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Note:  This is a repost of an article I originally wrote on Christmas Eve, which few people read (it being Christmas Eve and all), but I received several personal messages urging me to post it again, so I am.  Hope that's okay...

The Illness

As some of you know, I am a Type 1 Diabetic.  Also called "Juvenile Diabetes", Type 1 Diabetes actually has nothing in common with the far more prevalent Type 2 Diabetes -- they're completely separate illnesses, and in a way, opposites.  Type 1 Diabetes isn't so much a "disease" as it is an event -- organ failure of the pancreas.  That means that, although my cells can process insulin correctly, my body isn't making any.  You could become a Type 1 Diabetic in a motorcycle accident, for example (which happened to a family friend).  Type 2 Diabetics, on the other hand, usually have a functioning pancreas, but the body's cells have forgotten what to do with insulin being produced.

While it's possible (for some) to prevent or even reverse Type 2 Diabetes, Type 1 Diabetes can never be prevented nor cured for anyone -- those of us who are preprogrammed to have their pancreas fail have to inject ourselves with insulin multiple times daily, in order to approximate what a functional pancreas would do.  To know how much insulin to give ourselves, we count carbs, and take 7-10 finger-poke blood sugar tests throughout the day, especially before meals.  It's not an exact science, but if I'm really diligent about it, and don't make too many life-threatening mistakes, my doctor says I could have another 30 years or so.  (I'm 32, now.)

The Good Old Days

Now, back when I was working for a larger company, my health care needs were more or less met.  My co-pays for insulin, syringes, and testing strips worked out to be around $120/month out of pocket.  Three years ago, however, I decided to try branching out on my own, and founded a web and graphic design firm as a sole proprietorship.  I used Cobra for a while, but when that was about to run out, I had to purchase my own insurance, which I had been dreading.  Even though I had heard horror stories, I didn't know how truly terrible health insurance was for a Michigan resident with a pre-existing condition.  Now, I do.

Michigan does not allow "groups of one" policies for self-employed individuals.  They do not allow people with pre-existing conditions to join group plans, such as would be offered by Sam's Club Business Association, or my Graphics Artist Guild membership.  Private insurance companies do not have to offer insurance to those with pre-existing conditions, and so none do -- not one, not in the entire state.  The only option that someone in my position has is to purchase Blue Cross Blue Shield's Individual Plan.  That's it.  

The Insurer of Last Resort

Because Blue Cross is a non-profit, the state requires them to accept everyone, earning them the name "the insurer of last resort."  That does not mean they have to offer very good coverage, nor be particularly competent in doing so.  (They have made an almost unbelievable amount of mistakes in my coverage just in the past two years.)  My premiums are quite low (only $250/month), but consider what little this is covering:

I am allowed only one doctor's visit (any type of doctor) per year.

I have a 30% Copay on all medications and doctors visits.

I have a $5,000 total cap on all services and benefits for each calendar year.

As you can imagine, being a Type 1 Diabetic on this plan is nearly impossible.  I'm supposed to see my endocrinologist four times a year, as all Type 1 Diabetics are required to do, but either can't, or have to pay $200 each non-covered visit, when I can afford it.  I'd like to be on a modern therapy, such as an insulin pump which could add 8-10 years to my life expectancy, but it's not covered by Blue Cross and it would be impossible to pay by myself.  I'd like to be testing my sugar as many times a day as my doctor recommends, but at $1 per test, that adds up too quickly.  And, a 30% copay for insulin works out to be hundreds and hundreds of dollars out-of-pocket just by itself -- per month.  Just for this one condition.  God forbid I ever get any other disease, or get into a car accident or something -- I would literally, instantly go bankrupt, even though I have insurance.

Which brings me to today's adventure.

Please Sir, Could You Spare a Syringe?

My health care premium check bounced earlier in the month, because a client check to me had bounced that week as well, and I didn't catch it in time.  Unfortunately, Blue Cross does not allow you to make a payment by phone.  There is no way to use a credit card.  You cannot pay online.  The only way you can pay is by sending a physical check through the mail, or driving more than 100 miles to the one and only payment center in the entire state.  During the time when you're waiting for a check to make its way through the mail, get lost, get found again, and eventually (hopefully) get processed, you have no coverage.

All this week, I've seen my remaining insulin supply dwindle away.  I've done my best to eat only low-carb foods, to help make the remaining units last, but I eventually ran out yesterday.  (I even tried calling other friends, or friends of friends, to see if anyone knew someone I could "bum" some insulin off of, but most Type 1 Diabetics have better insurance and are on incompatible modern therapy.)  Every morning this week, I would check my bank to see if the check had been cashed, or call Blue Cross to see if my coverage had turned back on.  Finally, yesterday, the money had indeed left my checking account, so I tried to get my insulin refilled.  No dice -- although they had apparently cashed the check, they still needed another day to "process".  But, they assured me if I could just hang in until this afternoon, everything should go through.


