I'm going to speak to our health care crisis this morning. There is something inherently wrong with a medical industry that has allowed itself to be pushed around and essentially led by the insurance carriers. There is no doubt in my mind that the insurance carriers are dominating and manipulating the care and treatment that we receive. I have been preaching about the health care crisis for years now and hoping that health care reform was actually here...My case in point: A year ago, our medical insurance premiums increased by a whopping 40%!!!! They had been increasing annually but that was the largest increase by far. I called Blue Shield and complained to no avail. Our medical coverage was now costing what a lot of Americans earn annually. We worked hard and begrudgingly, paid the premiums. We didn't hit our $8000 deductible last year. This year, we didn't go to the Dr. unless it was a necessity and yet, our premiums increased another 13%!!!! Fast forward to Sept. 16th, when our lives were engulfed by the very real and present emergency that threatens Tracy's existence. As each increasingly serious test was done, we were asked for the Blue Shield negotiated rate up front before services were given. It tested our patience, emptied our pocketbooks and fulfilled our deductible. Tracy made a wry comment when asked for $2641 before his lymph node biopsy. As a licensed General Contractor, he could NOT ask for payment of services prior to completing the work. Interesting and oh, so true.... Fast forward to Oct. 14th, when Tracy's Oncologist informed us that he was to pack a bag (because they'd probably want to keep him) and appear at the Cancer Center at Stanford the following morning at 8:00AM. Dr. A also informed us that there was no alternative if T wanted to live more than a couple months. The gravity of the situation was mind blowing.
We appeared at Stanford according to instructions and were immediately immersed in the fight for Tracy's life. It is all consuming and without the loving and personal treatment that Tracy is lucky and blessed enough to receive... I don't know how we'd survive. Now, fast forward 8 days. Tracy has been in treatment and has developed an infection that prevents him from moving his head, speaking and is extremely painful. The Giant's are about to start their last game of the pennant and all the forces have been gathered. Tracy is hoping they won't take him for his cat scan until after the game. I'm hovering. Tracy evicts me. I stop at the Whitney's briefly not wanting to rain on their birthday celebration. I arrive home and cry my fears out and then, proceed to open the mail. There is a letter from Blue Shield that states that Tracy is only approved for 5 days at Stanford. Nice.... Yesterday, I called Blue Shield to talk about an EOB (Explanation of Benefits) that we hadn't received, where there hadn't been any contract negotiation by Blue Shield and THE letter. I was subsequently informed that I could not speak about the policy or coverage since I was no longer the Subscriber... interesting... since I'd been continuously speaking with Blue Shield for the 16 years we'd been covered under my name and also continuously for the last year when Tracy became the Subscriber....no sympathy, empathy, compassion, sensitivity. My husband is fighting for his life and Blue Shield is dictating what can be done. I was advised by my sis, Shar, to find the advocate at Stanford. I took the five page document that would grant my ability to speak to Blue Shield for us and THE letter to Tracy. He filled out the authorization and signed it. I then found our advocate. She very tactfully informed me that insurance companies were all the same and this was the reason for her position. These advocates are forced to ask for treatment approval every 2 days. So, insurance companies are dictating our treatment... NOT our Doctors. Isn't there something glaringly WRONG with this picture? I'm disgusted to discover that this is the very real state of our health care today. WE NEED HEALTH CARE REFORM and we need it now!!!!