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  Let me tell you a story. It is a story of a transition in my life that was badly timed with the collapse of the american economy. A time when i thought i could stomach working in the bowels of a beast I reviled. It is the story of a mistake.

Ive had several careers. The last being trucking. It allowed me to see almost every city and town east of the mississippi. To understand how different and how alike we all are. It was with that mindset i took a job answering phone calls about peoples health insurance. As much as i reviled large corporations, office politics, insurance companies and the rest i reasoned that working in the belly of the beast wouldnt be so bad. That maybe i could help people. It was a scarring mistake.

I spent a lot of my time explaining why our company (a very large health insurance corporation) was raising rates as much as 30-40%. Where i spent a lot of time explaining to employers why they couldnt renew their insurance because they were one day too late on their premiums. Where i explained to people i couldnt help them or give them information as to why their insurance was cancelled when in reality i knew the employer just couldnt make the payments anymore. Where i referred employers to sales because they simply couldnt pay $500 or $1000 or $1500 per employee anymore.

But let me tell you the story that ill carry with me for life.

On an early monday morning in the middle of winter i was having a splendid day. All the callers were reasonable and there were no tragedies to darken the day. My coworkers were positive and the one or two i reviled had stayed home. And then the call came..

An elderly lady was calling me about her prescription insurance. Prescription coverage isnt traditionally very expensive, at least from our point of view. And then there are the "other" plans. You see corporations are compartmentalised for a reason. While sales may know that high risk individuals are to be funneled to certain very expensive plans, the normal persons prescription coverage isnt a burden.

I spent an hour talking to this lady. Usually i got them off the phone but quite honestly i was quite happy talking to this lady. I really wanted to help her. I had visions of a tiny little lady in a one room house. You know the kind, with the perfect little yard. Lots of flowers everywhere. Neighborhood kids waving hi as they went by. But this lady was on a fixed income. You see thats the thing about fixed incomes. There is no "more" to dip into. There are no "extra overtime hours" to make up. And this lady was at the limit. And we had just doubled her prescription rates.

To me or you that may not seem like such a horrible thing. Just a few bucks more a month. But , as the elderly tend to be, she had prescriptions. Prescriptions she couldnt live without. And she was scared. Scared but kind. I tried everythign i could think of. Talked to sales. Asked around in my department.  There simply was no help. In the end i looked up her states medicare and medicaid numbers. I suggested she talk to agencies and organisations i dont even remember. I will tell you this is the first person i talked to whom if i had the money id have paid her premiums. All of them.

Eventually she stopped crying. And when my supervisor walked over to say i needed to end the call i was none too nice. Dont get me wrong my supervisor was a very very nice person. But she had been trained. We arent supposed to help people. To suggest other places they could get help. We're supposed to get them off the phone. My supervisor was a corporate employee and corporate employees are efficient cogs. I got off the phone not too long after. And i went on break far far outside the "time window" i was supposed too. Deep down hoping someone tried to stop me.

I went outside and for the first time in my adult life i felt dirty for having this job. I felt evil. I had violated the one rule i have lived my life by. To never put money or career above morality.

I quit that job not long after. I nearly quit that day. Ill never do anything like that again. I will become homeless first.

Her story isnt the only one. I cannot list the number of times i had to tell people or employers that i was sorry.. theres nothing i can do. Or tell employers that because they hadnt made the payment their employees bills wouldnt be paid, they wouldnt get further care, and that their employer couldnt reinstate. That people were going to die. Because we needed profit. That people are going to suffer and die because a congressman needs some graft. That people are going to die because a suit needs a new Jaguar.

This is the story of american healthcare. Not one of singular evil. A system of corporatist, greedbased machinery. Machinery designed to extract profit regardless of the cost in blood.

This is why we need a healthcare revolution. This is why when someone cheerleads about the wonder of HIR some of us react with a deep abiding anger. Because somewhere in america today , and each day in 2011, and every day until we Revolutionise american healthcare someone is going to die because someone else wants nicer toys. And thats wrong.

Originally posted to cdreid on Mon Jan 03, 2011 at 03:40 AM PST.

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Comment Preferences

  •  Wondering what effect... (6+ / 0-)

    the new requirement that 80% - 85% of premiums be spent on healthcare will actually have on the regular annual increase in premiums.  Will they "fudge" the figures, or will this actually stop the huge increases of the past?  Despite the requirement, I doubt it will do anything to stop the larger problem of those lacking insurance, or the employers stopping coverage for employees because they can no longer can afford to pay for insurance either because of premium cost or poor business economy.

    •  ITs a separate issue (6+ / 0-)

      but i can tell you i saw memos that in effect stated they were going to fight the provisions that cost them money tooth and nail. The only ones they were going to accept as far as i could tell were the change to dependant30 and the mandate.

      As far ast the 85/15 split. If youre mandated to pay me for my product and my current price is $100. Then im mandated to only take 15% in profit. Why wouldnt i simply raise my price to $200?