A Not-Unexpected Surprise

I waited as long as I could today, as they recommended, but finally had to try the pharmacy and see.  Predictably, I had still not been switched back on.  Blue Cross staff left at noon for the holidays, so there was no one to call, and Rite Aid's hands were tied.  They couldn't just sell me one insulin pen from the pack -- I'd have to buy the whole pack.  Unfortunately, that would cost me $525, which I simply didn't have, even if I emptied every penny from both my accounts and filled up my one remaining credit card.  What's worst, they couldn't just let me buy a singular bottle of insulin either, because I don't have a prescription for a single bottle, I only have a prescription for the packs of pens.  Even though it's the exact same medication (Humalog).  

So, the pharmacists told me I'd have to go to the emergency room, to get an on call physician to write a script for a single bottle, which I could then afford.  I went to our local hospital, Sparrow, and explained the situation.  They said they'd be happy to help, but recommended I try a redi-care center first instead, as it would be cheaper.  They gave me a list of all the local redi-care centers, but being Christmas Eve, they were all either closed, or had closed hours earlier.  I drove around frantically for a while, and almost made it to the last one that closed at 5:00pm, but they were already locking the doors when I pulled up.

Defeated, I drove back to Sparrow hospital to talk to their physician on-call.  They were very quick and efficient, and since all I needed was to talk to someone for a minute and get a script, they didn't even bother with the standard intake tests (i.e. no forms, no taking my temperature, no stepping on a scale, etc.)  I just sat with a nurse practitioner, explained the medication I needed, he wrote me a script, and that was that.  After all the hours driving around today and talking to people on the phone and trying to get help, the Sparrow Hospital solution took only five or six minutes.

But What Will it Cost?

So I walked to the hospital's pharmacy (my normal pharmacy had already closed early for the holiday) and bought the bottle I needed, now that I had a prescription.  It's only a seven-day supply, but it was also "only" $125 -- which I could afford.  Finally, for the first time in two days, I could eat something other than lunchmeat and water.

Then I go to check out.  Explaining the insurance glitch to the receptionist, she assured me it would be no problem -- she'd just bill Blue Cross the "old fashioned" way, which would take a few days, and surely the insurance would be turned back on by then.  So, she said I'd only have to pay my normal 30% copay for the visit today.  

"Great!" I replied, since I had very little money left and guessed I couldn't possibly afford the full bill, even though I just met with an n.p. for five minutes.  "How much?"

"Well, it looks like the total bill is $624."

My jaw dropped to the floor, as I started doing the math in my head.  30% of $624 is, what, $180?  $190?  I didn't have that anymore, because I had already bought the insulin.  

"It costs $624 to talk to a nurse for five minutes?" I said, astonished.  "So what's my portion?"

"No, no, you misunderstand," she explained.  "The full cost of your visit is $2,080.  $624 is your copay."


Yes, that's what she said.  That's what the receipt says.  $2,080, and $624 for my copay.  For five minutes with a nurse practitioner, just so I could get a script for an amount of insulin to stay alive a few days, so I wouldn't go into a ketoacidosis coma (which would have happened had I been without insulin for another 48 hours or so).  

I gave the receptionist the last $20 from my wallet, and sadly gave her my address to bill me for the rest.

The Future

Honestly, I don't know what to think of the health care reform compromise that they're working on.  I still can't get a good answer from anyone as to whether it will even help me or not.  Right now, I spend about 1/3rd of my total income solely on managing my one and only illness (an illness, I remind again, could not be caused nor prevented on my end.)  I already lost every penny of savings last year, and the bank is sadly due to repossess my car any day now.  Although I'm quite successful these days in terms of clients, awards, and national recognition in my field, to say I'm still struggling financially is a bit of an understatement.  I don't qualify for programs like Medicaid because I make "too much" based on their poverty level calculations.  But after you subtract 1/3rd of my income (which is what I spend on health care), then ironically I would qualify for Medicaid.  But that's not how they do the math, because then if I went on Medicaid, I would instantly be kicked off, because without the medical expenses, I'm making "too much" again.  So... yeah.  Like so many people caught in the working or lower middle class, I'm caught in a solution-less cycle: I make too much to get government assistance with my health care, but not enough to be able to afford health care without assistance.  As to what the Senate bill will do to help me, and how many year I have to wait for it to kick in... well, I've emailed my Senators but the form letter responses don't clarify a thing.

Anyway, at the end of the day, I was able to use the system to get the insulin I needed.  As Republicans would say, it's not like they just let me die or anything, right?  It's just amazing what kind of damage a single, tiny bounced check can do.  I'll be paying for this mistake all of the next year.  

But, hey at least I'm alive!  :)  

Originally posted to cartwrightdale on Sat Dec 26, 2009 at 12:11 PM PST.


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Comment Preferences

      •  I just don't understand... (17+ / 0-) Republicans can say, with a straight face, that everyone has "access to health care" because everyone can go to the ER and they're not allowed to turn anyone away.  Don't they realize these people still get billed for the care provided, to the tune of thousands and thousands of dollars even for simple procedures?  I'm guessing if you don't have health insurance, you probably don't have the money to pay these bills, either, and will see your credit destroyed and go bankrupt just for getting a broken leg fixed, or an emergency asthma treatment, to say nothing of an actual life-threatening injury or illness.  It's lunacy.  (And, I suppose the hospitals will say that's exactly WHY they have to charge so much -- to make up for the people you don't pay.)  Sigh.

