Showing posts with label health insurance. Show all posts
Showing posts with label health insurance. Show all posts

Friday, June 5, 2020

One Week


Surreality.

It was approximately a year ago when I began marking "lasts"..."this is the last time I'll..."

My job has distinct seasons. Summer is more laid back and allows one time to think and create. It was approximately a year ago that I formed my events committee. My goal was to form a cohesive unit out of a gaggle of hermits who kept their faces glued to their screens 99.9% of the day. Together my work group devised activities that made people laugh and actually converse with one another. Also, food helped. Maybe the biggest mark I made on my department was the formation of the Star Catchers (not my name ~ it was a group vote).

As winter approaches, the department becomes busier and scurrier. There is much to be accomplished before the year ends, and long hours ensue. Many days I alighted at my office before sunup and left for home in the dark. This was not my favorite time of year. So, one of my countdowns was "one more year of reinsurance".

I naively thought I could count down other day-to-day activities, but that was before Corona showed up and made us all flee to the confines of our homes to work remotely. I'd envisioned a going-away party, during which I would tell everyone how much I treasured them and would miss them. Ehh. I guess I can email a few people next week.

Today as I was working, it suddenly hit me how much I know about what I do. I'm not normally a claim examiner ~ training is my responsibility ~ but in these times, I do whatever needs to be done. So as I was processing claims, I was transported back to the many weeks I sat next to a new employee in the training room and guided them through the intricacies of their brand-new job. I found today that I'm pretty good at it. Some like to know how to follow each step; the good ones also can intuit when to question something. It's not an easy skill to instill. Maybe it only comes with years and years of experience. In a week I can discard all of that, I guess. 

I feel inexplicably sad, but I must remind myself of the alternative. How many more years could I carry on with this? Every single thing has to end.

Tomorrow I shall go into the office for the first time since March 16. I will clean out my desk and dump my belongings into a cardboard box. The office is deserted, so I'll be able to say goodbye to my cubicle unimpeded. Tomorrow I will cry a tear.


Things I did this week:


  • I don't even know how Monday zoomed to Friday. This was the fastest week in history. 


Things I learned this week:


  • The Ace In The Hole SiriusXM channel is no more. It was delicious while it lasted.



So I did little and learned even less. That's how it goes when things are winding down. 













Friday, June 29, 2012

What Just Happened?


Let's see if I have this right.

The Obama administration argued before the Supreme Court in March that Obamacare was not a tax.

In fact, the solicitor general was vehement that it was not a tax.

I apparently missed this part of the argument:

CHIEF JUSTICE ROBERTS:  "So, you're saying it's a tax?"

SOLICITOR GENERAL:  "No, your honor, it is definitely NOT a tax."

ROBERTS:  "Well, you're wrong!  It is a tax, and YOU WIN!  Tell him what he's won, Ruth!"



Now, I'm no deep thinker.  I am barely a thinker at all.  However, even I can understand that the person with the losing argument is the LOSER.  But not in Roberts' world.

So, what happens now?  Well, first of all, the 30 million people, most of whom by their own choice, do not have health insurance will now be forced to buy it or pay a penalty (for now ~ later they will be forced to buy it).

How can that be enforced?  You know, everybody is supposed to have car insurance, too, so why is it I see so many claims from people in auto accidents who ~ oops!  forgot to buy it?

Well, the Fed Gov has that all worked out.  Obama is creating jobs (!) by hiring more IRS agents.  Need a job?  How about the IRS?  The IRS will hunt you down to make sure that you have purchased health insurance, and woe to you, if you have not.  If they find that you are not in compliance, no problem!  You will be financially penalized!  (I think that's phase one.  Phase two is most likely a bit more draconian).

Can't afford to buy health insurance?  Well, first of all, prove it.  Did you really need that second cup of latte today?  We (the Fed Gov) feel that your money would be better spent saving up to buy a health insurance policy.

If we, the Fed Gov, decide that, yes, you seem to not be able to afford it (this distinction will be made according to the political party in which you are registered), then you can go on Medicaid!  Who pays for Medicaid?  Silly.  You do, of course.  All of you out there.  Except the 1/3 of the country who pays absolutely no taxes whatsoever.

Medicaid is great, we, the Fed Gov, say.  Oh sure, a lot of doctors don't accept Medicaid patients, and yes, we've reduced the compensation we pay doctors for that service, so there'll probably be even fewer doctors available by the time you need to see one, but if you don't mind the wait, somebody will be sure to slot you in for an appointment in, say, a couple of months.  Oh, you have a collapsed lung?  Take two aspirin and call somebody in the morning (not us!)

But the good news, as opposed to your collapsed lung problem, is, everybody gets free birth control!  Oh, you're a guy?  Still.

Another great piece of news for everybody is (as the Prez loves to say over and over), insurance companies can no longer deny you coverage because of a pre-existing condition.

Here's a poorly-kept secret:  Nobody is denied coverage because of a pre-existing condition now.

I never understood why nobody, anywhere, on TV, radio, in print; ever refuted this lie.  Didn't anyone even bother to check if it was true?

