Tuesday, June 16, 2015

Holding Pattern

One topic I've refrained from discussing on this blog is the health insurance issue. The reason is, up until a couple of months ago, I was one of those rare individuals who wasn't constantly battling with my provider. Unfortunately, all that changed in April, and now I find myself in a holding pattern while a very patient patient advocate wages war on my behalf. Is that too confusing? Maybe I should have referred to the advocate as "diligent". Well, since I am metaphorically hamstrung at the moment, I will indulge in the pun. 

One very disturbing fact about life in the good old U.S. of A. is that being diagnosed with cancer can lead you to confront very dire financial straits. Having watched every episode of "Breaking Bad", I remain convinced that series creator Vince Gilligan was chastising the insurance industry, in addition to giving us way too much information about how to manufacture metric tons of methamphetamine. Maybe if I had watched the series before my diagnosis, I'd feel differently, but I binge-watched it on Netflix while I was going through chemo.

Walter White was essentially a good guy, but when he received a lung cancer diagnosis, and found out that his shitty-public-high-school-teacher-insurance-coverage wasn't going to pay for his treatment, he morphed into Heisenberg, and became a monster. It's an extreme scenario, but one that many of us are familiar with on a not-so-melodramatic level. 

There is a push-pull between patient and provider; a sort of tango you must dance in order to get through your medical ordeals. This dance requires many steps, and can get quite stressful. The vast majority of us learn early on that once you are confronted with cancer, you might have a positive prognosis, but when it comes to your health insurance, you have no choice but to get used to living in the "Land of No".  

I was very fortunate to have gotten though my diagnosis, surgery, and treatment without any issues, but I had to switch insurance providers back in March in order to remain under the care of my family doctor and medical oncologist. That switch has caused me more stress over the past two-and-a-half months than dealing with cancer has caused over the past year. My new provider has said "no" to all my lymphedema treatments, including visits to the physical therapist I was seeing, and, at this moment, will not pay for a compression sleeve for my ever-expanding left arm. The patient advocate was able to get me 12 physical therapy visits to last the rest of the year, and is currently awaiting word about the compression sleeve. Moreover, I want to try out a pair of breast prostheses, because, well, I'm curious. Those aren't covered, either. 

 I must disclose that I am an advocate of the Affordable Care Act, more commonly known as "Obamacare", and my insurance coverage was made possible by it. I am a freelance writer, which means I work for myself - I do not have an employer that provides insurance coverage for me. I am so happy this is the case, because we all know people who slog away at dead-end jobs just for the benefits. We shouldn't have to do that, but in the U.S., "single payer healthcare", "socialized medicine" and "Canada-style healthcare" are phrases that scare the hell out of certain people. They shouldn't, but if you suffer from chronic ignorance and/or make your living as a paid political operative, you're going to disagree. Unfortunately, ignorance can be tough to treat, and lobbying is legal, for the most part. 

As I sit here waiting to get an e-mail or phone call from my diligent patient advocate, I wonder what it would be like to live in world where patient advocacy is an unnecessary occupation, like lactation consultants, or Feng Shui experts. 

Wouldn't it be great if we could get what we needed from our health care providers without having to resort to filing bankruptcy, or write television shows about destitute science teachers who have to resort to a life of crime to survive? 

We always say we have insurance "just in case". When just-in-case turns into life-or-death, the fight for survival shouldn't include worrying about what your provider will and will not pay for. I'd sleep a hell of a lot better at night knowing I don't have to fight for fake boobs and a contraption that will keep my arm from exploding. Since I'm currently not sleeping very well, I take comfort in the fact that if I want sleeping pills, my insurance will pay for them. 


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