        A health care worker, beaten at work, then denied health care:

        by cartwrightdale on Sat Dec 26, 2009 at 12:20:43 PM PST

        [ Parent ]

        •  SO out of touch. To the point of (11+ / 0-)

          they must be from an alternate reality.

          Unaware, greedy, out of touch, moronic, condescending bastiges the lot of em.

        •  Pay to play (12+ / 0-)

          It's all about the $$$, and if you ain't got none, they don't give a rat's ass about you.  End of story.  

          This is why I have a hard time understanding how so many poor folks can be Republicans.  The GOP doesn't like poor folks, doesn't help poor folks and yet the poor folks line up to vote for them every time.  You can't afford to be a Republican, I want to tell them!  

          Of course, one needn't be poor to be so negatively impacted by our existing healthcare system.  Even the comfortably middle-class folks are one major disease or illness away from medical bankruptcy- they just don't realize it.  

          I don't even know where to start on the medical billing issues.  It's just a travesty.  Shameful.  Unethical.  

          •  But remember (7+ / 0-)

            Poor folks want to be, and expect to be, rich folks someday.  That's why tax cuts are such a big deal -- even though they don't help the poor Republican today, it will let them keep their own hard-earned money once their business finally takes off, or once they get that better job, or once they win the lotto.

            A health care worker, beaten at work, then denied health care:

            by cartwrightdale on Sat Dec 26, 2009 at 01:21:16 PM PST

            [ Parent ]

            •  Don't they ever learn? (7+ / 0-)

              You'd think anyone past 35 has figured out their station in life is not likely to change drastically in the future.  Of course, that doesn't keep my mom from buying into her "retirement plan" every week- playing the lottery!

              And keeping that mindset allows them to keep on blame-shifting.  It's not their fault, it's the fault of the System, the Man, and the President that they aren't living in Utopia.  Never anything to do with their own actions and choices, not ever.

              •  But that's the thing... (3+ / 0-)

                their actions and choices are constrained by all sorts of social facts... how much money and education their parents had, how much money and education their great-grandparents had, whether their great-grandparents and beyond were slaves or immigrants or landowners or slave owners.  What their schools were like, when and where they grew up.  Where they live, what's happened to local industries and employment opportunities over their lifetimes, what their health is like.

                And because it's verboten in this country to discuss class (and only slightly less outre to discuss racism's impact on achievement and social standing), people are left with two alternatives when they don't Succeed, as we define it: blame someone else, or blame themselves.  

                Some people have made bad choices, but some have done their best with what was available to them.  They should blame The System!  Better than the classic scapegoats: minorities, immigrants, and women.  They just have somewhat skewed ideas about what's wrong with the system, because their very well-paid media sources keep them in ignorance.

        •  people pay for each other. (3+ / 0-)
          Recommended by:
          ladybug53, Pris from LA, ilovecheese

          most republicans i know pay for each other's health care when an expensive ER visit comes along or something similar.  so do a fair number of democrats and independents.  

          but then most of the people i know believe that you should know your neighbors well enough to help out or be helped by those neighbors and vice versa, so everything is community-focused.  

          it is a different mindset to expect your local community to help and have that help happen as the norm.  

          by shoeboy on Sat Dec 26, 2009 at 03:03:32 PM PST

          [ Parent ]

          •  the problem with that (1+ / 0-)
            Recommended by:
            Angie in WA State

            the unpopular neighbors get left out of the helping.  The brown neighbors, the gay neighbors, the radicals, the secularists, or  . . . well, you get the idea.  

            "Rules must be binding. Violations must be punished. Words must mean something." President Obama in Prague on April 5

            by jlynne on Sun Dec 27, 2009 at 06:27:38 AM PST

            [ Parent ]

            •  nope, not my experience. (0+ / 0-)

              i just mentioned people all over the political map doing this.  that straw-man won't play.  it may be shocking to some, but there are americans who take care of their neighbors no matter if they disagree with their neighbors' politics or belief systems.  

              i do it, the people i spend my time with do it, and it is just how we live life.  


              by shoeboy on Mon Jan 04, 2010 at 12:34:29 AM PST

              [ Parent ]

              •  It's not a straw man (0+ / 0-)

                in my experience.  My community is neither so charitable nor so egalitarian.

                "Rules must be binding. Violations must be punished. Words must mean something." President Obama in Prague on April 5

                by jlynne on Mon Jan 04, 2010 at 08:33:13 PM PST

                [ Parent ]

    •  Thanks for another reminder just how screwed up (4+ / 0-)

      our system is. I voted in your poll in the "I have great healthcare" category - through employer, costs Mr. P and me $12k/year (for the moderate plan, not the Cadillac). However, we recently got a note that Mr. P's one-day hospital stay for surgery - $75k - (yes, really) would not be paid immediately b/c the company needed to do an "internal review" or something. So, we had the positively un-American luxury of never worrying once about the cost when Mr. P needed surgery - but now I'm not sure what they're up to.

