I don’t really circulate petitions unless I feel they fight a real credible threat to someone else.
When I say I’m in recovery from my job, I’m only half joking about that.
My employer & the self-funded insurance market was a hell of a lot more fair & equitable than most of the major players in the fully insured health insurance sector that most of us are used to dealing with. There are things I miss about working in it, but definitely others I don’t.
Because we had to report results & answers to multiple entities (employers, insurance network partners, subscribers alike) & had to account for everything, there was more transparency than what most employers get from standard (or fully insured plans).
I see this even my own company insurance.
I learned how the health insurance market works overall over the past 3 or more years (still continue to) & I’m glad I did.
I’ve been in a better position to successfully navigate the bureaucratic end of transplant as it comes up than I would have been without that experience.
There are many things that I don’t agree with but understand about the industry itself.
In fairness, I also didn’t fully grasp what happened behind the scenes (or otherwise) until I was there doing the daily grind & saw it in action myself.
For me, it’s conflicting at times.
Yet that conflict was why it mattered to me to stay in, grow, & learn from the bottom up when I started. It’s why I hung with the hard & frustrating parts of the job. I felt it was education I needed in dealing with issues on my own as they arose.
I also remained there because my employer actually allowed me to explain plans, claims, & benefits to people without penalizing me for doing so (which is an all too rare occurrence in the sector as a whole now). I didn’t have call averages & a million scripts to spit back to people or adhere to.
When I was navigating the system from the outside, even now I have just as much confusion & anger as the next person.
When someone used to yell at me on the job it was easier for me NOT to take it personally. I understood the frustration all too well because more often than not I had been there or asked the same question or reacted similarly (albeit under my breath).
That said, the advocate in me really rails against the issue pointed out in this article (The issue was reported in this Nephrology News & Issues article originally. The Kidney Buzz links I pointed & linked to here are also very informative & easy to follow.)
Especially because I know how the underwriting process is & how it works (I was privy to this part once I was promoted. I was knee deep in a lot of that part of the process just before I had to go on extended medical leave to prepare for my transplant).
I know how it works & how some companies protect their own “butts” so to speak at the expense of the truly sick.
I know how they have replaced pre-existing condition clauses with behind the scenes practices targeting those people they feel cost a plan too much money.
But what these articles point out is overreach & interference to a disturbing degree. It must be called out & stopped.
I would not have been able to afford my COBRA payments or oxygen rentals while on disability & out of work until transplant without assistance in raising funds through a nonprofit like HelpHopeLive. They issue those payments on my behalf at my request. I’m still paying it, but having a nonprofit fund through them helps me afford other things like my medications & keeping a roof over my head while on disability.
The AKF works a bit differently, but provides similar assistance.
We must stand together to protect organizations like the American Kidney Fund (AKF) who protect those who need extra help, especially in the face of ever rising deductibles & out of pocket costs.
If the AKF is denied their ability to help their constituents & insurers are allowed to overreach & interfere to this disagree, a disastrous ripple effect will happen.
That’s no chicken little talk either, it’s reality.
What few social safety nets there are for all of us need to be preserved & staunchly protected.
There are already too many people (sometimes even with assistance) who have been forced into bankruptcy, homelessness, & abject poverty due to lack of coverage, sky rocketing deductibles, & serious illness or disability.
Nonprofits like this one is are one of too few resources we all have to try to level that playing field & keep people afloat & alive through trying times.
As long as they get their money, what should it matter who signs off on the checks or makes the payment to the insurance company?
Would they rather not get paid & then have to eat more claims for people’s health they jeopardize because of the obtuseness of their “rationale” in rejecting these programs?
Excuse my French but “Fuck their risk pools!”
They’re already unbalanced to begin with (& were prior to the Affordable Care Act).
Most of those savings from the risk pools in the fully insured health insurance market model don’t go to the employers, subscribers, or even to people on the front lines doing the actual work — they go to pad & protect executive pockets & bonuses.
Time for these games to end.
If we allow this now, they’re surely going to follow suit with targeting others.