If there is anyone out there who has been explicitly denied health insurance coverage because they have a pre-existing condition, what bizzaro insurance world are you trying to buy a policy in?  Come see me.  I'll help you out.

The thing about "insurance" is, it's supposed to "insure you" against an unforeseen event.  Just like auto insurance is there in case you have an accident.  Or your homeowner's insurance policy exists in case your house gets burglarized or spontaneously combusts.  For some odd reason, State Farm doesn't let you ring up an agent and buy an auto policy while you're lying in the roadway, bleeding profusely from that head wound you acquired from the head-on collision you just had.  They're quirky that way.

But unlike auto insurance or homeowner's insurance, if you suddenly discover that you, say, need a hip replacement, just call up Acme (well, maybe not them, specifically) and tell them you're ready to buy in!

Those mean old insurance companies will be forced to enroll you!  Against their will, because they're cruel and heartless.  But we, the Fed Gov, have now told them what's what!  They have to do it!  Because we said so!

Who pays for all this?  You're asking me this question again??  Well, you know the answer!  Everybody pays!  And pays big!

Apparently, a too-common misconception is that Mean Cruel Insurance Companies sit around, counting their huge piles of money over and over, ignoring the ringing telephone, because it's most likely some member calling, wanting them to pay a claim, which means that the Mean Cruel Insurance Company will have to dip into its money pile and slip out a few bucks, and that would ruin the whole ambience of the "big pile".

Well, most businesses are what's called "self-insured".  This means that the companies put up the money; not the insurance company.  The insurance company is tasked with managing the business's money efficiently.  What did you think?  Insurance companies were just doling out their own money to pay claims?  Where the heck would they get that money to begin with?  That's just stupid.

(So, by the way, if you are unhappy that your insurance policy doesn't cover some specific thing, talk to your HR department; don't scream at the insurance company.  Your employer is the one who decides what's covered and what isn't.  Or, at least, that's how it used to be.  No more, with Obamacare.  Now, every company has to cover, say, fertility treatment, and you will pay the premium for that.  Even though you are a sixty-year-old man who really doesn't want to get pregnant.)

Herein lies the problem with someone only choosing to take his employer's insurance coverage when he finds that he has a major medical condition.

Affiliated Nuts and Bolts, Inc. signs on with ABC Health Insurance to administer its insurance program Affiliated says, I will give you, ABC Health Insurance, ten million dollars this year.  Out of that, you will pay my employees' claims.  Now, Johnny Blackstone, who has always gambled and gone without insurance coverage, suddenly finds that he needs a heart transplant.  Well, says Johnny, I guess I'd better sign up for health insurance!  Now, with Obamacare, I still get my transplant paid!

So, Affiliated's ten million dollars quickly dissipates, just for paying for Johnny's heart transplant.  Sorry, rest of you employees!  says Affiliated.  "Don't get sick!  That's all we can say!"

(This self-insured issue, by the way, is at the heart of the Catholic church's current contraception fight.  The Prez said, "Okay, I guess you all have some kind of problem with paying for your employees to have free birth control pills; you rigid old-fashioned religious zealots.  Geez, I just can't please you, can I?  Well, here's what I'll do:  I'll make your insurance company pay for the birth control.  How's that?"   "But we're self-insured!" the Catholic church replied.  "We're the ones who'd have to pay for it!"  "You know, I've got a lot on my plate", responds the Prez.  "Can't we quickly come to some compromise?  Meaning, you compromise and just do what I say." )

Another bright piece of this legislation that we can all embrace is that the Fed Gov will now have access to everybody's medical records!  That's neat!  The Gov needs them, you see, in order to ensure that you can easily switch doctors at any time (which you will need to do when your doctor decides to retire because Obamacare has driven him/her out of business), and your medical records will be "portable".

Do you know what HIPAA is?  HIPAA stands for the Health Insurance Portability and Accountability Act.  You have to sign one of those HIPAA forms about once a year at your regular clinic, or anytime you go to a new clinic or hospital.  You probably just sign it, like I do with every form slapped in front of me when I'm sick and just want to see the doctor to get some meds, and don't really care about their stupid forms, and you might not even listen to the receptionist droning on in her most effusive monotone about what the form is about.  Well, it's a privacy form.  It says that the clinic or hospital can't share your medical records with anyone without your signed authorization.

Well, guess what!  I bet you can guess!  I'm not saying that the Fed Gov would use your records for anything non-kosher.  But again, there's a lot of things the Fed Gov does that we don't know about, isn't there?

So, what else happens now?  I can consult the Magic 8-Ball, or I can consult my own brain.  Here's what my brain is telling me:  Businesses will either drop insurance coverage all together, and make you, the employee, sign up with one of those government exchanges, or your company will tell you that you now have to pay ten zillion dollars a year for their insurance plan; you know, to make up for Johnny's transplant.  So, it's your choice, really.  And isn't that what it's all about?  Choice. 

Oh, and either way, get ready for a huge tax increase.  But that's really a small price to pay to have the Federal Government invade every single aspect of our lives.  Right?