      Our system of law is premised on the idea that an unfettered government - rather than criminals - is the greatest danger to our lives and liberty.

      by pixxer on Sat Dec 26, 2009 at 08:37:47 PM PST

      [ Parent ]

      •  Internal Review is Insurance speak for (1+ / 0-)
        Recommended by:

        we don't want to pay this bill and will look for a way not to pay it.

        Be prepared for months of

        Letters from your insurer stating that they are still 'reviewing' the claim.
        Letters from your insurer demanding paperwork (which you and/or your treating physician/surgeon may very well have already sent more than once).
        Letters from your insurer requesting a list of all physicians seen and conditions treated for a period of up to ten years in the past.
        Letters from your insurer....

        Ok, so you get the point.  They will bombard you with paperwork.  It is likely that they will request/demand you send them hardcopy paperwork by mail, and repeat the request over an extended period, claiming that paperwork you previously sent was not received.

        Send everything to them via registered USPS mail.  You get a receipt proving that it was delivered, and on what date and time.  Keep those receipts.

        Talk to your physician/surgeon's administrative staff, and let them know the insurer has notified you about an 'internal review' and the billing for the services may not be paid for an extended period of time.  They have every reason to assist you in overcoming any negative review results - it will get them a paycheck.

        I'm serious, and you need to be proactive.

        How would you react if the insurer finds that your spouse's surgery was not a covered benefit, and that now you owe the entire bill (which you state is in the $75K range)?  

        Good luck, you're going to need it.

        •  Thanks, Angie. (1+ / 0-)
          Recommended by:
          Angie in WA State

          I have one additional ace in the hole (or I hope it's an ace. Could be a Jack or something ;) which is an advocacy company retained by my employer. In truth, we have never had a problem with this HMO, including an outpatient surgery of mine (less than $20k), but this was spouse of the insured, and considerably more. I'm not really worried at this point, but we do have a lot of experience with registered mail {{sigh}}.

          You reminded me of an interesting experience we had with a record club. They said we owed them $, we said we didn't. We said "send copies of the bills, and copies of the receipts". They sent a partial list of things we'd ordered, but not a complete list - plus it wasn't arranged into bills and shipments. Finally they told us their records weren't arranged that way, and didn't go back any farther than what we'd sent.

          We just said "we'll pay you as soon as you show us that we owe you," and waited. Anyway, quite awhile later, we got a notice from a collection agency. Their letter said "let us know if there is any additional information you need." I bet they were surprised by our response. We wrote back "On thank you so much! We have been trying to get this information for months!" and we included a copy of every letter we had sent, and a complete history. Next thing we heard was a notice from the record company "forgiving" our account or something. Anyway, we ended up being pretty amused by the whole thing.

          Our system of law is premised on the idea that an unfettered government - rather than criminals - is the greatest danger to our lives and liberty.

          by pixxer on Sun Dec 27, 2009 at 01:52:18 PM PST

          [ Parent ]

    •  Well while you are at it ... (3+ / 0-)
      Recommended by:
      Sandy on Signal, Pris from LA, Powell

      Sue he bastard who issued you a dud check.  Let him pay for the consequences (including your hourly rate for all the time you spent addressing the problems caused by it).

      Best Wishes, Demena Left/Right: -8.38; Libertarian/Authoritarian: -6.36

      by Demena on Sat Dec 26, 2009 at 09:02:24 PM PST

      [ Parent ]

    •  apologize for hijacking your tipjar (5+ / 0-)

      but have you ever actually applied for Medicaid?  Many states have a Medicaid category for the "medically needy" (someone having a chronic medical condition requiring large out-of-pocket monthly expenditures).  If your out-of-pocket is large enough, the income limits aren't the same (it depends on a spend-down formula).

      Your BC/BS "coverage" is highway robbery.

  •  Sucks to be under this system. (10+ / 0-)

    And "under" it we are. It is suffocating us.

  •  Oh my god -- this insanity must STOP. (13+ / 0-)

    This diary makes me absolutely furious . . . our HC system is, to put a fine point on it, seemingly Fucked Up Beyond All Repair.

    I am so sorry, cartwrightdale.

    "Luminous beings are we . . . not this crude matter." --Yoda

    by GreenMtnState on Sat Dec 26, 2009 at 12:20:37 PM PST

    •  Yeah (13+ / 0-)

      One of the sadder things that's come out in recent years is the possibility that my Type 1 Diabetes was actually caused or triggered by the Accutane therapy I had gone on a couple years earlier.  I have no family history of the disease, and I got it when I was 22 -- very, very late for "juvenile" diabetes to kick in, so I was always a perplexing case to my endocrinologist anyway -- not unheard of, but certainly rare.  A family friend doctor had expressed surprise I had gotten Type 1 Diabetes under those conditions, and asked, almost as an aside, "hey, you've never been on Accutane, have you?"  It was the first time I had heard of the possible connection, and my jaw dropped -- Accutane, at the time, was actually the only prescription drug (outside of antibiotics) I had ever taken in my life.