      Voters will choose a person who fights a losing battle for his principles over one who fights winning battles against them every time.

      by cdreid on Mon Jan 03, 2011 at 04:27:50 AM PST

      [ Parent ]

    •  Not likely to effect premiums. (5+ / 0-)

      The requirement is a percentage so it doesn't matter what the premiums are the insurance company still needs to hit the percentage.  Is the new reg 80% or 85%?  A number of insurers hit that now.

      Personally, I think the targeting of insurance companies as evil is misguided.  The companies are not evil - in general, although there are some companies that are rip offs and there are some instances (or periods) where focus is placed too heavily on cost containment which then leads to poor decisions regarding care.  The real problem with health insurance is that the financial model is completely wrong.  Insurance is protection.  It works decently when you (the consumer) has a risk of loss and you want to protect yourself from that risk.  Healthcare is not a risk. It is a guaranteed event.  We all use healthcare (albeit to varying degrees at varying times in our life).  

      Health insurance fails as the financial mechanism when insurance companies apply their mode, period - which is to evaluate the risk and set premiums accordingly. That is a sensible business approach for some things but not for health care.  For healthcare it is disastrously wrong.

      What we really need is a complete restructuring of healthcare provision in this country. One which would include the removal of the current financing model.  ONe that would involve cooperative care throughout a region (as opposed to duplicative care).  One that would include a vast network of primary care physicians (physician assts/nurse practitioners etc) rather than a vast network of specialist concentrated in urban regions.

      And this country does not have the political/social/intellectual wherewithal to pull it off.  And it is made worse by one political party's steadfast devotion to making rich people richer.

      "You have attributed conditions to villainy that simply result from stupidity"

      by newfie on Mon Jan 03, 2011 at 06:02:36 AM PST

      [ Parent ]

      •  It is not just (10+ / 0-)

        a cost containment gone wild thing.

        When my wife became seriously ill, I found out exactly how insurance companies roll. They deny claims for minor paperwork errors. They require preapproval for everything, then claim they didn't receive the paperwork. They nickel and dime you to death. Deny, deny, deny. Delay, delay, delay.

        Until this expensive event, I never had an issue with them.

        And this is from a large, well respected company that is organized as a non profit (BCBS) and one of those supposed "Cadillac" insurance plans us undeserving union members receive.

        "A lie is not the other side of a story; it's just a lie."

        by happy camper on Mon Jan 03, 2011 at 06:43:54 AM PST

        [ Parent ]

        •  Depends on the BCBS, (3+ / 0-)
          Recommended by:
          cdreid, happy camper, NoMoJoe

          I have found a few of them to be encumbered with ineptness.

          "You have attributed conditions to villainy that simply result from stupidity"

          by newfie on Mon Jan 03, 2011 at 06:48:58 AM PST

          [ Parent ]

          •  To say the least! n/t (3+ / 0-)
            Recommended by:
            cdreid, Aspe4, newfie

            "A lie is not the other side of a story; it's just a lie."

            by happy camper on Mon Jan 03, 2011 at 07:05:17 AM PST

            [ Parent ]

          •  Something i shouldnt say (0+ / 0-)

            But my understanding is that basically bcbs is slashing costs anyway it can. Especially through outsourcing. They also have tiers of insurance. You can get high deductable bottom rung "cheap" insurance that basically covers nothing. Or you can get platinum plans where you walk into any medical facility on earth at any time and walk away without paying a cent. Thing is... you have to already be rich to afford number two.

            Voters will choose a person who fights a losing battle for his principles over one who fights winning battles against them every time.

            by cdreid on Mon Jan 03, 2011 at 01:42:51 PM PST

            [ Parent ]

      •  You make a good point. (4+ / 0-)

        After all, I can concievably go through my whole life without my house being burned down or ripped apart by a tornado. Insurance makes sense for that contingency, because out of all the people paying for the insurance, only a fraction will need to be compensated for loss. But nobody can go through life without ever having to see a doctor. And it is the nature of humans that we have a lot more things go wrong with us as we grow older.

        Sometimes I think that our corporate systems are the exact opposite of life. In our system, employees are burdens on employers. The public is always demanding food, clean water and housing from the government. Children are expensive, and there is nothing in the corporate culture that acknowledges their importance. People go around getting sick all the time. Old people want to retire and also eat. Not only that, but our life expectancy keeps getting longer. Its as if all we are is an expense of some form or another.

        "YOPP!" --Horton Hears a Who

        by Reepicheep on Mon Jan 03, 2011 at 09:15:09 PM PST

        [ Parent ]

        •  True in all cases. (3+ / 0-)
          Recommended by:
          Reepicheep, kurt, radical simplicity

          And more so when it comes to health insurance - ethically wrong but absolutely correct for that financing model.  The major problem is that we as a whole are very poorly informed and perhaps ill equipped to think through the issue critically.  Otherwise universal/socialized medicine would be in place.  It is what most of us want - but many of us appear to only want it for ourselves and no one else.  I say appear because I think the real factor is that we are very easily swayed by a logic that is based on falsehoods.  If you don't know that the very premises the logic stands on then you would buy into the logic.  So you get "it's gonna cost ME too much to pay for YOU" instead of "it already costs me too much to pay for ME and YOU and it could cost less to pay for all of us".

