sick and insured, part II

I took Bev Davis’ advice and wrote to my representative in Congress (after being sure that she was a co-sponsor of HR 676, the United States National Health Insurance Act), Tammy Baldwin. I received an almost cookie-cutter response from one of her staffers today. This is it:

Dear Mr. Lawler,

Thank you for emailing Congresswoman Baldwin regarding your private health care concerns. She appreciates hearing from you and asked that I contact you to share some ideas for assistance.

The Wisconsin Office of the Commissioner of Insurance oversees private insurance companies operating in the State of Wisconsin. They can investigate your complaints. To contact OCI visit their website at www.oci.wi.gov or call (608) 266-3585.

If you come to believe you need legal assistance you may wish to explore the services offered by the UW Center for Patient Partnership. To learn more about CPP visit their website at www.law.wisc.edu/patientadvocacy or call (608) 890-0321.

We hope you find these resources helpful. Please do not hesitate to contact Congresswoman Baldwin again if she can be of assistance with some federal matter, or if you simply have a concern or opinion to share. Thank you.

Sarah Benedict Anstaett

Office of Congresswoman Tammy Baldwin

phone (608) 258-9800

fax (608) 258-9808

And I thought: tell me some things I don’t already know. But then, what did I expect — Tammy Baldwin calling “Assurant Health sucks” and demanding they pay what they rightfully should?

And then I got a rare phone call from Tara last night. She said, “guess what I found out?” I said (what else?), “what?” Speaking through a friend, she learned that it is illegal for an insurance company to claim a pre-existing condition if the patient has had uninterrupted coverage — the change of companies does not matter, in other words, if the transition was seamless. Therefore, since our coverage was not interrupted, “Assurant Health sucks” cannot claim that I had a pre-existing condition (even if I did prior to their coverage, which I DID NOT).

Okay, so now what? It all comes back to the burden falling to the patient. I still have to call the Office of the Commissioner of Insurance and explain what’s going on, file a detailed complaint, and wait more. I still have to call our medical creditors and explain why we aren’t paying the bills. I still have to hope we don’t miss a call and send one of the bills into collections. I can’t imagine how any of this is supposed to help me, how any of this is supposed to heal me. If there was any doubt in my mind before, I now am convinced that the insurance industry really is about nothing but money. The insurance companies want to turn huge profits, and pay out as little as possible — and they will do whatever it takes to keep the money in their pockets (or, at least the pockets of their CEO’s and major stockholders). And this is what we pay for. We pay premiums so that we can be harassed by creditors and hassled by our insurance company. Interesting. I can think of better things to spend money on.

Last night, Dawn and I went up to Blockbuster to rent a movie. As we walked by the “S” section of the new releases, I said, “hey, let’s get Sicko.” She didn’t think that was funny.

'What can I do?' - SiCKO

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4 Responses to “sick and insured, part II”

  1. Hi Mike,

    I was the one to tell Tara about the pre-existing condition stuff. My friend Melissa (who works for ACS) is always good at educating me about that kind of crap the insurance companies will pull and made sure that when I was switching policies around we never had even an hour gap between policies. I’m sure she can hook you up with more information or advocacy groups, since it is closely related to the work ACS does. You can email her at potionsprofessor _at_ gmail.com.

    I’ve also found the phrase “you’ll be hearing from my lawyer” is very effective. (No actual lawyer required. It’s just the threat that seems to cut through some of the bull shit.)

    I bet Tara would play a very scary lawyer on the phone.

    Let me know if I can help in any way.
    Phoebe

  2. Well thanks for the tips, Phoebe. As you can see in my most recent post (Ups and Downs), we’ve made some decisions about the insurance company situation, and just have to find the time and fortitude to compile the complaint and then file it. Other than that, we have to be sure not to let any of our bills go into collections, and stay on top of our communication with Assurant Health sucks.

    Thanks again. You’re more than just a great hat-maker.

  3. Phoebe and her husband Don can actually testify to my ability to pay an evil lawyer-type. I’m surprisingly good for such a smiley person. 🙂

  4. That should say “play an evil lawyer-type.” Homegirl isn’t paying anyone.

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