      There's no way to ever know for sure, but Accutane's connection to autoimmune disases is more and more documented these days, and Roche actually gave up after losing several lawsuits (mostly related to Crohn's disease, which they have conclusively linked to Accutane), and pulled Accutane from the market completely.  I have mixed feelings on the matter, since Accutane really did cure my acne, instantly and permanently, and I've always been grateful for that.  And, it really is the only drug that's ever been able to cure serious, debilitating conditions far worse than acne, so part of me is sad to see it pulled from the shelves.  But I've found so, so, so many stories online from other people who got "juvenile" diabetes well into adulthood after going on Accutane therapy, and given the rarity of the disease springing up without family history and well into adulthood, I've seen way too many to seem to be a coincidence.  

      Still, jury is still out, so take this with a grain of salt.  I don't want to be accused of the same faulty "post hoc ergo propter hoc" reasoning that drives me nuts about the anti-vaccine movement.  :)

      A health care worker, beaten at work, then denied health care:

      by cartwrightdale on Sat Dec 26, 2009 at 12:36:22 PM PST

      [ Parent ]

  •  Just compare it to the evil socialism of France (11+ / 0-)

    We were visiting Paris and she fell and we thought she had broken her wrist. Went to the emergency room. Took 40 minutes to get seen, get an x-ray AND have it read (no break). Cost? Just under 60 bucks.

    Repent. The end is extremely f*cking nigh.--28 days later

    by voroki on Sat Dec 26, 2009 at 12:37:18 PM PST

  •  Don't you just love being punished for (13+ / 0-)

    your auto-immune disease?  I really believe we are being punished. Exclusions, waiting periods, high copays, high drug prices; feels like punishment to me!

    I too have Type 1 diabetes. I've been lucky not to have to go through what you did, but there's always a possibility...  I think it's criminal that the hospital charged you for a 5 minute conversation, and even more so that they couldn't just give you a bottle of insulin. At $125 per bottle though, with hospital markup, they were probably hoping to charge you $1250. Oooh, person in need! Profit! <snark>

    The high cost of drugs and supplies that keep us alive is one of my biggest complaints in discussing healthcare, second only to the punishment of us by insurance companies for our pre-existing condition.

    I really hope you can succeed in challenging your ER bill.

  •  I read this in shock, jaw dropping (13+ / 0-)

    I had no idea. First the facts you offered on diabetes 1 and 2 taught me things I didn't know I didn't know. That wasn't the shocking part.

    Most of the rest was

    Michigan does not allow "groups of one" policies for self-employed individuals.  They do not allow people with pre-existing conditions to join group plans, such as would be offered by Sam's Club Business Association, or my Graphics Artist Guild membership.

    That bothered me a lot to read but hey, I knew you had BC/BS option so you'd be OK. I lazily wondered things like if you shouldn't "hire" a part time assistant who needs health care and could get it at a better cost through a group of two plan.

    I knew that only BC/BS had to take people with preexisting conditions which were driving their rates up. Glad to see how low yours were.
    Until I read what they offered you for $3,000 per year.

    I am allowed only one doctor's visit (any type of doctor) per year.

    I have a 30% Copay on all medications and doctors visits.

    I have a $5,000 total cap on all services and benefits for each calendar year

    Since most people with conditions need to see a doctor regularly...  and since for anyone seeing a doctor when needed is the best way to avoid the need for more expensive care... that 1 doctor visit is offensive. Horrible.
    But what do they care if the lack of care sends you to the hospital? Their 5,000 cap is... you know, groovy.
    Sure they could lose a couple thousand on you then and sure it would devastate you financially but be fair. If they let you do to the doctor whenever you needed to and thus likely avoid a hospital and avoid devastating health consequences...but people like you would greedily go to the doctor and specialists and all that and eat up the money they get from your premiums and then what good are you?

    That is the most ridiculous health care plan I have ever heard of.  

    OK I won't go line by line expressing outrage. But

    it's not like they just let me die or anything, right?

    Because you could afford to buy the medicine you prescribe they didn't just let you die.
    What if you couldn't?
    As far as I know if you lapsed into a coma or had some horrible side effect they'd take you in and stabilize you and then let you go get worse and bill you, right?
    They are currently assisting in your earlier demise by expecting you to pay a huge amount for something they could have as easily not billed you for...making you less likely to afford the insurance or strips or medication.

    Let's say none of us liked you at all and think you deserve nothing good because of the way you beat up every child you see, robbed all of our IRA accounts and slept with our husbands before you sold all our cars for parts and cut our electric lines.

    So maybe we wouldn't be sympathetic to you but your story should still move and anger and motivate us because odds are you are not the only uninsured/underinsured person in your situation.

    Diabetes carries a huge cost to everyone. Sure the cost of the pump isn't worth another 8 years of a person's life or anything....but in terms of productivity for the person, reduced hospital and other medical costs...
    sure seems like proper medical care would save society big money and isn't that what we care about?

    I doubt any of these would be helpful or you'd know about them already but just in case...

