlog of clients like myself who cannot get assistance when they need it.

People signing up doesn’t mean jack shit if those people can’t actually access the policy or services that they’ve bought and paid for.

Sarah Palin was wrong, there won’t be death panels.

There will simply be people dying of neglect. If you’d like to see how that plays out I suggest that you get hold of a movie called “The Hospital” sorry it’s not available on Netflix.  The movie has, George C Scott, Diana Rigg, Barnard Hughes, and Richard Dysart. It was made in 1971. The blurb on IMDB doesn’t sound like much but it’s really well done.

Well this time, it turns out the computers cancelled me on Jan 1st.

Might have been bloody nice if they’d told me I was cancelled. Of course that cancellation wasn’t supposed to have happened. Then again neither was my migration to another policy that wouldn’t have taken effect until March of this year, leaving me with no coverage for 2 months.

Again it would have been really nice if the insurance company had, oh… I don’t know, MENTIONED something to me about it.

Instead my only indications were that I suddenly didn’t have prescriptions coverage. Thank God I didn’t need to go to a hospital.

All this has been absolutely wonderful raising my blood pressure.

Everything is sorted out until Feb 15th When I get to go through another enrollment process and figure out if I’m eligible for subsidies.

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Subsidies?!?!? to pay a bill that I was capable of paying without assistance before Obamacare. I’m very confused about that. After all where does the money for subsidies come from?

Oh yeah from our tax dollars.

I guess this is what redistribution of wealth looks like.

Thank God for Obamacare. (NOT!)

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What follows is my personal experience in the odyssey of trying to obtain and / or keep health care insurance.

In March of 2013 I obtained a personal healthcare policy at a substantial savings over the nearly $700 dollars a month I had been paying under COBRA.

Yes, I was unemployed, I still am unemployed. Make no mistake, my unemployment isn’t for lack of trying to find something. I’m old (in my 50s) so obviously I’m not employable anymore and everything I know about anything is of course null & void.

I’ve applied to retail places, I’ve applied at Apple as a retail store clerk, I’ve applied at places that I should have been a shoe in. But nothing has led to my obtaining gainful employment.

So here I am, unemployed, with no unemployment benefits. I’m still paying my bills by using my 401k and being eaten alive with the penalties incurred from early withdrawal of funds.

I’ve got scary amounts on my credit cards and I’ve been just trying to hold out a little longer.

Ok, maybe I’m a foolish optimist, maybe, I should have cashed out and moved to South America or Indonesia when I could live for a good long time on the cash I have, and simply checked out of the rat race.

I haven’t, I still have hope. I still believe there is a place for me in the society of my birth. Albeit I’m starting to question that belief.


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In November or December I received a notice from Anthem saying the due to Obamacare my policy was going to be cancelled.

I called Anthem and was told that due to the lateness of the notices, I had the option to extend my policy to February.

I thought “Cool” that will give the whole Obamacare rush and ensuing nightmare scheduled for January 1st, time to settle.

There were, and still are so many unknowns about the way that Obamacare is going to affect the health care industry I figured by mid February the information would be more available and I’d be better able to make an informed choice as a consumer.

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So I told the Anthem representative I wanted to take the option. The representative said “excellent”, took some additional information and we terminated the connection.

Flash forward to yesterday. A routine monthly RX was suddenly denied. The pharmacy says that I need to show them a new insurance card, which I don’t have.

I’m thinking WTF?

I do some checking and find that the Anthem automatic deduction from my checking account didn’t take place. It usually happens within a 5 day spread we’re three days past that 5 day spread.

I’d noticed the billing was late but hey it’s January and they have to be busy as hell thanks to Obamacare.

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Apparently, I’m now in an indeterminate state with my insurance. I’ve spent the past 4 hours on hold trying to reach an Anthem representative and had the call dropped 5 times.

This is not an issue I can fix on their damn web site, or via their voice recognition computer, I need a human being because something has clearly gone awry but I have no capacity to correct the problem (whatever that may be) by myself.

I did get a letter of explanation about why my original policy had been cancelled.

I apparently absolutely must have pediatric dentistry as part of the policy.

Since I have no children, I’m confused about why my health care policy was canceled to force me to add a service I will never use.

There have been reports of other single men across the country having their policies cancelled because their existing policy didn’t cover mammograms, pap smears, and other related singularly female issues.

