There’s nothing quite like having great insurance only to find out your insurance coverage — for reasons still unknown — is no longer as great as it used to be a few years ago. Is that result the rubbing off of Obamacare on established health insurance plans that have now been debrided down to an even more lowest common denominator, or is something else stinking afoot?
A dear friend of mine hurt her back and now has trouble walking, sitting and standing. She has what is considered a government employee “Gold Standard” in health insurance. Over the years, she has pretty much been able to see any doctor and go anywhere she pleases because all the health concerns in her area participated “in network” with her health insurance.
That’s not true any longer.
When my friend hurt her back, finding an “in network” doctor to see her close to home became a nigh impossibility. Yes, they accepted her insurance over the phone, only to find out upon arrival, in person, that they actually did not accept her insurance and so she’d be paying “out of network” — it became clear a big scam was happening to get a severely ill person to trek to an office only to be denied coverage that had previously been “vetted” and “approved” over the phone.
My friend quickly learned to force the doctor’s office to “pre-certify” her coverage over the phone before arrival to guarantee her “particular” vein of government insurance was actually accepted by her physician.
There’s nothing quite like the feeling of being “Uninsured While Insured” with no way out from the pain.
After countless tries and failures, she was able to find an “Old Skool Cool” in network surgeon who was able to see her within 10 minutes of her phone call. It seems the older doctors are much more willing to actually take “any and all insurance” and then be able to sleep at night because they haven’t had to turn away people in pain during the day.
Once you find the right “in network” doctor, then you’re “inside” because they know which MRI center and which physical therapy shop will “take” your health insurance and that makes everything easier when you have a surgeon’s office behind you and making calls on your behalf to get you healthy in situ.
Getting pain medication is also a challenge because you cannot use an electronic prescription for a controlled substance like Percocet. The addicts have ruined it for the rest of us. That sort of narcotic med is highly controlled Schedule 2 drug and is regulated by the Federal Government and getting a prescription filled must be done the Old Skool way with pen on paper. So much for the convenience of being in pain!
When you need to get around town — to the doctor, to the MRI station, to the pharmacy, to physical therapy, and back to the doctor all in one day — and you have a bad back and cannot walk or sit or stand for very long, you quickly realize how absolutely crippled you’d be without the Godsend that is Uber.
Sure, Uber uses surge pricing to their advantage. When my friend was dealing with her back issues, Uber was recovering from a snowstorm and pricing for several days was stuck at 2X the base price. A minimum surge price fare is $7 in her area and so to travel a single block costs her $7 — but that’s $7 you’re glad to pay when cannot walk ten steps alone.
I thought Obamacare was the golden pot at the end of our healthy rainbow, but in my friend’s experience, everything has changed in the couple of years since she last really needed her insurance to come through for her — and the case seems to be singularly, and more strongly, made for single payer universal healthcare coverage — because the current system is still incoherent and broken.