Saturday, July 31, 2010

Health "care"

So I call my insurance company to find out whether things like walkers and wheelchairs are covered, and if so, how to get such things.

Well, the first thing I was warned about, was that if I just go get one, they won't pay for it. Well, they may pay something for it, but not much. Because it wasn't approved, you see. It has to be approved.

So, I ask, how does the approval process work?

It starts with a doctor prescribing the device. (Fair enough, I suppose.) But he has to prescribe a specific device. Now, understand, I am blessed with a primary care physician who also happens to be a board-certified neurologist. WTF does a neurologist know about specific types of locomotion-assistance devices? WHY TF should a neurologist have to know about about how insurance companies classify specific types of locomotion-assistance devices?

Anyway, step two. I need to go to an approved (there's that word again) provider of said devices. There, people who neither know me nor my condition or medical history will decide whether or not I need the specific device that my doctor has prescribed.

If...IF...they approve--ah, the poetry of that word--the prescription and the application of the prescribed device to my condition, which they don't know much if anything about, then they contact the insurance company, where more people who know even less about me, my condition, or my medical history, will decide whether said device is in their opinion appropriate for my situation, and then decide whether my plan covers said device given their (based upon nothing but paperwork) assessment of my situation.

And once that final, blessed approval is given... then, they'll pay for it.


Right now, they have an extremely poor record of even processing claims that I submit to them. I've submitted somewhere on the order of twenty or thirty claims... they've processed about five. Where are the missing claims, I asked? What missing claims, they responded. Oh, just send 'em in again, they suggested.

To people who foam at the mouth about what they deride as "Obamacare" and the evil evils of "socialized medicine," I want to say... shut TF up. Try walking a mile in my shoes, using my malfunctioning legs--that is, if you can, which you won't be able to, because it really really hurts and your legs will probably give out long before you hit the quarter-mile mark... and see how you like how our current system "helps" you to get something to help you walk at all.

'Course, if I could stand the travel (which I can't), I could go to a country with a reasonable health-care system, see a doctor, have them prescribe me a walker or wheelchair, and leave the hospital with it. That day; that hour. And the national health-care system would probably pick up most of the tab.

Horrible life, that. Good thing we don't have a system like that.

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