My Anthem Dental policy recently FAILED to cover any part of a necessary treatment like a crown and refused to cover a necessary filling. But my new policy will, by God include pediatric dentistry.

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I’d already decided that I wasn’t going to do a Dental policy when I selected the Obamacare approved policy in February.

My current Dental policy was costing more yearly, than the cost of 2 cleanings and once yearly X-rays, if I were to pay for these services out of pocket.

Since it didn’t cover much in the way of other dentistry I figured why bother? I’ll shop around for a dentist on my own and we’ll figure out a reasonable price for services on our own.

I’m confused by all these required services being required in every single policy. If I were to get married I’d review my insurance policy and make appropriate changes. If I were to become a father I would again review my insurance and make necessary changes.

In point of fact, these LIFE CHANGES have always been accommodated in corporate policies regardless of open enrollment periods.

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I find myself completely confused and pissed off because Obamacare is screwing over the healthcare system. for the sake of maybe 10% of the population. But the other 90% of us are being absolutely FUCKED.

When I say FUCKED, I mean hard, fast, and dry!

When I found out there’d been a problem with my RXs, I asked the pharmacist what’s it going to cost for me to just pay for the stuff I need? The answer was astounding, $297.00!

And that is for generics!

I thought generics are supposed to be cheaper. Which led me to wonder what the “real” drugs cost. Would I be better off going to Tijuana and filling my RXs there? Or should I contact a Canadian Pharmacy and have a lovely 3 day weekend in Toronto once every six months?

OH Wait… That’s right, our FDA says the Canadian Drugs or Tijuana drugs aren’t the same, or as safe as the American versions.

Right! We’re expected to believe this in light of the defective Warfarin from China a few years ago?

Or the Oxycontin debacle, or the Indian drug company that had glass in it’s Statin products.

Or the other Indian drug company whose drugs were not at the correct concentration, or even the correct drug in some cases, or otherwise contaminated?

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The FDA is full of shit and obviously in collusion with big pharmaceutical companies. But the FDA still wants us to believe American drugs are somehow safer than their foreign counterparts.

Uh, sure, yep, I’ll believe that.

In a pigs eye!

As I move into the fifth hour on hold I find myself wondering why I, and apparently a large chunk of average American citizens are being punished to provide insurance for a relatively small portion of the overall population?

It would have been far easier, and certainly more direct for the federal government to just PAY for all coverage for that part of the population. Or the government could have required that the insurance companies pay for the uninsured population out of their obscene profits. That would have had the same effect.

Yet we have a congress that apparently passed Obamacare without reading it.

Those members of congress that did read the law, raised objections and have subsequently been painted as some evil caricature of satan because they actually did their job and questioned the far reaching impacts of the law.

Any average citizen who questions the effectiveness of Obamacare is similarly painted as a racist, GOP RWNJ (Right wing nut job), and evil beyond all of Satan’s inner circle.

Discussion of the subject is more forbidden at the holiday table than religion, politics, or the next superbowl winner.

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Many in the medical profession have been warning of massive disruptions in medical care and irrevocable changes or damage to our system that will likely leave our healthcare system in shambles.

Doctors are retiring early because they see a situation where they will not be able to provide their services without such intense government intrusion that compliance with government regulations will trump patient consideration.

I myself am once again looking at a 700 per month bill for insurance (per the conversation of December.) But my policy isn’t substantially changing.

After SIX hours in a hold queue I finally got an operator who had stuff on the ball and who was able to help me. Yeah, you read that correctly. SIX hours!

I still didn’t get all the stuff done I needed to with regard to the routine maintenance of the policy. But I was able to get the correct numbers to get the RX filled.

I’m grateful to that lady and I hope she had a great day.

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As far as the rest of it?

I’m really starting to believe that Obamacare should be terminated before the damage done to the healthcare industry is irrevocable.

Of course since I’ve said that, I’m automatically a rabid, racist, gun totin, GOP RWNJ.

Hey ultra liberals, you may want to be very careful how you paint me. I might decide to own it.

 

 

Lies! more Lies!

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I wasn’t going to comment any more on this Obamacare debacle but each day there are yet more revelations that just cannot be allowed to pass.

In addition, yesterday I got the letter I’ve been waiting for.

My other half got a similar letter last week describing that their group policy was being cancelled as well. We’re both scrambling to figure out if it’s better for us to have separate policies or to combine our coverage.

