Diabetic Recipes
I've always been blessed with fairly amazing insurance. My dad worked for the city of Houston for several decades, so our family has always had the group policy with a large subscriber base and it's stayed the same since I was born.
After he retired, we kept the same insurance as part of his pension plan. Our co-pays rarely change for either doctors or prescriptions. They pay roughly eighty percent of most procedures and devices. And since I was blessed with a stable income family, I'm able to afford the $45 copays and twenty percent of the pump.
But in the last few years and with the new health issues, my health bills seem to be piling up. And with the economy the way it is, I'm starting to stress about how to pay for some of the necessary (and probably not so necessary) items.
My insurance has started rejecting some procedures (like the ultrasound I had done for my ovarian cyst last spring) and a few incidents with Medtronic have left me on the phone fighting for coverage and crying over the stress of my health.
I'm frustrated by my insurance company because I see their faults and I see the effort I put in so that I can live with as few health problems as possible. As a patient, it's difficult to sit on the phone for hours and not get anywhere. Half the time, I get sent back to the same person I spoke to before and told the same thing. My head spins in circles.
I wish that Medtronic and my insurance company would communicate together without putting me in the middle of everything. I wish that both companies would put the patient first and have a little understanding.
I would love to speak to the same person every time at my insurance company. I want someone who is familiar with my case and my issues, who knows when I've called ten times before, who takes time to research things for me instead of sending me in circles.
If all the companies involved would step back and look at the situation, I think they'd see that I'm only trying to get my money back or get procedures payed for that I had no warning about. If they could put my shoes on, they'd see how many hours I add up working on this, on top of school and my jobs and trying to live. They'd understand that the stress of insurance companies only adds to the demise of my health.
Does having chronic illnesses mean inevitable insurance frustration? Are there resources out there for those of us that hassle with insurance? What rights do I have? Is money more important than my health?
I'm left confused, frustrated, and utterly empty in trying to get my insurance settled and keep my health intact. All I'm asking for is a little empathy and someone who is on my side, for once.
Hey, Lindsey. Does your insurance provider (I'm assuming your dad's ex-employer) have a patient advocate? Often these folks can act as a liaison of sorts between you, the doctors and the insurance company. Start with the subscriber's HR department.
I'll definitely look into this! Thanks, Michelle!
Oh you think it's fun NOW. Wait until you're too old to be covered by your parents' policy. If there's any gap between that coverage and your own, independent policy, they like to hit you with their "pre-existing condition" clause, and refuse to pay for anything for a year +. It's quite a good time...
Not that I'm advocating universal health care (I'm actually strongly against it), but our health system needs a complete overhaul.
ryanator, why not universal health care? Is it so terrible to think that all Americans could have access to health care?
Oh, Lindsey... I'm so sorry to say the answer to your question is YES. Having a chronic condition means inevitable insurance frustration. The best advice I can give you is to learn to be your own advocate. If you hear NO once to something you KNOW you need, make noise and don't stop until you've gotten what you know you need. Yes, it's exhausting. Yes, it's unfair. Life can be exhausting and unfair. This is area is no exception.
And astronomer. I think universal health care, in the tradition of some of the existing universal health care systems used in Europe and elsewhere, would be a disaster for the United States. Ask a person from a country with a state-run health care system about how long it takes to get to see a doctor and how much crap they must go through to get just the basic supplies they need. Ask them how they feel about the quality of the care they receive. Ask them how likely it is that they will get, through that state-run system, any kind of specialized devices (ie: an insulin pump) or how much fighting it takes to get specialized numbers/types of prescriptions (ie: more than 4 strips per day).
I want to be able to continue to CHOOSE which doctors I see and be able to do it at the cost I'm doing that at now. I want to be able to use the kinds of technology that I think are best for the care of my disease. I don't want the state to make those decisions for me.
From everything I've read/researched, most Universal Health Care systems work fine for preventative care or basic health issues (ie: you have a cold, you need birth control) - but when things get complicated (ie: you're diagnosed with a chronic multi-system effecting condition like diabetes/you need heart disease treatment/your eyesight has been damaged by retinopathy) the system flounders. Seeing a specialist in reasonable time is nearly impossible. Waiting lists are long and underpaid, overworked health care workers simply can't keep up. There is no system existing in the world that works in a way I can see myself wanting to live with.
I agree that our system needs a total overhaul - and I agree that in an ideal world everyone would have coverage. But selfishly, I don't want my coverage cut into pieces or made unaffordable to make that possible.
Nicole pretty much said everything I could have said, and more eloquently as well. So, um, yeah. It works for basic health care in countries that don't have 300 million people. It would take a freakin' miracle to put together something that works in the U.S.
From the people I know of in places that have universal health care systems (Turkey and England/Ireland), they really don't have complaints. Yes, it's easier to only need these systems for colds or other typical conditions. But, that's our insurance as well. I know several diabetics in Ireland and England that have pumps and haven't had much issue getting them or more strips or continuous monitors. I don't think universal health care is as bad as Americans think. I don't think their exact systems are what America needs because of the mass population, but something similar would be nice.
So, you are all agreed that basic health care is not a basic right?
Basic Health Care, in an ideal world, is available to every person. We do not live in an ideal world. I am not being cold - I am not an uncaring person nor am I ignorant to the challenges of poor populations - I have worked with non-profit organizations for more than ten years fighting for people to have enough to eat and the ability to read. BUT I will not give up my right to quality health care in order for others to have health care provided by the government. In my opinion, universal health care as it exists in other countries would not work here in the United States. And it's not just a population issue. Our national leaders need to work with health care providers, insurers, and local and state governments to make a determination about how to make health care available without crippling the system that IS working for people who have the ability to pay. This, if done right, isn't a short term proposition. Beyond that - given the fundamental flaws in our governing body/process - I'm not sure it could EVER happen.
Lindsey, I know a diabetic in England. She was diagnosed at 30, cannot get enough test strips to last her a full month, has been in hospital 4 times over the past year with DKA and cannot get an insulin pump, and can only schedule appointments with her endo every 8 months because his waiting list is so long. I know another in Canada who was diagnosed at 12 - is now 33 - also has to wait up to 9 months between appointments with his endo. Battled with the government for nearly 3 years. 3. years. to get a pump. Often runs out of supplies for the pump because of restrictions on what the system will pay for. I also worked with a young lady who moved here because she has diabetes and chronic fatigue syndrome and she and her fiance' felt that the care they would get here would simply be far better than the care they got in the UK. Little of what I've been told tells me universal health care systems already in place work just fine. It's a freaking mess.