Free Healthcare

“In America, no one should go without health care.”

~AFL-CIO

My husband is a teacher so we don’t have to pay for health care.  They just take $3,000 a year in premiums out of his paycheck.  We’ve chosen the most affordable “plan” his school offers.  This year they didn’t even increase our premiums, they just doubled our co-pays.

With our Vermont Health Partnership Plan we get a “Primary Care Provider,”  “preferred benefits,”  and a “three-tier prescription drug benefit.”  It’s fancy, and it takes an entire staff to explain the “features” of our plan each time we need to use it.  But that’s not too much of an inconvenience because we rarely use it.

Our family of four actually relies on traditional care provided by a Naturopathic physician.  Though Naturopathy is on the rise and is more affordable and effective in treating common ailments, it’s frowned upon.  Thus in addition to our premiums and co-pays, we dish out another few thousand a year to cover our “real” care.

On the other hand, given our limited use of “the system,” we’ve never had to  encounter some of the insurance sagas that we hear about from those unable to get the medical attention they need.  Until yesterday.

Yesterday was the first time we’ve needed something from a pharmacy other than an antibiotic.  A simple air cast is all we wanted.  At the cost of $180. Our Naturopath put the order in, but then called us right back to say that there was a problem.

Apparently, our insurance plan with Blue Cross and Blue Shield of Vermont would cover pharmaceutical prescriptions, but not “durable equipment” prescriptions because this pharmacy was not in our “network” as a “durable equipment provider.”

After an aggravating amount of time on hold, my husband was given the name of two “providers” in network and he scrambled to call them before the end of the work day.

Unfortunately, he discovered that the two local “providers” did not have air casts.  In fact, one of them was simply an oxygen supply company.  Didn’t the insurance company know this? Thus my husband spent another half an hour on the phone after which he was told that he would need to use an out of state provider if he wanted insurance to cover the cost.

This seemed a ludicrous request given that the same product was available in our town– immediately–and given that my husband was in pain and required the cast to support his leg from re-injury.   After another 20 minutes with the insurance company, they suggested we request “delivery” of the item, which was an additional expense that they would surprisingly cover. (Imagine how much that would cost from an hour away.)

However, delivery wasn’t available from the out state “providers” and neither was a cast– for 3 to 7 days.   Thus my husband called the insurance company again, punching in all his numbers, giving all the same information to a new person, and finally being told that he should call our physician to have her submit a special “pre-approval” for the local cast– which could also take up to 3 days to be “approved” by the special “pre-approval durable equipment reviewers.”

Unfortunately by the time my husband got off the phone with the insurance company and the various “providers,” the doctor’s office was closed.

During this circus, we learned that had he used the Emergency Room over the weekend, rather than wait for our health care provider to see him on Monday, the hospital could have easily issued the air cast and all expenses would have been covered.  (The system obviously doesn’t reward the cost-effective prudence of a doctor’s daughter who thought the Emergency Room wasn’t an appropriate use of our benefits in this instance.)

Toward the end of this escapade, I found myself wanting to rip the phone from my husband and scream bloody murder at the insurance company–or cry.     This was inane and cruel and despairing.  The poor guy just needed an air cast for his leg to relieve the pain and protect him from greater injury, but we had to play some crazy game to get it.  (Imagine how many insurance “players” it takes to “pretend” that this game actually works.)

“Be specific in the pre-approval request,”  our Blue Cross, Blue Shield  Health Advocate tells us.  “Make sure they know that it’s urgent.  Tell them that you can’t find a local provider.  Tell them that it will take a week to get one through the out of state provider. The “advocate’s” sincere (and misdirected) kindness makes me want to cry, and I’m appalled that I’m in the ridiculous situation of begging for a cast for my husband.

“Make sure the doctor includes all the details,” she repeats over and over again, saying “They can’t read your mind.”

Can they read an x-ray?  I wonder.  WTF!

This was our family’s first bitter “taste” of what many others endure in much more dire circumstances~ when it comes to having their medical needs met–or unmet–by our country’s “superior” health care system.

Our personal drama–and call to action– is aligned with the national one following the loss of Ted Kennedy’s seat (to a Senator who opposes health care reform) on the one-year anniversary of President Obama in the White House.

The politics of the healthcare debate may have changed,” says the Democracy in Action group MomsRising, ” but the needs of real people for healthcare have not.” Click here to tell your members of Congress to be strong and continue the fight for real health care reform.