Apparently, our insurance policies are so called “Crap” policies according to wondrous Obamacare.

I’ve got time until my policy is gone, and I have to figure out what to do.

I spent some time on the phone with the insurance company and I found out a couple of interesting things.

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The first is that MY PPO plan may not allow me to go to my Doctor of many many years because he’s in a different county and therefore in a different provider net called EPO.

The implication being that unless you’re very careful you could find yourself having to see only physicians, specialists, and going to hospitals that are in your county if you don’t have compatible provider networks.

I told the lady at the insurance company that if my choice was to go to my doctor OR to have insurance… I choose my doctor, I’ll pay out of pocket, insurance be damned.

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How does restricting my coverage to a specific geographical area benefit me? Would I have insurance coverage if I was traveling out of state?

I’ve written before about my preference for doctors whose First language is English.

I have vivid memories of waiting in my Kaiser hospital waiting room in Fontana believing I was having a heart attack, and not hearing a fucking word of English. NewImage

I might as well have been in a hospital in another country. Then when I finally got to see a Doctor (if that’s what he was) I couldn’t understand him due to an unbelievable and unintelligible heavy accent.

He finally called a nurse in who explained in Spanish what was going on.

My Spanish is poor at best, but since I have some scientific grounding I was able to “get” most of the medical stuff that she was talking about  because I remembered the rudimentary Latin I’d learned as a kid.

Really?

My only choice was to rely on my understanding of a dialect of Spanish that she wasn’t speaking (Mexican versus Castillian) and routing the medical jargon through a dead language?

My Kaiser plan was cancelled the very next day!

I paid out of pocket for medical care until open enrollment at my company, then I went PPO.

There are those who would say I’m racist.

I disagree! I’m about survival!

If I can’t understand what the doctors or nurses are even saying how can I possible be engaged in my medical care?

If I don’t understand their instructions how can I comply?NewImageWorse, if these folks don’t understand my complaint how the hell can they make a diagnosis?

This is still America, like it or not The Defacto spoken language is English.

I don’t think it’s racist at all for me to insist on speaking the language of my birth, the language I was taught in school, and the language printed on all the streetsigns.

I’m even less charitable when it comes to medicine. The wrong shit, taken the wrong way 

CAN KILL YOU!

Now it looks like PPO no longer has the advantages it once had.

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It looks like I’m not alone in discovering a certain “Regionality” to the coverage plans. Reports are cropping up of hospitals and doctors being excluded from networks. Ostensibly this is a cost cutting move. The reality is far more sinister.

If I’m on a Bronze plan, then presumably I’ll be limited to Bronze plan network providers. If I’m on a Gold plan, I’ll be limited to Gold plan providers.

Dollars to doughnuts those lines and restrictions will draw rather stark lines between rich & poor.

The practical application of this could mean that all the poor folks from South LA get sent to Martin Luther King Hospital, which in recent years was on the verge of being closed due to inferior care. The rich folks in the gold plan will be sent to Cedars Sinai.

You want to talk about something hideously wrong? There’s your talking point. Wasn’t Obamacare supposed to be egalitarian?

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Obamacare in it’s current implementation lends itself to government sanctioned and enforced Classism.

Taking that thought to an obscene conclusion… Obamacare could enforce and create an underclass of people for whom inferior medical care will be the norm. A “Worker Class” if you will.

The most frightening thought is that this system eventually creates a dystopian world of “haves” and “have nots”.

The “have nots” are disposable and always underperforming because their health problems will be greater in number.

They’ll be absent from their jobs more. Their survival rates after an accident will be lower than their wealthier counterparts.

Leading to elites asking, “ Why spend a lot of time or money training them, they burn out like lightbulbs and are replaced just as easily. ” 

I doubt we’ll see this in the next 10 years but what about the next 50? We already have people on both sides of the political aisle who’re telling the American people in effect “ We’re better educated than you. We know whats best for you.”  NewImage

You could argue that to some extent we have this classism now. You’d be right.

However, hospitals must take anyone in an emergency today. A person who needs specialized care, even on the lowest tier of a “Crap” insurance plan typically is allowed to go to the hospital where they can obtain the care they need.

They pay their insurance deductible and 20%, 30% or 40% of the treatment bill and that’s it. Yes there’s a financial hardship component to this system, there is no denying it.