          It is a pattern that repeats - pretty much explains why most of us don't have pensions but instead have 401k plans that give us less than the pensions used to.  It is why we'll see public sector pensions going away as much as Republicans can make it happen.  Because the Republicans will convince enough people that pensions are bankrupting the States rather than the pensions being used to fund the States or SSN carrying much of the burden of our deficit spending. We are continually sold a bill of goods and the bulk of us think that it is "the right thing".

          "You have attributed conditions to villainy that simply result from stupidity"

          by newfie on Tue Jan 04, 2011 at 05:12:21 AM PST

          [ Parent ]

  •  Thank you. (9+ / 0-)

    Well written. I love the 'sound' of a compassionate heart in the morning.

    I used to be Snow White. And then I drifted. - Mae West

    by CherryTheTart on Mon Jan 03, 2011 at 04:27:31 AM PST

  •  I've Done Customer Service and Sometimes Dealing (5+ / 0-)

    with such people, also disabled etc. that our system had harmed or inconvenienced.

    In my case my situation allowed me to get them off the hook, eventually, but we would at times disrupt people's lives greatly for a while when money or mobility were like the fixed income in your case and the people totally had no more available to give.

    I stuck with the job 3 years but that was only possible because in our case the issues were trivial compared to yours.

    We are called to speak for the weak, for the voiceless, for victims of our nation and for those it calls enemy.... --ML King "Beyond Vietnam"

    by Gooserock on Mon Jan 03, 2011 at 05:59:19 AM PST

  •  The "toys" line. (9+ / 0-)

    reminds me that on my list of phrases I absolutely loathe is

    "He who dies with the most toys wins."

    I read somewhere recently that some of the brokers on Wall Street are complaining because their bonuses have shrunk. Complaints not fueled because they need the extra money, but because the size of your bonus determines your status on Wall Street.

    Status. Bragging rights. The winners.

    While people lose their homes, their jobs, their health care coverage, everything they've worked for.


    Freedom has two enemies: Those who want to control everyone around them...and those who feel no need to control themselves.

    by Sirenus on Mon Jan 03, 2011 at 06:25:35 AM PST

    •  Sirenus: he who dies w/ the most toys (1+ / 0-)
      Recommended by:

      is still dead.

      So there's that.

      I remember the first place I saw that bumper sticker. My SO's dad had it on his (beater) wagon.
      Guy listened religiously to Limpbaugh.

      LBJ & Lady Bird, Sully Sullenberger, Molly Ivins, Barbara Jordan, Ann Richards, Drew Brees: Texas is No Bush League! -7.50,-5.59

      by BlackSheep1 on Mon Jan 03, 2011 at 09:41:18 PM PST

      [ Parent ]

  •  Thanks for sharing. I worked in the corporate (2+ / 0-)
    Recommended by:
    BlackSheep1, Reepicheep

    world too (laid-off last year), but not in the insurance world. Been looking into various fields - non-corporate - where I could do things and earn money providing real services people need. Public school teaching for example. Unfortunately, the corporate culture is creeping in everywhere. That is my big dilemma.

  •  My employer switched (3+ / 0-)
    Recommended by:
    BlackSheep1, kurt, congenitalefty

    prescription carriers to a corporation called Medtrak. It is supposed to be cheaper than what our normal carrier can provide.

    My first experience with them (and I'm sure it won't be the last) occurred before our insurance actually switched over to these guys. I was renewing a presciption and the pharmacist told me that the amount the doctor had prescribed was too much. Instead of 90 pills, the new prescription company would only allow 60. I shrugged, and took the 60. The pharmacist looked abashed, but I assured him it would be fine.

    About a week ago I got a letter from the company offering me a wonderful deal. I could save on my co-pays if I signed up for a program that would let me consult with a pharmacist over the phone about my medicine. Signing up for this would also give them permission to "consult" with my doctors. I had been picked for this wonderful new program because they looked at my records and saw that I took maintenence medicines for a chronic condition.

    Why, in the name of god, would I sign up to have some random person on the phone "consult" me about medicines that I've been taking for years, and that I've already consulted with my doctors about? My doctors know me. We have a relationship. I've tried some medicines that weren't very effective, but over time we seem to have found the right meds and the right dosage. I don't need some faceless person telling me I ought to be taking something cheaper that I've already tried. And anyway, its really none of their goddamned business. I'm paying them to insure me, not to treat me.

    My fear is that even if I don't sign up for this, that I will "accidentally" be signed up for it, and will have to endure endless hassle to get them to unsign me. We shall see.

    Anybody ever done business with this company?

    "YOPP!" --Horton Hears a Who

    by Reepicheep on Mon Jan 03, 2011 at 08:56:23 PM PST

  •  Murder by spreadsheet (0+ / 0-)

    is what it is & needs to be called by that name. When the accumulation of "toys" is more important than human life something is wrong.

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