Taming the Purple Elephant in the Room
Written on August 10, 2009 by Seth
How can anyone afford to ignore what’s going on?
Most people opt out of politics unless there’s a juicy scandal involving an intern, a bag of money in the freezer, or an escort. Which really grinds my gears, because when a subject like health care comes up, we all need to pay attention. The old saying goes “if you don’t have your health …” — so I ask myself, how could anyone afford to ignore what’s going on?
Here’s the problem: it affects all of us (especially those with arthritis) because we’re the ones living with a chronic condition who rely on good health care to live a decent life.
If you’ve ever gotten a referral, been prescribed multiple medications, needed a test (like an MRI) or even a second opinion, you’ve likely had difficulty navigating the complicated mess of approval, authorization, and reimbursement that is health insurance benefits.
It’s hard not to get angry at the thought of an insurance company denying a claim. I remember way back when I was prescribed a Prilosec (proton pump inhibitor) to keep the other medicine I was taking from causing an ulcer. That one little pill (back then it was prescription-only) was so annoying to get approvals for, it must have taken a dozen phone calls a month between the doctor’s office, pharmacy, insurance company and my mom. And why? Because an MBA graduate at the health insurance company made a formula that kicked back costly drugs because there were other alternatives available.
Even then I never understood how an insurance company could challenge a doctor’s decision to prescribe a certain medicine. Why even separate the two? If we’re going to get screwed by the insurance company, why not take out the middleman and have Blue Cross open clinics for their doctors to tell us up front that the medicine or tests we need aren’t covered, so we won’t even bother.
Whichever “side” or whatever opinion one might have about the health care conversation, it’s best to at least get involved and know more. And know more doesn’t mean learn everything from Fox News or even MSNBC. It comes down to learning and thinking about some of the complexities that comprise the issue. Boiling down health care into small sound bites or news stories (like disruptive town hall meetings) doesn’t scratch the surface.
And it doesn’t do us any good if we’re going to actually get hooked up and stop being jerked around.