    Call Levin and Stabenow every damn day and ask what people like you get before 2013/14.

    btw Sparrow has a patient assistance program too, don't know financial limits. It is free or reduced care for ALL of their services (meds too? Don't know) for 6 months at a time.

    But you better win that fight. If not turn to the newspaper. Send that John Scneider (?) guy at Lansing State Journal what you wrote here. Send you Senators and reps this too. ASK FOR A REAL ANSWER AND NOT A FORM LETTER IN BIG PRINT LIKE THIS

    How the hell does any kid who grows up with Type 1 diabetes ever get insurance unless it is with proper employer. (Work for U of M. Think they still have diabetes treatment/supplies/meds at no copay)

    This is just ridiculous.
    Shame on USA
    Shame on MI
    Shame on BC/BS
    Shame on Sparrow

    That is if you are unwilling to take the blame yourself. Maybe it isn't as unfair as it seems. You chose the parents to be born to and the genetics it would lead to. You have to live with your choices. Or something.

    Sorry for my rambling rant, thank you for sharing, let us know how it goes
    and I wish you the best

  •  diet may help. (3+ / 0-)
    Recommended by:
    ladybug53, 4Freedom, ilovecheese

    anecdotal, but some interesting discussion about how altering diet to high-fat and high-protein (paleo diet) alleviates even type 1 diabetes (it can reverse type 2 entirely).  the alleviation would reduce your insulin requirements greatly, saving you drug and doctor visit expense.  

    certainly something to research, in any case.

    by shoeboy on Sat Dec 26, 2009 at 03:07:49 PM PST

    •  I can see how such a diet would help in theory (7+ / 0-)

      At least in that the lower-carb the diet, the less insulin I'd need to inject into me, and therefore the fewer side effects I'd have that were insulin-related (the big one being weight gain, but also all the low blood sugar risks, etc.)  The problem I see is that Type 1 Diabetics, myself included, have much higher rates of difficulty with high blood pressure and high cholesterol, which a high-fat, high-protein diet would exacerbate.  Although, I suppose if I did lose the weight that an Atkins-ish thing would accomplish, that might offset some of that.  Interesting thought.

      A health care worker, beaten at work, then denied health care:

      by cartwrightdale on Sat Dec 26, 2009 at 04:37:39 PM PST

      [ Parent ]

  •  Yeah, I'm on BCBS and I'm diabetic, type 2. (3+ / 0-)
    Recommended by:
    Kitsap River, 4Freedom, Pris from LA

    It's unfair but you could go back to work for a company. I'm so sorry this happened to you.

    Before President Obama got elected I was afraid that if I ever lost my insurance the only way I would qualify for insurance is to divorce my husband (I will not let him work all his life, save just enough to retire on and then have nothing because of me). So, I had panic attacks for a year waiting and working for him to get elected.

    Will it help you, yes, and me and millions of others. I've studied every version, it's pretty good for basically making us all covered. Of course we don't know what the final bill will look like but John McCain's entire plan was to let the  insurance companies handle it as they knew best.

    Me? I don't know what's worse, the panic attacks that the left will sit out 2010 or the diabetes. What gets me is that if you listed all of the evil done in America, anything anyone in the Obama administration did was not done with evil intent, I believe that with all my heart. I think there is one big thing he knows that we don't and it's not terrorism--it's what the republicans will really do to us. But he can't tell us--they are demanding that he try to be bipartisan or not get reelected.

    Like it or not, I'd like to try to see anyone build a new economic system from the ground up. Right, we can't get healthcare done--but a new economic system- sure!

    The republicans don't care one thing about anyone. Look at them. They are mean. Please don't sit out 2010. You won't have to worry about insurance. They want victory in Iraq and Afghanistan. They will draft anyone that is not them. The army will give you medical insurance. Right. Victory in Iraq and Afghanistan.

    The thing we must all do now is get out the vote!! (Dems of course)

    A miracle is simply something we cannot understand, or explain yet.

    by Crispian Day on Sat Dec 26, 2009 at 09:11:31 PM PST

    •  Yeah (4+ / 0-)
      Recommended by:
      Angie in WA State, jlynne, 4Freedom, cai

      It's unfair but you could go back to work for a company.

      This is a really hard concept for me to grasp -- because I have an autoimmune disease, I don't have the same rights to become an entrepreneur as a healthy person?  There's something inherently, perversely anti-American about that.

      (But, alas, I am indeed considering it.  Unfortunately, I'm in Michigan, and there are no jobs here.  And I refuse to be more than two hours away from my little girl.)

      A health care worker, beaten at work, then denied health care:

      by cartwrightdale on Sun Dec 27, 2009 at 12:20:46 AM PST

      [ Parent ]

      •  p.s. (5+ / 0-)

        Can you blame me?




        A health care worker, beaten at work, then denied health care:

        by cartwrightdale on Sun Dec 27, 2009 at 12:33:02 AM PST

        [ Parent ]

      •  one of my biggest bitches about the Senate Bill, (0+ / 0-)

        is that it is designed to force us all to become wage slaves.  "Perversely anti-American" sums it up nicely.

