You might think that what with all the hub-bub over health insurance reform, health insurance companies might go out of their way to be on their best behavior just right now. Oh, wait, they see the same Democratic “leadership” the rest of us do. Well done, Senator Baucus.
Anyway, the in the midst of watching my spineless political party negotiate with themselves into giving away the farm, I’ve gotten two emails in the past 26 hours that make me want to start throwing bricks through the windows of insurance company executives:
The first is really sad: a friend of mine from college was in a tragic bicycle accident a few weeks ago and suffered traumatic brain injury. She’s been slowly improving, recently opening her eyes more every day, and showing increased tracking and eye response to light. But the care available at the hospital has leveled out, and her family has been trying to find a more specialized facility where she can get the care she needs…apparently it’s been difficult as many TBI clinics look for more responsiveness than my friend is currently showing, but they found a place with a wider range of care. Last night I got an email update that her insurance company has prohibited the transition to the rehab center, claiming that the care she would be receiving would be “experimental”. An appeal by her doctors and therapists has already been denied.
Of course, this is exactly the kind of thing that private health insurance companies do: interfere with care, stand between patients and the care they need, and refuse to pay when it’s actually needed. And it’s reprehensible.
The second is less heartbreaking and more just petty and stupid. Just a few minutes ago I got an email from representatives of my union notifying me of a change in my health plan this year. Due to the financial crisis, the university this summer decided to close the university health center’s urgent care facility from midnight to 8am, to save money. This fall Aetna has changed our health plan to add a $600 deductible for any off-campus care. This means, to quote the email, “If you have an urgent medical issue in the middle of the night, try to wait it out until UHS urgent care opens at 8am. Otherwise you will get stuck with a $200 bill (or more for families).”
Now, there’s always been a clause about getting a referral for any off-campus care, with no exception for emergencies, and I’ve always felt that was idiotic: if I had time to get a referral, it wouldn’t be an emergency, would it? And I’m not going to ask the ambulance to wait while I try to find out which hospital in the strange city in which I’m having my emergency is in Aetna’s network — just take me to the closest hospital! But now, with the campus health center closed, I have no choice but to incur these extra charges if I have a medical emergency during the night (to say nothing of the fact that I probably drive past half a dozen hospitals between my apartment and the university health center). The union is preparing to file a grievance, as this change constitutes a benefits reduction and thus violates our contract; situations like this make me glad I have a union to take on the university administration.
So, can we please acknowledge that even with Max Baucus bending over double for the insurance companies who’ve bought him, his watered down plan for adding millions of customers to insurance company rolls without any cost controls STILL doesn’t have any Republican support and is dead on arrival, and get on with passing a real reform bill with teeth?