Being OUT OF NETWORK means that even with insurance, I still have to pay 100% of the specialist bill. This is not an improvement over the current system. In fact, this is beyond reprehensible.

When someone manages to explain how this works to the poor, Obamacare and the presidency of Obama will be over. The Presidents already low approval ratings could well drop to zero (That would be interesting to see from a historic perspective.) Any Republicans or Libertarians reading? Here’s your chance, to engage across class boundaries.

Then as I pulled at the frayed threads of the new policy offering I discovered this…

My monthly payment will probably go up, as will my deductible. My RX coverage even for Generic drugs will be reduced or eliminated.

WTF? I thought Obamacare was supposed to make insurance more affordable – not less.

I think that Obamacare will break the back of the insurance companies and the medical profession.

When the experiment is finished we’ll all be worse off than before, and Americans may well be dying in their beds from simple treatable illnesses because they can’t afford the costs of insurance AND treatment.


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Then I think about the Obamacare web site and my head explodes again.

I’ve worked in Banking, and Mortgage Insurance. We, and by “We” I mean relatively small groups of developers, testers and analysts built systems that facilitated the earning, control, or transfer of literally BILLIONS of dollars per year.

It was not uncommon for the teams I worked in, to have 4 major projects per year and those projects interacted with customers and in many cases various governmental agencies.

For someone in my position, my head explodes with each new revelation about the manner in which the Healthcare.gov website was created, If ever there was an excuse to fire a group of people this is it.

Best practices for web design and implementation are printed in books, available from Amazon, Barnes & Noble, and Apple. The first two vendors will sell you the books as a set, in hardcopy. You may not know how to code a website… but you damn sure can learn how to manage a website project.

This is not new technology, webs sites, and e-commerce sites are well understood and there are literally millions of people in this country with the correct expertise for a project like Healthcare.gov.

Many of the people with this expertise are/were unemployed!

The revelation this morning was that as much as 60% to 70% of the backend of the Obamacare site hasn’t been written.

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Screech!!! Wait! What!

Primary accounting functions, Transaction functions haven’t even been written!

So what HHS is saying, is the website that has been broken from day one… doesn’t actually connect the user to the insurers is a really useful way?

Yet to interact and shop on the site you have to enter all kinds of personal data, Then the site is incapable of taking the consumers payment information, supplying the insurer with that payment and applying the subsidy if applicable?

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What the hell? Just what have these contractors been doing for the past 3.5 years?

I know exactly what they’ve been doing…

The various contractor groups and the HHS Department have been involved in a clusterfuck of inter-office politics. No-one was in control, yet everyone thought they were top dog.

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Every one curried favor and allies and then tried to figure out who’s was bigger.

All the while saying that they were tightening budgets and hiring people who met EOE regulations even though the people they hired weren’t the best people for the job.

But there were no specifications about what the freaking website was supposed to accomplish and how.

There were probably people like me asking why? Those folks were shusshed and told that they didn’t understand the process.

There were endless reports written, powerpoint presentations given and lots of self congratulatory back slapping.

Meanwhile the specifications were too specific about irrelevant issues like the manufacturer of the resistor at location g239 on board 12 of the servers being used to host the website. And not specific enough about what the button on the screen labeled “Submit” was actually supposed to do.

The folks like me were  probably pointing out, in corporate America that heads would be rolling down the hallways.

The govt contractors and employees all just looked at them astounded. The fundamental disconnect is that for govt workers the reams and reams of paper reports that no one reads, and endless uninformative powerpoint presentations and meets ARE working. Even though these activities rarely get things done.

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The people actually doing the work were no doubt left to guess at what the government wanted, and how it was supposed to work.

Then every six months, there would be a change in direction that required the programmers and technical people to start all over again.

That’s why we have a simple website that’s all but useless.

That’s why our government has pissed through a BILLION dollars and has a site that looks like a Junior High School kid built it.

That’s why we’ll spend another billion to get it right.

Every single one of those people in government who were in control of this whole ACA (Obamacare) abortion… should be thrown out on the streets.

Set an example at the ballot box.

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Demand that your congressman take action and start firing, or impeaching, or recalling these people.

Whatever it takes it’s time to clean house and start fresh.

I can’t promise I won’t write about Obamacare again.

I’ll try not to.