        My read of the Senate Bill is that it won't save you a dime and will likely cost you more.  It may mean that you will get better care options (once you exceed the out-of-pocket cap, you should at least be able to test your sugar levels as frequently as your doctor recommends), but I don't actually see anything that would force that result.

        Another big problem is that if you can't carry the financial burden of maintaining insurance, eventually, you are going to be bankrupt.  Because you have a decent income, you won't meet the means test for a Chapter 7 discharge, and you will be forced into a Chapter 13 repayment plan.  You won't be able to get the fresh start that bankruptcy is supposed to provide, and at least in your case, the medical bills aren't going to stop coming due.  

        Hardship exception?  Maybe, but I can't find much info on what the guidelines will actually be for that.  

        "Rules must be binding. Violations must be punished. Words must mean something." President Obama in Prague on April 5

        by jlynne on Sun Dec 27, 2009 at 01:35:20 AM PST

        [ Parent ]

        •  I am curious where you get your information (0+ / 0-)

          My read of the Senate Bill is that it won't save you a dime and will likely cost you more

          The next link is the most recent iteration of the Senate bill called Managers Amendment or read the entire bill here.

          .Democrates Senate Gov

          or side by side comparison to congress here

          Kaiser side by side

          or summary here

          Actually both plans would help the diarist immeasurably. For one both plans don't allow pre existing conditions. Everyone in the diarists age group pays the same.

          There's been a lot of false information put out by Republicans that simply isn't true. Most people when they take a look at the actual plans find they'd either be much better o or left the same way they are now.

          The diarist being self employed and having a serious condition would be . . . well. . . much better off.

          "Don't fall or we both go" Derek Hersey

          by ban nock on Sun Dec 27, 2009 at 06:39:41 AM PST

          [ Parent ]

          •  I read the Bill (0+ / 0-)

            You don't address the issues I raised.

            "Rules must be binding. Violations must be punished. Words must mean something." President Obama in Prague on April 5

            by jlynne on Sun Dec 27, 2009 at 07:17:54 AM PST

            [ Parent ]

            •  actually that was exactly what I was addressing (0+ / 0-)

              with links to source.

              Without knowing someones income I can't give exact numbers but they are all available on the links.

              By any measure under the current senate plan the diarist would be much much better off. He currently has benefits capped at 5K!

              Sennat bill the only caps are on what patient pays, no caps on insurance comapny coverage.

              I'd strongly suggest you familiarize yourself with what is really praposed in the senat and house bills, then if you still have questions ask away.

              "Don't fall or we both go" Derek Hersey

              by ban nock on Sun Dec 27, 2009 at 09:26:06 AM PST

              [ Parent ]

  •  IIRC, in at least one state... (1+ / 0-)
    Recommended by:
    Pris from LA

    you need a prescription to get needles, but you can just walk into a pharmacy and buy insulin, no prescription.  Precisely because there is such a danger in running out.

    I'm not diabetic, but I heard this from someone who did buy insulin.

  •  Father a 50+ year survivor (3+ / 0-)

    PLEASE do not give up hope.  My dad lived for 54 years with Type One.  He was such a conservative he never changed from that one shot in the ass every morning.  His secret?  Lorna Doones and Michelob.

    •  Well, wait a minute :) (3+ / 0-)

      Right now, I'm told I can live until 62.  I don't wanna hear that it's actually 54!  :)  I wouldn't even get to see my daughter graduate college if it was 54.

      A health care worker, beaten at work, then denied health care:

      by cartwrightdale on Sun Dec 27, 2009 at 12:10:23 AM PST

      [ Parent ]

      •  I suspect kolea's father was (3+ / 0-)

        actually a lot older than 1 when diagnosed. Maybe he was 20. That would mean he lived to be 74.

        It can be done. There are quite a few stories of people with Type 1 living over 50 years. Joslin Diabetes Center gives out 50 year medals. They recently had to give out a 75 year one for the first time. So please do not give up hope, and work to get one of those medals. If you can do it, you'll have earned it!

        I'm a Type 2. Diabetes of any kind is difficult to live with (but can be done), but Type 1 in particular. One of my dearest friends is Type 1. She is now in her 50s and I expect that we're going to be egging each other on for many years to come.

        Living kidney donor needed; type B, O, or incompatible (with paired donation). Drop me a note (see profile).

        by Kitsap River on Sun Dec 27, 2009 at 04:26:46 AM PST

        [ Parent ]

  •  this is insane (2+ / 0-)
    Recommended by:
    Sandy on Signal, Pris from LA

    and I am so sorry that you are going through this.

    This may be silly, but if you become friends with a doctor, and run up against a situation like this, could they just write a script for you?  It would have to be someone in your state, I am sure.  But it seems like it might work for 'emergencies'.....

