Recently, I started fighting back against my health insurance company. I was on the phone with the person filing the appeal, but their automated system simply found a keyword and denied the appeal seconds after she hit enter. This opened my eyes to just how really messed up we have allowed our healthcare system to become.
Insurance companies overrule our doctors, chastising them for spending more than 15 minutes with us and trying to shame them into being less than the providers they want to be. They spend more time doing paperwork than they are allowed to spend doing hands-on examinations. They are not given a choice. Even in the 21st century, they still have to fill out paper forms and fax them to the insurance company. Meanwhile, patients need to write letters and mail them within 30 days of denial in order to appeal. By the way, the clock is ticking while you’re in the ICU and on a ventilator. It’s a very cruel system.
Computer programs deny chemotherapy for children, often only because the wrong code was put on the form. The software searches for anything that they can use to deny medical care. Can you imagine the joy in the boardroom as they go over the numbers and cheer the success of being able to deny care to thousands in less than 60 seconds? The efficiency of their system to end hope is staggering.
I was invited to speak at the United States Capital during a healthcare town hall. As the only patient on the panel, I needed to paint a picture of what insurance companies do to us, and why the best course of action for our nation is a national healthcare system. Getting rid of private, for-profit insurance companies would lead to healthcare outcome improvements. Take away the ability of an insurance company to deny care, and you are left with a doctor being able to take care of patients without any barriers to care.
This is more possible than you might think, as part of it exists already today. We could simply allow everyone in America to have a Medicare card. That system already works. People don’t get denied care on a routine basis, and the bills get paid. More importantly, doctors can treat their patients without begging a computer to approve the care.
If your file lands on the desk of a human, they know nothing of you. They’ve never seen your medical history or even lab values. They see a code on the paper and click deny, thus starting months of back and forth that you are required to do in order to finally get your exam approved, only to find out that the clinic your doctor sent you to is not in your network. Now you’re looking at a bill you have no idea how to pay. Continuity of care does not mean a thing to private insurance companies. Treatment delay means bigger profits for them.
There is a bill in Congress which if passed, would open the door to medical care for everyone. It would enable all of us to see the providers we need and have preventative care all covered by a national healthcare system. Imagine your doctor is able to spend 30 minutes with you because they don’t have to fill out mounds of redundant paperwork to satisfy the insurance. Imagine a provider being able to talk with you, do a thorough examination, and take time to teach you preventative care measures.
There are over 100 congressional members who have signed as cosponsors of the bill. That is encouraging, but we need more. We need to demand of our elected officials that they not only support but co-sponsor, this lifesaving legislation.
It’s a gimmick, insurance, the greatest fleecing of Americans. We pay our premiums and work ourselves to death, only to find that when we are sick and need to use that insurance, we are out of a job. We are too sick to work, so we lose our jobs, and now our health insurance. Imagine being diagnosed with cancer, not being able to continue working, and then losing the very insurance that you need to pay for treatments because you no longer have a job. This isn’t theoretical. This happens every day in America, and it is beyond cruel.
I want to live. I want to live in good health. We all deserve access to the same care, no matter our station in life. Sometimes, the very people who give the care wind up being the very ones who can’t access it when it’s their turn to get sick. I know this. I’ve lived it.
I’m not giving up, and we have a real chance at a future where our kids get the same medications that rich kids do when you don’t have to fear a $500 copay for just one med. No child should be priced out of life. Every day people die two doors down from a hospital or pharmacy holding the medication that could have saved their life.
I need you to fight alongside me. I need you on my team. We need to fight to end the stranglehold of private for-profit insurance companies that make the most money on the backs of the suffering and dying. Every day we have to work for this to make it real. The tomorrow that we want depends on what we do today.