Kelly Salasin

(Click here to see additional posts on health care reform at the intersection of life and politics.)

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Sarah Palin & Me, Part II~ Choice & Healthcare Reform

Earlier this fall I was surprised to find that one of my readers was referred by the Sarah Palin Information blog.  But then I discovered that this link of her conservative voice to my own (progressive one) was a simple slip of the Net–joining two voices on health care–albeit opposing ones.

This time, however, it is me who is initiating the link,

and here’s why…

I just found out, on the family grapevine, that my grandmother had two illegal abortions in the late 1940s (after giving birth to four children.)

My uncle (a fundamentalist pastor), was her fifth child (following the abortions) and it was he who shared this information with me on Facebook after a flurry of posts in which I attempted to solicit an understanding of the infuriating connection between healthcare reform and abortion.

This shocking news about my grandmother, followed my reading of:  Sarah Palin: Abortion Is So Bogus.

According to Salon,”The former Alaska governor gave a speech to Wisconsin Right to Life this past Friday, where she relied on words like “bogus” and “awesome” to make points about healthcare reform and abortion.”

Said the ex-governor, “It is so bogus that society is sending a message right now and has been for probably the last 40 years that a woman isn’t strong enough or smart enough to be able to pursue an education, a career and her rights and still let her baby live.”

It must have been 60 years ago that my grandmother had her illegal abortions (which she and many other entitled women referred to as their “miscarriages.”)

The first time she found herself pregnant was at the age 19, after which she dropped out of college to become a mother to my father (and a wife to my grandfather,)  giving birth to three more children before she choosing abortion as a means of birth control.

My grandmother never returned to her education or embarked on a career, although she had always dreamed of serving at the United Nations as a translator.  All those hours spent working with me on my French at her kitchen table now make even more sense.

I wish I had known about her abortions. It would have softened the harsh solitude of my own choice, 40 years later. Discovering this link now, opens a million doors in my understanding of women, and I feel a renewed connection to those who have come before me, and to the challenge of our choices-or lack of them.

My own mother was sent to live in a home for unwed mothers when she became pregnant with my older sister who she gave up for adoption.  The following year she met my father and became pregnant with me, resulting in a sudden marriage.

Raised Catholic, my mother gave birth to 9 children and never chose abortion, though she accepted my choice with understanding, and often said, “If you ever get pregnant, don’t make a second mistake. You don’t have to get married.”

Both she and my grandmother became alcoholics who never fully claimed their education, their careers or their rights despite their shared and differing choices.

My uncle (who is a fundamentalist preacher) explains to me on Facebook that he was my grandmother’s 7th pregnancy–the one she didn’t tell my physician grandfather about until the second trimester– when he wouldn’t have allowed her to have another abortion.

This implies that perhaps she hadn’t wanted any of the abortions. But whether she did or not, I have compassion for the choices she faced.

I tell my uncle that I’m happy he wasn’t aborted, that I love all babies–and I do.  I love the ones who have come into my life and the ones who haven’t– including the grievous loss of two early pregnancies in my  thirties before I became a mother of two wonderful sons.

This contradiction of love doesn’t take away my understanding of a women’s desire to choose when she brings another child into the world. And it isn’t always as simple as a decision about education, or career or even rights, as Sarah Palin exclaims.

Whether Christian, Jew or Muslim, Pro-Life or Choice, Conservative or Progressive, a mother of many or of none, the choices that we face as women are unique to us.  And when we sit across from each other at the kitchen table, our separations fall away, and what remains is what is also unique to women–compassion, understanding and acceptance.

In this spirit of understanding, I have compassion for how it is that Sarah Palin chooses her career over caring for her children full time, how she leaves her tiny baby in another’s arms while she runs a state, or a national campaign, or embarks on “rogue” book tour–While I, on the other hand have given up everything to be at home in these vital years when my children need me most–particularly my teenage son, who will soon be making decisions about his own sexuality, as Sarah Palin’s daughter did.

What I don’t understand is how Sarah Palin, the politician, works to protect unborn children, while preventing legislation that would support them once they are born.

What I can’t accept is that she and others take this so-called “moral” stance for the sanctity of life without wanting to provide for it and without taking responsibility for many of the harsh choices that many women face.

Framing the provision of health care reform around the issue of abortion is the most immoral act of all.

If Sarah Palin is “America’s Conservative Conscience,” as the t-shirts worn at the Right to Life Rally proclaimed, it’s time we go shopping for a new look!

Kelly Salasin

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