    War cannot be waged to instill any virtue, including democracy or the liberation of women. - Chris Hedges

    by dancewater on Sat Dec 26, 2009 at 10:16:53 PM PST

  •  Too bad I can't select 2 answers in the poll. (4+ / 0-)

    I have good private health care coverage via my partner's employee group health plan, and I am also on Medicare because I have ESRD and am on dialysis. Thank all the Gods for the Democrats in Congress back in the early 70s who decided that it wasn't fair to make people go before real death panels that decided whether they'd get dialysis and live, or not get dialysis and die. Congress decided everybody who needed it should be able to get it, and that Medicare ought to pay for it to make sure that was the case.

    Medicare's not perfect - you still have a 20% copay with no ceiling - but it's a darned sight better than dying of uremic poisoning. Since I nearly did do just that before I started dialysis, I have personal first-hand experience on which to draw.

    And my private insurance isn't half bad. Aetna sucks a lot in a lot of ways, not least of which is Joe Lieberman, and tried to make me wait a year before starting dialysis (a wait which certainly would have killed me), but once I fought and won, by proving that I'd had insurance for the two consecutive years before we were covered by Aetna, and had had insurance from a different company within 63 days before we were covered by Aetna, they stopped squawking and started helping. The first big thing I got approved for after that was to get evaluated for a kidney transplant, and then got approved by both the transplant program and Aetna to get a transplant. Aetna sent me a letter stating that I was approved for a transplant through December 2010. If I can't get one by then, they'll have to approve an extension, but with my blood type, that may already be something they are expecting to need to do. What I don't like is that they are ending their contract with the university hospital where my nephrologist practices and where I'm listed on the transplant waiting list. I need to get a different nephrologist and find a different transplant program. This is really too bad, because UW has all my records, and because UW is really very good. I don't know about Virginia Mason's program. Swedish I don't know about either, but I have friends who swear up and down by Swedish and won't go anywhere else.

    I think it may be time to start looking at other programs, not just in my area but elsewhere in the country. Aetna will cover some, but by no means all (they don't cover the Mayo Clinic, for instance). I want to find out if they cover the Cleveland Clinic, because if they do, I really want to get listed there. Those folks are the leading edge when it comes to kidney transplantation.

    Living kidney donor needed; type B, O, or incompatible (with paired donation). Drop me a note (see profile).

    by Kitsap River on Sun Dec 27, 2009 at 04:15:44 AM PST

  •  Outrageous (2+ / 0-)
    Recommended by:
    Angie in WA State, 4Freedom

    My husband has Diabetes I, too.  He wears an insulin pump, I hope you can get one too, Cartwrightdale.  

    A couple of years ago, we went on COBRA, it cost us $2300 a month with BCBS.  We could not afford to retire so he is back working for a big company 120 miles away from home.  He lives in a small apartment during the week and makes it home on weekends.  The whole thing is stressful and that is the last thing one needs with Diabetes, but we have no other alternative.

    I am so disappointed in this health care bill, we needed the public option.  No way in hell, do I think there will be insurance reform.  I feel it will only be worse for those with life threatening conditions.  The Dems should have and could have done better, 2010 will be ugly for them, but they reap what they sow.  So be it.  

    Thanks for the great diary.  Sad this happened to you.  

  •  I'm Type 1 Diabetic too (2+ / 0-)

    But we had to choose to not be insured because we're in the same financial boat as you. My husband supports us now because I'm jobless (without unemployment benefits), but he makes too much for us to get any assistance and not enough to pay for health "insurance". In CT the lowest rate I could get was BC too, and we can't afford that at all. Luckily I got my insulin pump before I  lost my job (and had decent health coverage), but the infusion sets and all that are just as expensive as your Humalog pens! For now, I switch weeks - 1 week on Lantus and Humalog, 1 week on pump.

    Thank you for sharing - I finally feel like there's someone out there who can understand what I go through every day. No one understands that checking blood sugars, exercising, and all the things we do to stay ahead of the condition is a huge factor in staying alive. Everyone is so used to treating something once it's already established, like cancer, rather than prevention, as in our case - keeping blood sugars stable.  

    Oh, and the person that said, "...go to work for a company."  If I could get a job tomorrow, don't you think I would? That was a horrible thing to say..

  •  I hope all of the commenters and diarist (0+ / 0-)

    struggling to keep ahead of a medical condition can hang on for a couple more years.

    I've posted links upthread to places to find out what the HCR making it's way through our legislature would actually do for you. In a nutshell for the first time it establishes your right to health care, you're covered, and you will  be able to aford it. It might not be free, but it will be affordable.

    My family and I run up against similar circumstances but this isn't about me and mine, rather about us and ours.

    "Don't fall or we both go" Derek Hersey

    by ban nock on Sun Dec 27, 2009 at 06:49:48 AM PST

  •  While challenging that $2080 charge... (0+ / 0-) might point out that it works out to ($2080)x(60 min in an hour/5min) = $24,960 per hour, and then ask them if it's a reasonable fee. If they say anything other than "No, we're sorry, have a nice day," demand to be hired immediately at that rate of pay.

    Health insurance is not the same as health care. Insurers may have to provide COVERAGE, but they'll still deny CARE.

    by SciMathGuy on Sun Dec 27, 2009 at 06:59:18 AM PST

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